Travellers Diarrhoea

[vc_tab title=”Overview” tab_id=”1415894353-1-49″][vc_column_text]

Erectile dysfunction (ED), also known as impotence, is the inability to get and maintain an erection that is sufficient for satisfactory sexual intercourse.

ED is a very common condition, particularly in older men. It is estimated that half of all men between the ages of 40 and 70 will have it to some degree.

Why does erectile dysfunction happen?

ED can have a range of causes that can be both physical and mental (psychological).

Physical causes include:

  • narrowing of the blood vessels going to the penis – commonly associated with high blood pressure (hypertension), high cholesterol or diabetes
  • hormonal problems
  • surgery or injury

Psychological causes include:

  • anxiety
  • depression
  • relationship problems
[/vc_column_text][/vc_tab][vc_tab title=”Symptoms” tab_id=”1415894353-2-61″][vc_column_text]The main symptom of erectile dysfunction (ED) is the inability to get and maintain an erection for satisfactory intercourse.

ED should not be confused with ejaculation problems such as premature ejaculation, which is a condition where the process of arousal, orgasm and ejaculation occurs very rapidly.

Inability to get an erection

Sometimes ED only occurs in certain situations. For example, you may be able to get an erection during masturbation, or you may find that you sometimes wake up with an erection but you are unable to get an erection with your sexual partner.

In these circumstances, it is likely that the underlying cause of ED is primarily psychological (stress related). However, if you are unable to get an erection under any circumstances, it is likely that the underlying cause is primarily physical.[/vc_column_text][/vc_tab][vc_tab title=”Causes” tab_id=”1415894677813-2-5″][vc_column_text]Erectile dysfunction (ED) can have many causes, such as other medical conditions, certain medications and stress related (psychological) issues.

To understand more about the possible causes of erectile dysfunction (ED) it is useful to understand how erections occur.

Erections

When a man becomes sexually excited (aroused), his brain sends signals to the nerves in his penis. The nerves increase the blood flow to the penis, causing the tissue to expand and harden. Therefore, anything that interferes with the nervous system or the blood circulation could lead to ED.

Anything that affects libido (level of sexual desire) can also cause ED because a reduced libido makes it more difficult for the brain to trigger an erection. Psychological conditions, such as depression, can reduce libido, as can changes in hormone levels (chemicals that are produced by the body).

Physical causes

There are four main types of health conditions that can cause physical problems resulting in ED. These are:

  • Vasculogenic – conditions that affect the flow of blood to your penis e.g. cardiovascular disease, high blood pressure (hypertension) and diabetes.
  • Neurogenic – conditions that affect your nervous system, which is made up of your brain, nerves and spinal cord e.g. multiple sclerosis, Parkinson’s disease and stroke.
  • Hormonal – conditions that affect your hormone levels e.g. hypogonadism, an overactive thyroid gland and Cushing’s syndrome
  • Anatomical – conditions that affect the physical structure of your penis e.g. Peyronie’s disease.

Medicinal causes

In some men, certain medicines can cause ED, including:

  • diuretics – medicines that increase the production of urine and are often used to treat high blood pressure (hypertension), heart failure and kidney disease
  • antihypertensives – medicines, such as beta-blockers, that are used to treat high blood pressure
  • fibrates – medicines that are used to lower cholesterol levels
  • antipsychotics – medicines that are used to treat some mental health conditions, such as schizophrenia
  • antidepressants – medicines that are used to treat depression and some types of pain
  • corticosteroids – medication that contains steroids, which are a type of hormone
  • H2-antagonists – medicines that are used to treat stomach ulcers
  • anticonvulsants – medicines that are used to treat epilepsy
  • antihistamines – medicines that are used to treat allergic health conditions, such as hay fever
  • anti-androgens – medication that suppresses androgens (male sex hormones)
  • cytotoxics – medication used in chemotherapy to prevent cancer cells from dividing and growing

Psychological causes

  • depression – feelings of extreme sadness that last for a long time
  • anxiety – a feeling of unease, such as worry or fear

ED can often have both physical and psychological causes. For example, if you have diabetes, it may be difficult for you to get an erection, which may cause you to become anxious about the situation. The combination of diabetes and anxiety may lead to an episode of ED.

There are many emotional issues that may also affect your physical ability to get or maintain an erection. These include:

  • relationship problems, such as being unable to talk openly about any problems that you have
  • lack of sexual knowledge
  • past sexual problems
  • past sexual abuse
  • being in a new relationship

Other causes can include:

  • excessive alcohol intake
  • tiredness
  • using illegal drugs, such as cannabis, heroin or cocaine
[/vc_column_text][/vc_tab][vc_tab title=”Treatment” tab_id=”1415894678677-3-1″][vc_column_text]

We offer a variety of prescription only medicine (POM) to treat ED at different dosages:

  1. Viagra 25mg (Sildenafil)(Branded Viagra)
  2. Viagra 50mg
  3. Viagra 100mg
  4. Sildenafil 25mg (Generic Viagra)
  5. Sildenafil 50mg
  6. Sildenafil 100mg
  7. Cialis 2.5mg (Taldafil)
  8. Cialis 5mg
  9. Cialis 10mg
  10. Cialis 20mg
  11. Levitra 5mg (Vardenafil)
  12. Levitra 10mg
  13. Levitra 20mg
  14. Spedra 50mg
  15. Spedra 100mg
  16. Spedra 200mg
  17. ED Trial Pack 4 x (Sildenafil 50mg, Cialis 10mg and Levitra 10mg)

Viagra lost its exclusive patent in the UK in June 2103. Viagra is now available legally in the UK under the name sildenafil. Sildenafil is sometimes also known generic Viagra or generic sildenafil. Viagra and sildenafil are both supplied by Dr Felix, they are medically the same but Sildenafil is much cheaper. See comparison table.

Phosphodiesterase-5 (PDE-5) inhibitors

Phosphodiesterase-5 (PDE-5) inhibitors are one of the most widely used and effective types of medication for treating ED. They work by temporarily increasing the blood flow to your penis.

In UK, three PDE-5 inhibitors are available for treating ED. They are:

  • Sildenafil – sold under the brand name Viagra
  • Tadalafil – sold under the brand name Cialis
  • Vardenafil – sold under the brand name Levitra

Sildenafil, Tadalafil and Vardenafil

Sildenafil and Vardenafil work for about eight hours and they are designed to work ‘on demand’. Tadalafil lasts for up to 36 hours and is more suitable if you require treatment for a longer period of time, for example, over a weekend.

Depending on the type of PDE-5 inhibitor you are taking and the dose, it should take about 30-60 minutes before it starts to work. With sildenafil and vardenafil, you should be able to have sex from one to 10 hours after taking the medicine. After taking tadalafil, the effects will last for up to 36 hours.

It may take longer to notice the effects of the tablet if it is taken with food, so you should take your PDE-5 inhibitor on an empty stomach. You can then eat after an hour without affecting the medicine.

Only take one tablet within a 24-hour period.

You may have the choice of which PDE-5 inhibitor to take as sildenafil; tadalafil and vardenafil are likely to be equally effective. Your GP should explain the benefits of each medication and how it works. The choice may depend on:

  • how often you are sexually active
  • whether you have tried any of the medications before

There have been many studies to test the effectiveness of sildenafil, tadalafil and vardenafil. In general, at least two-thirds of men report having improved erections after taking one of these medicines.

If you do not find that PDE-5 inhibitors are effective it may be because:

  • you have not waited long enough after taking the dose
  • you have waited too long after taking the dose
  • the dose is not high enough
  • you have not had enough sexual stimulation

These medications are triggered by sexual stimulation, so you also need to be aroused for the medication to work.[/vc_column_text][/vc_tab][vc_tab title=”Side Effects” tab_id=”1415894679430-4-8″][vc_column_text]Most men do not experience significant side effects. On rare occasions a sustained, painful erection called a priapism can occur, which needs medical attention. Possible side effects are:

Cialis Levitra Viagra (Sildenafil)
headache headache headache
flushing muscle pain palpitation
indigestion indigestion indigestion
congestion congestion dizziness
nausea flushing congestion
dizziness dizziness flushing
blurred vision
[/vc_column_text][/vc_tab][vc_tab title=”Which Treatment?” tab_id=”1415894681131-5-2″][vc_column_text]
Drug name Viagra Cialis Levitra
Active Ingredient Sildenafil Tadalafil<“2>dizziness flushing
blurred vision    
[/vc_column_text][/vc_tab][vc_tab title=”Comparison Table” tab_id=”1415977538436-5-6″][vc_column_text]
Drug name Viagra Cialis Levitra
Active Ingredient Sildenafil Tadalafil Vardenafil
Time required to take effect usually 30 minutes to become active 15-30 minutes to become active, slightly faster than Viagra and Levitra 30 – 60 minutes to become active
Duration of action Normally about 4 hours (but up to 8 hours) Up to 36 hours 12 hours and in some cases longer
Some pros/cons Reported to be the most effective of the three drugs, but also reported to have the most side effects of the three drugs Because it lasts for up to 36 hours, the dosage cannot be repeated the following day, unlike Viagra and Levitra. Reported to be the most suitable of the three drugs for diabetics. Fewest side effects out of the three drugs.
Dosages Normal starting dose is one 50mg table taken as required
Reduce to one 25mg if initial dose is highly effective
Increase to 100mg if ineffective or lasting less than 4 hours
The usual starting dosage is 10mg taken as needed.
Reduce to 5mg if initial dose is highly effective.
Increase to 20mg if the standard dose is consistently ineffective.
Men who require treatment two or more times a week can take daily Cialis 2.5mg or 5mg tablets as an alternative.
The usual starting dosage is 10mg taken as needed.
Reduce to 5mg if initial dose is highly effective.
Increase to 20mg if the standard dose is consistently ineffective.
Levitra dissolvable 10mg tablets are a quick acting alternative.
Caution Men with cardiovascular disease/anatomical issue with their penis/priapism/taking long-lasting alpha-blockers should use with caution and discuss with a doctor first.
Do not mix with drugs/medications containing nitratesDo not take if you:
  • have been told not to have sex, not to engage in sexual activity/actions that widen your blood vessels;
  • have low blood pressure (hypotension);
  • have had a stroke lately;
  • have unstable angina;
  • have had a heart attack; or
  • have a history of non-arteritic anterior ischaemic optic neuropathy.

  

Side Effects

All can have the following side effects:

  • pain in your back/muscles/head;
  • migraines;
  • getting flushed/going red;
  • indigestion;
  • feeling and or being sick;
  • getting a blocked or runny nose
  • vision disturbances

 [/vc_column_text][/vc_tab][vc_tab title=”Q&A” tab_id=”1415977601482-6-6″][vc_column_text]1. Why me? Is ED a normal part of ageing?

No, the number of men affected increase with age, but it is not inevitable and it is treatable. ED/impotence is not uncommon. Around half of men aged 40-70 years experience some degree of ED and this rises to 70% of the over 70s.

 

2. I’m so embarrassed – do I really need to see my GP?

Yes, ED may be a result of treatable, medical conditions. Your doctor may ask questions, examine you and order a few simple blood tests to find out. It is important to identify and treat conditions such as cardiovascular disease, diabetes or high blood pressure, as untreated your ED/impotence may worsen and also they may predispose to other serious conditions such as heart attacks and stroke. An online consultation does not replace a face-to-face assessment with a doctor.

 

3. How can I talk to my GP about this?

It is understandable for you to be embarrassed, but please be reassured that your doctor won’t be. Your GP’s role is to advise and help you. Your medical records are always confidential. Dr Felix can remove this embarrassment factor with our ED online consultation and supply genuine UK medicines to your door. We also use discreet packaging and appear as ‘D R Felix’ on your bank statement.

 

4. This is embarrassing, what can I say to my wife or partner?

Talking to your partner is very important. Acknowledge the issue. She may well be worried about it too. Reassure her that she is still attractive. If you can, tell her how you feel and ask her how she is feeling. You may be surprised how supportive she is.

 

5. What are the causes of ED?

ED (impotence) has physical and psychological causes, or can be due to a combination of both. The older you are the more common medical issues are. High blood pressure, diabetes, high cholesterol are causes. They are treatable and if left undiagnosed or untreated pre-dispose to strokes and heart attack as well as causing ED. Less common causes are neurological diseases such as Parkinson’s or multiple sclerosis, nerve or blood supply damage to the penis (as a result of injury of prostate, bladder or rectal surgery).

Less commonly low levels of male hormone (testosterone) may affect a man’s ability to get an erection. ED can also happen when a man’s thyroid hormone level is too high or too low ED can be a side effect of some medicines, including high blood pressure medication and antihistamines (medicines that treat allergies).

 

6. What are the treatments for ED?

There are various treatment options. Firstly lifestyle adjustments would be advised. In some cases counselling is effective. The most common medicines prescribed are tablets called PDE5-inhibitors, you may have heard of as sildenafil (Viagra), Tadalafil (Cialis) and Vardenafil (Levitra). These facilitate blood flow to the penis – this is the mechanism for getting and maintaining an erection. See Dr Felix comparison table which shows how they vary. For most men these are very effective, but if not there are lesser used treatments such as urethral suppositories, injections, vacuum pumps or surgery (penile implants).

 

7. What can I do to improve ED without taking any medicines?

There are several lifestyle changes which can help ED/impotence.

Sometimes ED can have an emotional cause such as stress, depression or anxiety about sexual performance. In this case counselling can be effective.

 

8. Does grapefruit cause issues with taking the tablets?

Grapefruit juice is a weak inhibitor of CYP3A4 gut wall metabolism and may give rise to modest increases in plasma levels of sildenafil.
Further information from NHS Choices: Does grapefruit affect my medicine?

 

9. I have ED/impotence, is it forever?

That depends on the cause. Lifestyle changes and tackling stress can resolve the problem. Sometimes men get in a cycle of worry about sexual performance, which results in the very problem that is feared. Breaking that cycle with counselling or ED medications: sildenafil (Viagra), Tadalafil (Cialis) and Vardenafil (Levitra), is curative. It is important to have any medical causes treated. In most cases treatment for medical causes of ED, such as diabetes, and blood pressure is to prevent worsening of those conditions to reduce the risk of strokes and heart attacks. ED drugs; sildenafil (Viagra), Tadalafil (Cialis) and Vardenafil (Levitra) are a treatment not a cure. They are used long term.

 

10. What are the risks of treatment and long-term side effects of Viagra?

Before a medication is licensed and available to prescribe, rigorous testing and clinical trials are performed. All new medications are monitored and any adverse events can be reported, by the prescriber or patient. In the UK this is via the MHRA (Medicines and Healthcare products Regulatory Agency) yellow card scheme.

In clinical trials Viagra was given to 3700 men, and over 550 were using it for over a year. The number of men stopping treatment due to side effects was 2.5%, which was not statistically different from placebo (2.3%).

In the past 15 years since Viagra became available, worldwide there have been millions of prescriptions. Serious adverse events are rare. In the low risk man (Viagra will not prescribed if patient is taking nitrates, has cardiac failure, or within half a year of a stroke or heart attack, and several other medical conditions or when taking other medications that effect Viagra levels) Adverse effects were mostly mild: headaches, flushing, heartburn, and nasal congestion.
>12 hours and in some cases longerSome pros/consReported to be the most effective of the three drugs, but also reported to have the most side effects of the three drugsBecause it lasts for up to 36 hours, the dosage cannot be repeated the following day, unlike Viagra and Levitra.

Reported to be the most suitable ith the nervous system or the blood circulation could lead to ED.Anything that affects libido (level of sexual desire) can also cause ED because a reduced libido makes it more difficult for the brain to trigger an erection. Psychological conditions, such as depression, can reduce libido, as can changes in hormone levels (chemicals that are produced by the body).

Physical causes

There are four main types of health conditions that can cause physical problems resulting in ED. These are:

  • Vasculogenic – conditions that affect the flow of blood to your penis e.g. cardiovascular disease, high blood pressure (hypertension) and diabetes.
  • Neurogenic – conditions that affect your nervous system, which is made up of your brain, nerves and spinal cord e.g. multiple sclerosis, Parkinson’s disease and stroke.
  • Hormonal – conditions that affect your hormone levels e.g. hypogonadism, an overactive thyroid gland and Cushing’s syndrome
  • Anatomical – conditions that affect the physical structure of your penis e.g. Peyronie’s disease.

Medicinal causes

In some men, certain medicines can cause ED, including:

  • diuretics – medicines that increase the production of urine and are often used to treat high blood pressure (hypertension), heart failure and kidney disease
  • antihypertensives – medicines, such as beta-blockers, that are used to treat high blood pressure
  • fibrates – medicines that are used to lower cholesterol levels
  • antipsychotics – medicines that are used to treat some mental health conditions, such as schizophrenia
  • antidepressants – medicines that are used to treat depression and some types of pain
  • corticosteroids – medication that contains steroids, which are a type of hormone
  • H2-antagonists – medicines that are used to treat stomach ulcers
  • anticonvulsants – medicines that are used to treat epilepsy
  • antihistamines – medicines that are used to treat allergic health conditions, such as hay fever
  • anti-androgens – medication that suppresses androgens (male sex hormones)
  • cytotoxics – medication used in chemotherapy to prevent cancer cells from dividing and growing

Psychological causes

  • depression – feelings of extreme sadness that last for a long time
  • anxiety – a feeling of unease, such as worry or fear

ED can often have both physical and psychological causes. For example, if you have diabetes, it may be difficult for you to get an erection, which may cause you to become anxious about the situation. The combination of diabetes and anxiety may lead to an episode of ED.

There are many emotional issues that may also affect your physical ability to get or maintain an erection. These include:

  • relationship problems, such as being unable to talk openly about any problems that you have
  • lack of sexual knowledge
  • past sexual problems
  • past sexual abuse
  • being in a new relationship

Other causes can include:

  • excessive alcohol intake
  • tiredness
  • using illegal drugs, such as cannabis, heroin or cocaine
[/vc_column_text][/vc_tab][vc_tab title=”Treatment” tab_id=”1415890519550-3-6″][vc_column_text]

We offer a variety of prescription only medicine (POM) to treat ED at different dosages:

  1. Viagra 25mg (Sildenafil)(Branded Viagra)
  2. Viagra 50mg
  3. Viagra 100mg
  4. Sildenafil 25mg (Generic Viagra)
  5. Sildenafil 50mg
  6. Sildenafil 100mg
  7. Cialis 2.5mg (Taldafil)
  8. Cialis 5mg
  9. Cialis 10mg
  10. Cialis 20mg
  11. Levitra 5mg (Vardenafil)
  12. Levitra 10mg
  13. Levitra 20mg
  14. Spedra 50mg
  15. Spedra 100mg
  16. Spedra 200mg
  17. ED Trial Pack 4 x (Sildenafil 50mg, Cialis 10mg and Levitra 10mg)

Viagra lost its exclusive patent in the UK in June 2103. Viagra is now available legally in the UK under the name sildenafil. Sildenafil is sometimes also known generic Viagra or generic sildenafil. Viagra and sildenafil are both supplied by Dr Felix, they are medically the same but Sildenafil is much cheaper. See comparison table.

Phosphodiesterase-5 (PDE-5) inhibitors

Phosphodiesterase-5 (PDE-5) inhibitors are one of the most widely used and effective types of medication for treating ED. They work by temporarily increasing the blood flow to your penis.

In UK, three PDE-5 inhibitors are available for treating ED. They are:

  • Sildenafil – sold under the brand name Viagra
  • Tadalafil – sold under the brand name Cialis
  • Vardenafil – sold under the brand name Levitra

Sildenafil, Tadalafil and Vardenafil

Sildenafil and Vardenafil work for about eight hours and they are designed to work ‘on demand’. Tadalafil lasts for up to 36 hours and is more suitable if you require treatment for a longer period of time, for example, over a weekend.

Depending on the type of PDE-5 inhibitor you are taking and the dose, it should take about 30-60 minutes before it starts to work. With sildenafil and vardenafil, you should be able to have sex from one to 10 hours after taking the medicine. After taking tadalafil, the effects will last for up to 36 hours.

It may take longer to notice the effects of the tablet if it is taken with food, so you should take your PDE-5 inhibitor on an empty stomach. You can then eat after an hour without affecting the medicine.

Only take one tablet within a 24-hour period.

You may have the choice of which PDE-5 inhibitor to take as sildenafil; tadalafil and vardenafil are likely to be equally effective. Your GP should explain the benefits of each medication and how it works. The choice may depend on:

  • how often you are sexually active
  • whether you have tried any of the medications before

There have been many studies to test the effectiveness of sildenafil, tadalafil and vardenafil. In general, at least two-thirds of men report having improved erections after taking one of these medicines.

If you do not find that PDE-5 inhibitors are effective it may be because:

  • you have not waited long enough after taking the dose
  • you have waited too long after taking the dose
  • the dose is not high enough
  • you have not had enough sexual stimulation

These medications are triggered by sexual stimulation, so you also need to be aroused for the medication to work.[/vc_column_text][/vc_tab][vc_column_text] [/vc_column_text][vc_tab title=”Side Effects” tab_id=”1415890546959-4-1″][vc_column_text]Most men do not experience significant side effects. On rare occasions a sustained, painful erection called a priapism can occur, which needs medical attention. Possible side effects are:

Cialis Levitra Viagra (Sildenafil)
headache headache headache
flushing muscle pain palpitation
indigestion indigestion indigestion
congestion congestion dizziness
nausea flushing congestion
dizziness dizziness flushing
blurred vision
[/vc_column_text][/vc_tab][vc_tab title=”Drug Comparison” tab_id=”1415890580553-5-2″][/vc_tab][vc_text_separator title=”About Erectile Dysfunction (ED)” title_align=”separator_align_left” color=”mulled_wine”][vc_tabs][vc_tab title=”Overview” tab_id=”1415976515-1-48″][vc_column_text]Erectile dysfunction (ED), also known as impotence, is the inability to get and maintain an erection that is sufficient for satisfactory sexual intercourse.

ED is a very common condition, particularly in older men. It is estimated that half of all men between the ages of 40 and 70 will have it to some degree.

 

Why does erectile dysfunction happen?

ED can have a range of causes that can be both physical and mental (psychological).

 

Physical causes include:

  • narrowing of the blood vessels going to the penis – commonly associated with high blood pressure (hypertension), high cholesterol or diabetes
  • hormonal problems
  • surgery or injury

 

Psychological causes include:

  • anxiety
  • depression
  • relationship problems
[/vc_column_text][/vc_tab][vc_tab title=”Symptoms” tab_id=”1415976515-2-82″][vc_column_text]The main symptom of erectile dysfunction (ED) is the inability to get and maintain an erection for satisfactory intercourse.

ED should not be confused with ejaculation problems such as premature ejaculation, which is a condition where the process of arousal, orgasm and ejaculation occurs very rapidly.

Inability to get an erection

Sometimes ED only occurs in certain situations. For example, you may be able to get an erection during masturbation, or you may find that you sometimes wake up with an erection but you are unable to get an erection with your sexual partner.

In these circumstances, it is likely that the underlying cause of ED is primarily psychological (stress related). However, if you are unable to get an erection under any circumstances, it is likely that the underlying cause is primarily physical.[/vc_column_text][/vc_tab][vc_tab title=”Causes” tab_id=”1415976914938-2-5″][vc_column_text]Erec0D
The other ED/impotence medications, Tadalafil (Cialis) and Vardenafil (Levitra), went through equally strict clinical trials and although have lower usage figures that Viagra, work in a similar manner and are also very safe.

 

11. Is Viagra addictive?

VardenafilTime required to take effectusually 30 minutes to become active15-30 minutes to become active, slightly faster than Viagra and Levitra30 – 60 minutes to become activeDuration of actionNormally about 4 hours (but up to 8 hours)

Up to 36 hoursTo understand more about the possible causes of erectile dysfunction (ED) it is useful to understand how erections occur.

 

Erections

When a man becomes sexually excited (aroused), his brain sends signals to the nerves in his penis. The nerves increase the blood flow to the penis, causing the tissue to expand and harden. Therefore, anything that interferes with the nervous system or the blood circulation could lead to ED.

Anything that affects libido (level of sexual desire) can also cause ED because a reduced libido makes it more difficult for the brain to trigger an erection. Psychological conditions, such as depression, can reduce libido, as can changes in hormone levels (chemicals that are produced by the body).

 

Physical causes

There are four main types of health conditions that can cause physical problems resulting in ED. These are:

  • Vasculogenic – conditions that affect the flow of blood to your penis e.g. cardiovascular disease, high blood pressure (hypertension) and diabetes.
  • Neurogenic – conditions that affect your nervous system, which is made up of your brain, nerves and spinal cord e.g. multiple sclerosis, Parkinson’s disease and stroke.
  • Hormonal – conditions that affect your hormone levels e.g. hypogonadism, an overactive thyroid gland and Cushing’s syndrome
  • Anatomical – conditions that affect the physical structure of your penis e.g. Peyronie’s disease.

 

Medicinal causes

In some men, certain medicines can cause ED, including:

  • diuretics – medicines that increase the production of urine and are often used to treat high blood pressure (hypertension), heart failure and kidney disease
  • antihypertensives – medicines, such as beta-blockers, that are used to treat high blood pressure
  • fibrates – medicines that are used to lower cholesterol levels
  • antipsychotics – medicines that are used to treat some mental health conditions, such as schizophrenia
  • antidepressants – medicines that are used to treat depression and some types of pain
  • corticosteroids – medication that contains steroids, which are a type of hormone
  • H2-antagonists – medicines that are used to treat stomach ulcers
  • anticonvulsants – medicines that are used to treat epilepsy
  • antihistamines – medicines that are used to treat allergic health conditions, such as hay fever
  • anti-androgens – medication that suppresses androgens (male sex hormones)
  • cytotoxics – medication used in chemotherapy to prevent cancer cells from dividing and growing

 

Psychological causes

  • depression – feelings of extreme sadness that last for a long time
  • anxiety – a feeling of unease, such as worry or fear

ED can often have both physical and psychological causes. For example, if you have diabetes, it may be difficult for you to get an erection, which may cause you to become anxious about the situation. The combination of diabetes and anxiety may lead to an episode of ED.

There are many emotional issues that may also affect your physical ability to get or maintain an erection. These include:

  • relationship problems, such as being unable to talk openly about any problems that you have
  • lack of sexual knowledge
  • past sexual problems
  • past sexual abuse
  • being in a new relationship

Other causes can include:

  • excessive alcohol intake
  • tiredness
  • using illegal drugs, such as cannabis, heroin or cocaine
[/vc_column_text][/vc_tab][vc_tab title=”Treatment” tab_id=”1415977434833-3-9″][vc_column_text]Dr K offers a variety of prescription only medicine (POM) to treat ED at different dosages:

  1. Viagra 25mg (Sildenafil)(Branded Viagra)
  2. Viagra 50mg
  3. Viagra 100mg
  4. Sildenafil 25mg (Generic Viagra)
  5. Sildenafil 50mg
  6. Sildenafil 100mg
  7. Cialis 2.5mg (Taldafil)
  8. Cialis 5mg
  9. Cialis 10mg
  10. Cialis 20mg
  11. Levitra 5mg (Vardenafil)
  12. Levitra 10mg
  13. Levitra 20mg
  14. Spedra 50mg
  15. Spedra 100mg
  16. Spedra 200mg
  17. ED Trial Pack 4 x (Sildenafil 50mg, Cialis 10mg and Levitra 10mg)

Viagra lost its exclusive patent in the UK in June 2103. Viagra is now available legally in the UK under the name sildenafil. Sildenafil is sometimes also known generic Viagra or generic sildenafil. Viagra and sildenafil are both supplied by Dr Felix, they are medically the same but Sildenafil is much cheaper. See comparison table.

Phosphodiesterase-5 (PDE-5) inhibitors

Phosphodiesterase-5 (PDE-5) inhibitors are one of the most widely used and effective types of medication for treating ED. They work by temporarily increasing the blood flow to your penis.

In UK, three PDE-5 inhibitors are available for treating ED. They are:

  • Sildenafil – sold under the brand name Viagra
  • Tadalafil – sold under the brand name Cialis
  • Vardenafil – sold under the brand name Levitra

Sildenafil, Tadalafil and Vardenafil

Sildenafil and Vardenafil work for about eight hours and they are designed to work ‘on demand’. Tadalafil lasts for up to 36 hours and is more suitable if you require treatment for a longer period of time, for example, over a weekend.

Depending on the type of PDE-5 inhibitor you are taking and the dose, it should take about 30-60 minutes before it starts to work. With sildenafil and vardenafil, you should be able to have sex from one to 10 hours after taking the medicine. After taking tadalafil, the effects will last for up to 36 hours.

It may take longer to notice the effects of the tablet if it is taken with food, so you should take your PDE-5 inhibitor on an empty stomach. You can then eat after an hour without affecting the medicine.

Only take one tablet within a 24-hour period.

You may have the choice of which PDE-5 inhibitor to take as sildenafil; tadalafil and vardenafil are likely to be equally effective. Your GP should explain the benefits of each medication and how it works. The choice may depend on:

  • how often you are sexually active
  • whether you have tried any of the medications before

There have been many studies to test the effectiveness of sildenafil, tadalafil and vardenafil. In general, at least two-thirds of men report having improved erections after taking one of these medicines.

If you do not find that PDE-5 inhibitors are effective it may be because:

  • you have not waited long enough after taking the dose
  • you have waited too long after taking the dose
  • the dose is not high enough
  • you have not had enough sexual stimulation

These medications are triggered by sexual stimulation, so you also need to be aroused for the medication to work.[/vc_column_text][/vc_tab][vc_tab title=”Side Effects” tab_id=”1415977482842-4-0″][vc_column_text]Most men do not experience significant side effects. On rare occasions a sustained, painful erection called a priapism can occur, which needs medical attention. Possible side effects are:

Cialis Levitra Viagra (Sildenafil)
headache headache headache
flushing muscle pain palpitation
indigestion indigestion indigestion
congestion congestion dizziness
nausea flushing congestion
dizziness No, the ED/impotence medicines aren’t physically addictive. In a majority of cases ED drugs are treating symptoms rather than curing, so they will continue to be needed on an indefinite basis. If the underlying condition deteriorates, higher doses of medicine may be required.When these medications are used for performance anxiety, men may become psychologically reliant on them: men feel unable to attempt sex without the backup. Rarely people are addicted to sex.

 

12. My partner has ED, is it me? What can I do?

Please be assured that ED has medical causes. It does not indicate that your partner no longer finds you attractive. Your partner may well be embarrassed and ashamed. Encouraging and supporting your partner to see his GP is important, to rule out treatable causes. Simple tablet treatments such as sildenafil (Viagra), Tadalafil (Cialis) and Vardenafil (Levitra) help a lot of couples re-attain their sex life.

 

13. I have ED, but we want to start a family, what can I do?

To start a family you need to have sex. Taking an ED/impotence medication: sildenafil (Viagra), Tadalafil (Cialis) or Vardenafil (Levitra) will improve your erectile function, enabling you to have intercourse. The more sex the greater the chances of conceiving. Studies show no adverse effects of these medications on sperm or testicular function.

 

14. When can you get NHS prescriptions for Viagra?

There is a list of eligible conditions, for which an NHS prescription can be issued. These are diabetes, Parkinson’s disease, multiple sclerosis, polio, prostate cancer, prostatectomy (surgery to remove the prostate gland), radical pelvic surgery, renal failure treated by dialysis or transplant, severe pelvic injury, single gene neurological disease, spinal cord injury, and spina bifida.

As well as sildenafil (Viagra), other ED/impotence medications can also be prescribed, e.g. Tadalafil (Cialis) and Vardenafil (Levitra).

 

15. What is the difference between Viagra and the generic vIAGRA (sildenafil)? I see it’s much cheaper, how come?

When a company makes a new drug it is patented. This gives the manufacturer exclusive rights to make that product for a set period of time. To make the drug commercially viable, the high cost of development and clinical trials needs to be recouped. Thus prices of new drugs reflects not only the production cost but also all the pre-manufacture costs too.

Once the patent runs out then any company can make the product. As there are no research, trial and marketing costs, and there is competition, the prices are significantly lower. These generic versions contain the same active ingredients as the original. They are considered the same, but some men do notice variations in effect and side effects.

 

16. I have a private prescription for Viagra – can I get cheaper generic sildenafil?

No, if a brand is prescribed, then that brand rather than a generic equivalent must be dispensed. If you prefer generic Sildenafil, you need request it at the time the prescription is written.

Branded viagra and generic sildenafil can both be requested through an online consultation.

 

17. I have heard I can split pills to save money?

This is not recommended by the manufacturer, but it is commonly done. Pill cutters are available to buy. Some pill manufacturer’s score their pills to allow them to be more easily broken into 2 or 4.[/vc_column_text][/vc_tab][/vc_tabs][vc_column_text css_animation=”fadeInUp”]

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]
[/vc_column_text] [/vc_column][/vc_row][vc_row][vc_column][vc_column_text] [/vc_column_text][/vc_column][/vc_row]