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Hypogonadism (which leads to lower testosterone levels) Medications: Many common medicines produce erectile dysfunction as a side effect. Medicines that can cause erectile dysfunction include many used to treat high blood pressure, antihistamines, antidepressants, tranquilizers, and appetite suppressants. Examples of common medicines that can cause erectile dysfunction include beta-blockers such as propranolol (Inderal), hydrochlorothiazide, digoxin (Lanoxin), amitriptyline (Elavil), famotidine (Pepcid), cimetidine (Tagamet), metoclopramide (Reglan), indomethacin (Indocin), lithium (Eskalith; Lithobid), verapamil (Calan, Verelan, Isoptin), phenytoin (Dilantin), and gemfibrozil (Lopid). For more, please visit the Medications Index. UprimaŽ represents a radical new departure in the treatment of ED. Rather than just stimulation to the penis for enhanced blood flow, for the first time brain receptor sites are being targeted for enhanced sexual performance. ED, or erectile dysfunction, is medically defined as the inability to achieve or sustain an erection long enough for sexual intercourse. Virtually all men experience some erection failures at certain points in their lives. It can be the result of stress, depression, or sometimes even for no reason at all. For some, the problem becomes chronic. When it does, a diagnosis of ED is made. According to the American Foundation for Urologic Disease, it's a problem that affects about 18 million men in the U.S. alone. Diabetes increases the risk of erectile dysfunction by two to three times compared to not having the disease. ED is seen as an early symptom of diabetes. Epidemiology of erectile dysfunction Erections therefore rely on blood flow which is why conditions like arterioscelerosis and diabetes that lead to hardened blood vessels and have an effect on blood pressure causing erectile dysfunction. Intermittent dosing: 10 mg PO before sexual activity; may increase to 20 mg maximum or decrease to 5 mg based on efficacy and adverse effects; not to exceed 1 dose/d A comparison of satisfaction rates and ED in subjects treated with sildenafil, intracavernous PGE1 (alprostadil), and penile implant surgery was performed by Rajpurkar and Dhabuwala in 138 men with ED. This was a nonrandomized study in which all subjects were initially offered sildenafil. The mean follow-up was 19.54 months, and questionnaires were used to obtain the data. Their conclusions were that men with a penile implant had significantly better erectile function and satisfaction. Contraindications Of 977 subjects who received double-blind medication, 774 (79.2%) completed the course of treatment. Several doses were used, but patients in all of the apomorphine dose groups reported erections firm enough for penetration more often than those taking placebo (P <.01). When separated according to dose, firm erections were reported by 45% versus 35% of the control group with the 2-mg dose. The 4-mg dose elicited positive responses in 55%, compared with 36% in the placebo group. With the 6-mg dose, 60% reported positive responses, compared with 32% in control subjects. Adverse events occurring in 10% or more of the patients in any group were nausea, sweating, dizziness, somnolence, vomiting, yawning, and asthenia. Most of these were considered mild to moderate in severity. Nausea was the most common adverse effect, which was found to be dose-related and reducible with repeated exposure to the drug. Erectile Dysfunction: Psychological Causes "It's an important message to get out," said Dr. Ira Sharlip, a spokesman for the American Urological Association. "There's an increasing body of knowledge that tells us that erectile dysfunction is a form of cardiovascular disease and often predates the onset of other forms of clinical cardiovascular disease, specifically coronary disease." canadian pharmacy viagra While you are being treated for ED, it is important to be patient with your progress and keep in mind that everybody is different and that a treatment that might work for one person may not work or be appropriate for you. It is also important to know that the treatment you choose may not work the first time or may not work every time. Don't rely on alcohol or drugs to reduce stress. Blood Tests and Urinalysis If you take nitroglycerin or a long-acting nitrate to treat chest pain. The combination of Cialis, Levitra or Viagra with these drugs can cause dangerously low blood pressure. If unsuccessful, does not interfere with other treatments Many medical conditions result in more physical discomfort than erectile dysfunction. But ED may be as psychologically challenging as any. Coping with serious medical issues is always a challenge. It's difficult for some men to understand that ED is completely the result of an underlying physical condition, or that, even so, an act of choice alone will not cure it. They feel out of control. For a man, that's always hard. But coping with ED does not have to be just an exercise in keeping a stiff upper lip to compensate for the lack of a stiff penis. Coping with ED involves a range of actions, including getting proper diagnosis, understanding treatment alternatives and above all, being honest about the condition and potentail outcomes. Realism, is the first principle to observe in order to optimize coping with erectile dysfunction. Whatever the underlying causes - be they the consequence of recent prostate surgery or diabetes, or substantial psychological problems - denial never helps. Being sensible about the effectiveness of treatments is equally important. Pharmaceutical drugs are only about 90% effective and may also include side effects. That's a very encouraging number, but it means that 10% may need to seek other remedies such a Herbal Supplements. In a small percentage of cases there simply is no short term remedy. That's always unfortunate, but the psychological impact can be reduced only by facing facts squarely. Only on that basis can a patient deal with possible subsequent effects on one's relationships and self-esteem. Still, optimism is not only pleasant, it's also a constructive attitude for coping with ED. Far from necessarily being the choice to always live in a fantasy world, optimism can and should be based on facts. Optimism is valid when, as is usually the case these days, real options are available that encourage or produce real results. Optimism is not the same as stoicism, though the latter may be appropriate to some degree. Stoicism is simply accepting consequences as inevitable. Optimism goes beyond this and believes that good outcomes are achievable, even likely. One then has an incentive to find them, even if they're not immediately obvious or attainable. Coping with ED involves developing strategies for long term treatment, some of which may involve substantial life changes. Erectile dysfunction is more likely, the older a man becomes. That's not only because of elementary changes such as a decrease of testosterone. It's also because the possibility of disease and other conditions that can result in ED increase with age. Life is risky andgets more risky the older you become. Taking that fact into account can help develop those plans that call for significant change. Those adjustments can range from simple adjustments of diet and exercise, to opting for a different career, to embracing any of the number of typically permanent treatments such as Herbal Supplements or a prosthetic implant. They may involve adjusting one's attitude toward oneself, toward what's achievable in life and toward sex. None of those are easy adjustments. But coping with ED, like many conditions, is done best when one looks at the situation head on, then summons the courage to do what is required to achieve the desired goal. Herbal Boost(http://www.herbalboost.co.uk) promotes a range of safe, Herbal Supplements that are used as sexual enhancers to improve libido and increase sex drive. cialis without prescription

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