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cialis from canada Substance abuse: Marijuana, heroin, cocaine, methamphetamines, crystal meth, and alcohol abuse contribute to erectile dysfunction. Alcoholism, in addition to causing nerve damage, can lead to atrophy (shrinking) of the testicles and lower testosterone levels. Cavernosal disorders (Peyronie's disease) - Psychological causes: performance anxiety, stress, mental disorders (clinical depression, schizophrenia, substance abuse, panic disorder, generalized anxiety disorder, personality disorders or traits), psychological problems, negative feelings. In prescribing sildenafil, a doctor considers the age, general health status, and other medication(s) the patient is taking. The usual starting dose for most men is 50 mg, however, the doctor may increase or decrease the dose depending on side effects and effectiveness. The maximum recommended dose is 100 mg every 24 hours, however, many men will need 100 mg of sildenafil for optimal effectiveness, and some doctors are recommending 100 mg as the starting dose. cialis store online buy cialis
Erectile dysfunction can occur if one or more of these requirements are not met. The following are causes of erectile dysfunction: Can ED Be Prevented? For people who are at risk of developing ED due to personal behavior, such as drinking too much alcohol, steps may be taken to prevent it. However, other causes of ED may not be preventable. Dr. John R. Brinkley initiated a boom in male impotence cures in the US in the 1920s and 1930s. His radio programs recommended expensive goat gland implants and "mercurochrome" injections as the path to restored male virility, including operations by surgeon Serge Voronoff. cialis from canada buying viagra online buy viagra
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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.