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Pharmacologic and/or surgical therapy to effectively will happen at the drug in your body after about 4 hours. Its molecular structure is very similar they target: nucleoside reverse transcriptase inhibitors; non-nucleoside reverse.

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Other things that increase your risk include: Diseases that affect blood vessels, such as diabetes, high blood pressure, and high cholesterol.

About half of men with diabetes develop erection problems. These include multiple sclerosis and Parkinson's disease.

Other health problems, such as low testosterone levels.

Injuries sildenafil citrate tablets 100mg price to the pelvic area, a spinal cord injury, or treatment such as pelvic surgery or radiation in the pelvic area.

Using substances, such as long-term (chronic) alcohol abuse.

Psychological risk factors, such as depression or a recent life change.

Activities that constrict blood flow to the penis may increase the risk for erection problems. For example, frequent long-distance bicycle riding on a hard, narrow saddle may increase risk.

But the possible link between bike riding and erection problems has not been proved. A vasectomy usually doesn't cause erection problems.

But pain after the operation may affect sexual performance for a time.

And if a man wasn't comfortable with his decision to have a vasectomy, or if he's having second thoughts, it could affect him psychologically.

Call your doctor now or seek medical care right away if: You have an erection that lasts longer than 3 hours. You have taken sildenafil (for example, Viagra) or vardenafil (for example, Levitra) in the past 24 hours or tadalafil (for example, Cialis) in the past 48 hours, and you have chest pain. Make sure all the doctors you see know that you took one of these medicines.

You have erection problems that occur along with pain or difficulty with urination, fever, or pain in the lower belly.

Call a doctor if erection problems occur: With any type of


sildenafil citrate 100mg tab for sale to the back, legs, buttocks, groin, penis, or testicles.

With other symptoms such as loss of hair, enlargement of the breasts, or backache. If your erection problem happens just now and then, there is no reason to call your doctor. If it happens often and upsets you or your partner, it is okay to call your doctor.

If an erection problem doesn't bother you or your partner, you may choose not to call your doctor. A single episode of an erection problem is often a temporary problem that is easy to reverse.

Try to forget about it, and expect a more successful experience the next time.

If you or your partner is concerned about it, talk about the problem. If self-care has not helped after 2 weeks and you are concerned about your erection problem, see a doctor who has experience in dealing with these problems.

Your family doctor or general practitioner can evaluate symptoms of erection problems.

You may be referred to an sildenafil citrate 100mg tab for sale internist or a urologist ,


on what may be causing your erection problem. If it is possible that a psychological problem is contributing to your erection problem, your doctor may refer you to a health professional such as a: Psychiatrist . Counsellor with special training in sexuality or relationship problems.

Because both physical and mental factors are often involved, it may be difficult to diagnose the exact cause of your erection problem.

To start, your doctor may: Review your risk factors for an erection problem. Do a complete physical examination of the abdomen, penis, prostate, rectum, and testicles. A sildenafil citrate 100mg tab for sale low level of testosterone may reduce sexual desire, leading to an erection problem. Prolactin, sildenafil citrate 100mg tab for sale follicle-stimulating hormone, and luteinizing hormone. If you have low testosterone levels, your doctor may recommend these blood tests. A thyroid hormone level that is too high or too low may cause problems with sexual desire or erections.

A high blood


level may mean the presence of diabetes , which can contribute to erection problems.

At this point, pills such as sildenafil (for example, Viagra), tadalafil (for example, Cialis), and vardenafil (for example, Levitra) are often recommended unless an easily treated cause (such as a medicine side effect or testosterone deficiency) has been identified. If pills don't work or if your doctor feels more testing is needed, he or she may recommend: Specific tests for erection problems.

These tests help find out whether physical or mental factors are causing your erection problem.

A psychological evaluation, if a mental issue is suspected.

An ultrasound may be done if your doctor thinks you may have a circulation problem ( peripheral arterial disease ). Treatment for an erection problem depends on the cause of the problem.

The cause may be mental, physical, or a combination of both. Many doctors take a step-by-step approach to treating erection problems. The treatment steps are: Looking for and then stopping medicines that may be causing your condition. Trying testosterone or another treatment to fix a hormone problem if tests show you have one.

Trying pills called PDE-5 inhibitors, such as sildenafil (for example, Viagra), tadalafil (for example, Cialis), and vardenafil (for example, Levitra). Trying counselling if a psychological cause is suspected.

Trying medicines that are injected or inserted into the penis. Erection Problems: Should I Try Injection Treatments?

If you are taking nitrate-containing medicines, such as nitroglycerin, you cannot use sildenafil (for example, Viagra), tadalafil (for example, Cialis), or vardenafil (for example, Levitra). You also should not take certain alpha-blockers—used to lower blood pressure and to treat an enlarged prostate gland —with these medicines.

There is a risk of a dangerous drop in blood pressure. Check with your doctor to see whether you can take PDE-5 inhibitors with your alpha-blocker.

Oral medicines are commonly tried first before other medicine or surgery.

It is important to involve your partner in your decision, regardless of the treatment you choose.

Many men overestimate how important being able to have erections is to their relationships. Some men find that when they are able to have erections again, the hassle of using the treatment isn't worth the effort. Other men may find that being able to have erections doesn't change their relationship as much as they or their sildenafil citrate 100mg tab for sale partners had expected.

You may be able to avoid erection problems related to anxiety and stress by taking a more relaxed approach to sex.

Talk to your partner about your problems and concerns.

If you and your partner


about sex, it will help reduce your stress and anxiety. Erections may gradually become more difficult to get and keep as you get older. But foreplay—erotic stimulation before intercourse—and the right environment can help increase your ability to have an erection, regardless of your age.

Here are some other things you can do that may reduce your risk for erection problems: Quit smoking.

Even small amounts of alcohol can cause erection problems.

Keep your cholesterol level low to reduce the risk of hardening of the arteries (atherosclerosis). Keep your blood sugar in your target range if you have diabetes.

In some cases, occasional episodes of erection problems can be treated at home, without a doctor's help.

And don't be embarrassed about seeking professional help if erection problems are consistent and troublesome. You may be able to help yourself by: Some men may try methods available in health food stores or through magazine ads.

Most of these methods have never been medically proved to work. Making lifestyle changes such as quitting smoking and drinking less alcohol can also help make erection problems less likely.

Medicines that can help produce an erection may be used to treat erection problems that are caused by blood vessel (vascular), hormonal, nervous system, or psychological problems. They also may be used along with counselling to treat erection problems that have psychological



Commonly used oral medicines include: PDE-5 inhibitors such as sildenafil (for example, Viagra), tadalafil (for example, Cialis), and vardenafil (for example, Levitra). Other medicines that may be used include: Injected medicines.

Hormones and other medicines may be prescribed for men who have low testosterone or high prolactin levels. Erection Problems: Should buy sildenafil 20 mg tablets I Try Injection Treatments?

Although oral medicines for erection problems can be purchased over the Internet, you need to talk with your doctor before using this medicine. This is especially important if you have a heart problem. PDE-5 inhibitors should never be used if you may need to take a nitrate-containing medicine, such as nitroglycerin. Taking nitroglycerin and a PDE-5 inhibitor within 24 hours of each other may greatly lower your blood pressure.

This could lead to a heart attack, stroke , or death.

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