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A thorough gentle physical examination of the genito urinary system is done. It is important to remember that ED and heart disease share certain comorbidities and hence a thorough evaluation of the heart lungs and abdomen is done. The penis is examined for plaques, curvatures, and the position of the meatal opening. Presence and size of both testis is determined. Features suggestive of hypogonadism(testis size, body hair, voice) are looked for.
The first oral medication for ED approved by the FDA, Viagra was released by Pfizer in 1998. Today, sildenafil is also sold as a drug for a certain type of high blood pressure in the lungs under the brand name Revatio. How does Viagra work? Viagra works by stopping the chemical reaction that causes blood to leave an erect penis. Viagra blocks cGMP-specific phosphodiesterase type-5 (PDE-5), an enzyme that encourages blood to flow out of the penis. When PDE-5 is inhibited, levels of cGMP remain elevated, which relaxes smooth muscle and encourages blood vessels to widen (a process known as vasodilation). That makes blood flow more freely, including to the penis.
Certain medications such as antidepressants, contraceptive pills or hypertension pills: Because of the estrogen they contain, oral contraceptives can affect the libido, and other drugs can have this negative effect, including those that reduce blood pressure and anxiety. , those for gastro-oesophageal reflux and antidepressants. For some, you can’t do anything because you need to take them, but others can be successfully replaced (such as using contraceptive methods that do not involve hormones, such as condoms or diaphragms).
Premature ejaculation or lack of Ejaculatory control is the second most common reason men come to see me in my clinic. “It is over before it starts doctor”, they say. A feeling of anguish and the guilt of not being able to satisfy their partners lingers. Though a scientific definition of Premature Ejaculation may be ejaculating within one minute, partners of men who ejaculate slightly after one minute are not necessarily happy. So, what’s the story? What are they thinking? Discover more details at InstaDocNow reviews.
Viagra has been fully tested in clinical trials and its safety and efficacy can be assured. You may find cheaper alternatives online that seem too good to be true – that’s because they are. Buying medicines from anything other than a registered pharmacy puts you at risk. The product may be a counterfeit and might not work. It can also be dangerous because illegitimate medicines often include harmful toxins like rat poison. All pharmacies require a prescription approved by a Healthcare Professional which requires a consultation with you. This ensures that Viagra is appropriate for your needs.