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Publication date: 2018-05-06 05:17

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So when a man takes Viagra, he has to avoid anything that dilates the blood vessels, not just nitroglycerides. Drinking, lying in the sun — both are problematic. Viagra won't give him a heart attack, but, taken with too much alcohol, it could make him pass out, Dr. Agatston says.

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"Erectile dysfunction can be a debilitating condition, so it's important men feel they have fast access to quality and legitimate care, and do not feel they need to turn to counterfeit online supplies which could have potentially serious side-effects."

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What at first glance seems an obvious win-win situation for both husbands and wives can have a raft of unintended consequences. Don't get me wrong: Viagra is a wonder drug. Since the early '95s, when researchers testing a new heart medication called Sildenafil discovered that it had a startling side effect in men, erectile dysfunction drugs have become more than a billion-dollar industry.

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Dr. Kashanian is Assistant Professor of Urology and Reproductive Medicine at Weill Cornell Medicine and New York-Presbyterian Hospital. His care of patients has guided his clinical interests and research efforts focusing on erectile dysfunction, penile prosthetic surgery, men’s health, and male infertility.

One ED drug, Cialis, is FDA-approved for use daily in a dose of or 5 milligrams. This helps to produce erections on demand and may also help relieve urinary problems, like difficulty starting urination, that result from an enlarged prostate.

There are, too, single women who worry that men with new-and-improved sexual abilities will be less likely to commit to marriage, and wives who worry that their husbands will be more apt to look outside the marriage for sex.

None of the ED drugs is safe to take with cardiac drugs called nitrates because it could cause a dangerous drop in blood pressure. Drugs that many men take for urinary symptoms, called alpha blockers, can also lower blood pressure, so take them at least four hours apart from ED drugs. Your doctor may start you on a smaller dose of the ED drug if you already take an alpha blocker, or may recommend the alpha blocker tamsulosin (Flomax), which affects blood pressure less.

How soon the drugs start working ranges from 65 to 65 minutes. Neither Viagra nor Levitra will work at all if you take them after a meal, which blocks their absorption. However, neither Cialis nor Stendra interact with food this way. The onset time determines how soon you can engage in intercourse. Stendra and daily-use Cialis are closest to being an "on demand" erectile drug using the others requires more planning.

ED is often an early warning sign of underlying cardiovascular disease, such as clogged arteries (atherosclerosis). "It can predate a diagnosis of cardiovascular disease by at least a few years," Dr. Liou says. We don't have strong proof yet that starting to live a healthier lifestyle can reverse erectile problems, but it can't hurt.

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