cialis online canada
The physical examination can reveal clues for physical causes of erectile dysfunction. For example, if the penis does not respond as expected to touching, a problem in the nervous system may be the cause. Small testicles, lack of facial hair, and enlarged breasts (gynecomastia) can point to hormonal problems such as hypogonadism with low testosterone levels. A reduced flow of blood as a result of atherosclerosis can sometimes be diagnosed by finding diminished arterial pulses in the legs or listening with a stethoscope for bruits (the sound of blood flowing through narrowed arteries). Unusual characteristics of the penis itself could suggest the root of the erectile dysfunction, for example, bending of the penis with painful erection could be the result of Peyronie's disease. Particular attention is paid to any underlying risk factors for erectile dysfunction. Erectile dysfunction, heart disease and other vascular diseases: Although ED can be caused by various conditions, about 7 in 10 cases are due to narrowing of the small arteries in the penis. This causes reduced blood flow to the penis. This is the same problem that can occur in other blood vessels. For example, narrowing of the blood vessels in the heart (the coronary arteries) is a cause of angina and other heart problems. Narrowing of blood vessels to the brain is a risk factor for having a stroke. Narrowing of blood vessels in the legs can cause peripheral vascular disease. viagra purchase online buy viagra online
What Causes Erectile Dysfunction? Common causes of ED include diseases that affect blood flow, such as atherosclerosis (hardening of the arteries) or venous leakage (weak veins); nerve diseases; psychological factors, such as stress, depression, and performance anxiety; and injury to the penis. Chronic illness, certain medications, and a condition called Peyronie's disease (scar tissue in the penis) can also cause ED. viagra online without prescription overnight buy viagra
In men 40 years of age or older, a breast examination, digital examination of the prostate, and a PSA level (prostate specific antigen) blood test should be done to exclude breast and prostate cancer before starting testosterone treatment since testosterone can aggravate breast and prostate cancers. Patients who have breast and prostate cancers or are suspected of having them should not use testosterone. cialis online canada Sildenafil has been found to be well tolerated without important side effects. The reported side effects are usually mild and include headache, flushing, nasal congestion, nausea, dyspepsia, (stomach discomfort), diarrhea, and abnormal vision (seeing a bluish hue or brightness). where do you buy viagra online buy viagra
Therefore, the dose and frequency of tadalafil has to be lowered in the following examples:No tadalafil dose adjustment is necessary for men with only mild kidney disease. Men with moderately severe kidney impairment should start tadalafil at 5 mg every 24 hours and not to exceed the maximum dose of 10 mg taken every 48 hours. In men with severe kidney disease and on dialysis, the maximum dose should not exceed 5 mg. cialis soft online ordering buy cialis online
Can Sexual Problems Be Prevented? While sexual problems cannot be prevented, dealing with the underlying causes of the dysfunction can help you better understand and cope with the problem when it occurs. There are some things you can do to help maintain good sexual function: Follow your doctor's treatment plan for any medical/health conditions. Limit your alcohol intake. Quit smoking. Deal with any emotional or psychological issues such as stress, depression, and anxiety. Get treatment as needed. Increase communication with your partner.