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PDE-5 inhibitor side effects include: headaches and migraines flushing (redness) indigestion nausea (feeling sick) vomiting (being sick) blocked or runny nose back pain vision disturbances muscle pain. NICE has not published a clinical guideline on erectile dysfunction but after the expiry of the sildenafil (Viagra) patent, the Department of Health in England has amended its regulations to allow unrestricted prescribing of generic sildenafil for men with ED.

However, prescriptions for other PDE-5 inhibitors (and branded sildenafil) will depend on your particular circumstances.

You should get PDE-5s prescribed if you have diabetes, multiple sclerosis, Parkinson’s disease, polio, prostate cancer, spina bifida, certain genetic conditions (such as Huntington's disease) or are receiving or have received certain other medical treatments (eg.

pelvic surgery, prostate treatments or kidney treatments including dialysis and transplant). Do not buy these drugs online without a prescription. (See the internet and health for more information.) We don't currently post comments online but are always keen to hear your feedback.

MAIN IMAGE: Erection by jm3 licensed under CC BY-SA 2.0.

Date published 08/03/16 Date of last review 08/03/16 Date of next review 08/03/19.

I work as an executive in the banking industry and have been married for nearly 30 years.

At this age, when my career is stable and the kids are all grown up, I am beginning to reflect on my own life.

I spent at least two decades of my life putting the priority of family, financial security and career progression high up on the agenda.

Now reaching my mid-50s, I realised perhaps I have compromised on my sexual relationship with my wife.

And that has recently caused some tensions in the relationship. To be honest, I am struggling at the moment to sustain an erection upon penetration.

I thought this might be temporary, but it has persisted for at least six months.

Of course, I have been out of practise for a while.

I went to see my GP (incidentally is a woman and a family friend) and she advised me to take the pills for Erectile Dysfunction. She gave me the options to try four different ones, without further elaborating.

Frankly, I think we were both too embarrassed to talk about this further.

Sorry to put Dr G on the spot, but can you tell me whether I am really suffering from ED? Also, I wonder if you are able to help me to decide which would be the best pill for me.

Technically, Erectile Dysfunction (ED) is defined as the inability to achieve or maintain erectile rigidity during sexual intercourse.

Although the condition is associated with comorbidities such as hypertension, dyslipidemia and smoking, there is no real identifiable causes found. Needless to say, anxiety and stress are a major obstacle in sustaining an erection. In a Malaysia, especially in the urban setting, the prevalence of sexual dysfunction is on the increase, and is reported to affect one in five men.

In reality, the condition may not be associated with any medical etiology, as sex lives are hugely personal to all couples, no matter how passionate their relationship is.

Other priorities in life can easily let the regularity of intimacy slide. Since the introduction of the blue pills in 1998, many couples have returned to nurture their sexual relationship, regardless of the etiology of the ED. In addition, the advancement of medicine has also provided a range of medication interventions to suit different needs in the bedrooms. There are essentially four types of medications (PDE5-I) in the market, namely Sildenafil, Tadalafil, Vardenafil and Udenafil. All the medications have the ability to enhance the blood flow to the penis, and the overall efficacy is around 80%. The general side effects of the drugs include indigestion and headache, which are mild and well tolerated. Technically, the only two real differences that distinguish the drugs from each other are the speed of onset and duration of action. Generally, the fastest onset of the medication is around 30 minutes, and some may take up to two hours to see the effect. The other consideration many users will take into account before usage is the duration of action.

Men who prefer some form of predictability (and manage to persuade their spouses to agree, of course) may opt for the shorter-acting medications that provide the window of opportunity for intercourse. And for others who prefer spontaneity, is the long-acting medication is generally the only option.

When couples are both breadwinners in the family, a busy lifestyle may not offer the “luxury of spontaneity” in a relationship.

In a recent sexual health survey on men taking ED medication, four out of five plan a specific time to have sexual intercourse. The same study also revealed that 71% of men planned sexual intimacy several hours ahead of the prospect of “getting lucky”. In a busy urban society, Dr G is constantly put on the spot to address issues faced by someone in David’s predicament. After an interval of “sexual draught” due to other commitments in life, it is hardly surprising that men would face some “hardness” issues.

Although many of these men may just be facing temporary ED issues, the help of medications is often the only solution to help them to regain confidence and get back into action. When it comes to choosing the right pills for the "action", one has to ask whether “spontaneity” in sex is a luxury you can afford in your busy lifestyle. TriMix Definition: TriMix is a common term used to describe a mixture of Papaverine, Phentolamine and Alprostadil (PGE).

Each of these drugs produce a vasodilating effect when injected into the penis.

The injection is done using a very small needle, inserted into the proper area along the shaft of the penis, so the drug mixture is delivered into the corpus cavernosum. The mixture of drugs causes the corpus cavernosum to relax, dilate and become filled with blood, producing an erection.

TriMix therapy is recognized as a viable treatment for erectile dysfunction by the American Urological Society. TriMix is generally an effective, low-cost treatment, especially for those patients who have not had good results, or experience moderate to severe side effects from PDE5 inhibitors, (Viagra®, Levitra®, Cialis®).

TriMix injections offer a solution for ED that is: – Safe – Reliable – Fast-acting – Long-lasting – More affordable than oral medications – Not affected by alcohol consumption.

TriMix medication can provide longer and fuller erections that may last through climax, allowing you to maintain and improve your sexual health! An intracavernous injection is the most effective non-surgical treatment for ED, according to the American Urologic Association. Penile injections, unlike most oral medications, can trigger an automatic erection in less than 5 minutes.

Erectile Dysfunction Symptoms Benefits TriMix Dosage TriMix Injection Studies TriMix Injection Instructions How to Get Started.

Erectile dysfunction is sexual dysfunction characterized by the inability to develop or maintain an erection sufficient for intercourse.

While erectile dysfunction can affect men of any age, it is most common in men over the age of 40.

Studies have estimated that the number of men suffering from erectile dysfunction in the United States is more than 30 million. Learn more about erectile dysfunction and penile injection medications today.

The inability to achieve or maintain an erection can affect a man at any time.

It can happen once in a while, or more frequently, and there can be many different causes.

Some common causes include: – Low testosterone – Cardiovascular disease – Diabetes – Prostate issues – Depression – Anxiety – Nerve/spinal cord damage – Effects of taking medications. Olympia compounds various forms of popular oral medications for erectile dysfunction, such as: – Sildenafil (compare to Viagra) – Available in capsules or rapid dissolve tablets (dissolve under tongue) – Vardenafil (compare to Levitra) – Available in capsules or rapid dissolve tablets (dissolve under tongue) – Tadalafil (compare to Cialis) – Available in capsules or rapid dissolve tablets (dissolve under tongue) Olympia also offers more than 40 combinations of TriMix, a popular penile injection therapy medication.

Our TriMix medications are backed by a full stability study as well as cGMP testing of every batch.

The goal of our TriMix injection treatment plans is to provide men with a reliable, easy to use, safe method of achieving and maintaining an erection suitable for sexual relations.

There are many benefits to using TriMix injections for ED, including: they’re safe, effective, easy to store, long lasting, easy to administer and more. Once you receive a prescription, or if you have additional questions, contact us. TriMix injections are a mixture of three drugs that are designed to provide an effective, low-cost erectile dysfunction treatment.

TriMix injection solution must be refrigerated between doses. TriMix injections are an alternative to PDE5 Inhibitor tablets (Viagra®, Levitra®, Cialis®) and most commonly include the mixture of three drugs; phentolamine, papaverine and alprostadil. These penile injections can be especially useful when patients are unable to take PDE5 Inhibitors because they are taking nitrates, certain beta blockers, or experience severe side effects from the oral medications. The initial dose should be .05cc to .2cc, depending on each patient’s level of ED.

Increase by 0.025 cc to 0.050 cc until a satisfactory dose is reached.

Do not be discouraged by a poor result with the first few injections, as the initial dose should be kept low to avoid a prolonged erection. TriMix injection is a medication that is very customized to the patient’s needs.

Olympia will work together with the physician and

patient

– Fax the signed and completed prescription form to Olympia (407-673-1234).

We support physicians and have more than 35 years of compounding expertise.

We provide custom formulation and custom dosing to fit your needs.

For other inquiries, including dosing information, please call our physician hotline at 407-673-2222 or email us at sales@olympiapharmacy.com. For detailed information about TriMix injections and their results, read this TriMix study conducted by the International Journal of Impotence Research below.

Introduction and Objective: Intracavernous injection of Trimix (Tx) is indicated for patients unsuitable for prostaglandin E 1 (PgE 1 ) injection due to lack of response, pain or cost.

We believe that the ideal ratio of ingredient doses in Tx is yet to be found.

We postulated that increasing the doses of individual drug components in an orderly manner would convey important data on penile hemodynamic response. Such information is needed to choose an effective and less costly alternative to PgE 1 with least side effects. We set out to evaluate the impact of varying the ingredient dosage on response and short-term safety of Tx compared with PgE 1 . We prospectively randomized 180 consecutive patients with erectile dysfunction into nine equal groups and each group received a different dose of Tx, namely phentolamine (1 mg) plus one dose of PgE 1 (2.5, 5 or 10 ?g) and one dose of papaverine (5, 10 or 20 mg). Each patient was injected with 20 ?g PgE 1 and one dose of Tx in two clinic visits 1 week apart. Following injection, duplex ultrasound best place to buy sildenafil online of cavernous arteries and axial rigidometry were carried out. Patients ranked the quality of erection, estimated overall satisfaction and reported time to detumescence and side effects. Patients’ mean age was 50.5±11.7 y with underlying organic condition in 91.1%. We set out to evaluate, by means of an acute, prospective, randomized, single blind study, the various dose combinations of Tx versus PgE 1 20 ?g using both subjective and objective end points. Hypothesis: We think that the ideal ratio of ingredient doses in Tx is yet to be found. The effect of increasing individual drug components on penile response is not known.

Such information is needed to choose an effective and less costly alternative to PgE 1 with least side effects. Results: In spite of oral drug therapy for ED, there is a considerable number of candidates for self-injection therapy.

These include patients who do not respond to or have a contraindication for PDE-5 inhibitor treatment. In addition, some patients prefer the rigidity provided by injections.

In patients undergoing ICI therapy and given the option to try sildenafil, 36.2% decided to use injections most of the time or at least sporadically.

The association of multiple vasoactive drugs produces a full erectile response in more than 90% of patients. In nonresponders to doses as high as 40 ?g PGE 1 , Tx combination produced a response in 31%. The cost of the medication is another important issue where Tx has an advantage. Use this helpful video for complete instructions on how to properly inject TriMix medication. Generic Viagra is an ED drug that is really effective, and today Generic Viagra is one of the most common drugs to treat erectile dysfunction.

Initially, the drug was designed to treat coronary heart disease and its main objective was to improve the blood flow in the myocardium. But the survey found that the effect of its active substance Sildenafil on heart blood flow is insufficient, but the drug had a pronounced effect on blood circulation in the pelvic organs (including the penis). These results were obtained in the early 1990s, literally opening a new page in the history of medicine.

By its value, Viagra is quite comparable with Penicillin, as revived many marriages.

The active ingredient of Generic Viagra is Sildenafil . It causes an increase in blood that enters the organs, including the penis.

Do not be afraid that it will happen at the most inopportune moment.

The drug is effective only when the patient is experiencing sexual arousal.

When the act is completed, the penis will return to its natural state.

Thus, Viagra (Sildenafil) affects only the natural mechanisms and is effective only if the case of blood circulation violation. As you know, sex often goes hand in hand with parties and alcohol intake.

From a medical point of view, Generic Viagra and alcohol is certainly not the best combination , as loss of self-control leads to bad consequences – unwanted pregnancies and sexually transmitted diseases. In addition, alcohol does not always produce a good effect on erectile function.

However, warnings from doctors are not likely to change anything, and, therefore, United Pharmacy will review Viagra and alcohol combination in more detail.

At the moment, there are no clinical studies on the subject.

At the same time, there is no reliable data that Generic Viagra and other tablets for erectile dysfunction treatment may lead to fatal consequences for health in combination with alcohol (in reasonable quantities, of course).

Still, the action of these ED drugs is aimed solely at stimulating blood circulation, and they practically do not affect the nervous system, unlike ethyl contained in alcoholic beverages. Ethyl can produce a depressing effect on the nervous system. So, a logical question arises: is it worth drinking alcoholic beverages and later take the ED drug in order to neutralize alcohol action? Just as in the case with alcohol, the manufacturers did not conduct specific clinical studies on this subject. Remember that drinking alcohol, you are harming your health, and taking drugs, you are not only destroying your health but also violate the law.

Besides, London has recently witnessed an interesting trend. When Viagra has just appeared on the pharmaceutical market, young people started to take the drug.

As a rule, it was the public who spent all night in the clubs and often took these pills at parties.

But after a while young people started addressing doctors complaining of heart attacks.

Usually, they were boys between the age of 20-25 and cardiovascular diseases were not typical for them, so, a study was conducted, which found out that cocaine negatively affects the blood circulation and, in some cases, can cause spasms of the coronary vessels.

To remove these side effects, many young people started taking Viagra, often mixing it with the popular Ecstasy. Such a mix was called “ Sextasy “, but the effect differed from the originally expected, as the simultaneous spasms of blood vessels and increased blood flow can hardly be called healthy. Many people still believe that ED pills such as Viagra are prescribed only to elderly men. However, earlier the PDE5 inhibitor was advertised as a tool for middle-aged men, the heroes of today’s commercials and articles are men under 40.

And it doesn’t mean that potency problems start earlier nowadays.

Drugs, such as Generic Viagra gave the opportunity to experience full and bright life, now they are taken not only as pills for erectile dysfunction treatment but as a means of pleasure prolonging.

Generic Viagra really helps men suffering from erectile dysfunction – these are men with diabetics and different kinds of neurological disorders, those who had been taking antidepressants for a long time (erectile dysfunction is a side-effect of antidepressants). Viagra is usually taken by men, who have not yet faced a similar problem but would like to insure.

Especially in those cases, when they are expecting an important event.

Well, the drug really gives the opportunity to feel more confident.

However, their administration can be combined with food and drinks, so the Viagra tablet can be discreetly taken during dinner. However, Viagra side-effects may be noticeable sometimes, as Viagra (Sildenafil citrate) affects the blood circulation and blood may rush to cheeks. Most men tend to believe that erectile dysfunction arises due to stress and a variety of psychological problems. However, recent studies have shown that this is true only for 20% of cases.

80% of erectile dysfunction cases have organic reasons .

This group includes all somatic diseases, including hormonal disorders, diabetes, and cardiovascular disease.

Erectile dysfunction treatment with Viagra is the most effective in this case.

There is also the possibility that impotence is a result of surgery or injury.

In this case, the ED pill, of course, does not help, there is a need for more radical methods.

Long-time people believed

that

In fact, age doesn’t have any marked effect on potency.

The problem is that over the years men are developing diseases, which are the true causes of erectile dysfunction . Treatment of these diseases is carried out through the administration of drugs.

In addition, sedentary lifestyle, smoking, alcohol – all these factors have a negative effect on potency.

So, Generic Viagra can not solve all these problems.

According to doctors, men need a complex approach: drug therapy; physical activity; walks in the fresh

air

There is another aspect of the problem, which is worth mentioning.

Often drugs like Viagra are necessary more for urban residents . And it’s not even the matter that village environmental conditions are better (although this is also important). The problem is that men of the big cities have accidental sexual contacts more often.

Very often, men meet these people at a party or on the internet resources.

Besides, today’s glossy magazines and movies depict the image of a perfect man, who is always ready to have sex and craves intimacy literally with every pretty girl. Fear not to meet expectations and not to conform to this image makes men drink PDE5 inhibitors. Well, in this case, Viagra does not affect men’s health but gives self-confidence. Once you experience the effect of this PDE5 inhibitor , a person asks himself: “How long can I take this preparation?

Can the drug damage the natural mechanisms of erection?” The last question is most actual among men who are planning to try Viagra not due to potency disorders, but due to the desire to bring something new in their intimate life. Returning to patients, it is worth noting that medicine knows no cases of nerve centers exhaustion responsible for the natural mechanism of erection, so, Viagra can hardly affect them.

Over the years, this function does not get worse – on the condition you take good care of your health. Of course, it’s recommended to take Viagra, as well as other drugs, only after consultation with a doctor. Generic Viagra instruction for use contains Viagra dosage recommendations.

The recommended single Viagra dosage is 100 mg per day . However, this dose can be adjusted depending on the individual tolerability of Sildenafil.

Do not think that the higher the Viagra dose is, the more effective the drug will produce.

In some cases, 25 mg Viagra (Sildenafil) dosage may be sufficient.

The average initial Viagra dosage is 50 mg , further dosage depends on its effectiveness.

If this Viagra dose is insufficient, it can be increased to 100 mg . The decision on the dosage increase can be

taken

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Erectile dysfunction; Impotence; Sexual dysfunction - male.

An erection problem occurs when a man cannot get or keep an erection that is firm enough for intercourse. Or, you may lose the erection during intercourse before you are ready. Erection problems do not usually affect your sex drive. Almost all adult men have trouble getting or keeping an erection at one time or another. Often the problem goes away with little or no treatment. If you have trouble getting or keeping an erection more than 25% of the time, you should see your health care provider.

Other factors, such as a person's physical health and emotional well-being, are more likely to be the reason for the lack of sexual performance in an individual.

You're a man and unfortunately, you aren't able to get an erection at all, or, you lose your erection during intercourse before you are ready.

Let's talk about the causes of this condition, and the various farmacia online sildenafil ways to make erection problems a thing of the past. Almost all men sometimes have trouble getting or keeping an erection. In many cases, the problem goes away with little or no treatment.

If you have trouble getting or keeping an erection more than 25% of the time, it is a problem.

An erection involves your brain, nerves, hormones, and blood vessels.

So, anything that interferes with any of these normal functions can lead to problems getting or keeping an erection.

Common causes of erection problems include diseases such as diabetes, high blood pressure, heart or thyroid conditions, poor blood flow, depression, or nervous system disorders like multiple sclerosis or Parkinson's disease. Medicines can also be a culprit, including those that treat high blood pressure, heart problems, sleeping pills, and antidepressants.