Advantages

• Having satisfying sex should not be denied to older men. Viagra has been shown to help problems with ED in this group. Mild to moderate side effects seem to be similar in older and younger age groups, and your GP will be able to discuss these with you.

• Ability to penetrate partners is significantly increased from a few times to most times for patients receiving 100 mg Viagra.

• Ability to maintain an erection after you have penetrated your partner should significantly increase.

• Viagra restores erections to a level almost that of men without ED, but it doesn't have any effect on sexual desire. So, although Viagra will help you to gain an erection with sexual stimulation, it may not have any effect on sexual desire (libido) if other things, such as relationship problems, are affecting that desire.

• Studies have shown that about 85% of attempts at sexual intercourse are successful following Viagra.

• The effect of Viagra does not appear to wear off the more you use it.

• Viagra can significantly improve the erectile response in patients with ED of no known physical cause. One study showed improvement in nearly 90% of men.

• When men's partners were questioned on partner satisfaction, it seems that Viagra significantly improves satisfaction with their sex life.

• Viagra has been on the market for some years now. So far it has shown a good safety record. Only 1 % of men have discontinued taking Viagra because of side effects (see Viagra side effects).

• If you are trying for a baby, there has been no suggestion in any of the extensive studies on Viagra that it does any harm either to a man's partner, or to a resultant pregnancy, or to the baby.

 

Disadvantages

• It must not be taken by people taking nitrates.

• If you have had liver failure, eye disorders and certain other illnesses, you must discuss the suitability of Viagra for you.

• Its effects are slower than the injected type of drugs.

How can take Viagra, how to buy Sildenafil (Viagra) online?

 

 

Sildenafil (Viagra)

Viagra was a major breakthrough for patients and doctors living with and managing erectile dysfunction, but it does not suit or help everyone with erection problems. When there is sexual stimulation, be that by touch, or sight, or smell, or whatever turns a man on, this is perceived by a certain area in the brain and then a cascade of chemical 'messengers' is sent out, which leads to the blood vessels supplying the penis opening up. One of these messengers is called 'cyclic GMP', and it is broken down by an enzyme called 'phosphodiesterase'. The medications such as Viagra, Levitra or Cialis work by blocking this phosphodiesterase and thus leading to an increased period where the blood vessels will be dilated. The way the drug works is very important for men regarding how it is used. It is only effective when there is sexual stimulation! The drug will not be successful if there is no stimulation, i.e. a man takes the medication and then awaits an erection before attempting any sort of sexual contact Many men claim that Viagra has failed for them because they have either taken it at too lower a dose, or not often enough, or they have taken it without any sexual stimulation.

At present Viagra is taken orally (by mouth) and, because of the relatively slow digestive process, it may be an hour or two before the drug produces its effects - certainly an issue in planning for sex. It affects not just the penis, but potentially could affect other parts of the body. As with most drugs, not everyone will benefit, although Viagra has been found to produce firmer, more frequent and longer lasting erections in the majority of men who have taken it Doses are 25,50 and 100 mg, taken 1 hour before sexual foreplay, and its effect lasts for 2-3 hours. Oral therapy is now prescribed in over 90% people with ED, and studies are showing that 70% of these achieve satisfaction. In one study of couples, where 87% of the men rated Viagra as 'somewhat satisfactory to very satisfactory', nearly 30% of their partners considered the treatment 'unsatisfactory', mostly because of their own lack of sexual interest

We get many questions about this drug. Some of its attributes are listed in the box.

All the junk email I get on my email account tells me that I can buy stuff from the USA that will work straight away. Is there an immediate-acting tablet?

At present, no there is not. Tablets that are taken under the tongue, or potentially in the future by nasal spray, will get into the bloodstream and act faster than tablets that are taken by mouth and swallowed, which need to be absorbed into your bloodstream to work.

All of the tablets that are presently licensed and indeed will be licensed in the near future require you to be sexually stimulated to work. The gap phase between taking a tablet and an erection developing would therefore be valuable for you and your partner to engage in the sort of foreplay that makes you both ready to enjoy making love.

Viagra sounds the perfect solution to my problems, which have affected my relationship with my new partner. How often can I use Viagra?

The recommended frequency of taking tablets is not more than once every 24 hours. There is no restriction on how many times a week you could use Viagra, but if you are getting it on the NHS, most GPs will limit their prescribing to one tablet per week as this is the recommendation in Schedule 11. You might find that, after using Viagra successfully to help you get an erection, your erections can also be better the following day. This could be a direct effect of the drug, but could also be due to the tissues in your penis being enlivened by getting a good supply of oxygenated blood in them.

I like to go out to dinner with my wife on Friday nights and have a Chinese meal. Can I take Viagra after a large meal? Would this be safe or sensible?

Taking Viagra after a large meal will slow the absorption of Viagra. What this means is that you may find that the Viagra does not work at all for you, or that it works much slower than it would have done had you taken it on an empty stomach, or after a light meal. In other words, it is safe in that it will have no harmful effects, but it is not sensible!

I am keen to get my love life as good as it was before we had kids, but do not want to go mad, as I have a demanding job. What dose of Viagra will I need?

The effect of Viagra does seem to improve the higher the dosage taken. The maximum dose is 100 mg. You might find that the dose of Viagra you need is dependent on other factors present at the time of intercourse, such as tiredness and stress. If you are unhappy with the first dose you are prescribed, visit your doctor again to discuss whether you could try a higher one.

I have seen the effect of Viagra on my husband, but do not feel stimulated myself. Could I try one of his Viagra tablets. Could women benefit from Viagra as well?

During foreplay and intercourse there are some very similar processes happening in women to those in men, so in theory Viagra could help to enhance sexual response, but so far there have been few studies of women while taking the drug. Women might feel that this shows a very particular gender bias in the testing of such drugs, but at the moment it is not licensed for women!

Viagra appears to improve the blood supply to the whole genital area. With sexual stimulation, this will lead to blood flowing into your clitoris and vulva and potentially make your vagina more slippery (better lubricated). This allows some women to enjoy sexual activity more; however, the majority of women with desire or libido problems don't appear to be helped. Further research in this area is going on and new results become available all the time. If you are interested in the treatment of Viagra in women, discuss this with your doctor or nurse.

There have been other reports of successful pregnancies in women taking Viagra, who were previously unable to have babies. Viagra may cause the lining of the womb to thicken from better nourishment from the bloodstream.

I am not well off, but should like to try Viagra to see if it will help our relationship. Will I have to pay for a private prescription?

Yes, if you don't conform to Schedule 11. A private prescription means that you will have to pay for the cost of the drug, plus whatever sort of percentage increase the pharmacy will put on the medication. Prices charged by retail pharmacies can vary greatly and it would be worthwhile asking your doctor if they know where the cheapest pharmacy is, or ringing round yourself, including the big retail chains. The prescription from the doctor won't cost you anything - the cost for the chemist lies in getting the drug privately rather than on the NHS.

I have a spinal cord injury and I am experiencing difficulty in achieving and maintaining an erection because of the effects of my injury. Will Viagra help improve my erections?

Viagra has been reported as being well tolerated and is effective in 45-60% of men suffering from spinal cord injury (SCI). As long as you are not taking any nitrates, there is no reason why you cannot take Viagra, but discuss treatment options with your GP. The side effects of taking Viagra are the same as for men who don't have a SCI (see section below). You may find that the results from Viagra are not as good as other treatments, such as injection therapy, for improving your erections, but this will dependant on your SCI.

Since having a spinal cord injury, I have had poor erections and Viagra didn't help improve them. Are there any other medications that will help?

Don't despair - there are other drugs available to treat ED such as Cialis, Levitra, Uprima (discussed in the following sections), MUSE, injections and vacuum therapy devices.

I had a car accident, which damaged my back and I'm now in a wheelchair. Could Viagra help me?

Yes. There have been a few studies of Viagra in people with nerve damage. In people with spinal cord injury, the majority had improved erections and preferred Viagra to 'placebo' (where there was no active-ingredient tablet taken). In a study of people with MS, Viagra improved the erection and side effects were mild to moderate. They felt that sex life was considerably better. So, yes, in your case, you should try consulting your GP, who may well prescribe it for you, and see if it improves your sex life.

I am 25 and have MS. I've read in the MS magazine about Viagra for men's impotence recently. Could that help me sexually?

There has been an enormous amount of publicity about Viagra in recent months, and the ways in which it may transform men's sex lives. Fortunately for many men with erection problems, caused by nervous system damage in MS, it may indeed offer some help.

Essentially Viagra acts on blood supply problems in MS and other similar conditions, by helping the penis to fill with blood. Even where nervous system damage is substantial and where erections are very difficult to obtain and sustain, Viagra might be able to help. As many men with MS are younger than those in which side effects with Viagra have happened, there should be fewer problems amongst your age group.

Note that, because of the cost of the drug, and the anticipated large demand for it, the Department of Health has been extremely circumspect about those for whom it can be prescribed via the NHS (see question in Chapter 5 on Schedule 11). However, MS is now one of the designated medical conditions - but there may still be local variations in supply, in addition to clinical reasons for its non-prescription.

Always get advice from your doctor and do not buy it on the internet. Viagra is a very safe and effective treatment, provided that you are guided medically - do not experiment without a medical opinion.

I had heart by-pass surgery 18 months ago. Can I take Viagra?

If this operation was successful and you now have no chest pain, then there is no reason for you not to be having sex, or be treated for any sexual dysfunction. If, however, you are still having chest pain, particularly at rest, then this needs to be sorted out before you embark on any physical activity, including having sex. If you are taking nitrates, you must not take Viagra.

Can I take Viagra? I had a stroke a year ago and worry that I might have another, which is not good for my self-confidence with my girlfriend.

The answer to this question is yes, in the vast majority of cases. Strokes can be either due to bleeding into the brain or to the brain not getting enough blood flow because of a blockage in the arteries. Viagra will open up the arteries flowing to the brain, and this results in some men getting a mild headache and a feeling of fullness in the head, following a Viagra tablet You will need to discuss the safety issue with your GP, but there is no reason why you should not try having sex again after having had a stroke.

I am on tablets for my depression. Could Viagra actually help my depression as well as my sex life?

Depression and sexual dysfunction can be very much a 'chicken and egg' situation because some ED problems could actually cause anxiety and depression, but, in long-standing depression, Viagra is successful in helping people have intercourse. We have discussed psychological problems in Chapter 2.

There is increasing evidence that men who are on anti-depressive treatment, when treated with Viagra, can, in some cases, decrease the amount of antidepressant therapy that they are taking.

If you are on medication called SSRIs (selective serotonin reuptake inhibitors), you should get better erections with Viagra.

I have had diabetes for the past 15 years (I'm 39) and rind it very difficult to make love to my wife nowadays because I cant sustain an erection. Would Viagra help me?

It could well do. In one study, Viagra helped over 50% of men with diabetes and ED. The effects did not seem to be affected by age, or how long they had had ED or diabetes. Although the response to Viagra was somewhat less than that seen in other groups, people with diabetes do often have many other problems, such as vascular disease or diabetic neuropathy.

The majority of side effects (see next section) seen with Viagra (e.g. headache, feeling of acidity, congestion in your nose) are not severe and don't last long, so these should not prevent you from trying Viagra.

I have had a kidney transplant and am on medication. Can I take Viagra?

Yes you can. There is no reason why the drugs normally taken after a transplant operation will interact with Viagra. (The only drug that you cannot take with Viagra is the class of drugs called nitrates, which are given to people for their heart pain.)

I had cancer some months ago, which left me rather incapacitated -1 now have trouble having sex with my partner. Would Viagra help me?

You do not say what your disability is, but there are various choices open to you. Tablets would still be your first choice: Viagra, Levitra or Cialis, or Uprima (see the following main sections), depending on what medication you are currently taking. However, you could also try other treatments such as injections, MUSE or a vacuum device (see Chapters 8 and 9), if drugs like Viagra do not work for you.

I've had an operation on my prostate and other treatment for cancer. My doctor was very negative about me having Viagra. Was he right to be so?

We know that men who have undergone surgery or radiotherapy for prostate cancer have taken Viagra successfully. Although the best response was seen in men with less severe ED, over half with complete ED were pleased with the effect Viagra had. So you doctor may well be over-pessimistic about it.

 

Side effects of Viagra

I have been prescribed Viagra but I am nervous about taking it as I don't like pills. What are the side effects?

When Viagra was first released there were several sensationalist newspaper headlines about men dying after taking the medication. These headlines have given many people the impression that Viagra is potentially a dangerous medication. This is not true. As men get older their blood vessels narrow and become hardened and inflexible (atherosclerotic). This is the reason that older men (and women) suffer from cardiovascular disease, which leads to, amongst other problems, heart attacks and strokes. It is the same disease process that stops the blood flowing into the penis, and it is therefore logical that people who are having problems with their erections because of this decreased blood flow might also have decreased blood flow to both their hearts and their brains.

In very extensive studies, both before and after Viagra had been launched ('licensed'), there was no suggestion of Viagra causing death. The one exception to this statement is that simultaneous taking of nitrates, which are drugs taken to stop angina (heart pain), or taken close to the time when Viagra is taken, can be extremely dangerous. This is because the Viagra and the nitrates work in the same way, i.e. by opening up the blood vessels. If taken together, the blood vessels can open too much causing the blood pressure to fall dangerously - in some cases this has led to serious problems, including death. However, if we exclude those people who have taken this combination of drugs, there is no sign of any increase in serious problems in people taking Viagra. Indeed, studies in Britain suggest that there may be fewer serious cardiovascular problems in people taking Viagra, compared with those men who are not taking the medication.

The danger therefore for men taking Viagra, as long they are not taking nitrates as well, is not to do with the drug itself, but with the level of energy expended in sexual activity. This level of energy expenditure is about the same as doing light housework, or walking 1 mile in 20 minutes on the level.

 

My older brother (I'm 59) had a heart attack recently and I'm worried that, if I take Viagra, I could be in danger too - at the moment I take water tablets for my high blood pressure.

Men who are having treatment for heart conditions, such as nitrates, run the risk of a dangerous further drop in blood pressure if they take Viagra. Older men, perhaps with an underlying undiagnosed cardiac problem, who may not have undertaken any exercise for several years, could find themselves in difficulty with vigorous sexual activity, so it is important that you discuss things fully with your doctor.

People with heart problems, including coronary heart disease, may benefit from Viagra because heart disease, rather than the drugs used to treat it, is the most common cause of ED.

Viagra does not cause heart attacks, any more than might occur by chance. Before trying it, have a check-up at the doctor's.

 

My doctor has given me a small pill to put under my tongue if I get breathless and my chest starts to hurt. I'd like to try Viagra. Is there a problem taking both tablets?

Yes, Viagra reacts with nitrates. You have been given nitrates and you most not take Viagra at the same time. There are alternative forms of therapy for ED, such as the new oral tablet Uprima (see below), injections into the penis, or MUSE.

Alternatively, you can talk to your doctor about changing to different treatments. Nitrates are for relatively weak angina (chest pain), and have no proven benefit in preventing heart attacks or sudden death. They are used only to help relieve pain and breathlessness. Heart specialists estimate that up to 90% of patients using nitrate therapy could be treated with other drugs, for example felodipine or amlodipine. Once the change has proved successful (2 weeks should be enough time), you can then try Viagra.

The American Heart Association suggests that it is unsafe to take a nitrate within 24 hours of a Viagra dose. You will be advised, if you are taking Viagra, that you should not keep nitrates in the house, to avoid accidentally taking both of these drugs together. If you do take Viagra and have sex, and then experience chest pain, you should stop the sexual activity and either sit or stand while the symptoms ease. If your chest pain does not ease with this rest, then get medical help immediately.

 

I am 74 years old and still very active. For the last 5 years I have been prescribed various medications for high blood pressure and cholesterol levels, and also for the mild angina from which I occasionally suffer: simvastatin (Zocor) or atorvastatin (Lipitor) for cholesterol, nicorandil (Ikorel) for angina, felodipine (Plendil) and perindopril (Goversyl) for blood pressure, plus baby aspirins. At the same time as starting these drugs I have suffered from ED, although a number of doctors have said that the treatment I am receiving should not have that effect. When I ask if I can take Viagra, I am told by more than one member of the cardiac department in our local hospital that they do not recommend it for anyone with a heart condition such as mine, the reason being, apparently, that they believe Viagra can constrict the blood vessels to the heart and bring on a heart attack. I appreciate that Viagra should not be taken as well as a nitrate medication and would naturally avoid this, but I have never read that it should be banned to everyone with a common heart condition. It would seem to be just a policy decision by our local cardiologist. What do you think?

If you are not on nitrates, and are a fit active man, then there is no reason why you can't take Viagra. There is an oral therapy, Uprima (see next section), which is suitable for men who are taking nitrates. It is similar in one respect to Viagra, i.e. it needs sexual stimulation to work. It is a tablet that is placed underneath the tongue to dissolve and then takes about 20 minutes to work.

As with all treatments it is not a 100% success, but there are other treatment choices. Talk to your doctor about other forms of treatment for ED. Vacuum therapy devices, injections and MUSE are all suitable alternatives for you.

A friend of mine had a heart attack after taking Viagra - it seems dangerous to me. Are the media reports wrong?

There is no increased risk of a heart attack from Viagra - in fact there were fewer cases of heart attack when Viagra was compared with a placebo (this is where people are given a tablet with no active ingredients in it, but they feel that it has had an effect - a 'placebo effect’)- Newspapers like headlines. The many millions of people who have taken Viagra safely seem to disprove this unfounded fear.

 

I'm really terrified of these chest pains that I sometimes get. It really puts me off taking Viagra.

Do not use a nitrate tablet or spray at the same time as Viagra. Stop your activity and sit or stand up. The pain should gradually settle. A glass of whisky or brandy might be helpful. Do not try to have sex again until you have discussed what happened with your doctor. There are other options available to you that your GP can tell you about.

 

I am in my late 60s and had a mild heart attack about 7 years ago. My doctor prescribed atenolol and atorvas­tatin (Lipitor). I started to have ED about 2 years ago. The doctor changed my tablets from atenolol to what he called an ACE inhibitor but I am still having problems. Injections have not helped. I gather Viagra should not be used. Are there alternatives?

This is a very interesting question which raises several important issues. As has been stressed repeatedly in this book, erections are all about getting blood in to the penis. In this case, the same disease process that has blocked the arteries supplying your heart and caused your heart attack has blocked the arteries supplying the blood to the penis. Many people associate their treatment for high blood pressure with ED. The GP in this case was quite correct in changing the medication, as the older drugs, such as thiazide diuretics and beta blockers, are associated with a higher incidence of ED than the newer ones, such as ACE inhibitors and calcium channel blockers. Also, the only reason not to take Viagra is if you are taking nitrates, either in long-acting form or in the form of tablets that go under your tongue to relieve angina. This is because nitrates plus the Viagra (or the newer drugs, Levitra and Cialis, which are similar to Viagra - see the next section), if taken together, can cause your blood pressure to drop very significantly and hence be very dangerous. In your case, you are taking a lipid-lowering agent and an ACE inhibitor, so there is no reason why Viagra should not be used.

If Viagra is not successful, taking apomorphine under the tongue can be tried.

Although you say that the injections have not worked, it would be worthwhile reconsidering how the injections were used and what dose was given, as most people will respond to injection therapy if the correct dose is administered correctly.

 

Would taking Valium before using Viagra interfere with Viagra's effects?

The effect of Valium is to calm the nervous system in the body and to make people feel less apprehensive. There is no reason that taking Valium should stop Viagra working. However, regarding your sexual performance, Valium and other drugs used to decrease anxiety can slow down the time taken to ejaculate. Indeed these drugs are used to treat people who have rapid ejaculation. So if you take a normal time to ejaculate and are taking these drugs, you may find that you are slower to ejaculate, or even find it impossible to ejaculate. This does not happen in most men and, if it does happen to you, then you need to discuss it with your GP - do not stop taking your Valium without discussing the problem first

Viagra, we all are very much aware of the pleasures this medication provide for those facing extreme failures in attaining erection that is required for the act of making love. The medication secured popularity as blue pills worldwide, and the effects of the drug are simply sensational. Various forms of the molecular formula is available that works for the betterment of the couples by bringing back the lost rejuvenation.

Sildenafil Citrate also sold as Viagra is considered to be the advanced oral therapy for the treatment of the erectile dysfunction. The reason behind the name of the Sildenafil Citrate is that Viagra is considered to be the citrate salt of t he Sildenafil which is considered to be the selective inhibitor of the cGMP. That is why most of the physicians recommend buying Sildenafil Citrate over Viagra. To buy Sildenafil Citrate is also not a small deal. You have to check the composition of the tablets so that it can be used in the treatment of ED in an effective manner. There is also cheap Sildenafil Citrate available in the market. But it is recommended to check the whole composition before consuming these cheap tablets also. The best thing about the Sildenafil Citrate is that it can show the results just in 30 minutes, and that too depends upon the dosage. Some of the advantages are: 1.It helps the men who are suffering from ED to have the erection in harder manner. Not only this, it also helps in the long time erections during the intercourse of the sexual activity 2.The best thing about the Sildenafil Citrate is that it has got the proven record for satisfaction and safety. It not only works for the people who are suffering from ED but also help those people who are suffering from large health related problems. There are some precautions also which have to be taken before starting the consumption of the Sildenafil Citrate. Some of the precautions are: 1.If you are already consuming the Sildenafil Citrate, then don't try to consume the Sildenafil Citrate because if done so then your blood pressure can be dropped down. 2.If a person is already suffering from the problem of high or low blood pressure, kidney problems or the heart disease then he must be cautious while consuming Sildenafil Citrate tablets. Caverta is the product of the Ranbaxy of Sildenafil Citrate which is very much helpful in the treatment of the impotence nowadays. This product can also be very much effective and an alternate of Viagra.

As with all forms of alternative therapies, the Tongkat Ali extract has more than its fair share of rumors, misrepresentations and misconceptions. Let's see if we can square away some of the myths about Tongkat Ali extract.






All Tongkat Ali products are not created equally. Tongkat Ali extract is the strongest of all herbal remedies derived from the Eurycoma Longifolia tree grown in Southeast Asia. Other diluted products come in varying strengths. Tongkat Ali extract 200/1 is the most powerful all-natural builder of increased testosterone levels.

The economy is in its worst shape in over 60 years. At this difficult time, does your company have the energy and drive it needs to compete successfully? Some indications that your company needs a strong dose of "Viagra" include:

Anyone who has used Viagra knows that the medication is expensive; however, for some men it is necessary in order for them to have a normal sexual relationship with their spouse or partner. Since most insurance companies do not cover this medication, cost becomes an issue of great concern. Sometimes it can be a difficult decision to make, especially when weighing the purchase of Viagra against being able to pay other bills, and for those on a fixed income, this can be difficult. After all, simply because one is retired does not mean they no longer want to have a sexual relationship. They have retired from work, not from life.

Since the introduction of Viagra, the options to treat erectile dysfunction have increased; these medications help men get erection. Once erectile dysfunction was thought to be a result of psychological factors only, but today advancement has made it clear that a variety of medical conditions such as diabetes and high blood pressure can also cause this condition. Erectile dysfunction, in actual fact may be the initial presenting symptom for some serious illness such as atherosclerosis or diabetes.

Men all over the world face some or the other sexual problems, at least once in their life time. Usually these sexual problem are temporary in nature, but at times it is possible that because of some or the reason, you suffer from the problem for a prolonged period of time. Some of the sexual problems include erectile dysfunction or impotence, ejaculation problems and problems related to sex drive or libido. These sexual problems can often create problems and hindrances in their day to day life. Men often start drifting away from their sex life, which can also result in a divorce. When a man starts drifting away from his sex life or avoids any sexual encounters with his partner, it also affects the partner's self confidence. This can ultimately lead to conflicts between the partners or at times even a divorce.