Sexual Advice Association Suite 301 Emblem House, London Bridge Hospital, 27 Tooley Street, London SE1 2PR Helpline 020 7486 7262 Website www.sexualadviceassociation.co.uk Email info@sexualadviceassociation.co.uk Oral treatments for impotence (erectile dysfunction)
There are (up to April 2011) three new treatments available. The first to be marketed was Viagra (or sildenafil) in 1998, followed by Cialis (tadalafil) in 2003 and then Levitra (vardenafil). Your doctor or specialist will discuss with you which of these oral treatments he or she thinks would suit you. All three treatments belong to a group of drugs called PDE5 inhibitors, which are in tablet form. Viagra is a blue diamond, Cialis is a yellow almond shape and Levitra is orange and round. How the drugs work They are not aphrodisiacs and do not increase sexual desire. For them to be effective, you need sexual stimulation (foreplay) as well, as they will not give you an erection spontaneously (taking a tablet and waiting for something to happen just doesn't work). There is no point in a man without impotence taking a tablet if he can get an erection anyway. It is unnecessary and makes no difference. The drugs work by relaxing the blood vessels in the penis, allowing blood to flow into it, causing an erection. They also make other blood vessels dilate and you may get a flush or a headache. These are usually not bad and are temporary. They shouldn't stop you continuing to have sex. You can also get a stuffy nose or indigestion, which usually goes with regular dosing over time or if the dose is lessened. With Cialis, you can (rarely) get some muscle aching or backache. Viagra is in three strengths – 25, 50 and 100 mgs, and Cialis and Levitra are in 10 and 20 mgs. Many doctors start treatment by prescribing the maximum dose, although some may start on a lower dose. The drugs usually work in a minimum of 30 minutes but many men find it better to wait longer to have sex if possible. Don't forget that you need sexual stimulation – foreplay – as well as sexual desire to get an
erection. Once you have taken one of the tablets (don't go above the maximum recommended dose – you simply increase the side effects and not the efficacy), Viagra and Levitra will continue to have an effect for four–six hours (although many men claim also to have a good erection the next morning), and Cialis can have an effect up to 48 hours, useful if things don't work out for you immediately. Don't have more than one a day.
With all three tablets, too much alcohol or a heavy meal can interfere with getting an erection, so if you want success, cut down on alcohol and don't have a big meal before sex. If you don't get much of a result after taking the highest dose on six different occasions, ask to try one of the others, as sometimes this works. Find out how a tablet works on you and what side effects it has, if any, before you drive, or have sex with your partner.
When it is not sensible to take one or other of the tablets
You should not take one of these treatments for impotence if you are taking a drug containing nitrates. These include inhalers for angina, or tablets for blood pressure such as Suscard, Sustac, an isosorbide (check the label of your tablets) or if you go clubbing, poppers. If you feel that you would like to try a PDE5 inhibitor and you are taking a nitrate for another reason, talk to your doctor and ask to be changed to another type of blood pressure tablet (which should not really be a problem unless you have severe angina). The reason is that the combination of a nitrate and a PDE5 inhibitor can lower the blood pressure catastrophically, with serious results.
If you are a "heart patient" check with your GP or consultant when you get your first prescription.
You shouldn't take two different PDE5 inhibitors at the same time.
They should not be taken by women as their safety in women hasn't been tested.
If any of these tablets do not help you to get an erection, or your erection does not last long enough for you to enjoy your chosen sexual activity, you should tell your doctor, who may suggest help from a sexual therapist or, if you are an older man, may want to check your testosterone. There are also other effective treatment options available and you can find what they are from your doctor or the Sexual Advice Association.
An invitation
…… to enrol as a friend of The Sexual Advice Association. For a small annual subscription you will know that you are contributing to a charity that helps overcome the problems of male and female sexual dysfunction. If you are interested please telephone or write for an application form or complete our on-line registration form.
Charitable Company registered in England and Wales. Company registration number 04997095. Charity registration number 1104691. Registered Office: 59 Knowle Wood Road, Dorridge, West Midlands B93 8JP (not for correspondence)
Sensors 2003 , 3, 524-533 sensors ISSN 1424-8220 Voltammetric Determination of Prochlorperazine and Ethopropazine Using a Gold Electrode Modified with Decanethiol SAM Yuxia Yang, Yan Peng, Faqiong Zhao and Baizhao Zeng* Department of Chemistry, Wuhan University, Wuhan 430072, P. R.China *Author to whom correspondence should be addressed. E-mail: zengbz@chem.whu.
ALLERGY INFORMATION MEDICATION AND IMPLICATIONS Nitric oxide is a biomarker for inflammatory mediators that reflect activity of the eosinophils, which are the main marker for severity of inflammation in asthma. The definitive test is a BAL (bronchialalveolar lavage) of eosinophils, which correlates with effectiveness of inhaled steroids. FeNO (fractional exhaled nitric oxide) can n
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erection. Once you have taken one of the tablets (don't go above the maximum recommended dose – you simply increase the side effects and not the efficacy), Viagra and Levitra will continue to have an effect for four–six hours (although many men claim also to have a good erection the next morning), and Cialis can have an effect up to 48 hours, useful if things don't work out for you immediately. Don't have more than one a day.