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can you order cialis online for canada buy cialis online The common PDE5 drugs approved in the United States are sildenafil (Viagra), vardenafil (Levitra), or tadalafil (Cialis). Actual head-to-head trials between these drugs have not been done to date to see which is the superior drug. Details on each of these medications for erectile dysfunction are outlined below. viagra online fedex delivery buy viagra online Cigarette smoking: Cigarette smoking aggravates atherosclerosis and thereby increases the risk for erectile dysfunction. Viagra buy now Erectile Dysfunction Basics: Erectile dysfunction, commonly referred to as ED, is the inability to achieve and sustain an erection suitable for sexual intercourse. This condition is not necessarily considered normal at any age and is different from other problems that interfere with sexual intercourse, such as lack of sexual desire and problems with ejaculation and orgasm. Diabetes mellitus: Erectile dysfunction tends to develop 10-15 years earlier in diabetic men than among nondiabetic men. In a population study of men with type I diabetes for more than 10 years, erectile dysfunction was reported by 55% of men 50-60 years of age. The increased risk of erectile dysfunction among men with diabetes mellitus may be due to the earlier onset and greater severity of atherosclerosis that narrows the arteries and thereby reduces the delivery of blood to the penis. When insufficient blood is delivered to the penis, it is not possible to achieve an erection. Diabetes mellitus also causes erectile dysfunction by damaging both sensory and autonomic nerves, a condition called diabetic neuropathy. Smoking cigarettes, obesity, poor control of blood glucose levels, and having diabetes mellitus for a long time further increase the risk of erectile dysfunction in diabetes. In addition to atherosclerosis and/or neuropathy causing ED in diabetes, many men with diabetes also develop a myopathy (muscle disease) as their cause of ED in which the compliance of the muscles in the corpora cavernosa is decreased, and clinically this presents as an inability to maintain the erection. 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. generic viagra online united states viagra online Erectile Dysfunction: Is A New Treatment On The Way? Nitric oxide. The chemical doesn't sound particularly sexy, but it plays a singular role in triggering male erections, a fact that's been known for 20 years. But figuring out how to treat erectile dysfunction and help men maintain erections has been far trickier to nail down. This section needs additional citations for verification. (May 2010)
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