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The risk of developing heart attacks or abnormal heart rhythms during sex is low in men with well-controlled hypertension, mild disease of the heart valves, well-controlled heart failure, mild and stable angina (with a favorable treadmill stress test), successful coronary stenting or bypass surgery, and a remote history of heart attack (more than eight weeks previously). Sildenafil can be used safely in men in these low-risk groups. Who should not use tadalafil (Cialis)? Tadalafil can cause hypotension (abnormally low blood pressure, which can lead to fainting and even shock) when given to patients who are taking nitrates. Patients taking nitrates daily should not take tadalafil. Most commonly used nitrates are medications to relieve angina (chest pain due to insufficient blood supply to heart muscle because of narrowing of the coronary arteries). These include nitroglycerine tablets, patches, ointments, sprays, pastes, and isosorbide dinitrate and isosorbide mononitrate. Other nitrates such as amyl nitrate and butyl nitrate are found in some recreational drugs called "poppers." How should tadalafil (Cialis) be administered? The recommended starting dose of tadalafil for most patients is 10 mg taken orally approximately one hour before sexual activity. The dose may be adjusted higher to 20 mg or lower to 5 mg depending on efficacy and tolerability. The maximum recommended dosing frequency is once per day, although for many patients tadalafil can be taken less frequently since the improvement in erectile function may last 36 hours. Tadalafil may be taken with or without food. cialis sale Erectile dysfunction (ED) is when a man has trouble getting or keeping an erection. ED becomes more common as you get older. But male sexual dysfunction is not a natural part of aging. viagra uk online viagra uk url buy viagra online
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When there is angina or heart failure, the doctor may need to determine whether the heart has enough reserve to safely carry out the work necessary for sexual activity by performing cardiac treadmill stress testing. Other factors leading to erectile dysfunction are diabetes mellitus (causing neuropathy). Drugs (anti-depressants (SSRIs) and nicotine are most common) viagra sales online buy viagra online
What Are Ejaculation Disorders? There are different types of ejaculation disorders in men, including: Premature ejaculation: This refers to ejaculation that occurs before or soon after penetration, Inhibited or retarded ejaculation: This is when ejaculation is slow to occur, Retrograde ejaculation: This occurs when, at orgasm, the ejaculate is forced back into the bladder rather than through the urethra and out the end of the penis.
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