Chlamydia

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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]

%0irculation 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 causesThere 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 causesIn 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:

  • Viagra 25mg (Sildenafil)(Branded Viagra)
  • Viagra 50mg
  • Viagra 100mg
  • Sildenafil 25mg (Generic Viagra)
  • Sildenafil 50mg
  • Sildenafil 100mg
  • Cialis 2.5mg (Taldafil)
  • Cialis 5mg
  • Cialis 10mg
  • Cialis 20mg
  • Levitra 5mg (Vardenafil)
  • Levitra 10mg
  • Levitra 20mg
  • Spedra 50mg
  • Spedra 100mg
  • Spedra 200mg
  • 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) inhibitorsPhosphodiesterase-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 VardenafilSildenafil 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=”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:[/vc_column_text][/vc_tab][vc_tab title=”Drug Comparison” tab_id=”1415890580553-5-2″][/vc_tab][vc_tabs][vc_tab title=”Overview” tab_id=”1415976515-1-48″][vc_column_text]Chlamydia is one of the most common sexually transmitted infections (STIs) in the UK. It’s passed on from one person to another through unprotected sex (sex without a condom). In 2010, 186,753 people tested positive for chlamydia in England. Most of these – more than 150,000 – were 24 years of age or younger[/vc_column_text][/vc_tab][vc_tab title=”Symptoms” tab_id=”1415976515-2-82″][vc_column_text]Most people who have chlamydia don’t notice any symptoms.If you do get signs and symptoms, these usually appear between one and three weeks after having unprotected sex with an infected person. For some people the symptoms occur many months later, or not until the infection has spread.Symptoms in womenAround 70-80% of women with chlamydia don’t notice any symptoms. If women do get symptoms, the most common include:

  • pain when urinating (peeing)
  • a change in vaginal discharge
  • pain in the lower abdomen
  • pain and/or bleeding during sex
  • bleeding after sex
  • bleeding between periods
  • heavier periods than usual

If chlamydia is left untreated in women, it can spread to the womb and cause pelvic inflammatory disease (PID). PID is a major cause of infertility, miscarriage and ectopic pregnancy (when a fertilised egg implants itself outside the womb, usually in one of the fallopian tubes).Symptoms in menAround half of all men with chlamydia don’t notice any symptoms. If men do get symptoms, the most common include:

  • pain when urinating (peeing)
  • discharge from the tip of the penis (this can be a white, butty or watery discharge)
  • pain in the testicles

Some men have mild symptoms that disappear after two or three days. Even if the symptoms disappear you will still have the infection and be able to pass it on. If chlamydia is left untreated in men they are at risk of complications such as orchitis (swollen testicles), reactive arthritis (inflammation of the joints) and infertility.Chlamydia in the rectum, throat or eyesChlamydia can infect the rectum, eyes or throat if you have unprotected anal or oral sex. If infected semen or vaginal fluid comes into contact with the eyes you can also develop conjunctivitis.Infection in the rectum can cause discomfort, pain, bleeding or discharge. In the eyes chlamydia can cause irritation, pain, swelling and discharge the same as conjunctivitis. Infection in the throat is less common and usually causes no symptoms.[/vc_column_text][/vc_tab][vc_tab title=”Causes” tab_id=”1415976914938-2-5″][vc_column_text]Chlamydia is caused by bacteria called Chlamydia trachomatis.Chlamydia is a sexually transmitted infection (STI), which means that you get it through having unprotected sex (sex without a condom) with someone who has chlamydia.How you get chlamydiaYou can get chlamydia through:• unprotected vaginal sex
• unprotected anal sex
• unprotected oral sex
• your genitals coming into contact with your partner’s genitals
• sharing sex toys when they are not washed or covered with a new condom between each person who uses themSexual fluid from the penis or vagina can pass chlamydia from one person to another even if the penis does not enter the vagina, anus or mouth. This means you can get chlamydia from genital contact with someone who has the infection even if there is no penetration, orgasm or ejaculation.It isn’t clear if chlamydia could be passed on by transferring infected semen or vaginal fluid on the fingers.Infected semen or vaginal fluid can cause conjunctivitis if it gets into someone’s eye.Chlamydia and giving birthDuring childbirth, a woman with chlamydia can pass the infection on to her baby. If chlamydia develops in the baby there might not be any obvious symptoms at first. Chlamydia in a newborn baby can cause inflammation (swelling) and discharge in the baby’s eyes (known as conjunctivitis) and pneumonia. The midwife or GP can arrange a simple swab test for chlamydia from the baby.[/vc_column_text][/vc_tab][vc_tab title=”Treatment” tab_id=”1415977434833-3-9″][vc_column_text]Chlamydia is usually treated with antibiotics. Antibiotics are very effective for treating chlamydia. More than 95 out of 100 people with chlamydia will be cured if they take their antibiotics correctly.The two most commonly prescribed antibiotics to treat chlamydia are:• Azithromycin (single dose)
Doxycycline (a longer course, usually two capsules a day for a week)Your doctor may give you different antibiotics if you have an allergy, or are pregnant. A longer course of antibiotics may be used if your doctor is concerned about complications of chlamydia. Other common antibiotics are ofloxacin anderythromycin.If there is a high chance that you have been infected with chlamydia (for example, your partner has been diagnosed with chlamydia and you have had unprotected sex with them) you might be started on treatment before you get your test results.Pregnant or breastfeedingTell your doctor if you are pregnant or breastfeeding, as this will affect the type of antibiotic you can be given. Azithromycin, amoxicillin and erythromycin are all safe for pregnant women to take.Antibiotics and contraceptionMost antibiotics are safe to use with contraception. If you vomit or have severe diarrhoea they may be less effective and put you at risk of pregnancy, especially if you have unprotected sex. Read Will antibiotics stop my contraception working? for more information.Talk to your doctor, sexual health adviser or pharmacist about whether the antibiotics you are given might affect your contraception.Having sex againYou should not have sex for at least one week after you have finished your antibiotic treatment. You may need to avoid having sex for longer if your sexual partner has not been treated so that you do not become re-infected. You should also avoid having sex until your symptoms have gone.Side effects of chlamydia treatmentThe side effects of antibiotics are usually mild. The most common side effects include:

  • stomach pain
  • diarrhoea
  • feeling sick
  • vaginal thrush (vaginal yeast infection, also called candida)

Occasionally, doxycycline can cause a skin rash if you are exposed to too much sunlight (photosensitivity).Treatment for sexual partnersIf you test positive for chlamydia, it’s important that your current sexual partner and any other recent sexual partners are also tested and treated.
In the UK, it’s advised that you contact any sexual partners you’ve had within the past six months.Sexual health clinics or GUM clinics can contact your sexual partners for you if you prefer. Either you or the clinic can speak to them, or can send them a note (called a contact slip) to let them know that they may have been exposed to a sexually transmitted infection (STI). The note will suggest that they go for a check-up. The note will not have your name on it, and it may or may not say what the infection is. Your confidentiality will be protected.Do I need another test to check chlamydia has gone?If you take all your antibiotics correctly then you should not need a follow-up test. The doctor or nurse will advise you to have a repeat test if:

  • you were treated for chlamydia and you are pregnant
  • you forgot to take any of your medication or did not take it properly
  • you had sex before you and your partner had finished treatment
  • your symptoms have not gone or if they have come back
[/vc_column_text][/vc_tab][vc_tab title=”Complications” tab_id=”1415977482842-4-0″][vc_column_text]If chlamydia is not treated, it can sometimes spread and cause long-term problems.Complications in womenIn women, chlamydia can spread to the womb (uterus), ovaries or the fallopian tubes. This can cause a condition called pelvic inflammatory disease (PID). Women may also develop an inflammation of the cervix (cervicitis), or an infection in the Bartholin’s glands near the vaginal opening. Very rarely women can develop a reactive arthritis.PIDChlamydia is one of the main causes of PID in women. PID is an infection of the womb (uterus), ovaries and fallopian tubes. It can cause infertility, persistent (chronic) pelvic pain and it increases the risk of miscarriage and ectopic pregnancy. PID can be treated with antibiotics, and the risk of infertility is reduced if PID is treated early.Inflammation of the cervix (cervicitis)Chlamydia can cause inflammation of the cervix (the neck of the womb), known as cervicitis. Cervicitis often causes no symptoms, but if you do get symptoms these may include:

  • bleeding during or after sex
  • bleeding between periods
  • discomfort in your lower abdomen
  • vaginal discharge
  • pain during sex

Blocked fallopian tubesChlamydia can spread to cause inflammation in the fallopian tubes (known as salpingitis). This can make it difficult for an egg to travel from the ovary to the womb and can make becoming pregnant more difficult. Find out more about conception and getting pregnant.Even if a fallopian tube is only partially blocked, this will increase the risk of ectopic pregnancy (when a fertilised egg implants outside the womb, usually in a fallopian tube). Blocked fallopian tubes can sometimes be treated with surgery.Swollen Bartholin’s glands (Bartholinitis)The glands that produce a woman’s lubricating mucus during sex are known as the Bartholin’s glands. They sit on either side of the vaginal opening. Chlamydia can cause the glands to become blocked and infected, leading to a Bartholin’s cyst.The cyst is usually painless, but if it becomes infected it can lead to an abscess. An abscess is usually red, very tender, painful to touch, and can cause a fever. An infected abscess needs to be treated with antibiotics. Very occasionally an operation is needed to drain the abscess.Complications in menUrethritis is inflammation of the urethra (urine tube) that runs along the underside of the penis. Symptoms include:

  • a white cloudy discharge from the tip of the penis
  • pain or a burning sensation when you urinate
  • the urge to urinate often
  • irritation and soreness around the tip of the penis

There are many causes of urethritis but chlamydia infection is the most common. If you have urethritis and the cause is not known then this is called a “non-specific urethritis” (NSU). NSU is often treated with the same antibiotics as chlamydia.EpididymitisThe main symptoms of epididymitis are swelling and tenderness in the epididymis. The epididymis is part of a man’s reproductive system and carries sperm from the testicle. If the testicles are affected it is called epididymo-orchitis.A chlamydia infection in the epididymis can cause inflammation, swelling and tenderness inside the scrotum (ball sack). A few men will notice that the whole of the scrotum is red and tender. Infection can lead to a build-up of fluid in the affected area, or even an abscess. If left untreated, epididymitis can sometimes lead to infertility.Reactive arthritisChlamydia can cause a reactive arthritis (inflammation of the joints). In some people the arthritis develops as part of a syndrome and they also develop inflammation of the urethra (urethritis) and the eyes (conjunctivitis).Reactive arthritis is more likely to occur in men than women. Symptoms usually get better in 3-12 months although they can return after this. Symptoms can usually be controlled by painkillers known as non-steroidal anti-inflammatory drugs(NSAIDs), such as ibuprofen. Some people will need to see a joint specialist if their symptoms are severe.[/vc_column_text][/vc_tab][vc_tab title=”Prevention” tab_id=”1416398663340-5-2″ tabicon=”fa-wifi”][vc_column_text]You can protect yourself against chlamydia by:

  • using a condom every time you have vaginal or anal sex
  • using a condom to cover the penis during oral sex
  • using a dam (a piece of thin, soft plastic or latex) to cover the female genitals during oral sex
  • not sharing sex toys

If you do share sex toys, wash them or cover them with a new condom between each person who uses them.These measures can also protect you against other sexually transmitted infections (STIs) such as genital herpes and gonorrhoea.[/vc_column_text][/vc_tab][/vc_tabs]