Drugs (Anti-depressants (SSRIs) and Nicotine are most common. A study entitled “Drug-induced male sexual dysfunction” concluded that of the 12 most commonly prescribed medications on the market today, 8 of those medications list “impotence” as a side-effect of the drug. Other drugs such as alcohol, cocaine, and heroin negatively impact male sexual libido.) How Well Do Vacuum Constriction Devices Work? High cholesterol or blood pressure For example, surgical patients can opt for a "nerve-sparing" procedure less likely to interfere with sexual function. And radiation patients can choose between external beam treatment and brachytherapy, in which radioactive "seeds" are implanted in the tumor, according to the American Cancer Society. Limit or avoid use of alcohol and caffeine. Erectile dysfunction is defined as the persistent inability to achieve or maintain penile erection sufficient for sexual intercourse. In the past, patients have underreported this problem because of embarrassment and the belief that little could be done to alleviate it. The availability and marketing of new therapies for erectile dysfunction have greatly increased public awareness of this problem. Naval Hospital Jacksonville, Jacksonville, Florida Patient information handouts on erectile dysfunction and Viagra, written by the authors of this article, are provided on pages 1169 and 1172. "It's relatively common in men with diabetes and various forms of vascular disease, or men who've previously had infections -- usually infections of a penile prosthesis," Sharlip said. "There are men who have such severe fibrosis that nothing can be done to restore their natural erection function, other than to implant a surgical prosthesis," he added. Rarely Related Health News By E.J. Mundell HealthDay Reporter Viagra Canadian Pharmacy Testosterone (Androgel, Testoderm, Depo-Testosterone) 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. Other Impotence Drugs B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals [edit] Causes Investigate the hypothalamic-pituitary-gonadal axis by evaluating testosterone levels (a morning serum free and total testosterone level is suggested) in most patients, especially if the patient has a history of reduced libido. Men with severe liver disease should not take tadalafil. Men with mild to moderate liver disease should not exceed tadalafil dose of 10 mg once daily.