Category: Erectile function

Sildenafil, known to most as Viagra but also available as a generically produced cheaper variant of the drug under numerous names, is a medicine that belongs to the class of phosphodiesterase type 5 inhibitors (PDE5).

This drug is mainly used in the treatment of erectile dysfunction – therefore the inability to achieve or maintain an erection even following adequate stimulation. In fact, it helps to relax the blood vessels in the penis, allowing a greater flow of blood when sexually stimulated thus allowing an erection.

In case of erectile dysfunction, it is recommended to take about 45 minutes before sexual intercourse and preferably on an empty stomach. The effect of sildenafil lasts about 4/6 hours, the time after which the penis returns to a rest condition.

In addition to being used in the treatment of erectile dysfunction, sildenafil is used in the treatment of pulmonary hypertension. Research has shown that this drug, when taken in low doses, is able to dilate the pulmonary arteries and block the progression of pulmonary symptoms.

Currently, there are more than 12 alternatives available on the market to the more well-known Viagra which have the name of the active ingredient and provide the consumer with the same therapeutic effect at a decidedly lower cost: for the purchase of a pack of four 50 mg tablets, the sildenafil price has decreased by almost 90%.

How does sildenafil work?

A dose of sildenafil should be assumed before sexual activity is planned. The 50 mg sildenafil dosage is usually recommended by specialists for the treatment of erectile dysfunction. We recommend taking about an hour before sexual intercourse as needed. It is important to follow the directions given by the doctor without exceeding the indicated quantity, in order to avoid possible side effects.

The recommended maintenance dose will be established based on the patient’s individual response, and can vary from 25 mg to 100 mg, to be taken from 30 minutes to 4 hours before sexual intercourse depending on needs and dosage.

Sildenafil blocks phosphodiesterase type 5 (PDE5) and helps to release nitric oxide, a substance that promotes the flow of blood. Since PDE5 is mostly found in the spongeous bodies located in the penis, it is there that the drug’s action is perceived the most. The dilated blood vessels absorb and retain the maximal amount of blood, which results in the ability to achieve and maintain firm and hard erections.

What conditions are required for sildenafil to work? First of all, the user has to be sexually stimulated for sildenafil-containing pill to yield any measurable benefits. But many patients actually state that they experience the improved flow of blood in the genitals shortly after ingesting the drug, so even minor and unintentional stimulation of the penis can result in its turgor.

Sildenafil works best and quickest when taken on an empty stomach or after a fairly light meal. It is also known that the medication has an accumulated effect and the response towards the drug improves with prolonged use.

Sildenafil is a prescription drug that is contraindicated in men with heart, stomach, liver or kidney problems, as well as some other health conditions. Remember that it should always be a doctor who appoints the medication and correct dose of any ED drug.

Since the little blue pill came on the market in 1998, men of all ages have opened their eyes to the miracles it can accomplish. Viagra is top notch for men who have erection problems, but the point is that healthy men aged 18 – 40 rarely or never need to use oral drugs for ED like Viagra or its follow-up Levitra to get an erection.

Younger boys and men who know that they need drugs like Levitra are often easily affected and they often think there is something wrong with them if they cannot perform as men in porn movies. It is quite natural that the penis does not stay as rigid as a cane throughout the intercourse, but porn has imagined that this is how sex works. The fact that the healthcare authorities of Norway, Great Britain and some other countries now make Viagra available without a prescription for men as young as 18 is both worrying and critical.

It is stated that Levitra is a drug that is approved for men over 18 with impotence. It is also written that the mandatory guidance will reduce the risk of misuse and side effects. Although you can buy Viagra Prescription-free at any pharmacy, the Drug Agency of Norway recommends having a health check with the GP within six months. Impotence can be an early sign of diabetes and cardiovascular disease, among other things.

To make matters clear, there has not been any official discussion as to whether or not Levitra should be sold over the counter. However, before even considering that as an option, there are other essential questions to consider.

The availability of Levitra and at some point in time other ED drugs without prescription can lead to healthy men aged 18-40 to buying these preparations to “test and try”. They often find that the erection they get is neither good nor bad, but rather painful and uncomfortable. So uncomfortable that they initially want to visit a doctor because they are worried but they dare not. That is the backside of the medal but there are so many that do not talk about it.

Erectile dysfunction epidemics grows, not only because men have poor health, but also because performance anxiety increases. Men are influenced in all channels and now they get a simple solution to the pharmacy bypassing the actual visit to a doctor who could make a timely observation that there is no pathology as such.

Vardenaifl should not be given to healthy men to improve erection and patients should be well advised against abuse. To say that “Viagra without a prescription has worked well in England”, having been available as a non-prescription drug for less than a year, is not good enough in this case.

The bottom line is this: it is not much of a hassle to either see a doctor in person or get a telemedicine consultation if you really are certain that your failures in bed are caused by erectile pathology. Even a telemedicine specialist can issue a prescription for you after asking you a set of elaborately thought-through questions, and many pharmacies online are prepared to provide this service for free. The question that you should be asking yourself is whether or not you have grounds to take Levitra; at this day and age, getting a presctiption for this and other ED pills is not a problem.

Erectile dysfunction can stem from the drop in libido to depression, repressed anger to anxiety. And again, from alcohol abuse to taking medications, from stress to obesity to problems with muscles, circulation or nerves. Listing the reasons behind impotence is really difficult, but the ones listed are the main ones. Better yet, those which – over the years – have been identified as the founding basis of the problem. Erectile dysfunction can be both physical and psychological in nature. In recent years, however, another cause was added to this list: pornography, because those who prefer the virtual sex or porn to the “physical” one run the serious danger of ending up in a complex mechanism from which it is difficult to escape.

Porn and erectile dysfunction: is there an association between the two factors? Absolutely yes. In fact, addiction to porn involves many difficulties in real sex. A reference study was conducted by a team of researchers led by Matthew Christman (American Urological Association) who monitored sexual behavior – including adult entertainment – on hundreds of women. and men between the ages of 20 and 40.

Researchers believe that porn affects men because of unrealistic expectations. Obviously, they think they can do everything they see doing in those films, and failing to do so can cause great anxiety. Their claim is reflected in the results of the aforementioned survey: the researchers examined 312 men, who were monitored in a urological clinic in San Diego in the context of the treatment of erectile dysfunction. 26% of those surveyed admitted to having seen pornography less than once a week, 25% once or twice a week, 21% three to five times a week, 5% 6 to 10 ten times a wee, 4% over 11 times a week.

Online pornography – a topic on which various essays have also been written – exerts a stimulus so strong as to raise the threshold of “tolerance” towards hard images in people, creating an addiction that refers to that of narcotics and reducing the ability to sexual response.

The large amount of dopamine produced while men watch hardcore films, in fact, raises the level that must be reached for a normal erection. For this reason, many men find themselves fantasizing about a porn movie, even while they are carrying out a “normal” sexual activity with their partner. In short, the so-called “performance anxiety” takes over, especially in young people. Contact with porn images risks creating unrealistic expectations in young and inexperienced people, almost a libido anxiety, which occurs when real-world sex does not match that intercepted on the internet.

During the recent years, natural solutions to boost virility and sexual stamina have come to prominence, growing bigger on the market proportionally to the advance and development of pharmacologically formulated substances – as a side-effect free alternative to the latter. And although no substance with curative powers is completely void of adverse reactions and contraindications, it goes without saying that herbal products have considerably fewer side effects and are available to a wider range of patients. They also have a considerable benefit of being cheaper and easier to buy: although a doctor’s consultation is always recommended, even in case of all-natural supplements, a medical prescription is not required.

So what is the celebrated testosterone booster, Saw Palmetto, all about? Is it worth the hype that has been building around it? Saw Palmetto is a supplement based on dry extract of Serenoa repens (or Sabal), a small palm tree native to the subtropical regions of the Atlantic coast of North America, the Mediterranean area of ​​North Africa and southern Spain. This small plant produces fruits similar to red berries, from which some active ingredients are extracted, in particular fatty acids and sterols traditionally known for supporting urinary functions and prostate function.

ED effects compared

The mechanisms of action are complex but an inhibition of an enzyme (5α-reductase) has been found which converts testosterone into dihydrotestosterone (DHT). DHT would be responsible for stimulating prostate tissue, causing hyperplasia. Another avenue of action would appear to be related to the inhibition of some estrogen-related processes that would lead to IPB. If the mechanisms of action can be multifaceted and not entirely clear, the benefits brought by this plant are evident: in fact, several studies have been conducted which have shown how the administration of Serenoa repens can be a valid support for the well-being of the prostate specifically in cases of nocturia by acting on the spasmolytic activity (sudden and involuntary contraction) of the muscles of the urinary tract. Fields of action: prostate function, urinary tract function.

How to choose a good Saw Palmetto supplement? Look for a supplement that contains dry extract standardized to 30% fatty acids, the only excipient present should be organic rice flour. Absence of allergens is important, so scan the ingredients closely to detect the substances that you have known sensitivities for. There are also products containing Saw Palmetto suitable for vegans and vegetarians.

Viagra, Cialis and Levitra: efficacy in ED treatment

Erectile dysfunction (ED) is the inability to achieve and / or maintain a penile erection of sufficient duration and stiffness for a satisfactory and complete sexual relationship. Currently, phosphodiesterase 5 (PDE5) inhibitors constitute the first-line management for ED – they are Viagra (sildenafil), Cialis (tadalafil) and Levitra (vardenafil). A systematic review and meta-analysis comparing PDE5i vs. placebo in which randomized controlled trials of high quality of evidence are included, showed that PDE5i in a period of use less than 12 weeks, consistently improved erectile function and the effectiveness between the different types is similar. Studies on cardiovascular safety of sildenafil show that there is no greater risk of acute myocardial infarction and cardiovascular deaths, compared with placebo.

ED effects compared

Cialis is not affected by heavy and fatty meals, while the effects of the other two pills will be delayed and somewhat inhibited.

None of the three drugs is available in the usual pharmaceutical arsenal in primary care centers, however, they can be found in virtually all pharmacies in the national trade and in online stores. With regard to the cost of drugs, in general, the different trademarks of sildenafil are the most economical, especially if you buy those containing higher doses and with more tablets per box. Tadalafil (Cialis) and vardenafil (Levitra) have a similar price and both are generally more expensive than sildenafil.

Side effect compared

Sildenafil contained in Viagra is the medicine that has the largest number of safety and adverse effects studies. In it, we can see that 34% of the patients reported some adverse effect, however, only 0.012% of the patients discontinued the treatment attributing it to side effects.

When comparing the adverse effects of the different ED drugs, these are similar, not very serious and the discontinuation rates due to an adverse effect are very low. The use of Viagra is more likely to result in headaches and changes to color perception, while Cialis causes muscle aches. Other common side effects for all the three drugs include:

• indigestion
• facial redness
• nausea
• stuffy / runny nose

To choose the best ED drug, you should also consider other factors such as time of action, cost, adverse effects and patient and partner preferences.

Some practical recommendations on the use of Viagra, Cialis and Levitra

Generalities: Avoid smoking or consuming alcohol the hours prior to its use, control the other cardiovascular risk factors when appropriate, evaluate withdrawal and / or substitution of drugs that may aggravate ED and preferably include the opinion of the sexual partner in the diagnostic process and treatment

Dosage: Viagra, Cialis and Levitra are prescription medications whose appointment and dose should be regulated by a doctor. Start sildenafil with a dose of 50mg and if it is well tolerated but the response is not as expected, it could be increased to 100mg. You could even try 25mg if the response is good. Take the medicine 30 to 60 minutes prior to sexual intercourse (action window up to 4hrs) and take the drug away from meals (decrease absorption) and only once a day. The same concerns the doses for Cialis and Levitra: start with the median ones of 10mg and ask your doctor to adjust the it up to 20mg or down to 2.5mg-5mg (Cialis) or 5mg (Levitra) if needed.

Patient information: Inform that although most of the time, success occurs in the first 2 times of use, it could take up to 8 doses to reach the success of the treatment. Discuss with the patient the possible frequent side effects, check the concomitant use of nitrites (contraindicated). Use with caution in users of alpha adrenergic antagonists.

Finally, schedule a control to see the response to treatment, optimize dose and evaluate referral to urology in the next controls if there is no adequate response to treatment.

The PDE5 inhibitors are widely used medications given their proven effectiveness, safety profile, mild side effects and affordable cost in their generic versions. Except for contraindications, they constitute the therapy of first line for the ED.

Viagra and other ED pills to retail OTC

Viagra becomes prescription-free and probably more expensive in many countries of the world – this is a tendency that started in 2018 with New Zealand and was followed by the UK and Norway. Will the trend hold up in 2020? Is it a good thing that over the counter ED pills become a palpable reality?

A whole new type of prescription class evolves where the customer gets mandatory guidance at the pharmacy upon purchase. This should reduce the risk of misuse and side effects. By taking a prescription drug, you will no longer need go through the doctor before picking up the drug at the pharmacy. It should make it easier to take care of one’s own health. In addition, it can relieve the regular doctors and better utilize the expertise of the pharmacists.

When the patient has received something at the pharmacy that the doctor did not know of, they can prescribe medication that conflicts with what the patient has received anonymously at the pharmacy. Both antibiotics and tablets for acid disorders can lead to severe side effects of Viagra, the specialist point out.

Another downside of this practice is that it increases the cost of brand medications. It is the initiative of the drug manufacturers to release Viagra without presctiption, and they also increase the unit price to make it less available for recreational use.

Viagra OTC, or Viagra Connect is a non-prescription drug that increases blood supply to the penis and makes it easier to get an erection when you are excited. The medicine is used for impotence, a condition where it is difficult to get or maintain an erection hard enough to have sex. Impotence is a common condition, and studies have shown that drugs such as Viagra provide improved erection in 70% of adult men.

Extra guidance ensures safe use

OTC ED drugs can be used by many men, but not all. You should be absolutely sure that you do not have any diseases or use other medicines that go badly with Viagra and its analogs – Cialis and Levitra. If you want to buy Viagra without prescription, a pharmacist will explain how to use the medicine and go through some questions with you. If you are unsure whether you can use medicines of this type, we recommend that you consult your doctor.

These drugs can help you get an erection, but it does not treat the very reason you are having erection problems. We therefore recommend that you contact your GP within 6 months of starting the medicine. Your doctor can find out what is wrong and start treatment that can help. There are many reasons why men experience erection problems, including stress, smoking, obesity, side effects of some drugs, drugs, and diseases such as high blood pressure and diabetes.

Is It dangerous to use ED pills without prescription?

The drugs used to treat male impotence should be used wisely, and if you are not having trouble getting an erection, we do not recommend you to try. Here are three good reasons why:

You may have unpleasant side effects. The active ingredient, sildenafil, works by widening blood vessels in the penis. This makes it easier to get an erection, but can also cause blood pressure drops or other side effects such as headaches, dizziness, visual disturbances, redness, upper abdominal discomfort and nasal congestion.

You can become psychologically “addicted”. Some people believe, or may begin to believe, that they need medicines like Viagra to perform well enough sexually, even if they really don’t.

It costs a lot of money. Viagra and its analogs are undoubtedly a very useful medicine for men who are having erection problems, but if you don’t really need it it will just be an unnecessary cost.

Is there something I need to watch out for when using ED drugs OTC?

Viagra, Cialis or Levitra should not be taken with grapefruit or grapefruit juice. Concomitant use can cause severe hypotension. Alcohol can make erection more difficult. Therefore, to get the maximum effect of the medicine, it is recommended not to drink large quantities of alcohol before taking ED drugs. They should not be combined with other medicines for erectile dysfunction except in consultation with a doctor.

Although the attention of subjects suffering from erectile deficit is mainly focused on the choice of specific medicines that can improve their performance, one should not forget that there are also drugs that can cause or aggravate this disorder. It is important to emphasize that erectile dysfunction does not represent the automatic consequence of taking these drugs, but a side effect that occurs in a generally minority percentage of patient users.

Here are some classes of drugs that cause problems with sexual function:

• antihypertensive drugs: diuretics (thiazides, spironolactone), centrally acting (methyldopa, clonidine, reserpine), a-blockers (prazosin, terazosin), ß-blockers (propanolol, metoprolol, atenolol).
• medications for the treatment of dyslipidaemias (hypertriglyceremia, hypercholesterolaemia): gemfibrozil, clofibrate
• heart failure medications: digoxin, chlortalidone, amiodarone, disopyramide
• neurological and psychiatric drugs: benzodiazepines, amitriptyline, clomipramine, imipramine, desipramine, tiotixene, lithium salts, tranylcypromine, isocarboxazide, phenelzine, haloperidol, chlorpromazine, flufenazine, pimozide, primidone, carbamurepepine,
• urological and endocrinological drugs: cyproterone acetate, flutamide, finasteride, analogues of GnRh, cortisone.
• gastroenterological drugs: cimetidine, ranitidine, metoclopramide, famotidine, nizatidine, propantheline bromide
• recreationally used substances (drugs of various kinds): cocaine, marijuana, amphetamines, codeine, methadone, heroin, meperidine, LSD, hashish

If an iatrogenic origin of erectile dysfunction is suspected, it is important not to spontaneously discontinue drug therapy; rather it is necessary to talk to the doctor, who may eventually prescribe alternative therapy.

Beyond the drugs and drugs that can cause or otherwise promote erectile dysfunction, we remember that alcohol abuse and cigarette smoking can also aggravate the disorder. Alcohol, for example, causes a drop in libido, premature ejaculation, testicular hypotrophy, increased prolactin and gynecomastia.

These substances can alter both the function of the hypothalamic-pituitary system and testicular steroidogenesis, or act by antagonizing the peripheral action of androgens. If an iatrogenic origin of erectile dysfunction is suspected, it is important not to spontaneously discontinue drug therapy; rather it is necessary to talk to the doctor, who may eventually prescribe alternative therapy.

Beyond the drugs and drugs that can cause or otherwise promote erectile dysfunction, we remind you that alcohol abuse and cigarette smoking can also aggravate the disorder. Alcoholism, for example, causes a drop in libido, premature ejaculation, testicular hypotrophy, increased prolactin and gynecomastia.

Cigarette smoking is a documented risk factor for erectile dysfunction as it results in peripheral vasculopathy, reduces penile blood pressure and inhibits neurogenic vasodilation. Nicotine reduces blood flow and induces vasoconstriction of the corpora cavernosa even in the absence of systemic vascular anomalies.

Is using Viagra safe?

Viagra is a non-prescription drug containing sildenafil. Viagra is used to address the inability to get or maintain an adequate erection for sexual activity. Sexual stimulation is required for Viagra to have an effect. The dosage is one tablet daily, about 1 hour before sexual activity.

How safe is the use of Viagra, and what side effects can the medicine cause? Viagra is the best studied drug in its class so far, since it was the first to be discovered more than two decades ago. Multiple studies are available on the safety of short-term and long term use of sildenafil, but one needs to understand that there are important application rules to observe for the drug safety to be complete.

Thus, you should not use sildenafil tablets or their analogs if you are taking nitrate medication, low blood pressure or have had severe vision loss or hereditary eye disease. It is not supposed to be taken with grapefruit or grapefruit juice. You should consult your doctor before taking this medicine if you have high blood pressure that is not well treated. To purchase the drug, some mandatory questions must be answered through a self-declaration form online or to a pharmacy pharmacist. The reason for this is that Viagra is a drug that not all men can use, due to health reasons. The drug does not treat the underlying cause of impotence and the GP should be contacted during use.

Viagra side effects: what are they?

Viagra is known to produce gastrointestinal, CNS and vision disturbances. Common side effects of the drug are dyspepsia, nausea, flushing, hot flashes, catarrh, stuffy nose, dizziness, distorted color vision (chloropsy, chromatopsia, cyanopsia, erythropsy and xanthopsia), vision disorder and misty vision. These symptoms usually go away with a continued use of Viagra.

Rare adverse events caused by the use of Viagra span the following symptoms: oral hypoesthesia, irritability, atrial fibrillation, myocardial infarction, sudden cardiac death, unstable angina, ventricular arrhythmia, Stevens-Johnson syndrome, toxic epidermal necrolysis, prolonged erection, hematospermia, penile bleeding, priapism, nasal edema, laceration, drying of nasal mucosa, cerebrovascular event, convulsions, syncope, recurrent seizures, transient ischemic attack, arteriosclerotic retinopathy, asthenopia, diplopia, glaucoma, iris disorder, conjunctival hyperemia, mouches volantes, mydriasis, deafness, myopia, visual acuity, non-arteritic ischemic anterior retinal neuralgia, rainbow vision, retinal disorder eye, eye swelling, eye irritation, eye disorders, eyelid edema and eye edema. Most of these symptoms are as serious as they are rare, and require immediate medical attention.

Managing adverse reactions towards sildenafil

It is first and foremost important to prevent Viagra overdose and eventual intoxication; 800 mg produces side effects similar to those at lower doses, but with increased incidence and severity. In case of overdose, standard support treatment is provided if needed. Dialysis is not believed to increase clearance.

Mild side effects of Viagra are usually felt when you are a beginner, but should become fewer and much more tolerable with tablets number 5-7. If this does not happen, or if the adverse reactions are much more serious or bothersome, ask your doctor to lower your dose of sildenafil. Note that there is something you can do yourself to minimize the impact of Viagra side effects: taking the drug after a light meal should help.