Can Viagra Cause Hours-long Erections ?

The facts: While this may sound intriguing theoretically, this condition (known as priapism) can be harmful.

Fortunately, it doesn’t really happen if you’re only taking Viagra.

 

 

“To my knowledge, Viagra has never caused a prolonged erection by itself,” Dr. Montague says. “But, it can happen if you’re also getting penile injection therapy.”

Combining the treatments has a cumulative effect — penile injection therapy makes your erections hard, and adding Viagra makes them harder and even more long-lasting. So, stay on the safe side and don’t pair them, he says.

How do you use Viagra?

Always take Viagra exactly as prescribed to you by your doctor. Viagra is an oral medication taken in pill form as and when the patient wishes to use it. This is typically between 30 minutes to 1 hour before engaging in sexual activity, although it’s possible to take the drug up to four hours in advance.

It’s usual to start taking Viagra with one 50mg tablet. A doctor may prescribe a lower dose for men over 65.

If you find your prescribed dosage isn´t working for you speak to your doctor. Don´t just increase the amount you take on your own as this could cause side effects.

Also, if the tablet you have taken doesn´t seem to be working at all do not take another. This could be dangerous and cause a painful erection that lasts several hours and damages the penis tissue. Speak to your doctor before commencing with further doses.

Your diet and your overall health will affect how Viagra works for you, including how long its effects last. The average length of time it lasts is between 2 and 3 hours. You may achieve more than one erection after taking one Viagra tablet but you will not have a continuous erection. After ejaculation you may or may not get another erection, depending on your metabolism. And you will only achieve more erections with further sexual stimulation.

You can take Viagra with or without food. If you take it after food or a heavy meal it may take longer to work.

There are many common misconceptions about Viagra, or Viagra more generally. In order for the drug to be effective, you will have to engage in normal sexual stimulation, it will not work on its own or sporadically. If you feel relaxed and comfortable the medication is likely to be more effective and act sooner.

If you do not experience erectile dysfunction then it is not advisable to take Viagra. It will not have any effect, it does not increase libido, penis size, or act as an aphrodisiac. This is a common myth. Viagra also won’t cause an erection without stimulation or for prolonged periods of time. It should be used as an aid for treating erectile dysfunction only.

Can Viagra Cause any Negative Long-lasting Effects?

Viagra is for adult men seeking to treat impotence, or erectile dysfunction. ED is the lack of blood flow to the penis, making it impossible to achieve or maintain an erection for long enough to have satisfactory intercourse. ED can happen due to age, a medical condition or it can be psychological.

Erectile dysfunction is often an embarrassing issue for those who suffer from it and can have many negative effects. Erectile problems can lead to stress in relationships, low self-esteem, and a decreased sex drive. Viagra (Sildenafil) can be an effective treatment for erectile dysfunction if taken correctly, as instructed by a doctor.

Often, men suffering from ED have already tried non-medical remedies to treat it, such as changing their diet, increasing exercise and reducing stress before deciding to seek medical treatment such as Viagra. If you have decided that Viagra is the right option for you we advise you to request a prescription through a doctor to ensure you take the right dosage.

Viagra works alongside sexual stimulation to achieve an erection. When a man becomes aroused something called cyclic GMP is released. This causes the blood vessels to relax and expand and more blood to enter the penis. The result of this is an erection. Cyclic GMP is broken down by an enzyme known as PDE5. Viagra (Sildenafil) works to stop this break down occurring and therefore helps maintain the erection.

Maintaining a healthy sex life is important for psychological and physical well-being. Viagra is an aid for men who have insufficient blood flow to the penis and therefore problems having sex.

When using ED pills, you should be aware of potential risks. Keep in mind that the uncontrolled use of sildenafil medication (for example, when using the drug in excessive doses, or more frequently than recommended, or when the drug is combined with other ED medications from Canadian Pharmacy or narcotic substances) can lead to a condition known as priapism.

It’s a long-lasting painful erection that needs medical help. Priapism is a disease named after the mythical ancient Greek god of fertility Priapus, who had a permanent erection. If a man has priapism, his erection has nothing to do with sexual arousal and the penis does not relax even after ejaculation and after a while it becomes painful. This condition can seriously damage the penis as it can cause blood stasis.

If your erection lasts for more than 4 hours and you feel pain, you should contact your doctor immediately.

In rare cases, Viagra can cause negative effects but they are unlikely to be long-lasting. The common side effects associated with the use of this medication include headache, redness of the face, hot flashes, dizziness, vision problems, sensitivity to light, nasal congestion, and stomach upset.

To avoid side effects of any kind, you should consult a doctor prior to taking these pills. You should be informed that sildenafil medication should not be used in combination with nitrates (medicines used to treat angina pectoris), as this can lead to a severe drop in blood pressure levels, which can lead to shock and sometimes even death.

In 2020, Viagra is considered safe when prescribed correctly.

Important: Prolonged use of ED pills can worsen the fertilizing potential of ejaculate and cause dependence (if you abuse stimulant drugs, one day an erection may simply not come). This is a crime against yourself. There is no need to risk health (and sometimes life). If you take ED medication in the recommended doses and do not abuse it, it won’t harm your health in any way!

The Effects of Viagra on the Body
The Effects of Viagra on the Body

The Effects of Viagra on the Body

Viagra is a powerful drug that increases blood flow to the penis so you can get and maintain an erection. It’s effective, but it can also cause some side effects.

Viagra is a brand-name version of the generic drug sildenafil. It’s a phosphodiesterase type 5 (PDE5) inhibitor. PDE5 is an enzyme that regulates certain chemicals in your blood, but as a result can make it harder for you to get and keep an erection.

Viagra is used to treat erectile dysfunction (ED). While it helps you temporarily maintain an erection so you can have sex, it doesn’t cure ED. It doesn’t affect sexual desire either. You still need mental or physical stimulation to get an erection.

This medication is only available with a doctor’s prescription.

Circulatory system

It takes a finely choreographed series of events to produce an erection. It begins with arousal signals from your brain, and it all hinges on good blood flow to the penis.

Within the penis are two chambers called the corpora cavernosa. Nitric oxide (NO) is released in the chambers during sexual stimulation. NO activates an enzyme called guanylate cyclase. That increases levels of cyclic guanosine monophosphate (cGMP), which causes muscles to relax.

The chambers also contain a network of blood vessels. When those blood vessels relax and widen, blood rushes in. The resulting pressure is what causes an erection.

PDE5 can dampen the effect of cGMP. Viagra works by inhibiting PDE5.

Viagra is rapidly absorbed into the bloodstream. Maximum concentrations are reached within about an hour.

One of the more common side effects is flushing, or redness.

This medication can also cause a decrease in blood pressure, particularly one to two hours after taking it. If you already have low blood pressure, discuss the pros and cons of Viagra with your doctor.

For most people, sexual activity is good for cardiovascular health. However, if you have cardiovascular disease, you should ask your doctor if it’s safe for you to take Viagra. You should also avoid Viagra if your doctor advised you not to have sex.

You shouldn’t take Viagra if you’ve had a stroke or heart attack or if you have unstable angina.

Certain drug interactions can harm your heart. Avoid taking PDE5 inhibitors if you also use long-lasting alpha-blockers or take medications that contain nitrates.

Reproductive system

Viagra can be quite effective, but it’s no magic pill. It does nothing for the libido. You still need some kind of stimulation to get an erection.

The effects of Viagra usually last about 4 hours, though they may last longer for some men. A rare, but serious side effect, is priapism. That’s when you get an erection that lasts for a long period of time. It can become quite painful.

If you have an erection that lasts for more than 4 hours, seek immediate medical attention.

You should also be wary of PDE5 inhibitors if you have an anatomical abnormality of the penis. If you have Peyronie’s disease, your doctor may advise against taking Viagra.

Viagra is a temporary fix and doesn’t cure ED. It offers no protection from sexually transmitted infections (STIs).

Central nervous system

Viagra helps to improve blood flow to the penis, but your brain is still your most valuable sex organ. Viagra won’t work if you’re not in the mood.

Some potential side effects of Viagra are headache and a runny or blocked nose, or a nosebleed. Some men feel lightheaded or dizzy. In rare cases, Viagra can cause fainting. Some men taking PDE5 inhibitors report back or muscle pain.

It’s not common, but some men experience ringing in the ears, hearing loss, or vision loss after taking PDE5 inhibitors.

Avoid PDE5 inhibitors if you have a history of an eye condition called non-arteritic anterior ischemic optic neuropathy (NAION). NAION is characterized by the interruption of blood flow to the optic nerve.

If you have hearing or vision loss while taking Viagra, seek immediate medical help.

Excretory and digestive system

Viagra is dispensed in a film-coated tablet. You can take Viagra with or without food, and it’s best to take it about an hour before you plan to have sex.

Don’t take Viagra more than once per day.

About 80 percent of Viagra leaves your body in your feces. The rest is washed out with your urine.

One fairly common side effect of Viagra is indigestion or stomach upset. PDE5 inhibitors can sometimes cause nausea or vomiting.

What is Erectile Dysfunction and Why I Get ED ?

Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex.

Having erection trouble from time to time isn’t necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.

If you’re concerned about erectile dysfunction, talk to your doctor — even if you’re embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.

Flaccid and erect penis

 

Symptoms

Erectile dysfunction symptoms might include persistent:

  • Trouble getting an erection
  • Trouble keeping an erection
  • Reduced sexual desire

 

Why I get Erectile Dysfunction ?

Depression – The brain is an often-overlooked erogenous zone. Sexual excitement starts in your head and works its way down. Depression can dampen your desire and can lead to erectile dysfunction. Ironically, many of the drugs used to treat depression can also suppress your sex drive and make it harder to get an erection, and they can cause a delay in your orgasm.

Alcohol – You might consider having a few drinks to get in the mood, but overindulging could make it harder for you to finish the act. Heavy alcohol use can interfere with erections, but the effects are usually temporary. The good news is that moderate drinking — one or two drinks a day — might have health benefits like reducing heart disease risks. And those risks are similar to erectile dysfunction risks.

Medications – The contents of your medicine cabinet could affect your performance in the bedroom. A long list of common drugs can cause ED, including certain blood pressure drugs, pain medications, and antidepressants. But do not stop taking any medicines without talking to your doctor first. Street drugs like amphetamines, cocaine, and marijuana can cause sexual problems in men, too.

Stress – It’s not easy to get in the mood when you’re overwhelmed by responsibilities at work and home. Stress can take its toll on many different parts of your body, including your penis. Deal with stress by making lifestyle changes that promote well-being and relaxation, such as exercising regularly, getting enough sleep, and seeking professional help when appropriate.

Anger – Anger can make the blood rush to your face, but not to the one place you need it when you want to have sex. It’s not easy to feel romantic when you’re raging, whether your anger is directed at your partner or not. Unexpressed anger or improperly expressed anger can contribute to performance problems in the bedroom.

Anxiety – Worrying that you won’t be able to perform in bed can make it harder for you to do just that. Anxiety from other parts of your life can also spill over into the bedroom. All that worry can make you fear and avoid intimacy, which can spiral into a vicious cycle that puts a big strain on your sex life — and relationship.

Middle-Aged Spread – Carrying extra pounds can impact your sexual performance, and not just by lowering your self-esteem. Obese men have lower levels of the male hormone testosterone, which is important for sexual desire and producing an erection. Being overweight is also linked to high blood pressure and hardening of the arteries, which can reduce blood flow to the penis.

Self-Image – When you don’t like what you see in the mirror, it’s easy to assume your partner isn’t going to like the view, either. A negative self-image can make you worry not only about how you look, but also how well you’re going to perform in bed. That performance anxiety can make you too anxious to even attempt sex.

Low Libido – Low libido isn’t the same as erectile dysfunction, but a lot of the same factors that stifle an erection can also dampen your interest in sex. Low self-esteem, stress, anxiety, and certain medications can all reduce your sex drive. When all those worries are tied up with making love, your interest in sex can take a nosedive.

Your Health – Many different health conditions can affect the nerves, muscles, or blood flow that is needed to have an erection. Diabetes, high blood pressure, hardening of the arteries, spinal cord injuries, and multiple sclerosis can contribute to ED. Surgery to treat prostate or bladder problems can also affect the nerves and blood vessels that control an erection.

 

Causes of Erectile Dysfunction

Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.

Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.

ED is not the same as premature ejaculation.

The major causes of ED include:

  • Vascular (blood vessel) disease — Erections happen when blood collects in the shaft of the penis. Vascular disease can limit the amount of blood flowing to or staying in the penis. Both can result in problems with erections.
  • Vascular disease is the most common medical cause of impotence.
  • Nerve damage — Nerves must be working normally for a man to get and keep an erection. Nerves can be damaged by diabetes, multiple sclerosis, prostate surgery or damage to the spinal cord.
  • Psychological factors — Psychological issues such as depression, anxiety, guilt or fear can sometimes cause sexual problems. At one time, these factors were thought to be the major cause of impotence. Doctors now know that physical factors cause impotence in most men with the problem. However, embarrassment or “performance anxiety” can make a physical problem worse.
  • Medications — Many medications cause problems with sexual function. These include drugs for high blood pressure, depression, heart disease and prostate cancer.
  • Hormonal problems — Abnormal levels of certain hormones can interfere with erections and sex drive. Hormonal problems, such as a low testosterone level, are an uncommon cause of impotence.

 

Physical causes of Erectile Dysfunction

In many cases, erectile dysfunction is caused by something physical. Common causes include:

  • Heart disease
  • Clogged blood vessels (atherosclerosis)
  • High cholesterol
  • High blood pressure
  • Diabetes
  • Obesity
  • Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
  • Parkinson’s disease
  • Multiple sclerosis
  • Certain prescription medications
  • Tobacco use
  • Peyronie’s disease — development of scar tissue inside the penis
  • Alcoholism and other forms of substance abuse
  • Sleep disorders
  • Treatments for prostate cancer or enlarged prostate
  • Surgeries or injuries that affect the pelvic area or spinal cord
  • Low testosterone

Psychological causes of erectile dysfunction

The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:

  • Depression, anxiety or other mental health conditions
  • Stress
  • Relationship problems due to stress, poor communication or other concerns

Risk factors

As you get older, erections might take longer to develop and might not be as firm. You might need more direct touch to your penis to get and keep an erection.

Various risk factors can contribute to erectile dysfunction, including:

  • Medical conditions, particularly diabetes or heart conditions
  • Tobacco use, which restricts blood flow to veins and arteries, can — over time — cause chronic health conditions that lead to erectile dysfunction
  • Being overweight, especially if you’re obese
  • Certain medical treatments, such as prostate surgery or radiation treatment for cancer
  • Injuries, particularly if they damage the nerves or arteries that control erections
  • Medications, including antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate conditions
  • Psychological conditions, such as stress, anxiety or depression
  • Drug and alcohol use, especially if you’re a long-term drug user or heavy drinker

Complications

Complications resulting from erectile dysfunction can include:

  • An unsatisfactory sex life
  • Stress or anxiety
  • Embarrassment or low self-esteem
  • Relationship problems
  • The inability to get your partner pregnant

Prevention

The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health conditions. For example:

  • Work with your doctor to manage diabetes, heart disease or other chronic health conditions.
  • See your doctor for regular checkups and medical screening tests.
  • Stop smoking, limit or avoid alcohol, and don’t use illegal drugs.
  • Exercise regularly.
  • Take steps to reduce stress.
  • Get help for anxiety, depression or other mental health concerns.

Diagnosis

For many people, a physical exam and answering questions (medical history) are all that’s needed for a doctor to diagnose erectile dysfunction and recommend a treatment. If you have chronic health conditions or your doctor suspects that an underlying condition might be involved, you might need further tests or a consultation with a specialist.

Tests for underlying conditions might include:

  • Physical exam. This might include careful examination of your penis and testicles and checking your nerves for sensation.
  • Blood tests. A sample of your blood might be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health conditions.
  • Urine tests (urinalysis). Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions.
  • Ultrasound. This test is usually performed by a specialist in an office. It involves using a wandlike device (transducer) held over the blood vessels that supply the penis. It creates a video image to let your doctor see if you have blood flow problems.This test is sometimes done in combination with an injection of medications into the penis to stimulate blood flow and produce an erection.
  • Psychological exam. Your doctor might ask questions to screen for depression and other possible psychological causes of erectile dysfunction.

Treatment

The first thing your doctor will do is to make sure you’re getting the right treatment for any health conditions that could be causing or worsening your erectile dysfunction.

Depending on the cause and severity of your erectile dysfunction and any underlying health conditions, you might have various treatment options. Your doctor can explain the risks and benefits of each treatment and will consider your preferences. Your partner’s preferences also might play a role in your treatment choices.

Oral medications

Oral medications are a successful erectile dysfunction treatment for many men. They include:

  • Sildenafil (Viagra)
  • Tadalafil (Adcirca, Cialis)
  • Vardenafil (Levitra, Staxyn)
  • Avanafil (Stendra)

All four medications enhance the effects of nitric oxide — a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation.

Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing normal penile function in some people. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in people who get normal erections.

The medications vary in dosage, how long they work and side effects. Possible side effects include flushing, nasal congestion, headache, visual changes, backache and stomach upset.

Your doctor will consider your particular situation to determine which medication might work best. These medications might not treat your erectile dysfunction immediately. You might need to work with your doctor to find the right medication and dosage for you.

Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor’s OK. Medications for erectile dysfunction do not work in everyone and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes. Some medications might also be dangerous if you:

  • Take nitrate drugs — commonly prescribed for chest pain (angina) — such as nitroglycerin (Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket) and isosorbide dinitrate (Dilatrate-SR, Isordil, Bidil)
  • Have heart disease or heart failure
  • Have very low blood pressure (hypotension)

Other medications

Other medications for erectile dysfunction include:

  • Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Caverject, Edex) into the base or side of your penis. In some cases, medications generally used for other conditions are used for penile injections on their own or in combination. Examples include alprostadil and phentolamine. Often these combination medications are known as bimix (if two medications are included) or trimix (if three are included).Each injection is dosed to create an erection lasting no longer than an hour. Because the needle used is very fine, pain from the injection site is usually minor.Side effects can include mild bleeding from the injection, prolonged erection (priapism) and, rarely, formation of fibrous tissue at the injection site.
  • Alprostadil urethral suppository. Alprostadil (Muse) intraurethral therapy involves placing a tiny alprostadil suppository inside your penis in the penile urethra. You use a special applicator to insert the suppository into your penile urethra.The erection usually starts within 10 minutes and, when effective, lasts between 30 and 60 minutes. Side effects can include a burning feeling in the penis, minor bleeding in the urethra and formation of fibrous tissue inside your penis.
  • Testosterone replacement. Some people have erectile dysfunction that might be complicated by low levels of the hormone testosterone. In this case, testosterone replacement therapy might be recommended as the first step or given in combination with other therapies.
A battery-powered penis pump
Penis pumps, surgery and implants

Penis pumps, surgery and implants

If medications aren’t effective or appropriate in your case, your doctor might recommend a different treatment. Other treatments include:

  • Penis pumps. A penis pump (vacuum erection device) is a hollow tube with a hand-powered or battery-powered pump. The tube is placed over your penis, and then the pump is used to suck out the air inside the tube. This creates a vacuum that pulls blood into your penis.Once you get an erection, you slip a tension ring around the base of your penis to hold in the blood and keep it firm. You then remove the vacuum device.The erection typically lasts long enough for a couple to have sex. You remove the tension ring after intercourse. Bruising of the penis is a possible side effect, and ejaculation will be restricted by the band. Your penis might feel cold to the touch.If a penis pump is a good treatment choice for you, your doctor might recommend or prescribe a specific model. That way, you can be sure it suits your needs and that it’s made by a reputable manufacturer.
  • Penile implants. This treatment involves surgically placing devices into both sides of the penis. These implants consist of either inflatable or malleable (bendable) rods. Inflatable devices allow you to control when and how long you have an erection. The malleable rods keep your penis firm but bendable.Penile implants are usually not recommended until other methods have been tried first. Implants have a high degree of satisfaction among those who have tried and failed more-conservative therapies. As with any surgery, there’s a risk of complications, such as infection. Penile implant surgery is not recommended if you currently have a urinary tract infection.

Buy Viagra Online

Sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis) and avanafil (Stendra) are oral medications that reverse erectile dysfunction by enhancing the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation.

What is Viagra (sildenafil)?

Sildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Sildenafil (Revatio) is used to improve the ability to exercise in adults with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Children should not usually take sildenafil, but in some cases, a doctor may decide that sildenafil (Revatio) is the best medication to treat a child’s condition.

Sildenafil is in a class of medications called phosphodiesterase (PDE) inhibitors. Sildenafil treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation. This increased blood flow can cause an erection. Sildenafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow easily.

How does Viagra work?

Viagra works by increasing blood flow to your penis. It’s a reliable treatment for men who are unable to achieve an erection and those unable to maintain an erection. If you’re struggling with erectile dysfunction, this might be the right ED medicine for you.

So what exactly does Viagra do? By relaxing the arteries and muscles in the penis, this medication helps increase blood flow to the area. When you experience sexual arousal after taking this medicine, blood flows through the relaxed arteries to your penis, allowing you to achieve and maintain an erection. But don’t worry, you won’t get a spontaneous erection just from taking a pill. You have to be sexually aroused after taking this medicine to get an erection.

Viagra is the most popular branded medication on the market for erectile dysfunction and has helped many men suffering from ED. Need help figuring out which is the right ED med for you? Schedule an easy online appointment with one of our doctors or nurse practitioners right now. We know how much privacy and discretion matter when it comes to your sexual health.

That’s why we offer convenient video appointments with medical professionals from the comfort of your own home and ability to message our medical team anytime. Plus, our online pharmacy will deliver meds to your door in discreet packaging in just 2-3 days. We’ve got you covered.

How should Viagra be used?

Sildenafil comes as a tablet and suspension (liquid; Revatio only) to take by mouth.

If you are taking sildenafil to treat erectile dysfunction, follow your doctor’s directions and the guidelines in this paragraph. Take sildenafil as needed before sexual activity. The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before sexual activity. Sildenafil usually should not be taken more than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take sildenafil less often. You can take sildenafil with or without food. However, if you take sildenafil with a high-fat meal, it will take longer for the medication to start to work.

If you are taking sildenafil to treat PAH, follow your doctor’s directions and the guidelines in this paragraph. You will probably take sildenafil three times a day with or without food. Take sildenafil at around the same times every day, and space your doses about 4 to 6 hours apart.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sildenafil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Shake the liquid well for 10 seconds before each use to mix the medication evenly. Use the oral syringe provided with your medication to measure and take your dose. Follow the manufacturer’s directions to use and clean the oral syringe. Do not mix the liquid with other medications or add anything to flavor the medication.

If you are taking sildenafil for erectile dysfunction, your doctor will probably start you on an average dose of sildenafil and increase or decrease your dose depending on your response to the medication. Tell your doctor if sildenafil is not working well or if you are experiencing side effects.

If you are taking sildenafil for PAH, you should know that sildenafil controls PAH but does not cure it. Continue to take sildenafil even if you feel well. Do not stop taking sildenafil without talking to your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

What are the risks and warnings for Viagra (sildenafil)?

Viagra (sildenafil) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options

RISK OF HEART ATTACK OR STROKE

  • Risk factors: Existing heart condition | Recent heart attack or stroke in past 6 months | High or low blood pressure

It’s not recommended for men to take Viagra (sildenafil) if they’ve had a heart attack, stroke, or symptoms of heart failure in the past 6 months, abnormal blood pressure, or if they have chest pain. The safety of Viagra (sildenafil) has not been studied in these situations. Talk to your doctor if you have any of these health conditions.

LOW BLOOD PRESSURE

  • Risk factors: Taking alpha blockers | Taking medications for high blood pressure or chest pain (angina) | Drinking alcohol

If you’re taking alpha blockers or medications for high blood pressure with Viagra (sildenafil), your blood pressure may drop too low. Make sure to check your blood pressure regularly if you’re taking these other medicines. Be very careful getting up from a sitting or lying down position since this can make you feel dizzy and more likely to fall. Drinking alcohol can also cause low blood pressure. Avoid or lower your alcohol consumption when taking Viagra (sildenafil). You should never take Viagra (sildenafil) when taking nitrate medication for chest pain (angina) because it can cause your blood pressure to suddenly drop to unsafe levels.

PROLONGED ERECTION
  • Risk factors: Peyronie’s disease | Cavernosal fibrosis | Sickle cell anemia

There have been reports of men having an erection lasting more than 4 hours while on Viagra (sildenafil). This is rare but if it’s not treated in time, it can cause permanent damage to your penis, including permanent impotence. Get medical help immediately if this happens.

VISION CHANGES

If you suddenly notice changes in your vision in one or both eyes, go to the emergency room or call your doctor immediately. Although this is rare, Viagra (sildenafil) can cause permanent eye damage.

HEARING LOSS

There have been reports of men having permanent hearing loss while taking Viagra (sildenafil). This may happen along with ringing in the ears (tinnitus) and dizziness. Go to the emergency room or call your doctor immediately if you notice changes in your hearing in one or both ears.

INCREASED SIDE EFFECTS WITH OTHER MEDICINES
  • Risk factors: Age 65 years or older | Liver disease | Kidney disease | Taking medications such as nitrates, anti-hypertensives, alpha blockers, ketoconazole, or ritonavir

You may experience more side effects while taking Viagra (sildenafil) if you are also taking medications called nitrates for chest pain, blood pressure medications, certain medications for HIV, are elderly, or have liver or kidney disease. Talk to your doctor before starting Viagra (sildenafil) if any of these apply to you.

How to take Viagra

Take 1 Viagra pill one hour before sex. Never take more than one pill on the same day.

Grapefruit can increase the risk that you experience side effects, so don’t eat grapefruit or drink grapefruit juice on the same day as using Viagra.

Take this medication only as needed. The usual starting dosage is 50mg but your doctor or nurse practitioner might start you on a different dose based on your unique medical history. This medication isn’t suitable for everyone and shouldn’t be taken if you’re also on a nitrate drug for heart problems. If you’re struggling with ED as well as a heart condition, please consult with a doctor or nurse practitioner before taking this medication.

Wondering when to take Viagra? Take it an hour or so before you plan to have sex since this medicine takes at least 30-60 minutes of taking it for it to work. If you have any other questions about how to take Viagra, our medical team is available and ready to answer them.

 

Viagra vs Sildenafil

Viagra and sildenafil are medically the same, containing the same active ingredient sildenafil. The main difference is price where generic sildenafil is cheaper than branded Viagra (sold by Pfizer). Also, sildenafil is available in 20mg dosage. Viagra comes in diamond shaped blue pills and sildenafil comes in white or blue tablets. Both are equally effective for the treatment of erectile dysfunction.

Viagra side effects

Sildenafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
  • headache
  • heartburn
  • diarrhea
  • flushing (feeling of warmth)
  • nosebleeds
  • difficulty falling asleep or staying asleep
  • numbness, burning, or tingling in the arms, hands, feet, or legs
  • muscle aches
  • changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green)
  • sensitivity to light
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
  • sudden severe loss of vision (see below for more information)
  • blurred vision
  • sudden decrease or loss of hearing
  • ringing in ears
  • dizziness or lightheadedness
  • fainting
  • chest pain
  • worsening shortness of breath
  • erection that is painful or lasts longer than 4 hours
  • itching or burning during urination
  • rash

Some patients experienced a sudden loss of some or all of their vision after they took sildenafil or other medications that are similar to sildenafil. The vision loss was permanent in some cases. It is not known if the vision loss was caused by the medication. If you experience a sudden loss of vision while you are taking sildenafil, call your doctor immediately. Do not take any more doses of sildenafil or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor.

There have been reports of heart attack, stroke, irregular heartbeat, bleeding in the brain or lungs, high blood pressure, and sudden death in men who took sildenafil for erectile dysfunction. Most, but not all, of these people had heart problems before taking sildenafil. It is not known whether these events were caused by sildenafil, sexual activity, heart disease, or a combination of these and other causes.Talk to your doctor about the risks of taking sildenafil.

Some patients experienced a sudden decrease or loss of hearing after they took sildenafil or other medications that are similar to sildenafil. The hearing loss usually involved only one ear and did not always improve when the medication was stopped. It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking sildenafil, call your doctor immediately. If you are taking sildenafil (Viagra) for erectile dysfunction, do not take any more doses of sildenafil (Viagra) or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor. If you are taking sildenafil (Revatio) for PAH, do not stop taking your medication until you talk to your doctor.

Sildenafil may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

 

Buying oral erectile dysfunction medications online

Treatments for erectile dysfunction are big business, and online scams abound. If you do buy medications over the internet:

  • Check to see if an online pharmacy is legitimate. Never order medications from an online pharmacy if there’s no way to contact the pharmacy by phone, if prices seem too good to be true or if you’re told no prescription is necessary. Some illegal businesses sell counterfeit versions of legitimate medications, which can be ineffective or dangerous. In the U.S., the National Association of Boards of Pharmacy can tell you whether an online pharmacy is licensed and in good standing.
  • Make sure you get the right prescription and dose. When you order medications — and when you receive them in the mail — make sure they’re the exact dose and type prescribed by your doctor.
  • Don’t be fooled into buying ‘herbal viagra.’ Never take any medications that claim to be the “herbal” or nonprescription equivalent of an oral medication for erectile dysfunction. These aren’t an effective alternative, and some contain harmful substances.

Interactions between Viagra (sildenafil) and other medications

Viagra (sildenafil) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Viagra (sildenafil). Please note that only the generic name of each medication is listed below.

 

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amprenavir
  • Amyl Nitrite
  • Atazanavir
  • Boceprevir
  • Cobicistat
  • Darunavir
  • Erythrityl Tetranitrate
  • Fosamprenavir
  • Indinavir
  • Isosorbide Dinitrate
  • Isosorbide Mononitrate
  • Lopinavir
  • Molsidomine
  • Nelfinavir
  • Nitroglycerin
  • Nitroprusside
  • Pentaerythritol Tetranitrate
  • Propatyl Nitrate
  • Riociguat
  • Ritonavir
  • Saquinavir
  • Telaprevir
  • Tipranavir

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Cannabis
  • Ceritinib
  • Clarithromycin
  • Conivaptan
  • Dihydrocodeine
  • Duvelisib
  • Fluconazole
  • Fosnetupitant
  • Idelalisib
  • Itraconazole
  • Ivosidenib
  • Larotrectinib
  • Lefamulin
  • Lorlatinib
  • Lumacaftor
  • Nefazodone
  • Netupitant
  • Simeprevir
  • Telithromycin
  • Voriconazole

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfuzosin
  • Bosentan
  • Bunazosin
  • Ciprofloxacin
  • Delavirdine
  • Doxazosin
  • Erythromycin
  • Etravirine
  • Ketoconazole
  • Moxisylyte
  • Nebivolol
  • Prazosin
  • Rifapentine
  • Silodosin
  • Tamsulosin
  • Terazosin
  • Trimazosin

How to use Viagra ?

Read the Patient Information Leaflet provided by your pharmacist before you start taking sildenafil and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

To treat erectile dysfunction-ED, take this drug by mouth as directed by your doctor, usually as needed. Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before is the most effective). Do not take more than once daily.

A high-fat meal may delay how quickly the drug begins to work.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Tell your doctor if your condition does not improve Buy Viagra 100mg Online

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GH is a stress hormone that raises the concentration of glucose and free fatty acids. It also stimulates production of IGF-1.

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What Factors Affect the Speed of Sildenafil and Is it Safe to Take Viagra with Alcohol?

The drug duration and the onset of action can be affected y several factors, including:

  • Alcohol. Alcohol-containing beverages decrease the blood flow to the penis. As a result, it becomes harder to achieve and maintain an erection necessary for sexual intercourse. One glass of good wine or one beer will not decrease the speed of sildenafil, but larger amounts of alcohol will surely slow down the effects of the drug and may even cause adverse reactions making it harder to get an erection;
  • Old Age. Men over 60 report that the drug starts working later because with age the body’s metabolism slows down. However, this means that sildenafil tablets will last longer in older men;
  • Dosage. The dosages may range from 25 mg to 100 mg. The higher dose you take, the more potent and long-lasting effects you will notice. Remember that only a doctor can determine the correct dosage of this generic medication for your case. Do not engage in self-treatment!
  • Heavy foods. If you eat too many fatty foods just before you take a pill, you may need to wait more time until the drug starts working since your body will be busy digesting the food. But if you take the pill on an empty stomach, the onset of action will occur quickly;
  • Drug interactions. Some medications can slow down the speed of the drug. For, example, antibiotic rifampicin can change the speed of the action. Always consult your doctor about any medications you are taking or going to take. This way you can ensure that generic Viagra (Sildenafil) is safe for your body;
  • Health condition. If you any pathological problems with kidney or liver, the medication can last longer. The thing is that the pill will be absorbed by your organism much longer. You should always inform a medical specialist about all medical conditions you have.

 

Is it Safe to Take Viagra with Alcohol?

Viagra was one of the first FDA-approved oral medications to be offered to men who have erectile dysfunction (ED) and is the most well-known ED drug—think “the little blue pill.” ED is a medical condition in which a man cannot get or maintain an erection long enough to have satisfactory sex. Viagra is still a commonly prescribed treatment for ED, which affects 30 million men, according to the American Urological Association (AUA, 2018).

The active ingredient in Viagra is sildenafil citrate, a type of drug called a phosphodiesterase 5 (PDE5) inhibitor. PDE5 inhibitors help treat ED by relaxing the muscles in the penis to allow for more blood to flow to the area. This increased blood flow enables you to have and maintain a satisfactory erection. Other PDE5 inhibitors used to treat ED include vardenafil (brand name Levitra) and tadalafil (brand name Cialis). Viagra is taken anywhere from 30 minutes to four hours before engaging in sexual activity. The drug alone will not give you an erection—you need to be aroused for the medication to work.

Is it safe to take Viagra with alcohol?

Many men drink alcohol on the days they plan to use Viagra. Alcohol can help you relax, and it decreases inhibitions, etc. As long as you are not drinking excessively (and have cleared it with your healthcare provider), it is likely safe for you to have a glass or two of wine (or the equivalent serving of beer or spirits) while taking Viagra.

However, people who abuse alcohol (more than 15 drinks a week) and take Viagra for recreational (non-medical) purposes may have a higher risk of side effects (Kim, 2019). One study showed that over 45% of men who took Viagra with alcohol for recreational purposes had a higher risk of side effects, including facial flushing, headaches, chest pain, changes in vision, and light headedness (Kim, 2019).

The type of alcohol you drink may matter. A study looking at men who drank red wine and took Viagra showed no clinically significant interaction with the combination (Leslie, 2004). However, if you prefer grapefruit juice with your cocktails, there may be an interaction with the Viagra.

Viagra is broken down by the liver, and grapefruit juice may affect how well the liver can accomplish this. Researchers looked at men who took Viagra with grapefruit juice and found that the combination can increase the amount of the drug circulating in your body (Jetter, 2002). While this is not usually a dangerous outcome, higher levels of Viagra may increase the risk of side effects like headaches, flushing, or low blood pressure. To be safe, you should avoid taking Viagra with grapefruit juice.

Alcohol and ED

ED tends to affect men in older age groups, especially those aged 70 years and over. However, ED does not only happen in old age—it can also occur in younger men. Lifestyle factors can also increase the risk of developing this condition. These include obesity, smoking, lack of physical activity, and excessive alcohol consumption.

viagra with beer

Impotence: how is it different from erectile dysfunction?

 

A common term for ED after drinking alcohol is “whiskey dick.” The effects of alcohol on a man’s erectile function will vary. In general, alcohol acts as a depressant, meaning that it has a sedating or relaxing effect on the brain and body. While this sounds good, it can also negatively affect some of the pathways involved in sexual arousal, blood circulation, and nerve sensitivity—all of these need to be functioning properly to have a satisfying sexual encounter.

For example, alcohol intoxication can slow the signals between the brain and the penis responsible for getting an erection. Drinking alcohol can also lead to dehydration, which reduces blood flow and impacts your ability to get an erection.

The amount of alcohol you drink matters. Excessive (more than 15 drinks per week) or binge drinking (5 or more drinks on a single occasion) can contribute to ED by affecting the pathways by which nerves and blood vessels allow you to get and maintain an erection. Heavy alcohol use can also decrease your testosterone levels, thereby reducing your sexual desire and ability to have satisfactory sex (Wang, 2018). One study looked at 100 men with diagnosed alcohol abuse disorders and found that over 72% of them had some form of sexual dysfunction, with ED being one of the most common (Benegal, 2007).

Alcohol is not all bad when it comes to ED. One study showed that moderate alcohol use (which they defined as 14.5 drinks per week) was associated with a 34% decreased risk of ED (Wang, 2018). Studies have also found that moderate alcohol consumption of up to two drinks per day could have other health benefits, like raising “good” HDL cholesterol and lowering the risk of diabetes (AHA, 2019). As with many other things in life, moderation is key.

In summary, if you are going to consume alcohol while taking Viagra, be sure to do so responsibly. Limit your alcohol intake to 1–2 drinks per day. According to the Centers for Disease Control and Prevention (CDC), a standard drink is one of the following:

  • 12 ounces of beer (5% alcohol content)
  • 8 ounces of malt liquor (7% alcohol content)
  • 5 ounces of wine (12% alcohol content)
  • 1.5 ounces or a “shot” of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey)

Drink water or nonalcoholic beverages in between the alcoholic drinks to prevent dehydration. Know your limits, and be sure to stop drinking alcohol when you start to feel intoxicated.

 

 

What is Viagra and How Viagra Works ?

Viagra (sildenafil) is a popular medication used to treat erectile dysfunction (ED) in men. The drug does not cure ED or increase sex drive. Instead, it helps you get an erection in a natural way.

Manufactured by Pfizer, the medicine has become the first ED treatment approved by the U.S. Food and Drug Administration (FDA). Today, in 2020, there are also generic versions of Viagra available on the market. Thet have the same efficiency but are much cheaper. Sildenafil is also a vasodilator and may be used to treat pulmonary arterial hypertension.

When is Viagra used?

Viagra is for adult men seeking to treat impotence, or erectile dysfunction. ED is the lack of blood flow to the penis, making it impossible to achieve or maintain an erection for long enough to have satisfactory intercourse. ED can happen due to age, a medical condition or it can be psychological.

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Erectile dysfunction is often an embarrassing issue for those who suffer from it and can have many negative effects. Erectile problems can lead to stress in relationships, low self-esteem, and a decreased sex drive. Viagra (Sildenafil) can be an effective treatment for erectile dysfunction if taken correctly, as instructed by a doctor.

Often, men suffering from ED have already tried non-medical remedies to treat it, such as changing their diet, increasing exercise and reducing stress before deciding to seek medical treatment such as Viagra. If you have decided that Viagra is the right option for you we advise you to request a prescription through a doctor to ensure you take the right dosage.

Viagra works alongside sexual stimulation to achieve an erection. When a man becomes aroused something called cyclic GMP is released.

This causes the blood vessels to relax and expand and more blood to enter the penis. The result of this is an erection. Cyclic GMP is broken down by an enzyme known as PDE5. Viagra (Sildenafil) works to stop this break down occurring and therefore helps maintain the erection.

Maintaining a healthy sex life is important for psychological and physical well-being. Viagra is an aid for men who have insufficient blood flow to the penis and therefore problems having sex.

 

How Viagra Works

Since the debut of the erectile dysfunction drug Viagra (sildenafil) in 1998, millions of men have discovered how this medication can help treat the symptoms of erectile dysfunction. But while countless men around the world (and their partners) have experienced the clear benefits of Viagra in their sex lives, there’s not as much awareness of how the “little blue pill” actually works. What does Viagra really do in the human body? How fast does it work, and how long does it last? We decided to dig deeper and find out. If you’ve ever been curious about what Viagra can do, read on – you might be surprised at what you discover.

The manufacturers of Viagra recommend taking Viagra one hour before having sex. However, studies have suggested that it could start working even sooner than that. Some men were able to achieve an erection just 12 minutes after taking Viagra, although this wasn’t conclusively proven to be due to Viagra. And while the maximum concentration of sildenafil in the blood isn’t reached until about an hour after taking it (and is potentially delayed by an additional hour if taken with food), it took a median of 27 minutes (with a range of 12–70 minutes) for men taking sildenafil to begin experiencing erections.

Chemically “Viagra” is a substance called sildenafil, PDE 5 inhibitor. This means that we have an enzyme in our body called phosphodiesterase, which affects the blood flow in the cavernous bodies of the penis and in the blood vessels. If this enzyme is blocked, then this very blood flow will increase.

This is how sildenafil works: it relaxes smooth muscles and blood vessels, and increases blood flow to the penis.  And this helps to keep the organ in an erect state. The medicine does not cure the cause of dysfunction, it simply eliminates the consequences.

The drug does not make you sexually aroused.  PDE5 inhibitors help only in the technical part. But if you don’t want to have intimacy, the pill may not work.

This was 23 minutes sooner than the median time of 50 minutes experienced by those who took a placebo.

The half-life of Viagra in the body is about four hours, meaning that every four hours after taking it, there’s only half as much of the drug left. However, even 10 to 12 hours after taking Viagra, men could still often achieve erections hard enough for penetration, though of a shorter duration.

By 24 hours, all traces of Viagra in the blood are practically gone.

We’ve seen how quickly Viagra can work – but once it starts working, how long do erections typically last? In one study, an hour after taking Viagra, men reported being able to achieve erections lasting an average of 33 minutes. After eight hours, this decreased to 23 minutes, and by 12 hours, the mean duration of erections was reported to be 16 minutes.

In comparison, men who took a placebo found that they experienced erections lasting an average of seven minutes – less than half as long as among men who had taken Viagra 12 hours ago.

Even long after the window of 30 minutes to four hours recommended by the manufacturers of Viagra, the drug clearly still has possible beneficial effects on erectile function.

What dosages are there?

The Viagra dosage will be determined by your age, gender, medical condition, and drugs which you are already taking (if any). A medical professional must assess these factors in order to prescribe a specific dosage for you.

Viagra comes in blister packs of 20mg, 50mg and 100 mg tablets. Always follow the instructions on the packaging and refer to your doctor’s prescription advice.

Most men are recommended a 50mg dosage to start with. If you experience strong side effects, this is usually decreased to 25mg. Alternatively, if you find the effects are not strong enough, you can increase the dosage to 100 mg. Always check with your doctor before increasing your dosage and if you have strong side effects or symptoms which you find alarming, stop taking the drug immediately and seek medical assistance.

Men aged 65 years and over are usually advised to take a 25mg dosage as the effects of the drug can be stronger than for younger people.

Some other important things to remember when taking Viagra are:

  • Take the tablet between 30 minutes and 4 hours before engaging in sexual activity.
  • Swallow your Viagra (Sildenafil) tablet whole: do not crush or chew it, and do not dissolve it in water.
  • Take Viagra (Sildenafil) with or without water.
  • Do not exceed one Viagra (Sildenafil) dose per day.

 

 

How Long Does Viagra Last?

Sildenafil is a common medication used to stimulate erections in men with erectile dysfunction (ED) and treat pulmonary arterial hypertension (high blood pressure affecting the lungs and heart).

For treating ED specifically, Viagra is the well-known brand-name version of this drug. Viagra is used to treat Erectile Dysfunction (ED) and Pulmonary Arterial Hypertension (PAH). It contains the active ingredient, Sildenafil.

It works by relaxing the blood vessel walls, allowing blood flow to the penis more easily, which is an essential factor in getting and maintaining an erection. Viagra is a blue, diamond-shaped tablet that comes in doses of 25mg, 50mg or 100mg. You should follow the advice of a doctor when taking this medication.

It is possible to buy it online without a prescription, but this is risky as the ingredients may be harmful, so we advise you to consult a doctor before taking Viagra.

 

They will advise you on the correct dosage and whether any other medication you are taking may interfere with its effectiveness. After taking the medication you should expect to see an effect after about 30 minutes. You will need to be sexually aroused in order for it to take effect.

Many factors can influence how long Viagra takes to start working. In general, Viagra takes about 30 minutes to produce noticeable effects.

But your diet, your overall health, the medications you’re taking, underlying conditions, and much more can all affect the amount of time Viagra takes to work in your body and how long it lasts.

How long does Viagra last for men and women?

The average duration of its action in men is about 4 – 6 hours. The drug is not intended for use in women. Sildenafil stays active for a different period of time, it works individually for every man. Most men say that sildenafil lasts about 4 hours, but others reported that they were able to feel the effect of the medication even the next morning. In some men, it lasts for 6 hours. But this also does not mean that a man will have an erection all this time. Below you can see the approximate duration of 25 mg and 100 mg tablets.

 

Viagra dosage How long does it last?
25 mg sildenafil 2-3 hours
100mg sildenafil 5-6 hours

 

Some men wonder: “How long does Viagra stay in your urine and blood?” Sildenafil usually leaves your system after 2-3 hours. Depending on your metabolism, sildenafil can take 5-6 hours to fully leave your system. A higher dosage of the drug will take longer to leave your urine and blood.

How does it work?

An erection happens when nerves in your penis are stimulated.

As a result, muscles around two cylinder-shaped chambers of spongy material along your penis, known as the corpus cavernosa, relax and allow blood to flow in, causing an erection.

With ED, your nerves don’t communicate properly with your brain and blood doesn’t flow properly into the corpus cavernosa. Taking Viagra relaxes the walls of your blood vessels and lets blood flow more easily into the parts of your penis that cause an erection.

How long does it take to start working?

Viagra normally starts working 30 to 60 minutes after you take it in oral tablet form. It may take up to 2 hours to work.

Viagra doesn’t work on its own. You’ll still need to feel sexually aroused to get an erection. Feeling relaxed and comfortable can also help Viagra take effect sooner.

How long does it last?

On average, Viagra usually lasts between 2 and 3 hours before its effects start to diminish. Viagra can last up to 5 hours or longer depending on your dosage, your body’s metabolism, and other external factors.

Depending on how your body metabolizes it, you may be able to get an erection several times with Viagra in your body. Viagra probably won’t make you last longer in bed, though. No research has proven definitively that Viagra can increase how long you can have sex.

Viagra may not work again immediately after you’ve had sex. Normally, you can’t get another erection right after ejaculating because your body isn’t physically prepared for it.

This is known as the refractory period. It may only last a few minutes, but it can last as long as a few hours or days. However, a 2000 studyTrusted Source found that Viagra may decrease this recovery time.

Can any factors affect how long it lasts?

Several important factors can influence how long Viagra lasts for you:

  • Dosage. The amount of Viagra you take affects how long it stays in your system. The smallest available dose, 25 milligrams (mg), won’t last as long as the largest available dose, 100 mg. But taking a higher dose isn’t always recommended, as it may not be safe for you.
  • Age. As you get older, your metabolism slows down. So Viagra may last longer as you age. In general, you may notice Viagra works for a longer period when you’re 65 or older.
  • Diet and lifestyle. Eating a large meal or a lot of high-fat foods right before you take Viagra can keep it from being metabolized quickly or effectively. But this can also make it last longer as it’s metabolized along with your meal. Drinking alcohol or smoking can also decrease blood flow to your penis, making Viagra less effective or shorter-lasting.
  • Medications. Some medications, especially antibiotics such as erythromycin (Ery-Tab), clarithromycin (Biaxin), and ciprofloxacin (Cipro), can interact with Viagra and affect how long it lasts.
  • Overall health. Certain existing conditions can affect how long Viagra lasts and how well it works for you. Diabetes, nervous system conditions like multiple sclerosis (MS), and heart conditions like atherosclerosis (fat buildup in your blood vessels) can all make Viagra less effective and not last as long. Some kidney conditions may make Viagra last longer because of the condition’s effect on your metabolism.
  • Psychological state. Feeling anxious, nervous, depressed, or stressed can all influence how your body responds to sexual stimulation. If you’re not relaxed or comfortable during sex, or if you have performance anxiety because of past sexual experiences, Viagra may not last long or be fully effective.

How long does it take to leave my system?

Viagra usually leaves your system after 2 to 3 hours. Depending on your metabolism, Viagra can take 5 to 6 hours to fully leave your system.

A higher dosage will take longer to leave your body. A 25-mg dose may wear off after a couple of hours, but a 100-mg dose may take nearly four times as long to leave your system.

Is there anything I should be concerned about?

Viagra often lasts for a few hours. You won’t normally have an erection the entire time, as Viagra is only used to help increase blood flow. If you don’t think Viagra is working fast enough, try masturbation or foreplay to help stimulate arousal.

If Viagra doesn’t work after 30 minutes, don’t take any more than the daily dose that your doctor prescribed. Never take more than 100 mg of Viagra in a 24-hour period.

Taking too much Viagra can cause priapism, a painful erection that lasts longer than 4 hours. This can damage penis tissue because blood stored in the penis isn’t receiving any oxygen. Get emergency treatment right away if this happens.

What is Erectile Dysfunction and How to Treat ED ?

Erectile dysfunction, or ED, is the most common sex problem that men report to their doctor. It affects as many as 30 million men.

ED is defined as trouble getting or keeping an erection that’s firm enough for sex.

Though it’s not rare for a man to have some problems with erections from time to time, ED that is progressive or happens routinely with sex is not normal, and it should be treated.

ED can happen:

  • Most often when blood flow in the penis is limited or nerves are harmed
  • With stress or emotional reasons
  • As an early warning of a more serious illness, like: atherosclerosis (hardening or blocked arteries), heart disease, high blood pressure or high blood sugar from Diabetes

Finding the cause(s) of your ED will help treat the problem and help with your overall well-being. As a rule, what’s good for your heart health is good for your sex health.

How Erections Work

During sexual arousal, nerves release chemicals that increase blood flow into the penis. Blood flows into two erection chambers in the penis, made of spongy muscle tissue (the corpus cavernosum). The corpus cavernosum chambers are not hollow.

Diagram of How Erections Work

Enlarge

During erection, the spongy tissues relax and trap blood. The blood pressure in the chambers makes the penis firm, causing an erection. When a man has an orgasm, a second set of nerve signals reach the penis and cause the muscular tissues in the penis to contract and blood is released back into a man’s circulation and the erection comes down.

When you are not sexually aroused, the penis is soft and limp. Men may notice that the size of the penis varies with warmth, cold or worry; this is normal and reflects the balance of blood coming into and leaving the penis.

Updated June 2018

Symptoms

With Erectile Dysfunction (ED), it is hard to get or keep an erection that is firm enough for sex. When ED becomes a routine and bothersome problem, your primary care provider or a Urologist can help.

ED may be a major warning sign of cardiovascular disease indicating blockages are building in a man’s vascular system. Some studies have shown men with ED are at significant risk of getting a heart attack, stroke or circulatory problems in the legs. ED also causes:

  • Low self-esteem
  • Depression
  • Distress for the man and his partner

If ED is affecting a man’s well-being or his relationships, it should be treated. Treatment aims to fix or enhance erectile function, help circulatory health and help the quality of a man’s life.

Updated June 2018

Causes of ED

ED can result from health problems, emotional issues, or from both. Some known risk factors are:

  • Being over age 50
  • Having high blood sugar (Diabetes)
  • Having high blood pressure
  • Having cardiovascular disease
  • Having high cholesterol
  • Smoking
  • Using drugs or drinking too much alcohol
  • Being obese
  • Lacking exercise

Even though ED becomes more common as men age, growing old is not always going to cause ED. Some men stay sexually functional into their 80s. ED can be an early sign of a more serious health problem. Finding and treating the reason for ED is a vital first step.

Physical Causes of ED

ED happens when:

  • There is not enough blood flows into the penis
    Many health issues can reduce blood flow into the penis, such as hardened arteries, heart disease, high blood sugar (Diabetes) and smoking.
  • The penis cannot trap blood during an erection
    If blood does not stay in the penis, a man cannot keep an erection. This issue can happen at any age.
  • Nerve signals from the brain or spinal cord do not reach the penis
    Certain diseases, injury or surgery in the pelvic area can harm nerves to the penis.
  • Diabetes can cause small vessel disease or nerve damage to the penis
  • Cancer treatments near the pelvis can affect the penis’ functionality
    Surgery and or radiation for cancers in the lower abdomen or pelvis can cause ED. Treating prostate, colon-rectal or bladder cancer often leaves men with ED. Cancer survivors should see a Urologist for sexual health concerns.
  • Drugs used to treat other health problems can negatively impact erections
    Patients should talk about drug side effects with their primary care doctors.

Emotional Causes of ED

Normal sex needs the mind and body working together. Emotional or relationship problems can cause or worsen ED.

Some emotional issues that can cause ED are:

  • Depression
  • Anxiety
  • Relationship conflicts
  • Stress at home or work
  • Stress from social, cultural or religious conflicts
  • Worry about sex performance

Diagnosis of ED

Finding the cause of your ED will help direct your treatment options.

Diagnosing ED starts with your health care provider asking questions about your heart and vascular health and your erection problem. Your provider may also give you a physical exam, order lab tests or refer you to a Urologist.

Health and ED History

Your doctor will ask you questions about your health history and lifestyle. It is of great value to share facts about drugs you take, or if you smoke or how much alcohol you drink. He/she will ask about recent stressors in your life. Speak openly with your doctor, so he/she can help you find the best choices for treatment

What Questions Will the Health Care Provider Ask?

Questions about your health:
  • What prescription drugs, over-the-counter drugs or supplements do you take?
  • Do you use recreational drugs?
  • Do you smoke?
  • How much alcohol do you drink?
  • Have you had surgery or radiation therapy in the pelvic area?
  • Do you have any urinary problems?
  • Do you have other health problems (treated or untreated)?

Questions About ED

Knowing about your history of ED will help your health provider learn if your problems are because of your desire for sex, erection function, ejaculation, or orgasm (climax). Some of these questions may seem private or even embarrassing. However, be assured that your doctor is a professional and your honest answers will help find the cause and best treatment for you.

Questions about your ED symptoms:

  • How long have you had these symptoms? Did they start slowly or all at once?
  • Do you wake up in the morning or during the night with an erection?
  • If you do have erections, how firm are they? Is penetration difficult?
  • Do your erections change at different times, like when going in a partner, during stimulation by mouth, or with masturbation?
  • Do you have problems with sex drive or arousal?
  • Do you have problems with ejaculation or orgasm (climax)?
  • How is this problem changing the way you enjoy sex?
  • Do you have painful with erections, feel a lump or bump in the penis or have penile curvature? These are signs of Peyronie’s Disease which can be treated but calls for an expert in urology to assess and manage.

Questions About Stress and Emotional Health

Your health care provider may ask you questions about depression or anxiety. He or she may ask about problems in your relationship with a partner. Some health care providers may also ask if they may talk to your sex partner.

  • Are you often under a lot of stress, or has something recently upset you?
  • Do you have any anxiety, depression or other mental health issues?
  • Are you taking any drugs for your mental health?
  • How satisfied are you with your sex life? Has there been any changes lately?
  • How is your relationship with your partner? Has there been any changes lately?

Physical Exam

A physical exam checks your total health. Examination focusing on your genitals (penis and testicles) is often done to check for ED. Based on your age and risk factors, the exam may also focus on your heart and blood system: heart, peripheral pulses and blood pressure. Based on your age and family history your doctor may do a rectal exam to check the prostate. These tests are not painful. Most patients do not need a lot of testing before starting treatment.

Lab Tests

Your health care provider may order blood tests and collect a urine sample to look for health problems that cause ED.

Other Tests

Questionnaires are often used by health experts to rate your ability to initiate and keep erections, gauge your satisfaction with sex and help identify any problems with orgasm.

Advanced Erectile Function Tests

For some men with ED, specialized testing may be needed to guide treatment or re-assess you after a treatment fails.

  • Blood work to check Testosterone and other male hormones
  • Blood work to measure blood sugar (Diabetes)
  • Ultrasonography (penile Doppler) to check blood flow
  • A shot into the penis with a vascular stimulant to cause an erection
  • Pelvic x-rays like arteriography, MRI or CT scanning are rarely needed to check ED unless there is history of trauma or cancer
  • Nocturnal penile tumescence (NPT), an overnight test to check for sleep erection

Treatment

The treatment for ED starts with taking care of your heart and vascular health. Your doctor may point out ‘risk factors’ that can be changed or improved.

You may be asked to change certain food habits, stop smoking, increase workouts or stop using drugs or alcohol. You may be offered alternatives to the drugs you take. (Never stop or change prescription drugs without first talking to your health care provider.)

Your health care provider may also suggest treating emotional problems. These could stem from relationship conflicts, life’s stressors, depression or anxiety from past problems with ED (performance anxiety).

The treatments below are available to treat ED directly.

ED Treatments

Non-invasive treatments are often tried first. Most of the best-known treatments for ED work well and are safe. Still, it helps to ask your health care provider about side effects that could result from each option:

  • Oral drugs or pills known as phosphodiesterase type-5 inhibitors are most often prescribed in the U.S. for ED (Viagra, Cialis, Levitra, Stendra)
  • Testosterone Therapy (when low testosterone is detected in blood testing)
  • Penile Injections (ICI, intracavernosal Alprostadil)
  • Intraurethral medication (IU, Alprostadil)
  • Vacuum Erection Devices
  • Penile Implants
  • Surgery to bypass penile artery damage for some younger men with a history of severe pelvic trauma. Penile vascular surgery is not recommended for older men with hardened arteries.

Oral Drugs (PDE5 inhibitors)

Drugs known as PDE type-5 inhibitors increase penile blood flow. These are the only oral agents approved in the U.S. by the Food and Drug Administration for the treatment of ED.

  • Viagra ® (sildenafil citrate)
  • Levitra ® (vardenafil HCl)
  • Cialis ® (tadalafil)
  • Stendra ® (avanafil)

For best results, men with ED take these pills about an hour or two before having sex. The drugs require normal nerve function to the penis. PDE5 inhibitors improve on normal erectile responses helping blood flow into the penis. Use these drugs as directed. About 7 out of 10 men do well and have better erections. Response rates are lower for Diabetics and cancer patients.

If you are taking nitrates for your heart, you SHOULD NOT take any PDE5 inhibitors. Always speak with your health care provider before using a PDE5 inhibitor to learn how it might affect your health.

Most often, the side effects of PDE5 inhibitors are mild and often last just a short time. The most common side effects are:

  • Headache
  • Stuffy nose
  • Facial flushing
  • Muscle aches
  • Indigestion

In rare cases, the drug Viagra ® can cause blue-green shading to vision that lasts for a short time. In rare cases, the drug Cialis ® can cause or increase back pain or aching muscles in the back. In most cases, the side effects are linked to PDE5 inhibitor effects on other tissues in the body, meaning they are working to increase blood flow to your penis and at the same time impacting other vascular tissues in your body. These are not ‘allergic reactions’.

Testosterone Therapy

In those rare cases where a low sex drive and low blood levels of Testosterone are at fault for ED, Testosterone Therapy may fix normal erections or help when combined with ED drugs (PDE type 5 inhibitors).

Vacuum Erection Device

A vacuum erection device is a plastic tube that slips over the penis, making a seal with the skin of the body. A pump at the other end of the tube makes a low-pressure vacuum around the erectile tissue, which results in an erection. An elastic ring is then slipped onto the base of the penis. This holds the blood in the penis (and keeps it hard) for up to 30 minutes. With proper training, 75 out of 100 men can get a working erection using a vacuum erection device.

Diagram of a Erectile Dysfunction Vacuum

Penis Enlarge

Intracavernosal (ICI) and Urethra (IU) Therapies

If oral drugs don’t work, the drug Alprostadil is approved for use in men with ED. This drug comes in two forms, based on how it is to be used: intracavernosal injection (called “ICI”) or through the urethra (called “IU therapy”).

Self-Injection Therapy

Alprostadil is injected into the side of penis with a very fine needle. It’s of great value to have the first shot in the doctor’s office before doing this on your own. Self-injection lessons should be given in your doctor’s office by an experienced professional. The success rate for getting an erection firm enough to have sex is as high as 85% with this treatment. Many men who do not respond to oral PDE5 inhibitors can be ‘rescued’ with ICI.

ICI Alprostadil may be used as a mixture with two other drugs to treat ED. This combination therapy called “bimix or trimix” is stronger than alprostadil alone and has become standard treatment for ED. Only the Alprostadil ingredient is FDA approved for ED. The amount of each drug used can be changed based on the severity of your ED, by an experienced health professional. You will be trained by your health professional on how to inject, how much to inject and how to safely raise the drug’s dosage if necessary.

ICI therapy often produces a reliable erection, which comes down after 20-30 minutes or with climax. Since the ICI erection is not regulated by your penile nerves, you should not be surprised if the erection lasts after orgasm. The most common side effect of ICI therapy is a prolonged erection. Prolonged erections (>1 hour) can be reversed by a second injection (antidote) in the office.

Men who have penile erections lasting longer than two to four hours should seek Emergency Room care. Priapism is a prolonged erection, lasting longer than four hours. It is very painful. Failure to undo priapism will lead to permanent penile damage and untreatable ED.

Intraurethral (IU) Therapy

For IU therapy, a tiny medicated pellet of the drug, Alprostadil, is placed in the urethra (the tube that carries urine out of your body). Using the drug this way means you don’t have to give yourself a shot, unfortunately it may not work as well as ICI. Like ICI therapy, IU Alprostadil should be tested in the office, before home usage.

The most common side effects of IU alprostadil are a burning feeling in the penis. If an erection lasts for over four hours, it will need medical attention to make it go down.

Surgical Treatment

The main surgical treatment of ED involves insertion of a penile implant (also called penile prostheses). Because penile vascular surgery is not recommended for aging males who have failed oral PDE5 inhibitors, ICI or IU therapies, implants are the next step for these patients. Although placement of a penile implant is a surgery which carries risks, they have the highest rates of success and satisfaction among ED treatment options.

Penile implants are devices that are placed fully inside your body. They make a stiff penis that lets you have normal sex. This is an excellent choice to improve uninterupted intimacy and makes relations more spontaneous.

There are two types of penile implants.

Semi rigid Implant (Bendable)

The simplest kind of implant is made from two easy-to-bend rods that are most often made of silicone. These silicone rods give the man’s penis the firmness needed for sexual penetration. The implant can be bent downward for peeing or upward for sex.

Inflatable Implant

With an inflatable implant , fluid-filled cylinders are placed lengthwise in the penis. Tubing joins these cylinders to a pump placed inside the scrotum (between the testicles). When the pump is engaged, pressure in the cylinders inflate the penis and makes it stiff. Inflatable implants make a normal looking erection and are natural feeling for your partner. Your surgeon may suggest a lubricant for your partner. With the implant, men can control firmness and, sometimes, the size of the erection. Implants allows a couple to be spontaneously intimate. There is generally no change to a man’s feeling or orgasm.

Penile Implant

Enlarge Penis

What is the Surgery Like?

Penile implants are most often placed under anesthesia. If a patient has a systemic, skin, or urinary tract infection, this surgery should be postponed until all infections are treated. If a man is on blood thinners, then he may need to talk with a medical expert about stopping the medications for elective surgery and healing.

Most often, one small surgical cut is made. The cut is either above the penis where it joins the belly, or under the penis where it joins the scrotum. No tissue is removed. Blood loss is typically small. A patient will either go home on the same day or spend one night in the hospital.

Recovery Time after Penile Implants:

  • Most men will feel pain and will feel better with a narcotic pain-relief drug for one to two weeks. After the first week, over- the-counter pain drugs (such as acetaminophen or ibuprofen) may be substituted for narcotic pain drugs.
  • Discomfort, bruising and swelling after the surgery will last for a few weeks.
  • For the first month, men should limit their physical activity. The surgeon will explain when and how much exercise to do during the healing period.
  • Men most often start having sex with their penile implants by eight weeks after surgery. If there is persisting swelling or pain, the use of the implant may be delayed. The surgeon or health care expert in the surgeon’s office will talk about how to inflate and deflate the implant.

There are risks to prosthetic surgery and patients are counselled before the procedure. If there is a post-operative infection, the implant will likely be removed. The devices are reliable, but in the case of mechanical malfunction, the device or a part of the device will need to be replaced surgically. If a penile prosthesis is removed, other non-surgical treatments may no longer work.

Most men with penile implants and their partners say that they’re satisfied with the results, and they return to more spontaneous intimacy.

Clinical Trials

Several restorative or regenerative treatments are under investigation for the future treatment of ED:

  • Extracorporeal shock wave therapy (ESWT) – low-intensity shock waves that aim to fix the erectile tissues and help restore natural erections.
  • Intracavernosal injection of stem cells – to help cavernous tissue regrowth
  • Intracavernosal injection autologous platelet rich plasma (APRP) – to help cavernous tissue regrowth

These are not currently approved by the FDA for ED management, but they may be offered through research studies (clinical trials). Patients who are interested should discuss the risks and benefits (informed consent) of each, as well as costs before starting any clinical trials. Most therapies not approved by the FDA are not covered by government or private insurance benefits.

Supplements

Supplements are popular and often cheaper than prescription drugs for ED. However, supplements have not been tested to see how well they work or if they are a safe treatment for ED. Patients should know that many over-the-counter drugs have been found on drug testing to have ‘bootlegged’ PDE 5 Inhibitors as their main ingredient. The amounts of Viagra, Cialis, Levitra or Stendra that may be in these supplements is not under quality control and may differ from pill to pill. The FDA has issued consumer warnings and alerts.

More information may be found here.

Updated June 2018

After Treatment

All of the treatments for ED (except for implant surgery) are used as needed for sex and then wear off. The treatments help the symptoms, but do not fix the underlying problem in the penis.

If medical treatments don’t work as well as hoped:

  • Changing the dosage (for PDE5i, IU or ICI alprostadil) as prescribed by the doctor may help
  • Reviewing the instructions again may reveal a missing step in a treatment plan
  • Considering a different path may be necessary: emotional/relationship counselling, a vacuum erection device or penile implant are all good alternatives when others methods fail. Don’t give up!

ED Diagnosis

Your doctor will ask you about your medical history. He or she will want to learn if any medical conditions might be causing the impotence. These may include vascular, neurological and hormonal disorders.

Vascular disorders affect the entire body. Many men who have impotence because of vascular disease also have a history of heart disease, stroke or poor circulation in their legs.

Neurological problems can contribute to impotence in men with a history of diabetes and spinal cord injury. They also can cause symptoms in other parts of the body.

In men with abnormal hormone levels, a reduced sex drive often accompanies impotence.

Your doctor will review the medications you take. These include over-the-counter products and herbal remedies.

Your doctor will ask about your sex life. He or she will ask about the quality of your sexual relationships.

Your doctor will examine you to look for evidence of medical problems. This will include an examination of your penis and testes. Your blood may be tested for blood sugar, cholesterol and levels of certain hormones.

Occasionally, a doctor may order additional tests. One such test is a nocturnal penile tumescence study. This is a way to determine how often you get erections while you sleep.

Another test that may be done is a Doppler ultrasound of the blood vessels in the penis. This test measures how well the blood is flowing in your penis.

Your doctor may not be able to give you a specific reason why you have impotence. But many of the treatments work well no matter what caused the problem. So extensive testing may not be necessary.

More Information

Frequently Asked Questions

How do I know my ED is physical and not mental?

It’s hard to know. Health providers now realize that most men have an underlying physical cause of ED. For most patients, there are both physical and emotional factors that lead to ED. It is impossible to prove that there is no psychological part to a man’s ED.

If I worry about being able to get an erection, can I make a bad condition worse?

Nothing happens in the body without the brain. Worrying about your ability to get an erection can make it difficult to get one. This is called performance anxiety and can be overcome with education and treatment.

Can I combine treatment options?

This is often done. However, only combine treatments after talking with your health care provider about this. Erections can last too long with drug therapy, which is dangerous. Ask your doctor for proper instructions.

I was fine until I began taking this new drug, what should I do?

Never stop or change a prescription medication without first talking with your health care provider.

Many drugs can cause ED, but some cannot be changed because the drug’s benefits are too important for you. If you feel sure that a specific drug has caused the ED problem, ask your health care provider if you can change drugs. If you must stay on the drug that is causing the problem, there are ED treatments that can help.

How is Erectile Dysfunction (ED) Diagnosed?

Because there are a variety of causes for Erectile Dysfunction ( ED ), there are several different tests your doctor may use to diagnose the condition and determine its cause. Only after the cause of ED is determined can it be effectively treated.

ED Diagnosis

Your doctor will ask you about your medical history. He or she will want to learn if any medical conditions might be causing the impotence. These may include vascular, neurological and hormonal disorders.

Vascular disorders affect the entire body. Many men who have impotence because of vascular disease also have a history of heart disease, stroke or poor circulation in their legs.

Neurological problems can contribute to impotence in men with a history of diabetes and spinal cord injury. They also can cause symptoms in other parts of the body.

In men with abnormal hormone levels, a reduced sex drive often accompanies impotence.

Your doctor will review the medications you take. These include over-the-counter products and herbal remedies.

Your doctor will ask about your sex life. He or she will ask about the quality of your sexual relationships.

Your doctor will examine you to look for evidence of medical problems. This will include an examination of your penis and testes. Your blood may be tested for blood sugar, cholesterol and levels of certain hormones.

Occasionally, a doctor may order additional tests. One such test is a nocturnal penile tumescence study. This is a way to determine how often you get erections while you sleep.

Another test that may be done is a Doppler ultrasound of the blood vessels in the penis. This test measures how well the blood is flowing in your penis.

Your doctor may not be able to give you a specific reason why you have impotence. But many of the treatments work well no matter what caused the problem. So extensive testing may not be necessary.

Before ordering any tests, your doctor will review your medical history and perform a thorough physical examination. The doctor will also “interview” you about your personal and sexual history. Some of these questions will be very personal and may feel intrusive. However, it is important that you answer these questions honestly. The questions asked may include:

  • What medications or drugs are you currently using? This includes prescription drugs, over-the-counter drugs, herbals, dietary supplements and illegal drugs.
  • Have you had any psychological problems such as stress, anxiety and depression?
  • When did you first notice symptoms of ED?
  • What are the frequency, quality and duration of any erections you have had?
  • What are the specifics of the circumstances under which ED first occurred?
  • Do/did you experience erections at night or during the morning?
  • What sexual techniques do you use?
  • Are there problems in your current relationship?

The doctor may also wish to interview your sexual partner since your partner may be able to offer in sight about the underlying causes.

After your physical examination and discussion, your doctor may then order any one of the following tests to further diagnose your condition:

  • Complete blood count (CBC): This is a set of blood tests that, among other things, can detect the presence of anemia. Anemia is caused by a low red blood cell count and can cause fatigue, which in turn can cause ED.
  • Liver and kidney function tests: These blood tests may indicate whether ED may be due to your kidneys or liver functioning improperly.
  • Lipid profile: This blood test measures the level of lipids (fats), like cholesterol. High levels may indicate atherosclerosis (hardening of the arteries), which can affect blood circulation in the penis.
  • Thyroid function test: One of the thyroid hormones’ functions is to regulate the production of sex hormones, and a deficiency in these hormones may contribute to or cause ED.
  • Blood hormone studies: Testosterone and/or prolactin levels in the blood may be measured to see if abnormalities in either of these sex hormones are present.
  • Urinalysis: Analysis of urine can provide a wealth of information, including information on protein, sugar and testosterone levels. Abnormal measurements of these substances can indicate diabetes, kidney disease or a testosterone deficiency, all which can cause ED.
  • Duplex ultrasound: This is perhaps the best test for evaluating ED. An ultrasound uses high-frequency sound waves to take “pictures” of the body’s tissues. For people with ED, an ultrasound may be used to evaluate blood flow and check for signs of a venous leak, atherosclerosis (hardening of arteries) or tissue scarring. This test is performed both while the penis is erect (usually induced by an injection of a drug that stimulates erection) and also while it is soft.
  • Bulbocavernosus reflex: This test evaluates nerve sensation in the penis. During the test, your doctor will squeeze the head of your penis, which should immediately cause your anus to contract. If nerve function is abnormal, there will be a delay in response time.
  • Nocturnal penile tumescence (NPT): This test measures a man’s erectile function while he is sleeping. Normally, a man will have five or six erections while asleep. A lack of these erections may indicate there is a problem with nerve function or circulation to the penis. The test uses two methods, the snap gauge method and the strain gauge method. The snap gauge method is performed by wrapping three plastic bands of varying strength around the penis. Erectile function is then measured based on which of the three bands breaks. The strain gauge method works by placing elastic bands around the tip and base of the penis. If the penis becomes erect during the night, the bands stretch, measuring the changes in penile circumference.
  • Penile biothesiometry: This test involves the use of electromagnetic vibration to determine sensitivity and nerve function. A decreased sensitivity to these vibrations may indicate nerve damage.
  • Vasoactive injection: During this test, an erection is produced by injecting special solutions that cause the blood vessels to dilate (enlarge) allowing blood to enter the penis.
  • Dynamic infusion cavernosometry: This test is used for men with ED who have a venous leak. During this test, fluid is pumped into the penis at a predetermined rate. By measuring the rate at which fluid must be pumped to attain a rigid erection, doctors can determine the severity of the venous leak.
  • Cavernosography: Used in conjunction with the dynamic infusion cavernosometry, this test involves injecting a dye into the penis. The penis is then X-rayed so that the venous leak can be seen.
  • Arteriography: This test is given to people who are candidates for vascular reconstructive surgery. A dye is injected into the artery believed to be damaged and X-rays will be taken.

Before you are given any of these tests, your doctor will explain what is involved. If you have any questions, do not hesitate to ask your doctor.

Recommend Surgery Treatment for Erectile Dysfunction

For most men, surgery should be a last resort.

Penile implants are devices placed inside the penis to allow men with erectile dysfunction (ED) to get an erection. Penile implants are typically recommended after other treatments for ED fail.

There are two main types of penile implants, semirigid and inflatable. Each type of penile implant works differently and has various pros and cons.

The placement of penile implants requires surgery. Before choosing penile implants, make sure you understand what surgery involves, including possible risks, complications and follow-up care.

Talk with your doctor about whether surgery is right for you. A urologist performs surgery at a surgical center or hospital to

  • implant a device to make the penis erect
  • rebuild arteries to increase blood flow to the penis
Penile Implant
Penile Implant

Implanted devices. Implanted devices, known as prostheses, can help many men with ED have an erection. Implants are typically placed by a urologist. The two types of devices are

  • inflatable implants, which make your penis longer and wider using a pump in the scrotum
  • malleable implants, which are rods that allow you to manually adjust the position of your penis

You usually can leave the hospital the day of or day after the surgery. You should be able to use the implant 4 to 6 weeks after the surgery.

Once you have either implant, you must use the device to get an erection. Possible problems with implants include breaking and infection.

Why penile implants is done ?

 

For most men, erectile dysfunction can be successfully treated with medications or use of a penis pump (vacuum constriction device). You might consider penile implants if you aren’t a candidate for other treatments or you can’t get an erection sufficient for sexual activity by using other methods.

Penile implants can also be used to treat severe cases of a condition that causes scarring inside the penis, leading to curved, painful erections (Peyronie’s disease).

Penile implants aren’t for everyone. Your doctor might caution against penile implants if you have:

  • ED that’s situational, the result of a relationship conflict or potentially reversible
  • An infection, such as a pulmonary infection or urinary tract infection
  • Diabetes that isn’t well-controlled

Keep in mind that while penile implants allow men to get an erection, they don’t increase sexual desire or sensation. Most penile implants also won’t make your penis any larger than it naturally is at the time of surgery. In fact, your erect penis might be slightly shorter than it used to be.

 

Types of penile implants

There are two main types of penile implants:

  • Inflatable implants. Inflatable devices, the most common type of penile implant used, can be inflated to create an erection and deflated at other times. Three-piece inflatable implants use a fluid-filled reservoir implanted under the abdominal wall, a pump and a release valve placed inside the scrotum, and two inflatable cylinders inside the penis.To achieve an erection, you pump the fluid from the reservoir into the cylinders. Afterward, you release the valve inside the scrotum to drain the fluid back into the reservoir. The two-piece model works in a similar way, but the fluid reservoir is part of the pump implanted in the scrotum.
  • Semirigid rods. Semirigid devices are always firm. The penis can be bent away from the body for sexual activity and toward the body for concealment.A positionable penile implant is a semirigid device with a central series of segments held together with a spring on each end. It can maintain upward and downward positions better than other semirigid rods can.

Other special designs can fit a shortened penis, or one that’s larger than average. Some inflatable penile implants are also available with antibiotic coatings, which might help reduce the risk of infection.

Three-piece penile implant

Illustration of two-piece penile implant

Semirigid penile implant

Comparing implant types

When choosing which type of penile implant is right for you, consider your personal preference and your medical history. Your doctor might suggest one type of design over another based on your age, risk of infection, and health conditions, injuries or medical treatments you’ve had in the past.

Type of penile implant Pros Cons
Three-piece inflatable
  • Creates the most natural, rigid erection
  • Provides flaccidity when deflated
  • Has more parts that could malfunction than does any other implant
  • Requires a reservoir inside the abdomen
Two-piece inflatable
  • Provides flaccidity when deflated
  • Is mechanically more complicated than is a semirigid implant
  • Provides less firm erections than does a three-piece implant
Semirigid rod
  • Has a low chance of malfunction due to the small number of parts
  • Is easy to use for those with limited mental or manual dexterity
  • Results in a penis that is always slightly rigid
  • Puts constant pressure on the inside of the penis, which can cause injury
  • Can be difficult to conceal under clothing

Before penile implant surgery you might also need to:

  • Avoid certain medications. Your doctor might recommend that you temporarily stop taking aspirin and anti-inflammatory drugs, which can increase your risk of bleeding.
  • Arrange for a ride home. Ask your doctor when you’ll be able to go home after surgery. Penile implant surgery typically involves an overnight stay.
  • Limit food and liquids. Don’t eat or drink anything after midnight before your surgery, or follow specific instructions from your doctor.

 

What you can expect

Before the procedure

Penile implant surgery is usually done at a surgery center or hospital. Your doctor might give you medication to make you unconscious during the surgery (general anesthesia) or medication that blocks pain in the lower part of your body (spinal anesthesia).

Your doctor will give you IV antibiotics to help prevent infection. The surgery site will also be shaved immediately before surgery to reduce the risk of infection.

During surgery

A tube (catheter) might be inserted into your bladder via your penis to collect urine at some point during surgery. Your surgeon will make an incision below the head of the penis, at the base of the penis or in the lower abdomen.

Next, your surgeon will stretch the spongy tissue in the penis that would normally fill with blood during an erection. This tissue is inside each of the two hollow chambers called the corpora cavernosa.

Your surgeon will choose the correct size implant and place the implant cylinders inside your penis. All sizes are customized to your exact body measurements.

If your doctor is implanting a two-piece inflatable device, a pump and valve are placed inside the scrotum. For a three-piece device, your doctor will also implant a fluid reservoir under the abdominal wall through an internal incision.

Once the device is in place, your surgeon will sew the incisions closed. Penile implant surgery usually takes 45 minutes to an hour.

After surgery

After penile implant surgery, you’ll likely need to take medications to ease pain. Mild pain might persist for several weeks. You might also need to take antibiotics for one week to prevent infection.

Your doctor might recommend keeping your penis up on your lower abdomen and pointing toward your bellybutton during the healing process to prevent downward curvature.

Your doctor will provide specific instructions about when you can resume normal activities. Most men can resume strenuous physical activity and sexual activity about four to six weeks after surgery. You’ll likely need to return to your doctor to have your stitches removed in about two weeks.

At this point, your doctor might recommend fully inflating and deflating inflatable penile implants twice a day to give you practice using them and stretch the area surrounding the cylinders.

 

Risks of penile implants

Risks of penile implant surgery include:

  • Infection. As with any surgery, infection is possible. You might be at an increased risk of infection if you have a spinal cord injury or diabetes.
  • Implant problems. New penile implant designs are reliable, but in rare cases the implants might malfunction. Surgery is necessary to remove, repair or replace a broken implant.
  • Internal erosion or adhesion. In some cases, an implant might stick to the skin inside the penis or wear away the skin from inside the penis. Rarely, an implant breaks through the skin. These problems are sometimes linked to an infection.

Treating an infection

Infections after penile implant surgery typically occur in the first few weeks or possibly years later. Early infections can cause swelling of the scrotum, pus buildup and fever. Later infections might involve persistent or recurrent long-term pain.

Surgery to remove the implant is likely necessary to treat an infection. Replacing a penile implant can be complicated and can lead to a buildup of scar tissue and a decrease in penis length.

 

How you prepare for penile implants

Initially, you’ll talk to your doctor or a urologist about penile implants. During your visit, your doctor will likely:

  • Review your medical history. Be prepared to answer questions about current and past medical conditions, especially your experience with ED. Talk about any medications you’re taking or have taken recently, as well as any surgeries you’ve had.
  • Do a physical exam. To make sure penile implants are the best options for you, your doctor will do a physical exam, including a complete urologic exam. Your doctor will confirm the presence and nature of ED, and make sure that your ED can’t be treated in another way.He or she will also try to determine whether there’s any reason that penile implant surgery is likely to cause complications. Your doctor will also examine your ability to use your hands, since some penile implants require greater manual dexterity than others.
  • Discuss your expectations. Make sure you understand what the procedure involves and the type of penile implant that suits you best. It’s also important to know that the procedure is considered permanent and irreversible.Your doctor will also explain the benefits and risks, including potential complications. Ideally, you’ll include your partner in the discussion with your doctor.

 

Results

Although penile implants are the most invasive and least often chosen treatment for erectile dysfunction, most men and their partners report satisfaction with the devices. The 10-year device survival is between 60 and 80 percent.