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In response, a number of erectile dysfunction treatments have been developed, with varying efficacy and side effects.

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Men with a known hypersensitivity to alprostadil should not use intraurethral prostaglandin E1.
Kramarsky-Binkhorst, S. (1978) Female partner perception of small carrion implant. Urology, 12, 545.CrossRefGoogle ScholarPubMed .

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The authors would like to acknowledge the University of Gondar for its support and facilitation of the study. The authors also want to thank all the study participants for their collaboration and participation in the study. 1. Gebreyohannes EA, Bhagavathula AS, Gebresillassie BM, Tefera YG, Belachew SA, Erku DA. Recreational use of phosphodiesterase 5 inhibitors and its associated factors among undergraduate male students in an Ethiopian University: a cross-sectional study. World J Mens Health. (2016) 34:186–93. doi: 10.5534/wjmh.2016.34.3.186 2. Guay AT, Perez JB, Jacobson J, Newton RA. Efficacy and safety of sildenafil citrate for treatment of erectile dysfunction in a population with associated organic risk factors. J Androl. (2001) 22:793–7. Erratum in: J Androl. (2002) 23:113. doi: 10.1002/j.1939-4640.2001.tb02582.x 3. Harte CB, Meston CM. Recreational use of erectile dysfunction medications and its adverse effects on erectile function in young healthy men: the mediating role of confidence in erectile ability. J Sex Med. (2012) 9:1852–9. doi: 10.1111/j.1743-6109.2012.02755.x 4. Zusman RM, Morales A, Glasser DB, Osterloh IH. Overall cardiovascular profile of sildenafil citrate. Am J Cardiol. (1999) 83:35C−44C. doi: 10.1016/S0002-9149(99)00046-6 5. Delate T, Simmons VA, Motheral BR. Patterns of use of sildenafil among commercially insured adults in the United States: 1998-2002. Int J Impot Res. (2004) 16:313–8. doi: 10.1038/sj.ijir.3901191 6. Bechara A, Casabé A, De Bonis W, Helien A, Bertolino MV. Recreational use of phosphodiesterase type 5 inhibitors by healthy young men. J Sex Med. (2010) 7:3736–42. doi: 10.1111/j.1743-6109.2010.01965.x 7. Makwana S, Solanki M., Raloti S., Dikshit R. Evaluation of recreational use of aphrodisiac drugs and its consequences: an online questionnaire based study. Int J Res Med. (2013) 1:51–9. 8. Harte CB, Meston CM. Recreational use of erectile dysfunction medications in undergraduate men in the United States: characteristics and associated risk factors. Arch Sex Behav. (2011) 40:597–606. doi: 10.1007/s10508-010-9619-y 9. Schnetzler G, Banks I, Kirby M, Zou KH, Symonds T. Characteristics, behaviors, and attitudes of men bypassing the healthcare system when obtaining phosphodiesterase type 5 inhibitors. J Sex Med. (2010) 7:1237–46. doi: 10.1111/j.1743-6109.2009.01674.x 10. Gebregeorgise DT, Belay YM, Kälvemark Sporrong S. Sildenafil citrate use in Addis Ababa: characteristics of users and pharmacists' dispensing practices. Int J Clin Pharm. (2018) 40:67–73. doi: 10.1007/s11096-017-0558-8 11. Both R. Sex, tension, and pills: young people's use of contemporary reproductive and sexual health technologies in Addis Ababa, Ethiopia (Doctoral dissertation). Anthropology Department, University of Amsterdam, Amsterdam, Netherland (2017). Available online at: https://pure.uva.nl/ws/files/9794196/Thesis_complete_.pdf 12. Both R. A matter of sexual confidence: young men's non-prescription use of Viagra in Addis Ababa, Ethiopia. Cult Health Sex. (2016) 18:495–508. doi: 10.1080/13691058.2015.1101489 13. Cheitlin MD, Hutter AM Jr, Brindis RG, Ganz P, Kaul S, Russell RO Jr, et al. Use of sildenafil (Viagra) in patients with cardiovascular disease. Technology and Practice Executive Committee. Circulation. (1999) 99:168–77. doi: 10.1161/01.CIR.99.1.168 14. Santtila P, Sandnabba NK, Jern P, Varjonen M, Witting K, von der Pahlen B. Recreational use of erectile dysfunction medication may decrease confidence in ability to gain and hold erections in young males. Int J Impot Res. (2007) 19:591–6. doi: 10.1038/sj.ijir.3901584 15. Schiefer J, Sparing R. Transient global amnesia after intake of tadalafil, a PDE-5 inhibitor: a possible association? Int J Impot Res. (2005) 17:383–4. doi: 10.1038/sj.ijir.3901301 16. Pomara G, Morelli G, Menchini-Fabris F, Dinelli N, Campo G, LiGuori G, et al. Epistaxis after PDE-5 inhibitors misuse. Int J Impot Res. (2006) 18:213–4. doi: 10.1038/sj.ijir.3901383 17. Tiryakioglu SK, Tiryakioglu O, Turan T, Kumbay E. Aortic dissection due to sildenafil abuse. Interact Cardiovasc Thorac Surg. (2009) 9:141–3. doi: 10.1510/icvts.2009.205849 18. Nachtnebel A, Stöllberger C, Ehrlich M, Finsterer J. Aortic dissection after sildenafil-induced erection. South Med J. (2006) 99:1151–2. doi: 10.1097/01.smj.0000240732.65859.aa 19. Suleman S, Woliyi A, Woldemichael K, Tushune K, Duchateau L, Degroote A, et al. Pharmaceutical regulatory framework in ethiopia: a critical evaluation of its legal basis and implementation. Ethiop J Health Sci. (2016) 26:259–76. doi: 10.4314/ejhs.v26i3.9 20. Gebretekle GB, Serbessa MK. Exploration of over the counter sales of antibiotics in community pharmacies of Addis Ababa, Ethiopia: pharmacy professionals' perspective. Antimicrob Resist Infect Control. (2016) 5:2. doi: 10.1186/s13756-016-0101-z 21. Jackson G, Montorsi P, Cheitlin MD. Cardiovascular safety of sildenafil citrate (Viagra): an updated perspective. Urology. (2006) 68(3 Suppl):47–60. doi: 10.1016/j.urology.2006.05.047 22. Kloner RA, Jackson G, Emmick JT, Mitchell MI, Bedding A, Warner MR, et al. Interaction between the phosphodiesterase 5 inhibitor, tadalafil and 2 alpha-blockers, doxazosin and tamsulosin in healthy normotensive men. J Urol. (2004) 172(5 Pt 1):1935–40. doi: 10.1097/01.ju.0000142687.75577.e4 23. Ethiopia CC. Summary and Statistical Report of the 2007 Population and Housing Census. Addis Ababa: Federal Democratic Republic of Ethiopia population Census Commission (2008). 24. Ausó E, Gómez-Vicente V, Esquiva G. Visual side effects linked to sildenafil consumption: an update. Biomedicines. (2021) 9:291. doi: 10.3390/biomedicines9030291 25. Gebreslassie M, Feleke A, Melese T. Psychoactive substances use and associated factors among Axum University students, Axum Town, North Ethiopia. BMC Public Health. (2013) 13:693. doi: 10.1186/1471-2458-13-693 26. Lindsey WT, Stewart D, Childress D. Drug interactions between common illicit drugs and prescription therapies. Am J Drug Alcohol Abuse. (2012) 38:334–43. doi: 10.3109/00952990.2011.643997 27. Murtadha M, Raslan MA, Fahmy SF, Sabri NA. Changes in the pharmacokinetics and pharmacodynamics of sildenafil in cigarette and cannabis smokers. Pharmaceutics. (2021) 13:876. doi: 10.3390/pharmaceutics13060876
A variety of testosterone therapies are available, including oral, topical (gel, spray, patch), intramuscular, and pellets. The patient should review the advantages and disadvantages of each of these with a physician, as well as the health risks and benefits of testosterone therapy.

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But there are also medical devices like the Elator, which is approved by the Food and Drug Administration (FDA) and is custom-made with medical-grade silicone based on a patient’s girth and shaft. The technology, which has no known risk factors, has two thin bars that glide along the bottom of the penis, and hold the organ partially or fully erect with a soft, flexible loop, a sliding latch and a base lock and base ring.
Research shows that around 3 million men of varying ages in Canada have frequent problems in the bedroom or wherever they choose to get busy. And about 30 million of the men south of the border do too. Many opt for Viagra in Canada, but there are other routes.

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Erectile dysfunction is a very common condition for aging men, but is it a normal part of the aging process? Though it’s a sensitive topic, it's important to discuss any signs of erectile dysfunction with your doctor -- especially because erectile dysfunction is sometimes the first sign of underlying health conditions such as cardiovascular problems.

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Patient Safety is a top priority. We are following all CDC safety recommendations for COVID-19 and require all of our staff and patients to wear masks in our facilities, at this time. Our Purpose Board of Directors Leadership Team News

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    He also noted that there are data on sexual attempts within 15 minutes of dosing tadalafil (Viagra) and sildenafil (Cialis) but he did not have that available.

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    Treatment depends on what is causing it. If it is caused by uncontrolled blood sugar and high blood pressure, take your medicine and follow your doctor’s instructions.

    SmokingObesitySedentary lifestylePoor diet and blood sugar controlChronic alcohol/substance abuse
    It's also important to know that drinking alcohol won't help you maintain an erection. In fact, excessive alcohol use can be a cause of erectile dysfunction.

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    Spycher, M. A., Hauri, D. (1986) The ultrastructure of erectile tissue in priapism. Journal of Urology, 135, 142–147.CrossRefGoogle ScholarPubMed

    When people think about erectile dysfunction treatments, they think of Viagra. The prescription medication is the brand name for sildenafil citrate. Men can take the tablets orally and enjoy sex as usual for up to two hours. Viagra and generic sildenafil work the same way. They inhibit PDE5, meaning that they relax the blood vessels in the penis during sexual stimulation. As a result, the ED pills let men obtain an erection faster and keep it longer. Cialis (tadalafil) serves as the 1B to Viagra's 1A. The vasodilator treats erectile dysfunction the same way, blocking PDE5 to improve blood flow to the penis. It also alleviates symptoms related to an enlarged prostate. Drug interactions can occur while using Cialis. You should not take these erectile dysfunction pills if you take anti-fungal medication or antibiotics. Ask your doctor if you're healthy enough to take Cialis if you have a history of strokes, kidney or liver problems, or stomach ulcers. Levitra (vardenafil) is one of the most popular Viagra alternatives. The prescription medication relaxes the muscles in the penis and blood vessels. This effect increases blood circulation, leaving you with a firm erection. A single tablet of Levitra can improve penile blood flow for up to four hours. If your erection lasts longer than four hours, contact a medical professional. You should also speak with a doctor before taking Levitra if you take blood pressure medications, alpha-blockers, anti-fungal medication, or antibiotics. Stendra (avanafil), also known as Spedra, has been around since 2012. The PDE5 inhibitor comes from Mitsubishi Tanabe Pharma, which touts the ED treatment's minimal side effects. The pills expand the blood vessels in the penis, so they fill with blood during sexual arousal. Users can take Stendra with up to three servings of alcohol before intercourse. You should not take the pill if you take anti-fungal medication, alpha-blockers, antibiotics, or other ED treatments. Contact a doctor immediately if you experience low blood pressure or hearing loss while taking Stendra. While each natural male enhancement supplement has a unique formula, many of them work the same way. They convince the body to produce more nitric acid, a molecule found in almost every cell in the body. So what makes nitric oxide special? It's a vasodilator. The molecule communicates with the muscles in your body and tells them to relax. This signal widens the blood vessels in the penis, lowering your blood pressure and improving blood flow. So while most researchers don't place nitric oxide on par with Viagra or Cialis as an ED treatment, the natural compound can work wonders for your sex life. The benefits of nitric oxide go beyond penis enlargement. The compound can put you at ease in the bedroom, instilling you with self-confidence. Its relaxing effect allows you to focus on your partner during sexual intercourse instead of your erectile performance. Each of the male enhancement supplements on our list has safe and effective ingredients. Unless you have an allergy to something in the formula, you don't have to worry about severe complications. The wholesome content supports your natural sexual health, allowing you to perform your best in the bedroom. If you have any questions or concerns about a specific treatment, talk with your doctor first. They understand your body and can guide you toward the right option. The conversation can also help you circumvent any unwanted drug interactions. Why Choose Natural Erection Pills vs. ED Medication for Treating Erectile Dysfunction Millions of men put their faith in natural erection pills each year. The supplements offer several benefits over traditional ED medication. That starts with convenience. When you want to purchase natural male enhancement supplements, you can order them online. So say adios to commutes and waiting at the doctor's office. Instead, manufacturers deliver the pills to your door so that you can spend your time on the important things in your life. This arrangement also offers more privacy. You can avoid having embarrassing or awkward conversations with your doctor about your erectile dysfunction. Instead, you can do your research online and purchase a supplement that fulfills your needs. Natural ED pills tend to cost less than ED medications. You can save a few hundred or even a few thousand dollars per year on drugs. Here are the costs of name-brand ED treatments at Hims: Cialis - 30 pills cost $520 per month Stendra - four pills cost $116 per month Tadalafil - 30 pills cost $235 per month Viagra - five pills cost $425 per month Finally, natural supplements tend to have fewer side effects. None of the products on our list have any significant side effects, giving you the green light to buy them. However, prescriptions come with a wide range of potential complications, such as memory problems, nausea, loss of hearing, headaches, and dizziness. If you have erectile dysfunction, you should strongly consider one of the top male enhancement supplements on our list. The state-of-the-art products deliver the results you need without a prescription. Not only do they treat ED symptoms, but they can also correct a wilting libido and premature ejaculation. Remember that each product has unique benefits. Male Extra works best if you want to turbocharge your sex drive, while VigRX Plus caters to men looking for firmer erections. Taking the time to review your options can make a world of difference for your sex life. Tags: Sponsored content, Viagra, Cialis, Levitra, Spendra, Tadalafil Local journalism is information. Information is power. And we believe everyone deserves access to accurate independent coverage of their community and state. Help us keep this coverage going with a one-time donation or an ongoing membership pledge. Forward Hospitality Acquires Smokey's BBQ Space in the Flats. To Become High 5, a Clubby Sports Bar Want Expanded Amtrak Service in Cleveland? 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    Suppositories. Pellets are placed inside the penis. You may hear this procedure called MUSE (medicated urethral system for erections). This may be less successful than injections.

    Sotile, W. M. (1979) The penile prosthesis: a review. Journal of Sexual and Marital Therapy, 5, 90–102.CrossRefGoogle ScholarPubMed
    The severity of ED has been correlated with the extent of CVD. Banks et al reported that the risk of future CV events increased progressively according to ED severity.28 This was shown in both men with and without known CVD at baseline and after controlling for confounders. Solomon and colleagues found an inverse correlation between international index of erectile function (IIEF) scores and plaque burden seen on coronary angiography.29 In addition, Yaman et al demonstrated a significant correlation between ED severity on IIEF questionnaires and coronary artery calcification.30

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Medications. You take drugs like sildenafil (Viagra), vardenafil (Levitra, Staxyn) and tadalafil (Cialis, Adcirca) as pills before you have sex. They work by increasing blood flow in your penis. This helps you get an erection once you're sexually excited.

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Various drugs have been found to be capable of stimulating erections when injected into the erectile tissue of the penis (the corpora). No single agent is guaranteed to be effective in all cases. However, Papaverine is widely used and accepted. Another drug which is becoming more widely used is Prostaglandin E1 (also known as Caverject). We recommend Trimix(which is a triple medication therapy including Papaverine, prostaglandin E1 and phenotolamine).

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Vascular causes account for up to 70% of cases of erectile dysfunction.High cholesterol and the buildup of arterial plaque over time cause blood vessels to narrow, lessening the capability of your circulatory system.Risk of heart disease and diabetes also increase with age which can cause or worsen erectile dysfunction.Men’s testosterone levels naturally decline at a rate of 1% a year, starting in a man’s thirties.

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Over the years, the medical management of erectile dysfunction has evolved greatly. For instance, before oral phosphodiesterase inhibitors (PDESi) like Cialis, Standra, Viagra, Levitra and related medications were introduced, doctors could administer one of only two effective treatments for erectile dysfunction: surgical penile revascularization and implantation of a penile prosthesis.

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