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The combination of the two substances can have a dangerous effect on your heart.

Organic nitrates are often used to treat angina, and butyl nitrate is a recreational drug that is more commonly known as 'poppers'. You are herbal viagra canada also warned not to take PDE-5 inhibitors if you: have been advised not to take part in sexual activity or in activities that widen your blood vessels have low blood pressure (hypotension) have recently had a stroke – a medical emergency that occurs when the blood supply to the brain is interrupted have unstable angina – an underlying heart condition that causes symptoms such as chest pain have had a heart attack – a medical emergency where the blood supply to the heart is suddenly blocked have a history of non-arteritic anterior ischaemic optic neuropathy – an eye condition that causes a sudden loss of vision.

PDE-5 inhibitors can cause some side effects, including: headaches and migraines flushing (redness) indigestion nausea (feeling sick) vomiting (being sick) a blocked or runny nose back

pain

You place your penis in the tube and pump out all of the air.

This creates a vacuum that causes the blood to fill your penis, making it erect. You then place a rubber ring around the base of your penis to keep the blood in place, allowing you to maintain an erection mercury drug viagra for around 30 minutes. It may take several attempts to learn how to use the pump correctly, but they are usually effective. After using a vacuum pump, nine out of 10 men are able to have sex, regardless of the cause of their ED. You should not use a vacuum pump if you have a bleeding disorder or if you are taking anticoagulant medicines, which reduce the ability of your blood to clot. Side effects of vacuum pumps include pain or bruising, although these occur in less than a third of men. Men who viagra tablet 25 mg price qualify for NHS prescriptions for erectile dysfunction treatments may be able to get a vacuum pump on the NHS (see above for more details). The Sexual Advice Association produces a number of factsheets, including one on vacuum pumps that provides details of companies that supply them.

If your erectile dysfunction doesn't respond to treatment, or you are unable or unwilling to use PDE-5 inhibitors or a vacuum pump, you may be given a medicine called alprostadil. This is a synthetic (man-made) hormone that helps to stimulate blood flow to the penis.

Alprostadil is available as: an injection directly into your penis – this is called an intracavernosal injection a small pellet placed inside your urethra (the tube that carries urine from your bladder to the tip of your penis) – this is called urethral application. You may be trained to correctly inject or insert alprostadil. If your partner is pregnant, use a condom during sex if you are inserting alprostadil into your urethra. Alprostadil will usually produce an erection after five to 15 minutes.

How long the erection lasts will depend on the dose. In men who did not respond to PDE-5 inhibitors, alprostadil injections were successful in 85 out of 100 men.

Alprostadil inserted into the

urethra

Urethral application may also not be used in: some men who

have

Alprostadil can cause some side effects including: changes in your blood pressure dizziness headache pain in your penis urethral burning or bleeding reactions at purchase viagra pills the site of the injection, such as swelling.

As with PDE-5 inhibitors, NHS prescriptions for alprostadil may only be available for men with particular health conditions or those receiving some types of medical treatments. If you need to pay the full prescription cost, a single injection of alprostadil costs around ?8 to ?22, depending on the dose.

A single dose of alprostadil for urethral application is around ?10. If a hormonal condition is causing erectile dysfunction, you may be referred to an endocrinologist (who specialises in the treatment of hormonal conditions). Many hormonal conditions can be treated using injections of synthetic (man-made) hormones to restore normal hormone levels.

Surgery for erectile dysfunction is usually only recommended if all other treatment methods have failed. It may also be considered in: younger men who have experienced serious injury to their pelvic area – for example, in a car accident men with a significant anatomical problem with their penis. In the past, surgery was used if there was clear evidence of a blockage to the blood supply of the penis. The surgeon could unblock the blood vessels to restore a normal supply of blood. However, research now suggests that the long-term results of this discount sale viagra type of surgery are poor, so it's unlikely to be used.

Penile implants are a type of surgery that may be considered.

These can be: semi-rigid implants – which may be suitable for older men who do not have sex regularly inflatable purchase viagra pills implants – which consist of two or three parts that can be inflated to give a more natural erection.

Penile implants are not usually available on the NHS and inflatable implants may be very expensive. However, around three-quarters of men report being satisfied with the results of this type of surgery.

As with all types of surgery, having penile implants inserted carries a risk of infection.

If you take preventative antibiotics, the rate of infection is around two or three in 100. Mechanical problems with the implants may occur within five years in five per cent of cases.

If your erectile dysfunction has an underlying psychological cause then you may benefit from a type of treatment called sensate focus.

If conditions such as anxiety or depression are causing your erectile dysfunction, you may benefit from counselling (a talking therapy).

Sensate focus is a type of sex therapy that you and your partner complete together. It starts with you both agreeing not to have sex for a number of weeks or months.

During this time, you can still touch each other, but not in the genital area (or a woman’s breasts).

The idea is to explore your bodies knowing that you will not have sex. After the agreed period of time has passed, you can gradually begin touching each other’s genital areas. You can also begin to use your mouth to touch your partner, for example, licking or kissing, them. You can find out more purchase viagra pills about sensate focus from the College of Sexual and Relationship Therapists (COSRT). Psychosexual counselling is a form of relationship therapy where you and your partner can discuss any sexual or emotional issues that may be contributing to your erectile dysfunction. By talking about the issues, you may be able to reduce any anxiety that you have and overcome your erectile dysfunction.

The counsellor can also provide you with some practical purchase viagra pills advice about sex, such as how to make effective use of other treatments for erectile dysfunction to improve your sex life. Psychosexual counselling may take time to work and the results achieved have been mixed. Cognitive behavioural therapy (CBT) Cognitive behavioural therapy (CBT) is another form of counselling that may be useful if you have erectile dysfunction.

CBT is based on the principle that the way you feel is partly dependent on the way you think about things.

CBT helps you realise that your problems are often created by your mindset.

It is not the situation itself that is making you unhappy, but how you think about it and react to it. Your CBT therapist can help you to identify any unhelpful or unrealistic thoughts that may be contributing to your erectile dysfunction – for example, to do with: your self-esteem (the way you feel about yourself) your sexuality your personal relationships.

Your CBT therapist will be able to help you to adopt more realistic and helpful thoughts about these issues. Some studies have suggested that, in a few cases, it may be beneficial to exercise your pelvic floor muscles.

These are a group of muscles around the underside of the bladder and rectum, as well as at the base of the penis.

Pelvic floor muscle exercise involves strengthening and training the muscles used to control the anus (back passage) and urinate.

If your GP feels this type of exercise could be beneficial, then you may want to discuss it with a physiotherapist to learn it correctly. By strengthening and training these muscles, you may be able to reduce the symptoms of erectile dysfunction. Some complementary therapies, such as acupuncture, have claimed to treat erectile dysfunction. In some cases, they may even include ingredients that could interact with other medications and cause side effects. Always speak to your GP before using any complementary therapies. Healthdirect Free Australian health advice you can count on. If you need urgent medical help, call triple zero immediately. healthdirect Australia is a free service where you can talk to a nurse or doctor who can help you know what to do. Erectile dysfunction, or impotence, means not being able to get or keep an erection that is sufficient for sexual intercourse. Many men have erectile dysfunction at some time in their lives. It is estimated erectile dysfunction affects about 1 million men in Australia.

Erectile dysfunction can have a range of causes, both physical and psychological. Physical factors that can cause erectile dysfunction include: general ageing health problems that affect your nerves, like spinal cord injury, multiple sclerosis (MS), diabetes, surgery that affects the pelvic area or spinal cord (prostate or bowel surgery), Parkinson’s disease and Alzheimer’s disease reduced blood flow to the penis, caused by atherosclerosis (clogging of the arteries) conditions like prostate disease, high blood pressure, underactive thyroid gland (hypothyroidism), cardiovascular disease, obesity or sleep disorders alcohol, some medicines, smoking or substance abuse Peyronie's disease (scar tissue inside the penis) treatments for prostate cancer or an enlarged prostate.