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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.
Failure to achieve an erection less than 20% of the time is not unusual and treatment is rarely needed. Failure to achieve an erection more than 50% of the time, however, generally indicates there is a problem requiring treatment.
"Take better care of yourself. Make sure you're not obese, eat well, exercise, and if you have diabetes or hypertension, make sure they're well-controlled," advised Lipshultz, who added that by addressing lifestyle factors, you may not need medication to treat erectile dysfunction.
MONDAY, Nov. 9 (HealthDay News) -- Researchers were able to restore sexual function to rabbits with damaged penises by growing new penile tissue in the lab and implanting it, a new study reports.
Surgery: Surgery performed to treat diseases such as prostate cancer and bladder cancer often require the removal of nerves and tissues around the affected area which can lead to ED. Some of these surgeries result in only temporary problems (lasting 6-18 months) while others result in permanent damage to the nerves and tissue around the penis and require treatment in order for an erection to be achieved.
Learning an effective means of relaxation and using it regularly is a good first step. Allow yourself some "quiet time," even if it's just a few minutes. Examine and modify your thinking, particularly unrealistic expectations. Talking problems out with a friend or family member can help put things in proper perspective. Seeking professional assistance can help you gain a new perspective on how to manage some of the more difficult forms of stress. Other approaches to reducing stress include:
Treatments include psychotherapy, drug therapy, vacuum devices, and surgery.
If, in fact, your man retreats even further, then he may be experiencing depression -- another possible cause for his ED. If this is the case, experts say don't let it throw you.
One of the most common tests used to evaluate penile function is the direct injection of PGE1 into the corpora. If the penile vasculature is normal or at least adequate, an erection should develop within several minutes. The patient and the clinician can judge the quality of the erection. If successful, this test also establishes penile injections as one possible therapy.
Penile erection is mainly mediated by the parasympathetic nervous system, which when stimulated causes arterial dilation and relaxation of the cavernosal smooth muscle. The increased blood flow into the corpora cavernosa in association with reduced venous outflow results in penile rigidity.
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Related Health News By Randy Dotinga
As a partner of a man with ED, you are also affected. Here are some tips to help you better deal with the situation.
How often do you feel stressed?
Review your medications with your doctor and ask about possible substitutions for those that may cause ED (never stop or change a medication without first talking to your doctor).
All 3 of the PDE-5 inhibitors are metabolized by the cytochrome P-450 3A4 enzyme. Sildenafil and vardenafil share similar pharmacokinetic properties (Table 2). Both have been shown in clinical trials to improve the ability to attain and maintain erections when taken 1 hour before sexual activity (Table 3). Since sildenafil was introduced, extensive clinical experience has been gained with prescriptions of it to more than 20 million patients. Vardenafil has distinguished itself by demonstrating efficacy in patients who have previously undergone radical prostatectomy for localized prostate cancer (a group that had been difficult to treat because of nerve and vascular injury secondary to surgery) and in patients with diabetes.34,35
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