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ED or impotence is a condition in which a man is unable to achieve or maintain an erection long enough for sexual intercourse. This can be a result of medical conditions such as high blood pressure, diabetes, prostate problems, and heart disease, or a side effect of the medications typically taken for these conditions. Personal lifestyle factors such as stress, alcohol and/or tobacco use can also play a contributing role. During surgery or radiation to the pelvic area (including prostate, bladder, and rectal procedures), damage can occur to the nerves that supply the penis. This can result in either temporary or permanent impotence. Some surgeons perform "nerve-sparing" surgeries in an attempt get viagra no prescription to preserve erectile function. Even in these cases, however, the nerves will suffer some injury, and it can take 18-24 months or longer for erectile function to return. These men should be treated aggressively with oral or injectable medications for ED in order to speed recovery of the nerves and to prevent muscle wasting in the penis. It should be taken around 60 minutes before sex, but can be taken as much as four hours or as few as 30 minutes before sex. Your doctor will determine the dose that is best for you. Some men require dose adjustments to find the dose that works best for them. Men who take sildenafil will not have an erection without sexual stimulation. This drug is not an aphrodisiac and does not affect libido or desire. Having multiple intercourse sessions with one dose has not been buy generic sildenafil online studied. You should not adjust your dose without talking to your provider first. Men who take nitrates, such as nitroglycerin, Nitro-Bid, Isordil, or Deponit should not take sildenafil. Men who take Cardura, Flomax, or Hytrin for urinary symptoms should not take sildenafil. This medication can affect how other medications work. Be sure your provider and pharmacist know all the medication (prescription and over-the-counter) and supplements you take. Store your medication in the original, labeled container at room temperature and in a dry location (unless otherwise directed by your healthcare provider or pharmacist). This medication should not be stored in a pillbox since it should only be taken prior to sexual activity. Ask your care team where to return any unused medication for disposal. Do not flush down the toilet or throw in the trash. This medication may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals without prescription drug coverage through the pharmaceutical company that makes the medication. Your care team can help you find these resources, if they are available. There are a few side effects experienced with sildenafil. Talk to your doctor, nurse or pharmacist if you have concerns about these side effects. Do not take a higher dose of sildenafil than your provider orders for you. Headache, facial flushing, stuffy or runny nose, and upset stomach can occur. Less frequent side effects include blurry vision, a bluish hue to the field of vision, difficulty telling the difference between the colors blue and green, a sensitivity to light, or a sudden loss of vision or hearing. If you experience any of the following while using sildenafil, you should seek immediate medical attention: An erection lasting more than 4 hours. Chest, arm or neck pain, or nausea during sexual activity. Sudden loss of vision in one or both eyes, loss of hearing, ringing in the ears or dizziness. Remember, sildenafil does not protect against sexually transmitted diseases, nor does it prevent pregnancy. Effective birth control is recommended during cancer treatment. Even if you are not producing sperm, you could still be fertile and conceive. Give guidance, not just Viagra, to men with diabetes and related impotence. Diabetic men with erectile dysfunction might consider a prescription for a drug like Viagra to be a permanent cure for a temporary issue: Take a pill, problem solved. But the truth, a leading urologist says, is entirely different. “If a diabetic patient has erectile dysfunction, it’s not enough to provide Viagra [sildenafil] or Cialis [tadalafil] and then send him on his merry way,” J. Francois Eid, MD, a New York City urologist, said at the annual meeting of the American Association of Diabetes Educators. “It’s important to let individuals know the drug has not cured the erectile dysfunction. If patients don’t take care of the diabetes, the erectile dysfunction progresses.” In an interview, Dr. Eid shared several messages for medical professionals who treat men with diabetes and related erectile dysfunction: • Diabetes has “devastating” effects on the penis, and may even cause it to shrink. • Long-term uncontrolled diabetes can make ED permanent. • While ED drugs often fail in men with diabetes, several other options exist; and penis implants may provide significant relief. An estimated 50%-75% of men with diabetes experience from some degree of ED, which is thought to be three times more common in diabetic men than other men, according to Dr. “Diabetes has a devastating effect on the muscle tissue inside the penis,” he said. “All the tiny little arteries that feed blood to the muscle get occluded. Little by little, the muscle inside the penis shrinks.” Indeed, some diabetics with ED complain that their penises have shrunk, he said. Diabetic damage doesn’t stop with these small vessels, he said. “You really have two parallel situations: You need blood flow that feeds the muscle of the penis, and you need an artery dedicated to bringing blood rapidly when a man becomes aroused and wants to be sexually active,” he said. They’ll say ‘I can get a partial erection, but I can’t maintain it.’ ” What comes after an ED diagnosis in diabetic patients? Eid will instantly refer these men to a cardiologist. “If a patient has diabetes and is newly diagnosed, a significant portion of these men are going to develop coronary artery disease in the next 2-3 years,” he said. “One of the things we do is recommend is that they see a cardiologist and perhaps have a stress test or some sort of evaluation.” Dr. Eid also urges these patients to treat their diabetes in order to avoid developing ED for life. “They need to manage their diabetes and make sure they control it so the ED will not progress and will stabilize, as a result,” he said. “If the diabetes is controlled after the patient is first diagnosed, then the erections will come back. But if the patient has diabetes for many years, and suddenly decides it’s time to control it, they cannot prevent the damage that’s already been done.” As for treatments, patients with diabetes and related ED should begin with medications like sildenafil and tadalafil, he recommended. But research findings suggest that the drugs will fail in half of men with type 2 diabetes, he said. Other options include penile self-injections, vacuum devices, and penile implants. The injections “can work well and are painless, but men detest having to inject themselves before sexual activity,” Dr. And he said men rarely have success using vacuum devices, which are available over the counter. By contrast, penis implants can successfully treat erectile dysfunction in many cases, Dr. Men trigger erections by squeezing a pump that is implanted into the scrotum. Fluid then flows from an implanted reservoir into a cylinder implanted in the penis. Men are often pleased by penis implants because they can have sex spontaneously without having to plan for it ahead of time, as required by medications. Eid receives or has received research support/grants from American Medical Systems, Coloplast, Lilly ICOS, Bayer, Vivus, Pharmacia-Upjohn, and Pfizer. He is or was a consultant and on the speakers bureau for Coloplast, American Medical Systems, Lilly ICOS, Bayer and Pfizer. How Viagra could boost a widely used blood cancer treatment. Hematopoietic stem cells can save lives in the treatment of blood cancer, but hurdles remain to effectively harvest them for transplantation. A research team at the University of California, Santa Cruz has evidence that Pfizer’s popular erectile dysfunction drug Viagra can facilitate the release of stem cells from the bone marrow into the bloodstream, which could ease collection. Transplantation practitioners traditionally mobilize stem cells using standard granulocyte-colony stimulating factor (G-CSF)—namely, Amgen’s Neupogen (filgrastim). The UC Santa Cruz team found that pairing Viagra with Sanofi’s stem cell mobilizer Mozobil (plerixafor) worked almost as well in mice, the team reported in the journal Stem Cell Reports. “Given that both drugs are FDA approved, they could be relatively quickly tested in human volunteers,” the study’s senior author, Camilla Forsberg, said in a statement. If successful, it could provide a new strategy for stem cell transplant preparation, she argued. Even though G-CSF agent works in most donors, it needs to be given for several days before the stem cells can be collected. It’s costly and can cause side effects such as fatigue, nausea and bone pain. The Forsberg lab previously showed that increasing the ability of blood vessel walls to allow molecules through—known as vascular permeability—could help hematopoietic stem cells escape from bone marrow and into the blood. So Forsberg and her team hypothesized that Viagra, which relaxes blood vessel walls, might promote stem cell mobilization. After all, the drug was originally designed to address cardiovascular diseases and is sometimes used to treat pulmonary hypertension. In mice, generic viagra pills a single oral dose of Viagra and an injection of Mozobil induced about 2,500 more hematopoietic stem cells to enter the bloodstream within just two hours, representing a 7.5-fold increase compared to control mice. In contrast, Viagra alone wasn’t effective, and Mozobil monotherapy only showed about a threefold increase. While three days of Viagra yielded slightly better results, the researchers figured the outcome from just one dose could already rival the performance of Neupogen, which is meant to be given for at least four days. The researchers went on to transplant the harvested stem cells into other mice. The animals that received cells resulting from the Viagra-Mozobil combo ended up with superior engraftment of functional, multipotent stem cells than did those given cells from mice that received Mobozil alone, the team reported. Often dubbed “the little blue pill,” Viagra has been available in the U.S. to treat erectile dysfunction for about two decades, and scientists are still finding potential new uses for it. University of Manchester researchers recently found that Eli Lilly’s Cialis (tadalafil), which belongs to the same PDE5 inhibitor class as Viagra, slowed the progression of heart failure in sheep models. In a 2018 study published in OncoImmunology, scientists at Ottawa Hospital Research Institute showed a combination of Viagra or Cialis plus Seqirus’ flu vaccine Agriflu could significantly reduce the chance of cancer spread post-surgery in mice. The PDE5 inhibitors could block myeloid-derived suppressor cells and in turn allow natural killer cells to target metastatic cancer cells, the team found. In recent developments from the Repurposing Drugs in Oncology project, researchers also identified a wide range of mechanisms of action from PDE5 drugs that could be complementary to other drugs in treating cancers, including the notoriously hard-to-treat glioblastoma. Forsberg and colleagues now plan to work with clinicians to advance their current findings into human studies. The hope is that Viagra-Mozobil could offer a more affordable alternative to G-CSF. The simplicity of administration and better safety profile “would likely attract more volunteer donors and make [hematopoietic cell transplantation] a reality for additional patient cohorts,” the authors wrote in the study. Since March this year, the erectile dysfunction drug Viagra - formerly a prescription-only medicine - has been available to buy over the counter. According to Pfizer, which manufactures the drug, this could benefit the estimated 4.3 million men in the UK who experience erectile problems. The drug, which has been rebranded as Viagra Connect (sildenafil), works by increasing blood flow to the genitals, which in men results in an erection. First made available in 1998, it has been credited as transforming countless men's sex lives. Perhaps unsurprisingly, it has piqued the curiosity of many women too - if it works so well for their male partners, might it not 'work' for them too? Authored by Abi Millar · Reviewed by Dr Sarah Jarvis MBE. The question was first raised in the New York Times , in an article entitled 'Curious women are seeing if Viagra works wonders for them', just months after Viagra became available. It also made its way into an episode of Sex and the City, in which sexually uninhibited character Samantha uses Viagra to shed her inhibitions further still. Coronavirus: how quickly do COVID-19 symptoms develop and how long do they last? Coronavirus: what are asymptomatic and mild COVID-19? Coronavirus: what are moderate, severe and critical COVID-19? What are the differences between colds, flu and COVID-19? Are any coronavirus home remedies safe or effective? However, despite anecdotal reports of its efficacy (the women in the NYT article describe becoming more 'sensitive' and 'receptive'), the drug is still not available for women 20 years on. You might be able to buy it on behalf of your male partner, if the pharmacist thinks that's appropriate. "Yes there is gentle blood flow improvement - however, that doesn't necessarily equate to sexual enjoyment," says Dr Anand Patel, a GP specialising in sexual problems. "Give Viagra to a man and he's generally pretty happy because his outward sign of arousal is an erection and then he can use that for pleasure. With a woman, you improve blood flow to the genitals, but there are more factors at play." Mental vs physical arousal. So why is Viagra not available for women, and what happens to those who take it anyway (against mainstream medical advice)? According to Dr Karen Morton, consultant gynaecologist and founder of Dr Morton's - the medical helpline, the drug should not be viewed as a simple libido enhancer. "The real reason for men to take Viagra is because they want to have sex and they can’t get or sustain an erection," she says. "It's easy to see how medication could cause a huge increase in blood supply and hence inflation of the blood vessels which cause the erection. It has nothing to do with 'desire'." She points out that relatively few women are troubled by anything similar. While women generic viagra pills do experience increased genital blood flow during sex, it doesn't follow that female arousal difficulties are related to problems here. "In women, the main problem is not really being interested in sex with their current (or often any) partner," she says. "So many women tell me they love their men but they would 'rather have a cup of tea'." In fact, low libido in women is a complex issue, with a wide range of potential causes. These can range from relationship problems to hormonal conditions, and should be addressed on a case-by-case basis. But to put it extremely simply, mental and physical arousal are two different things. "Both men and women can be genitally aroused without any mental interest," says Patel. "It's a separate mechanism, which allows lubrication in women or blood flow to the penis in men." Is your lifestyle impacting your sex drive? Many people experienced a drop in libido during lockdown and with restrictions still in place, m. What this means, then, is that a woman could take Viagra without seeing any real effect on her sexual functioning (depending on how this is defined). All this said, there have been some studies in which female Viagra users have reported an increase in sexual pleasure. The most famous of these, conducted by the UCLA Female Sexual Medical Center in 2003, involved 202 postmenopausal women with female sexual arousal disorder (FSAD). (Importantly, none of these women reported emotional difficulties or problems in their relationships.) Over the course of the 12-week trial, participants took either Viagra or a placebo prior to sexual activity. The Viagra group experienced greater sexual enjoyment overall, and most side-effects were minor. However, follow-up studies have failed to replicate these results, and there have been no large clinical trials in the area. The evidence base is simply too limited for any real conclusions to be drawn. On a similar note, we can't say definitively how safe the drug is for women. While it has been well tolerated in studies, there isn't much information out there about its long-term effects. What we do know for sure is that you shouldn't mix it with certain other drugs. "It's generally a very safe drug, but if you're opening up blood vessels, that means your blood pressure drops," says Patel.
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