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Low-dose once-daily use: 2.5 mg PO qd, without regard to timing of sexual activity; may increase to 5 mg/d based on efficacy and tolerability
Men who buy fake internet drugs for erection problems can face significant risks from potentially hazardous contents and bypassing healthcare systems could leave associated problems like diabetes and high blood pressure undiagnosed. That's the warning just published online by IJCP the International Journal of Clinical Practice.
A. Penile implant surgery is usually a last resort. Although there is nothing wrong with this approach, for many men it's a disservice. In medicine, the option of last resort is usually something that rarely works or has terrible side effects. Implants present a medical conundrum because they are one of the best treatments we have for ED. Implants have the highest patient and partner satisfaction rating, running higher than 90 percent. The only reason they're offered last is because of the surgery involved. In addition, if removal of the device is necessary, the other erectile dysfunction treatments will not be effective because corporal tissue is destroyed with implantation. Also, its risks, although very infrequent, can be significant.
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The laboratory investigation depends on information gathered during the interview. Laboratory testing is necessary for most patients, although some may not require any laboratory work.
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"If a man says 'no' to you with a lot of irritability, I still wouldn't take it personally or feel rejected, because it's very likely he's suffering some depression -- and again, it's not you," says Foley.
By Randy Dotinga
The TV commercials make it all seem so simple: He can't get an erection so he pops a pill. The next thing you know, his partner is cooing about how her guy is back to his old wild and romantic self.
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Neurogenic Disorders (spinal cord and brain injuries, nerve disorders such as Parkinson's disease, Alzheimer's disease, multiple sclerosis, and stroke.)
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
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Experts often treat psychologically based impotence using techniques that decrease anxiety associated with intercourse. The patient's partner can help apply the techniques, which include gradual development of intimacy and stimulation. Such techniques also can help relieve anxiety when physical impotence is being treated.
The most important component of diagnosing erectile dysfunction is obtaining a complete medical and sexual history. It is important to distinguish the condition from other sexual dysfunctions, such as premature ejaculation and loss of libido. Several formalized sexual questionnaires, such as the IIEF (Internation Index of Erectile Function) and EDITS (Erectile Dysfunction Inventory of Treatment Satisfaction), allow one to detect the presence and grade the severity of erectile dysfunction. The complete IIEF is composed of 15 questions; an abridged 5-item version, called the sexual health inventory for men (SHIM), has been developed and validated.29 Allowing a patient to complete such a questionnaire before his first clinical encounter may produce a more comfortable clinical environment.30 The duration of the problem, time of onset and degree of patient and partner concern should also be elucidated. The circumstances surrounding erectile dysfunction may be helpful in determining whether a situational or nonorganic factor is involved. Sudden onset, maintenance of nocturnal erections, presence of psychological problems and concurrent major life events or relationship issues may be associated with nonorganic erectile dysfunction.31 Concurrent medical illnesses and any medications the patient may be taking should be reviewed. Erectile dysfunction is often a component of generalized medical illness and may represent the initial presentation of cardiovascular disease or diabetes. The history may also reveal certain reversible or modifiable risk factors, such as tobacco use or inadequate diabetes control.
Some insurance plans cover sex therapy. Once you select a therapist, call her/him to ask about whether or not his or her services are covered by your insurance provider. If payment cannot be worked out through insurance, many therapists can adjust their fees. Sex therapy clinics tend to be less expensive than private therapists. The cost of sex therapy programs varies, but generally range between $600 and $2,300 dollars, depending on the nature of the problem and the response to treatment.
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In a tactic called "watchful waiting," the patient does not receive treatment. Instead, regular checkups monitor the progress of the cancer.
Kushida suggested that there may be a role for restless legs drugs in erectile dysfunction treatment, and said the question warrants further research.
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