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For a long time treatment for impotence was restricted to penis injections, mechanisms that create voids or prostheses implanted through surgery.
Normal erection To understand how the PDE-5 works, you must understand how a normal erection occurs. There are two widely vascularized cylindrical structures inside the penis, called corpora cavernosa. When the corpora cavernosa is filled with blood it takes a signal from the central nervous system, releasing a substance called nitric oxide. PDE-5 chemical structure Not to go into details about complex biological and chemical mechanisms, we can say roughly that the substance responsible for the emission of nitric oxide action, which is responsible for the erection, is called Phosphodiesterase type 5 (PDE-5). Knowing now how erection works and how these drugs act, it is possible to imagine that Viagra or other PDE-5 inhibitors may not have an effect on some patients, especially on those with problems with the nerves and vessels of the penis.
Sildenafil pills Sildenafil, marketed under the name Viagra since 1998, was the first drug in the class of PDE-5 inhibitors to be launched.
Viagra is sold in tablets of 25 mg, 50mg or 100mg, with a dosage ranging from 25mg to 100mg per day, depending on the clinical evaluation. The action of Viagra starts after 30 minutes and lasts for up to four hours, but that does not mean that erection will continue during all this time.
Sildenafil is a vasodilator and although preferably acts on the vessels in the penis, there is also an increase in nitric oxide causing a reduction in systemic blood pressure. Drugs used for prostate hypertrophy, terazosin and doxazosin, also have vasodilator and are also enhanced by the Viagra, which may cause hypotension. Patients with heart failure, Viagra should not be used without explicit medical clearance, as it may cause decompensation of the frame. Some drugs alter the effect of Viagra and its consumption should also be avoided, including: Erythromycin, ketoconazole, cimetidine, itraconazole, rifampicin, phenytoin, indinavir and ritonavir. The most common side effects of sildenafil are headaches and dizziness caused by the effects of systemic vasodilation. There are other effects, which are rare, ant they include visual disturbances such as bluish vision, blurred or increased sensitivity to light. Priapism, which is a prolonged, painful erection, is a very rare event, but may occur after use of Viagra.
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Since late 1990s, however, there has been a simple and convenient treatment for erectile dysfunction, drugs that inhibit Phosphodiesterase type 5 (PDE-5), commercially known as Viagra, Cialis and Levitra.
When sexual stimulation occurs, blood flow to these structures increases, causing increased penis size and consequent compression of the penile veins.
This neurotransmitter relaxes the blood vessels of the cavernous body, helping the entry of blood in it. There are drugs that inhibit PDE-5, which have a more prolonged action of nitric oxide, thus ensuring ease of the blood flow to the corpora cavernosa.
The success rate is around 70%, being higher only for patients with psychological problems and lower for those with poorly controlled diabetes or pelvic nerve damage after prostate surgery. The tablet should ideally be taken on an empty stomach (at least 2 hours after the last meal) and 1 hour before an intercourse.
Sildenafil only helps erection to occur because it increases the lifetime of nitric oxide already produced, not directly affecting its production.
Patients who had a stroke, especially in the last six months, must also be careful with the use of sildenafil.
Erectile improvement with this combination is highly possible but there is still a high risk of toxicity. Every patient with continuous erection for more than four hours should call the emergency because there is risk of ischemia and thrombosis of the penis. As Viagra, it is to be taken an hour before intercourse and preferably away from the last meal. There are no differences between the effectiveness of Cialis, Levitra and Viagra, but the former has some peculiarities: Cialis has a longer effect, which lasts for up to 36 hours, does not seem to cause the rare vision changes as Viagra and Levitra, and can be taken close to meals. Earlier I used Cialis, but now, after re-reading the instruction - I found all my sores in the section of contra-indications. Now we have a new drug Cialis, its main difference is in softer and longer action, such as where "weekend pill", 1.5 - 2 days of action. If you require further details regarding the transaction data, please contact the supplier directly. These are veins that are responsible for returning blood to the rest of the body and therefore, when they are compressed, they are unable to perform its role.


Until there is nitric oxide in the corpora cavernosa, the penis will remain engorged with blood, and therefore, erect, when nitric oxide level falls, the erection ends.
For example, men with low testosterone level cannot produce sufficient amounts of nitric oxide. Sildenafil is not a medicament for everyday use, the minimum interval between two dosages should be at least 24 hours. If there is sexual stimulation, there is no stimulus for the release of nitric oxide and erection, just as it typically occurs. The PDE-5 inhibitors in very high doses (above mentioned) can cause a stroke and a serious hypotension. Priapism is a common side effect when Viagra is used recreationally by young people combined with other drugs such as ecstasy, cocaine and amphetamines.
My husband and I'd like to give birth to the second child, but for the past seven months we were not a success.
So, does the difference between low dose Cialis from ordinary reduce the period or does it reduce the "strength" of the drug?
Symptoms may also include reduced sexual desire or libido.These kinds of issues can happen at any time and to any man. We had taken this picture on the internet we think would be one of the most representative pics for free samples canada. We had taken this image on the net we consider would be one of the most representative pics for connor franta phone number. We took this image on the internet we consider would be one of the most representative photos for abesha fekade bangkok hospital medical center. This leads to blood retention in the corpora cavernosa, maintaining an erection, which is only interrupted when sexual stimulation ends. When there is an orgasm or when the stimulus for the erection ends, the corpora cavernosa and the penis becomes empty and flaccid again. Research has found that some natural options can improve your ED symptoms.What Causes Erectile Dysfunction?A number of factors can increase your risk of ED. A patient with diabetes and diseased vessels may be unable to supply enough blood for the penis to fill, even if there is enough nitric oxide.



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