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Sildenafil has been found to be well tolerated without important side effects. The reported side effects are usually mild and include headache, flushing, nasal congestion, nausea, dyspepsia, (stomach discomfort), diarrhea, and abnormal vision (seeing a bluish hue or brightness). Prostaglandin E1 injection test is sometimes performed to determine the penile blood flow. Prostaglandin is directly injected into the corpora cavernosa in order to cause dilation of blood vessels and promote blood flow into the penis. If erection ensues, it confirms normal or adequate blood flow to the penis. This can also provide information about possible therapeutic options. 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. Cigarette smoking: Cigarette smoking aggravates atherosclerosis and thereby increases the risk for erectile dysfunction. viagra online australia forum viagra online without prescription
Have you considered your other medication? As mentioned, some medicines can cause ED. Check the leaflet that comes with any medication that you take to see if ED is a possible side-effect. Do not stop any prescribed medication, but see your doctor if you suspect this as the cause. A switch to a different medicine may be possible, depending on what the medicine is for. viagra online kaufen österreich viagra online pharmacy
There is a good chance that a medicine will work (about an 8 in 10 chance of it working well). However, they do not work in every case. There are pros and cons for each of the above, and your doctor will advise. For example, you may not be able to take certain tablets for ED if you have certain other medical conditions, or take certain other medicines. For example, you should not take a PDE5 inhibitor if you take nitrate medicines (including glyceryl trinitrate (GTN)) which are often used to treat angina. Also, if you take a certain type of medication, called alpha-blockers, for high blood pressure (doxazosin, indoramin, terazosin or prazosin) you need to wait until you are on a stable dose, as the combination with a PDE5 inhibitor can cause a sudden pressure drop. Cheap viagra online cialis online aus deutschland cialis online without prescription
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Penile erection is managed by two mechanisms: the reflex erection, which is achieved by directly touching the penile shaft, and the psychogenic erection, which is achieved by erotic or emotional stimuli. The former uses the peripheral nerves and the lower parts of the spinal cord, whereas the latter uses the limbic system of the brain. In both conditions, an intact neural system is required for a successful and complete erection. Stimulation of the penile shaft by the nervous system leads to the secretion of nitric oxide (NO), which causes the relaxation of smooth muscles of corpora cavernosa (the main erectile tissue of penis), and subsequently penile erection. Additionally, adequate levels of testosterone (produced by the testes) and an intact pituitary gland are required for the development of a healthy erectile system. As can be understood from the mechanisms of a normal erection, impotence may develop due to hormonal deficiency, disorders of the neural system, lack of adequate penile blood supply or psychological problems. Restriction of blood flow can arise from impaired endothelial function due to the usual causes associated with coronary artery disease, but can also be caused by prolonged exposure to bright light.