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There have been rare reports of priapism (prolonged and painful erections lasting more than six hours) with the use of oral PDE5 inhibitors such as vardenafil, sildenafil, and tadalafil. Men with blood cell diseases such as sickle cell anemia, leukemia, and multiple myeloma have higher than normal risks of developing priapism. Untreated priapism can cause injury to the penile tissue and lead to permanent loss of potency. If there is prolonged erection (longer than four hours), immediate medical assistance should be sought. Metabolism (breakdown) of sildenafil is slowed by aging, liver and kidney dysfunction, and concurrent use of certain medications (such as erythromycin -- an antibiotic, and protease inhibitors, for HIV). Slowed breakdown allows sildenafil to accumulate in the body and potentially may increase the risk of side effects. Therefore in men over 65, in men with substantial kidney and liver disease, and in men who also are taking protease inhibitors, the doctor will initiate sildenafil at a lower dose (25 mg) to avoid accumulation of sildenafil in the body. A protease inhibitor ritonavir (Norvir) is especially potent in increasing the accumulation of sildenafil, thus men who are taking Norvir should not take sildenafil doses higher than 25 mg and at a frequency of no greater than once in 48 hours. levitra generic online cheap cialis strips sale online buy cialis This section needs additional citations for verification. (May 2010) best online price for generic viagra buy viagra Drug therapy for erectile dysfunction: In a small number of cases, people who have taken sildenafil have complained of headaches, flushing and stomach-ache. It can also cause some visual problems, including an increased sensitivity to light, blurred vision or an inability to tell the difference between blue and green. Men who are already taking medicines that contain nitrates, such as nitro-glycerine (usually for angina or heart disease), are strongly advised not to use Viagra as this is dangerous and may result in a heart attack. Other similar drugs are tadalafil (‘Cialis’)and vardenafil (‘Levitra’). How Do Sexual Problems Affect Men? The most common sexual problems in men are ejaculation disorders, erectile dysfunction and inhibited sexual desire. This section needs additional citations for verification. (May 2010) buy cialis soft online buy cialis online How Is Male Sexual Dysfunction Treated? Many cases of sexual dysfunction can be corrected by treating the underlying physical or psychological problems. Treatment strategies may include the following: Medical treatment: This involves treatment of any physical problem that may be contributing to a man's sexual dysfunction. can i buy viagra online buy viagra levitra generic online