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More Information: Male Sexual Problems
More Information: Viagra, But No Eye Effects
More Information: Comprehensive Information About Impotence

Viagra Information

Uses:
Viagra is used to treat problems relating to male sexual function, particularly problems concerning the ability to achieve and maintain an erection.
How to take Viagra:
Sildenafil should be taken by mouth between four hours and one-half hour before sexual activity (about one hour before is most effective). If taken as directed (usually once a day) viagra, along with sexual stimulation, aids in achieving an erection.
Possible Viagra side effects:
As with any medication, you need to be aware of any side effects you might experience. Headache, flushing, stomach upset, nasal stuffiness, diarrhea and dizziness might occur. If these effects persist or worsen, notify your doctor promptly.
Precautions:
Before using viagra or any drug, you need to notify your doctor of any allergies (especially drug allergies), any penis conditions such as fibrosis/scarring, history of painful/prolonged erection (priapism), sickle cell anemia, blood system cancers (such as leukemia or myeloma), or Peyronie's disease, eye problems (retina diseases), kidney or liver disease, bleeding disorders or active stomach ulcers, heart diseases, stroke or severe high or low blood pressure. Alcohol intake should be limited as it may aggravate side effects of viagra. To avoid dizziness and lightheadedness when rising from a seated or prone position, get up slowly. The elderly may be more sensitive to the side effects of viagra; therefore, caution is advised in this group
Drug interactions:
To avoid any possible complications or drug interactions, you need to list on our questionnaire any nonprescription and prescription medications you may use, especially any nitrate medications (e.g., nitroglycerin, isosorbide dinitrate), nitroprusside (any "nitric oxide donor" medicines), cimetidine, erythromycin, azole antifungals (e.g., itraconazole, ketoconazole), mibefradil, rifamycins (e.g., rifampin) or high blood pressure medicines.
Viagra Storage:
Store at room temperature between 59 and 86 degrees F (15-30 degrees C) away from light and moisture. Keep viagra and all medications out of the reach of children.

Erectile dysfunction

Erectile dysfunction, also called impotence, means that a man's penis doesn't get hard enough to have intercourse. Erectile dysfunction is not the same as premature ejaculation, the inability to ejaculate (retarded ejaculation) or infertility. The man cannot get or maintain an erection. This condition affects approximately 30 million men in the United States.

Diagnosis

Your doctor will ask you about your medical history to learn if any medical conditions might be causing the erectile dysfunction, including hormonal, neurological, and vascular disorders. In men with abnormal hormone levels, a reduced sex drive often accompanies erectile dysfunction. Because vascular disorders affect the entire body, many men who have erectile dysfunction because of vascular disease also have a history of heart disease, stroke or poor circulation in their legs. Neurological problems can contribute to erectile dysfunction in men with a history of diabetes and spinal cord injury. They also can cause symptoms in other parts of the body, such as numbness or weakness in legs. Your doctor also will review the medications you take, including over-the-counter products and herbal remedies. Your doctor will examine you, including your penis and testes, to look for evidence of underlying medical problems. Your blood may be tested for blood sugar (to check for diabetes), cholesterol and levels of certain hormones. Occasionally, a doctor may orderadditional tests, such as a nocturnal penile tumescence study. This is a way to assess how often you get erections while you sleep. A Doppler ultrasound of the blood vessels in the penis is another test that occasionally will show a cause for poor erections. Your doctor will ask about your sex life. This sometimes is called a psychosexual history. It includes questions about the quality of your sexual relationships. Although your doctor may not be able to give you a specific reason why you have developed erectile dysfunction, many of the treatments work well no matter what caused the problem, so extensive testing may not be necessary.

Prevention

Little is known about how to prevent erectile dysfunction. However, avoiding cigarette smoking and maintaining normal blood pressure and cholesterol levels can help because smoking and high cholesterol can affect blood vessels. Because certain medications have been associated with erectile dysfunction, ask your doctor about possible side effects before you start using any new prescription. Men with diabetes should strive to keep blood sugar levels under control.

The major causes of erectile dysfunction include:

Nerve damage (neuropathy) Nerves must be working normally for a man to get and keep an erection. Nerve damage can result from diabetes, multiple sclerosis, prostate surgery or damage to the spinal cord.

Psychological factors

Psychological issues such as depression, anxiety, guilt or fear can sometimes cause sexual problems. At one time, these factors were thought to be the major cause of erectile dysfunction. Doctors now know that physical factors are present in most men with erectile dysfunction. However, embarrassment or "performance anxiety" can make a physical problem worse. Erectile dysfunction caused only by psychological causes is found most commonly in young men.

Medications

Many medications cause problems with sexual function, including drugs for high blood pressure, depression, heart disease and prostate cancer.

Hormonal problems

Abnormal levels of certain hormones, such as testosterone, thyroid hormone and a pituitary hormone known as prolactin, can interfere with erections and sex drive (libido). This is an uncommon cause of erectile dysfunction.

Vascular

(blood vessel) disease. Because erections are caused by the buildup of blood in the shaft of the penis, poor blood flow in the penis can result in problems with erections. Damage to blood vessels can be caused by hardening of the arteries (atherosclerosis) or from trauma. Vascular disease is believed to be the most common medical cause of erectile dysfunction.

Expected Duration


How long your erectile dysfunction lasts depends upon what causes it and how quickly your treatment starts to work. The important thing to remember is that erectile dysfunction is treatable in all age groups.

Symptoms


A man with erectile dysfunction has either a problem getting an erection or difficulty maintaining one. This usually interferes with sexual activity by preventing penetration during intercourse. Some men slowly lose the firmness of their erections or how long the erections last. In other men, especially those whose impotence is largely caused by psychological factors, the problem may occur unpredictably and can improve at any time. Erectile dysfunction can occur suddenly or gradually. Despite their difficulties with erections, men with impotence often continue to have normal orgasm and ejaculation.

Treatment


There are many effective treatments for erectile dysfunction. The most popular option is a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors, which includes sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis). These drugs, taken in pill form from zero to 60 minutes before sexual activity, work in approximately 70 percent of men, though they are less effective in men with neurological causes of erectile dysfunction such as nerve damage from prostate surgery, diabetes or spinal cord injury. PDE5 drugs can cause minor side effects such as flushing and headache, but they have been shown to be safe in most men, including those with heart disease. However, PDE5 drugs can interact with other medications and cause dangerously low blood pressure. In particular, they should never be taken with nitroglycerin or other nitrate medications commonly used to treat heart disease. Men with enlarged prostates who take alpha-blocker drugs such tamsulosin (Flomax) or doxazosin (Cardura) should probably avoid PDE5 drugs. If these drugs don't work or cannot be used because of potential side effects, your doctor can recommend other therapies. The drug alprostadil (Caverject, Edex, Muse) causes blood vessels to widen. This can allow blood to flow more freely in the penis, leading to an erection. The drug can be injected with a tiny needle, or a small pellet (suppository) can be inserted into the opening of the penis. Suppositories like this are effective in approximately two-thirds of men. Injections are effective about 80 percent of the time. Men whose blood test results are abnormal can try taking hormones. Psychological therapy such as counseling, behavioral therapy or couples' therapy can be effective in men whose impotence is caused primarily by psychological factors. Men who do not benefit from medical or psychological treatment often have success with mechanical or prosthetic devices. External products, known as vacuum erection devices, are safe and highly effective, but many men and their partners find them unappealing. Another option is a surgically placed penile implant. However, because implants require surgery (with the risk of surgical complications), only 10 percent of men with erectile dysfunction choose this option. Vascular (blood vessel) surgery sometimes is recommended for young, healthy men who develop impotence after trauma to the groin. Unfortunately, the long-term success rate of this surgery is not known.

Prognosis


In general, the prognosis for men with erectile dysfunction is excellent. Although most cases of impotence have medical causes that cannot be cured, many treatment options will restore sexual function. In addition, there are several permanently curable forms of the disorder, including erectile dysfunction caused by psychological problems, hormonal disorders and traumatic injury to the penile arteries.

When To Call A Professional


A man should speak to his doctor if he has trouble getting or keeping an erection over a period of three months or more. Because of embarrassment or shame, many men with erectile dysfunction don't talk to their doctors. They hope that the problem will go away on its own. However, this often is not the case. Although erectile dysfunction caused by psychological factors may get better on its own, treatment is needed if the problem is caused by a physical factor.

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Resources


Patient's guide. Viagra Chemical information.     Patient's guide. Viagra Chemical information
Patient's guide. Viagra Chemical information.(MS Word)     Patient's guide. Viagra Chemical information
Full list for Viagra, Cialis and Levitra.     Full list for Viagra, Cialis and Levitra.

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