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Keep in mind that these medications are amplifiers, not magic pills; you must have sexual stimulation for them to work. These pills also typically do not work the first few times. Here are instructions for how to properly take Viagra, Levitra, or Cialis: Take your medication one hour before sexual activity. Take the pills prior to a meal or after a light snack, especially for Viagra. They do not absorb well if you have a full stomach.

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Life-changing problems or even everyday stress can trigger erectile dysfunction. Talking about these things with a licensed therapist can ease sexual anxiety and help you feel more confident in your relationship.
Urologists are the doctors that can examine, diagnose and treat your erectile dysfunction (ED). .

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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
More than two drinks a day is considered a risk factor for ED. Alcohol can lower testosterone levels, decrease flowing blood to the penis, and cause nerve and hormonal imbalances. Low testosterone from alcohol or drug abuse can also affect your libido and performance, potentially leading to further psychological ED complications.

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ED is a treatable condition and most men are able to return to healthy sexual function.
All drugs have some side effects and these may vary according to the dosage used and the sensitivity of the individual to the substance. Prolonged Erection (Priapism) An erection lasting for more than 4 hours has occurred in some cases following penile injection. Sometimes this is due to people injecting themselves with excessive doses of the drug. Occasionally it can happen at the first injection because of the persons sensitivity to the drug. If this happens it may be necessary for a doctor to give an injection of a different drug to counteract this effect. If the counteracting drug is given within 5-6 hours of the original injection it will usually reverse the effect and no long term harm will result.

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This is a common exercise especially among women. Research has shown that it’s also great for men who want to exercise their pelvic muscle for improved blood flow which helps in holding an erection.

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Hims is a great telemedicine company where, after a free consultation with a doctor, you can access a few different ED treatments proven to be effective: sildenafil (and brand-name Viagra), tadalafil (and brand-name Cialis), and Stendra. As a company, Hims impresses us very much, and there are circumstances in which we recommend Hims above all others for ED treatment providers.

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    Medications may include drugs to manage underlying health conditions such as diabetes, high blood cholesterol, or kidney diseases in addition to medications that specifically target erectile dysfunction. Sildenafil Tadalafil Vardenafil Avanafil Alprostadil (injectable drug or a suppository)

    Side effects of intraurethral alprostadil include pain in the penis and sometimes in the testicles, mild urethral bleeding, dizziness, and vaginal itching in the sex partner. Patients rarely report syncopal (fainting) episodes with initial use, and thus the first trial of this medication should be performed in the physician's office.
    National Center for Complementary and Alternative Medicine: "Aromatherapy May Make Good Scents, But Does It Work?"

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    Most people ignore these issues as they think that there is no way that they can treat their sexual problems. And going for any surgery and operation is not an option for them.

    If you are suffering from erectile dysfunction and would like to meet with a U of U Health urologist, call 801-213-2700 to schedule an appointment. You do not need a referral from your primary care provider to see our urologists for treatment because shockwave therapy is not covered by insurance.
    VEDs are noninvasive devices that are available OTC or by prescription. They are used to generate negative pressure, drawing arterial blood into the corpora cavernosa, thereby promoting erection.5,7 Despite being less discreet than other treatment options, they are effective, low-cost, and associated with high rates of satisfaction.6 Use of VEDs can cause transient penile petechiae or bruising, discomfort or pain, and difficulty with ejaculation.6,7 Men receiving anticoagulants are at increased risk of bruising, and therefore, caution should be observed when considering a VED.7

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    For more information, visit www.wolterskluwer.com, follow us on Twitter, Facebook, LinkedIn, and YouTube.

    Your doctor may make suggestions to improve your overall health, including the health of your heart and circulatory system. Increasing your amount of exercise, eating well, and ensuring that you get sufficient vitamins and minerals can help with this overall wellbeing. Another recommendation may be reducing or eliminating your use of drugs, tobacco, or alcohol. Your doctor may also recommend losing weight.
    Physical causes of ED can include; hormonal conditions such as diabetes, hypogonadism and an under or overactive thyroid, which can affect hormone levels adversely; anatomical conditions such as Peyronie's disease(due to scar tissue inside the penis); vascular conditions like high blood pressure, diabetes and cardiovascular disease; and neurogenic conditions (affecting the nervous system) such as Parkinson's disease and multiple sclerosis.

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    Weight loss (calories are burned as a result of increases in lean body mass and basal metabolism)Prevention and management of diabetes (which is associated with ED)3. Pelvic floor exercises (aka Kegels)

    Mayo Foundation for Medical Education and Research. (2021, August 21). Erectile dysfunction. Mayo Clinic. Retrieved October 14, 2021, from https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/diagnosis-treatment/drc-20355782.
    Sildenafil users who started using the drug (Sildenafil) for <6 months before the data collection period.

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Extra weight can make a man more likely to develop diabetes or cardiovascular disease, which are both associated with erectile dysfunction. Also, carrying fat around the middle can affect a man’s hormones, which can contribute to penile dysfunction.

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The information on this web site is provided as a service by IASH for educational purposes only. It is not a substitute for medical care, and medical advice. If you have or suspect you have, a health problem, you should consult sexologist or andrologist.

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However, you do not have to suffer in silence as the vast majority of men with ED can look forward to a return of satisfying sexual activity with the treatments now available and many men have found that they have transformed their lives.

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