In prescribing sildenafil, a doctor considers the age, general health status, and other medication(s) the patient is taking. The usual starting dose for most men is 50 mg, however, the doctor may increase or decrease the dose depending on side effects and effectiveness. The maximum recommended dose is 100 mg every 24 hours. However, many men will need 100 mg of sildenafil for optimal effectiveness, and some doctors are recommending 100 mg as the starting dose.
Dr. Honig is an internationally recognized speaker on issues related to sexual health and conducts research into experimental treatments of erectile dysfunction. Our researchers are studying the links between erectile dysfunction and cardiovascular disease. .
The problem does not go away with lifestyle changesThe problem begins after an injury or prostate surgeryYou have other symptoms, such as low back pain, abdominal pain, or a change in urination
Advanced ageCardiovascular diseaseHypertensionDiabetes mellitusHigh cholesterolCigarette smokingRecreational drug useDepression or other psychiatric disordersPelvic surgery, including radical prostatectomy and colorectal surgeryPelvic radiation, such as for prostate cancer and some colorectal cancersTrauma to the pelvis (pelvic fracture), penis (penile fracture), and perineum
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Diet rich in vitamins and minerals is essential. Also, you must cut down on junk, caffeine, alcohol, and cigarettes.
Gerbild agrees, but stands by the recommendation as a goal for people looking to improve erectile function.
A number of medical treatment options exist for erectile dysfunction include the following:
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ED can be stressful for men and their partners, and depression can develop from relationship conflict. The man with ED might worry that he is not meeting his partner’s needs and feel that he is inadequate or less masculine. His partner might worry about being attractive enough or suspect that the man is having an affair. If these feelings aren’t brought out into the open, the situation can worsen, with both partners withdrawing, avoiding each other, or missing the intimacy that they once shared.
Your doctor will ask you to describe the firmness and duration of your morning erections and sexually stimulated ones. The doctor will also ask if you have problems with arousal, ejaculation, and orgasm.
Your doctor will take a medical history to understand your general state of health. As part of the medical history your doctor will ask about any other conditions you may have. If you take any medication If you smoke When and how much you drink If you drink much coffee or alcohol If you use recreational drugs on a regular basis If you ever had pelvic surgery If you have any heart and/or vascular problems If you have hormonal disorders If you have any psychological problems
Nebivolol seems to have an advantage over other beta-blockers when used to treat men with hypertension and ED. It has additional vasodilating effects because it stimulates endothelial release of nitric oxide (NO), resulting in relaxation of smooth muscle in the corpus cavernosum, allowing penile erection.25 Despite limited studies, nebivolol does not seem to worsen erectile function and some studies have demonstrated significant improvement in erectile function with nebivolol compared with second-generation cardioselective beta-blockers.23,26–28
When the aforementioned strategies prove insufficient to address ED symptoms, medical therapies are warranted. The simplest treatments include use of a class of oral medications known as phosphodiesterase type 5 inhibitors (PDE5I, e.g. sildenafil, tadalafil, vardenafil, and avanafil). These drugs enhance the effects of nitric oxide, a natural molecule within the body that relaxes the smooth muscle of the penis, to enable increased blood to flow and result in erection. These medications are generally very safe and reliable. Men who use nitrates (found in certain heart medications and in some recreational drugs) should not use PDE5I. Optimal use of PDE5I requires advice on timing and proper use of these drugs for maximal effect.
Given that ED isn't openly spoken about, it can feel like an isolating experience but it doesn't have to be. There are simple and effective ways to treat erectile dysfunction (that's where Pilot comes in!) that will help ensure that your sex life, and in turn, you, are happy and healthy.
Since the arteries in the penis are very small, often ED is one of the first signs of damage resulting from other medical conditions like diabetes and heart disease.
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