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Viagra en gel One of the forms of phosphodiesterase is termed PDE5. The prescription PDE5 inhibitors sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) are prescription drugs which are taken orally. They work by blocking the action of PDE5, which causes cGMP to degrade. Erectile dysfunction, heart disease and other vascular diseases: Certain risk factors increase the risk of more atheroma forming which can make atheroma-related conditions worse. These are discussed in more detail in another leaflet called 'Preventing Cardiovascular Diseases'. Briefly, risk factors that can be modified and may help to prevent atheroma-related conditions from getting worse are: Smoking. Smoking is one of the biggest risk factors for developing an atheroma-related condition. Smoking roughly doubles your chance of developing ED. Young smokers may not be aware that they have a much greater risk of developing ED by middle age compared with nonsmokers. If you smoke, make every effort to stop. High blood pressure. Make sure your blood pressure is checked at least once a year. If it is high, it can be treated. If you are overweight, losing some weight is advised. A high cholesterol. This can be treated if it is high. Inactivity. We should all aim to do some moderate physical activity on most days of the week for at least 30 minutes. For example, brisk walking, swimming, cycling, dancing, gardening, etc. Diet. Aim to eat a healthy diet. Details in a separate leaflet called 'Healthy Eating'. Alcohol excess. Diabetes. If you have diabetes, good control of the blood sugar level and blood pressure can help to minimise the impact of diabetes on the blood vessels. Viagra en gel buy cheap kamagra jelly online uk buy kamagra online Viagra en gel cialis online from us pharmacy buy cialis online Counselling - Sometimes couple counselling, or sex therapy is useful. These are most useful if certain psychological problems are the cause of, or the result of, ED. In some cases, sex therapy is used in addition to another treatment option. Sildenafil is used for the treatment of erectile dysfunction of either physical or psychological cause. It has been found to be effective in treating erectile dysfunction in men with coronary artery disease, diabetes mellitus, hypertension, depression, coronary artery bypass surgery, and men who are taking antidepressants and several classes of anti-hypertensives. Medication (tablets taken by mouth) In 1998, the first tablet to treat ED was launched. This made a huge impact on the treatment of ED. There are now four different tablets licensed in the UK to treat ED: Apomorphine (trade name Uprima�) works by increasing the level of certain chemicals in the brain which are involved in sending messages down nerves to the penis when you are sexually aroused. You take a tablet, which dissolves under the tongue, 20 minutes before you plan to have sex. How Common Is Erectile Dysfunction? Failure to achieve an erection less than 20% of the time is not unusual and treatment is rarely needed. Failure to achieve an erection more than 50% of the time, however, generally indicates there is a problem requiring treatment. safe place to buy viagra online forum buy viagra online Another treatment regimen is injection therapy. One of the following drugs is injected into the penis: papaverine, phentolamine, and prostaglandin E1.