Men
Erectile Dysfunction
Erectile dysfunction (ED) is an extremely common problem that affects men and intersex individuals of any age. People with this condition are unable to reach or maintain an erection to take part in sexual activity. ED affects up to 22% of American men, mostly in older age groups. Once considered primarily a psychological disorder, it is now clear that most cases of ED have a physical cause. The leading causes are chronic conditions that damage blood vessels and nerves vital for normal erectile function; diabetes, atherosclerosis (a condition in which plaque builds up inside your arteries) and hypertension (high blood pressure). The medications used to treat these problems and other ailments can also contribute to ED. Hormonal abnormalities are less common, but they are particularly important to detect since they can be corrected. That's also true of psychological problems, which can cause up to 15% of ED.
For many people with ED, the hardest thing is to admit the problem. Every man or intersex individual, experiences ED from time to time. Although ED is defined as a consistent inability to get and sustain an erection sufficient for sexual intercourse, this definition should not be used to exclude those with occasional or less severe ED from getting treatment. A simple questionnaire can help you determine if you are having ED. Talk to a primary care doctor, urologist, or endocrinologist for advice.
When Viagra first appeared back in 1998 as a drug treatment for ED, it promised an exciting future for many people with the condition. This was of particular importance given the number of men with the condition. The Massachusetts Male Ageing Study (MMAS) demonstrated that 40% of 40-year-old men reported ED, and this figure rose to almost 70% in men aged 70 or older.
Viagra is the brand name for the active ingredient, sildenafil citrate, used for the treatment of ED. It works by relaxing the muscles in the walls of blood vessels which supply the penis. This in turn increases blood flow to the penis, leading to a firmer erection. Sometimes however, it just doesn't work.
As mentioned earlier in this article, there are many causes of ED and therefore, many reasons why Viagra may not work.
Atherosclerosis for example, is a condition where plaque builds up in the walls of the blood vessels or arteries. This can lead to narrowing of the arteries which supply blood to the penis. During an erection, blood needs to flows quickly into the penis to increase its length, width and firmness. If atherosclerosis is advanced, and the blood vessels are too narrow, Viagra may not be strong enough to work its magic.
The problem is that in a significant number of patients, simply swallowing the pill isn't enough to result in a firm erection. This is understandably disappointing for patients and has led to a high drop-out rate. Some studies have found that at least 30% don't even get past their first prescription. This is a mistake, since alternative ED medications, dose adjustment and lifestyle changes, can lead to a better effect.
Be sure you give alternative medications a try; but never take more than the approved maximum dosage, and never use Viagra or its generic or non-branded alternatives more than once in a 24-hour period.
The good news is that in 'non-responders', up to 60% can be rescued with the right counselling. This involves advising on a healthy lifestyle to maximize the chances of the drug working, as well as managing expectations.
Here's how to make sure you get the best treatment for your condition:
It’s important to talk to your doctor when you start taking Viagra or other ED medication, and when the medicine doesn’t work for you. Tell them about your expectations for the medication, your results, and any side effects you experience. Your treatment plan isn’t set in stone. Work with your doctor to understand why Viagra is not working, and find the best treatment for you.
Your doctor may start with a simple evaluation of your condition. A careful medical history, including a review of your health habits and medications, is the first step. It's also important to be assessed for diabetes, hypertension, atherosclerosis, and other cardiac risk factors. Many doctors also check blood levels of the male hormone testosterone, which is an important test for patients who experience loss of sexual desire. Your doctor may also want to know if you’re taking Viagra properly.
Men who are recovering from a nerve-sparing procedure involving partial or complete removal of the prostate (prostatectomy), should try an ED pill every month or two after surgery, since sexual function may gradually improve over the 6–18 months following.
Viagra is available in 3 doses of 25 milligram (mg), 50mg and 100mg. The tablet is taken orally, by swallowing it with a drink of water. The effect ofnViagra isn felt approximtely 30-60 minutes after ingestion, and last for about 5-8 hours. The best time to take Viagra is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before. Viagra does need to be timed prior to sexual activity, which may not always work out as planned.
Viagra comes in different doses because the goal of ED medication is to find the lowest dose of medication that still gets positive result. The goal is not to find the highest dose of Viagra you can handle, but to find a dose that is safe and effective, while minimizing side effects.
If you do not achieve an erection with sexual stimulation, you can increase the dosage of your medication the next time sexual activity is planned. Don’t increase the dosage on your own. Get your doctor’s advice first, to make sure that doing so is right for you. Your dose requirements may depend on a variety of factors, inluding:
You should always follow your healthcare practitioner’s dosing instructions, and never take more than one dose of Viagra per day or exceed 100 mg of Viagra in 24 hours.
Once swallowed, the active ingredient (sildenafil citrate) in Viagra takes 30-60 minutes to reach suitable levels and take effect. It can then last up to eight hours. If you're turned off by the need to take a tablet just before sex, you could try other alternatives, such as Cialis (brand name for the active ingredient, tadalafil), which can be taken daily. It can last up to 36 hours, which allows for less planning and more spontaneity.
A romantic dinner won't do you any favours if you're using Viagra or sildenafil. Having a substantial meal in your stomach reduces the absorption of the drug and both weaknens and delays the effect. Also, when your gut is focused on digestion, blood flow is diverted away from the penis.
It is best to take Viagra on an empty stomach, but you should at least avoid a fat-heavy meal before taking it. If you cant resist the temptation of a heavy meal, you should then wait at least 2 hours before taking Viagra, to insure maximum effect. This is because a fatty meal can slow down digestion and prevent the medication from being absorbed properly.
Eat lightly or not at all, to allow Viagra to be absorbed into the body and start working quicker.
Drinking alcohol increases the risk of a bad reaction to Viagra and related medications, and drinking alcohol frequently can lead to lower testosterone levels. and reduces testosterone levels.
Grapefruit juice can also affect how Viagra works. You should avoid consuming grapefruit products while taking Viagra, as they may lead to an increase in the levels of active ingredient (sildenafil citrate), therebye increasing the risk of side effects.
A healthful lifestyle can go a long way toward preventing ED, but can it also help correct the condition in people who are already experiencing it?
According to a study in Italy, it may be that approximately 30% of men who take part in a diet an execise program can correct their ED without medication.
Lifestyle therapy is slower than Viagra, but it produces major gains in reducing cardiovascular disease, preventing heart attacks and strokes, and improving or reversing ED.
Viagra is one of the most effective medications for treating ED. In most cases, it works well and will change people's lives for the better. In some cases, it doesn’t work. There are many reasons why Viagra may not work, and a wide range of options on how to make it work better for you. Talk to your doctor to understand why it doesn’t work and find the best treatment for you.
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