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Is the patient suffering from erectile dysfunction or from loss of libido or a disorder of ejaculation (for example, premature ejaculation)? A diagnosis of erectile dysfunction is made in men who have repeated inability to achieve and/or maintain an erection for satisfactory sexual performance for at least three months. Candid communication between the patient and the doctor is important in establishing the diagnosis of erectile dysfunction, assessing its severity, and determining the cause. During patient interviews, doctors try to answer the following questions: kamagra online review buy kamagra online
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Cialis online canada Metabolism (breakdown) of sildenafil is slowed by aging, liver and kidney dysfunction, and concurrent use of certain medications (such as erythromycin -- an antibiotic, and protease inhibitors, for HIV). Slowed breakdown allows sildenafil to accumulate in the body and potentially may increase the risk of side effects. Therefore in men over 65, in men with substantial kidney and liver disease, and in men who also are taking protease inhibitors, the doctor will initiate sildenafil at a lower dose (25 mg) to avoid accumulation of sildenafil in the body. A protease inhibitor ritonavir (Norvir) is especially potent in increasing the accumulation of sildenafil, thus men who are taking Norvir should not take sildenafil doses higher than 25 mg and at a frequency of no greater than once in 48 hours. Quitting smoking, exercising regularly, losing excess weight, curtailing excessive alcohol consumption, controlling hypertension, and optimizing blood glucose levels in patients with diabetes are not only important for maintaining good health but also may improve or even prevent erectile function. Some studies suggest that men who have made lifestyle improvements experience increased rates of success with oral medications. Mental heath (psychological) causes - Various mental health conditions may cause you to develop ED. For example: Stress. For example, due to a difficult work or home situation. Anxiety. Relationship difficulties. Depression. Sildenafil should be used cautiously in men on alpha blockers such as doxazosin (Cardura), terazosin (Hytrin), and tamsulosin (Flomax). There have been occasional reports of low blood pressure in men who have taken the two classes of drugs simultaneously and therefore it is recommended that there be at least a span of four to six hours between the ingestion of sildenafil and alpha blockers. viagra online new zealand buy viagra online
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Can Sexual Problems Be Prevented? While sexual problems cannot be prevented, dealing with the underlying causes of the dysfunction can help you better understand and cope with the problem when it occurs. There are some things you can do to help maintain good sexual function: Follow your doctor's treatment plan for any medical/health conditions. Limit your alcohol intake. Quit smoking. Deal with any emotional or psychological issues such as stress, depression, and anxiety. Get treatment as needed. Increase communication with your partner.