Posts tagged Erectile Dysfunction

For men who suffer from erectile dysfunction there is a product available called Cialis which is known as the “weekend pill”. (1) It performs the same function as Viagra in that it helps to maintain an erection, but Cialis lasts in the body for 36 hours so you can take the pill on Friday night and it will still be active on Sunday morning. This doesn’t mean that you will have an erection for that length of time but you will be ready for satisfactory sexual activity when you have been sexually aroused.

The active ingredient in Cialis is Tadalafil, and you can now buy generic Cialis under the name of Tadalafil which produces exactly the same effect. The big advantage is that it is much cheaper. You can buy Tadalafil 10mg and Tadalafil 20mg, the latter being the high dose. Tadalafil 10mg is the recommended staring dose, but this can be increased to 20mg if necessary if you find that it’s not as effective as you would like and you haven’t suffered from any side-effects.

You can also buy Tadalafil Daily online.  Tadalafil Daily is available in strengths of 2.5mg and 5mg. The lower dose takes 4 – 5 days to take effect, but once it has you will be able to respond to any sexual stimulation anywhere, at any time.

Tadalafil Daily tablets should be taken once a day and it’s best to take it at the same time of day. So it’s a good idea to stick to a regular time of day, like when you’re having your breakfast, so that you don’t forget. You are advised not to drink grapefruit juice when taking Tadalafil as this can affect the effectiveness of the pill. You should also not drink more than one or two units of alcohol before taking the medication because that can also affect your ability to get an erection. (2)

References

1. Summary of Product Characteristics. Cialis 2.5mg, 5mg, 10mg & 20mg film-coated tablets. Eli Lilly and Company. Date of revision of the text: 03 September 2008. Accessed via http://emc.medicines.org.uk on 7/6/19 

2. British National Formulary, 76th edition. Accessed via www.bnf.org on 7/6/19.

Medically reviewed by
Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
9th June 2019

Sildenafil is a generic treatment for erectile dysfunction and today you can buy Sildenafil online which many men may find less embarrassing and more convenient than having to make a journey to their local pharmacy for it.

Sildenafil (the generic form of Viagra) and Viagra are medically identical, and so are found to be equally effective.

Both products contain the identical amount of active ingredient. (1)

Until 2013 nobody else could produce Sildenafil because Pfizer had a patent. However, that patent expired in 2013 and today other companies can manufacture Sildenafil. As you might expect, generic Sildenafil tablets are less expensive than Viagra even though they contain exactly the same ingredient and produce the same effect. This has enabled many more men to be able to enjoy a more fulfilling sex life.

The only difference between generic Sildenafil tablets and Viagra are the fillers. These are used to bulk up the tablets, since the amount of Sildenafil required in each is only tiny. Different manufacturers use different fillers and that is why the brands differ in shape, colour and size. (2) A commonly used filler is lactose. Those who are lactose intolerant should carefully check the Patient Information Leaflet supplied with their Sildenafil tablets before taking them. There is one brand which does not contain lactose and that is called Mylan.   Fortunately, Webmed Pharmacy only supplies the Mylan brand of Sildenafil.

Viagra contains lactose.

Sildenafil is usually sold in white or blue tablets, the blue being a form of identification with Viagra which is sold in blue diamond shaped pills. Pfizer has trademarked the shape of its pills which cannot be copied, but they cannot trademark the colour.

Both Sildenafil and Viagra are available in 25mg, 50mg, and 100mg tablets.

References

1) https://sciencebasedmedicine.org/are-generic-drugs-equivalent-to-brand-name-drugs/ (accessed on 7/6/19)

2) https://sciencebasedmedicine.org/whats-all-that-other-stuff-in-my-medicine/ (accessed on 7/6/19)

Medically reviewed by
Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
9th June 2019

Erectile dysfunction (ED) is a problem generally viewed in society as being associated with middle aged and elderly men. However, contrary to popular belief, ED can affect men of all ages, and does affect plenty of younger men. But why?

There are numerous physical and emotional factors which can cause or contribute to ED. Anxiety is a major contributor for younger men. You may worry that your partner is negatively judging your sexual performance, or that they won’t reach orgasm. You might fear that a partner will become pregnant. These anxious feelings may result in a stress response, directing blood away from the penis to other parts of the body, and therefore causing loss of erection. (1, 2)

ED in younger men may also be caused by anxiety or stress that is not directly related to sexual activity. Just a few examples of factors which can contribute to anxiety and stress are problems in the workplace, financial struggles, ill health (yourself or a relative or friend) or a rocky relationship. All of this can have an impact on ED. What’s more, ED can cause further anxiety, worsening the problem in a cruel spiral. (2)

If you smoke and suffer with ED, you may want to consider stopping as smoking is a major cause of the condition in many men, younger and older. The components of cigarette smoke can have a damaging effect on blood vessels, including those in the penis. One such effect is the formation of plaque on the walls of the blood vessels, known as atherosclerosis. This makes the area through which blood can flow narrower, impairing the surge in blood flow to the penis that is essential for an erection. Visit your GP for help getting started on your path to being smoke free. Alternatively, many pharmacies offer a smoking cessation service, with regular meetings with a member of staff to guide you through the quitting process. (2)

Alcohol can also be a culprit. In the short term, after a session of heavy drinking, the physiological response to sexual arousal can be sluggish or non-existent, causing an episode of poor erectile function. However, this should right itself once you sober up. In the long term, persistent binge drinking can damage the blood vessels of the penis, leading to ED. Stick to no more than 14 units of alcohol per week, and no more than 8 units in one drinking session. (2, 3, 4)

Being overweight or obese, particularly if you carry a lot of excess weight around the abdomen, puts you at higher risk of ED. Having a greater body mass means that your heart has to work harder to pump blood around your body and to your extremities, such as the tip of the penis. A diet high in fat and cholesterol can also lead to atherosclerosis, as with smoking. Aim for at least 30 minutes of moderate to intense exercise at least five times a week, and reduce or cut out high fat foods such as cheese, red meat, chocolate, cakes and biscuits, and fried foods. (5)

If you’re an avid cyclist or commute to work by bike, this can work wonders for your cardiovascular health and help to keep excess weight off. But did you know that cycling for over three hours per week can be a cause of ED? Prolonged or regular pressure on the pudendal nerve, which runs through the perineum (the area separating the genitals from the anus), can damage this nerve which plays a part in erectile function. You could consider supplementing cycling with other forms of exercise, or investing in a specialised saddle which is designed to ease pressure on the perineum. (3, 6)

Taking all of this into account, it really isn’t a surprise that younger men can experience ED. There are so many lifestyle factors and health conditions which affect men of all ages and can also contribute to ED. Don’t be embarrassed to seek a diagnosis and treatment – remember there are plenty of other men in your position and your doctor is there to help. If you don’t want to see your doctor initially, Viagra Connect (sildenafil) is available over the counter in pharmacies, subject to filling out a safety questionnaire. However, you’ll be strongly advised to see your doctor within six months of starting Viagra Connect, as it is important that your doctor knows which medicines you are taking on a regular basis, as well as to rule out any serious problems which may be contributing to your ED.

Viagra Connect is available to buy from Webmed, and the prescription only ED medicines Cialis (tadalafil), Spedra (avanafil), Levitra (vardenafil) and higher strength Viagra (sildenafil) are available to purchase here, as well as the generic sildenafil and tadalafil, after a quick medical questionnaire which is reviewed by a doctor.

References

1. British Pregnancy Advisory Service. Erectile dysfunction (male impotence) [cited 24 May 2019. Available at: https://www.bpas.org/more-services-information/erectile-dysfunction/

2. International Society for Sexual Medicine. Is erectile dysfunction (ED) common in men under age 40? [cited 24 May 2019]. Available at: https://www.issm.info/sexual-health-qa/is-erectile-dysfunction-ed-common-in-men-under-age-40/

3. NHS. Erectile dysfunction (impotence) [cited 24 May 2019]. Available at: https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/

4. NHS. Binge drinking [cited 24 May 2019]. Available at: https://www.nhs.uk/live-well/alcohol-support/binge-drinking-effects/

5. The Telegraph (2018). ‘Does anxiety cause erectile dysfunction?’ [cited 24 May 2019]. Available at: https://www.telegraph.co.uk/health-fitness/living-with-erectile-dysfunction/does-anxiety-cause-erectile-dysfunction/

6. Men’s Health. Is Your Bike Killing Your Boner? [cited 24 May 2019]. Available at: https://www.menshealth.com/health/a19539158/can-bicycles-cause-erectile-dysfunction/

Author
Gabby Gallaher MPharm

Medically reviewed by
Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
24th May 2019

Cycling is great for both mind and body – depending on whether you’re going uphill, downhill or on a flat surface, or on smooth or rough terrain, you can exercise different muscle groups at different intensities – all while soaking up the sights and sounds of the world around you. But could your daily commute, or your weekend unwind, be damaging your sexual health? A number of studies and news articles over the years have suggested that there may be a link between cycling and erectile dysfunction (ED).

Does research show a correlation between Cycling and ED?

A study conducted in Norway in 1997 collected data from 160 men who had taken part in a long distance bicycle race. It found that 13% of this sample had developed temporary ED after the race, in some cases lasting longer than a month. (1) In 2001, another study on 40 men found that ED occurred in nearly a fifth of long distance cyclists. (2) In 2004, a review of 62 medical articles summarised that up to a quarter of male cyclists had reported ED. (3) And in 2010, a further review found a ‘significant relationship’ between cycling and ED. (4)

The sample sizes (number of people studied) for many of these studies are small – generally the larger the sample size, the more reliable the results of a study are. But clearly the general message from these studies is worth noting, as the NHS Choices page on ED advises men against cycling for three hours or longer per week. (5)

How can I  avoid ED?

The Men’s Health and Cycling UK websites suggest investing in modified bicycle seats. A split bicycle seat has part of the saddle ‘cut out’ to ease pressure on the groin area, especially the pudendal nerve, which runs through the perineum (the area separating the genitals from the anus), which if damaged can lead to ED. Noseless saddles reduce contact between the saddle and the perineum. And saddles incorporating holes and grooves are also available, which are designed to be a better fit to the genital area, reducing pressure. (6, 7)

An article from the prestigious US-based Harvard Medical School also highlights the importance of saddle shape for those concerned about cycling and ED. Wider, softer saddles are preferable to hard, narrow saddles as the weight of the cyclist is spread out over a larger area and the softer seat will put less pressure on the genitals. (8)

Would it be safer if I just stopped cycling altogether?

Absolutely not! Don’t forget, cycling is a superb form of exercise. The better your health and fitness, generally the better your sexual health will be. Just take heed of the above advice and consider supplementing cycling with other forms of exercise if you feel 3 hours a week isn’t enough Even if you do find yourself with ED issues further down the road, there are many treatments available online that can help.

References

1. Andersen KV, Bovim G. Impotence and nerve entrapment in long distance amateur cyclists. Acta neurologica Scandinavica. 1997 Apr;95(4):233-40. Available at: https://www.ncbi.nlm.nih.gov/pubmed/9150814 [accessed 30 August 2018].
2. Sommer F et al. Impotence and genital numbness in cyclists. International journal of sports medicine. 2001 Aug;22(6):410-3. Available at: https://www.ncbi.nlm.nih.gov/pubmed/11531032 [accessed 30 August 2018].
3. Leibovitch I, Mor Y. The vicious cycling: bicycling related urogenital disorders. European urology. 2005 Mar;47(3):277-86; discussion 286-7. Available at: https://www.ncbi.nlm.nih.gov/pubmed/15716187 [accessed 30 August 2018].
4. Sommer F, Goldstein I, Korda JB. Bicycle riding and erectile dysfunction: a review. The journal of sexual medicine. 2010 Jul;7(7):2346-58. doi: 10.1111/j.1743-6109.2009.01664.x. Available at: https://www.ncbi.nlm.nih.gov/pubmed/20102446 [accessed 30 August 2018].
5. NHS Choices. Erectile dysfunction [cited 30 August 2018]. Available at: https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/
6. Men’s Health. Is Your Bike Killing Your Boner? [cited 30 August 2018]. Available at: https://www.menshealth.com/health/a19539158/can-bicycles-cause-erectile-dysfunction/
7. Cycling UK. Boy stuff: cycling, the prostate and erectile dysfunction [cited 30 August 2018]. Available at: https://www.cyclinguk.org/blog/olivercw/boy-stuff-cycling-prostate-and-erectile-dysfunction
8. Harvard Medical School. Can cycling cause erectile dysfunction? [cited 30 August 2018]. Available at: https://www.health.harvard.edu/staying-healthy/can-cycling-cause-erectile-dysfunction

Author: Gabby Gallagher MPharm

Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 11/09/18

There are a number of things to consider when deciding on a treatment for erectile dysfunction (ED) - how long will the effect last, how often do I need to take it, how much does it cost? But did you know that tadalafil, once only available as the Cialis brand, is now available to buy online as a generic (unbranded) version?

What is Generic Cialis (Tadalafil)?

Generic forms of any medication are medically identical to the branded originals and are quality controlled to the same standards as the brand name versions; they are just as safe and effective but generally cost much less.

Generic tadalafil contains exactly the same active ingredient as Cialis, but at a fraction of the price. This may be of benefit if you’ve thought about trying Cialis in the past but were put off by the cost. However, cost isn’t the only factor to take into account, and the information below aims to help you decide on the best erectile dysfunction (ED) treatment for you.

Which erectile dysfunction (ED) treatment should I choose: Sildenafil or Tadalafil?

Sildenafil and tadalafil are the two most popular treatments for erectile dysfunction (ED), with sildenafil, brand name Viagra, being the oldest and most well known of the two. But which is better?

Sildenafil is taken an hour before sexual activity, and it will help you get an erection up to at least four hours after taking it, sometimes up to six hours (this doesn’t mean you’ll have an erection that lasts for this length of time - just that you’ll have the potential to have an erection if sexually aroused within the four to six hours after taking). Tadalafil, on the other hand, can be taken 30 minutes before sexual activity and will help you to get an erection up to 36 hours later, so it allows for more sexual spontaneity and has been dubbed “The weekend pill”. Both sildenafil and tadalafil should not be taken more frequently than once a day.

The effect of sildenafil can be impaired if taken with or after food, but tadalafil works just as well taken after a meal as it does on an empty stomach.

Which erectile dysfunction (ED) treatment is best for lactose intolerant people?

If you are lactose intolerant, sildenafil may be the best option as it is available as a lactose free formulation. You can buy the Mylan brand of sildenafil at Webmed, which is lactose free.

Tadalafil can also be taken as a daily dose if you are sexually active at least twice a week. This means you don’t need to worry at all about waiting for the effects to kick in - you’ll be ready for sexual activity at any time.

Other erectile dysfunction (ED) medicines are available besides sildenafil and tadalafil - avanafil, available only as the brand Spedra, is the fastest acting, taking effect in just 15 minutes. Vardenafil, marketed as Levitra, may work more quickly and last slightly longer than sildenafil and tadalafil and may be the most suitable ED medication for people with diabetes.

What’s the best erectile dysfunction (ED) treatment?

Overall, it appears that tadalafil comes out on top when compared with sildenafil, with the notably longer duration of action, slightly faster onset of effectiveness, compatibility with food and the option to take it as a once daily dose. But everyone has different needs, and what works for one person may not work for the next. Hopefully, this information will have helped you to decide on which erectile dysfunction (ED) treatment will be best for you.

To see the full list of erectile disfunction (ED) medication available from Webmed, click here.

Author: Gabby Gallagher MPharm

Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 24/08/18

Viagra Connect is available to buy NOW!

Around 50% of men over the age of 40 suffer some form of erectile dysfunction.

This widespread condition can cause embarrassment, frustration and even depression for those affected. Some men are so ashamed about having erectile dysfunction that they choose not to seek help from their GP. They just continue to put up with the condition or more worryingly, opt to purchase treatment from illegal vendors online.

Purchasing any medicines in this way poses risks as there is no guarantee that they have been produced following the stringent quality and safety procedures and testing that medicines from UK registered and regulated online pharmacies undergo.

The good news is that this has impelled the Medicines and Healthcare products Regulatory Agency (MHRA) to reclassify Viagra Connect (sildenafil 50mg) from a prescription-only medicine (POM) to a pharmacy (P) medicine, meaning that it is available to purchase over the counter without a prescription in the UK from the spring of 2018. (1, 2)

Viagra Connect should be taken around one hour before sexual activity, ideally on an empty stomach as food can slow absorption. No more than a single tablet per day should be taken. Although the majority of men will be successful first time, it may take a few doses (therefore a few separate attempts) to reach the desired effect of a penile erection sufficient for satisfactory sexual activity. If this fails, you will need to see your GP. (3)

Men wishing to purchase Viagra Connect over the counter in a pharmacy will need to have a quick discussion surrounding symptoms, medical conditions and other medicines with the pharmacist, so that it can be determined whether the medicine is suitable or safe to take.

If buying from an online pharmacy, a short medical questionnaire will need to be completed to assess suitability. Certain medical conditions, such as cardiovascular diseases, high cardiovascular risk, and liver or kidney failure, may mean that the medicine cannot be sold and a GP appointment is needed. (2)

Viagra Connect is available to order from Webmed Pharmacy by selecting the medicine after clicking the ‘Treatments’ tab on the homepage. You will need to complete a short confidential online consultation, and then, like in any other pharmacy, the pharmacist will review the information you’ve given and assess whether the medicine is safe for you to take.

This regulatory change will benefit millions of UK men. For many, a trip to the pharmacy seems much more informal and is often more convenient than an appointment with the GP. The patient can even visit a pharmacy they don’t usually go to or use a General Pharmaceutical Council (GPhC) registered online pharmacy such as Webmed if they fear embarrassment. The danger to health of obtaining medicine from illegal, unregulated and unregistered websites will also be reduced. It may even help other underlying conditions to be diagnosed, since pharmacists will inform men buying Viagra Connect that they should make a follow-up appointment with their GP within 6 months so that such conditions can be tested for. (1)

Other options include:-

Viagra is the most well-known treatment for erectile dysfunction, often referred to as “the blue pill”.
The active ingredient in Viagra is sildenafil which dilates the blood vessels leading to the penis to enable a firm, long lasting erection when a man is sexually aroused or stimulated.

Viagra and Sildenafil both contain exactly the same active ingredient. They are both equally effective, but sildenafil is much cheaper.

Tadalafil, the generic form of Cialis, became available in November 2017 when the patent expired and has become very popular.

Tadalafil on demand is known as “the weekend pill” as, due to it's 36 hour duration of action, it can be taken on a Friday night and still be active on Sunday morning.

There is also a low dose tadalafil option taken on a daily basis, called Tadalafil daily, so you don’t have to plan ahead and can be ready for action “anytime, anyplace, anywhere”.

Worried about buying fake medicines online?  Then read our blog on what to look for to prove that it is a fully approved and Regulated pharmacy only supplying genuine UK sourced medication.

1. You’ll be able to buy Viagra for the first time ever- in the UK [cited 20 February 2018]. Viagra Connect to be available over the counter from Spring 2018. Available at: http://fortune.com/2017/11/28/viagra-over-the-counter-uk/

2. GOV.UK. MHRA reclassifies Viagra Connect tablets to a Pharmacy medicine [cited 20 February 2018]. Available at: https://www.gov.uk/government/news/mhra-reclassifies-viagra-connect-tablets-to-a-pharmacy-medicine

3. emc. Viagra Connect [cited 20 February 2018]. Available at: https://www.medicines.org.uk/emc/product/8725

   Author: Gabby Gallagher MPharm

   Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 09/07/18

Cialis has become popular as an erectile dysfunction (ED) prescription medication as it is effective for 36 hours. All other medications, Viagra, Sildenafil, Levitra and Spedra are active for 4-6 hours.

Cialis is the brand name for the medication created by Eli Lilly in 2003. The active ingredient in Cialis is Tadalafil and the composition couldn’t be recreated, by law, until Eli Lilly’s production patent ended on 14th November 2017. Now it can be produced and distributed by other drug manufacturers, in the generic form of Tadalafil.

Generic forms of any medication are medically identical to the branded originals and are quality controlled to the same standards as the brand name versions; they are just as safe and effective but generally cost much less.

Tadalafil on demand is known as “the weekend pill” as, due to it's 36 hour duration of action, it can be taken on a Friday night and still be active on Sunday morning.

There is also a low dose tadalafil option taken on a daily basis, called Tadalafil daily, so you don’t have to plan ahead and can be ready for action “anytime, anyplace, anywhere”.

Cialis (tadalafil) has been licensed in the UK for over a decade. It was the third erectile dysfunction (ED) prescription medication of its type to receive a UK license, after Viagra and Levitra.  Its prolonged duration of action and the option to take a low dose daily tablet have led to Cialis(tadalafil) becoming increasingly popular and being more widely prescribed.

How does tadalafil work?

Erections are primarily achieved through blood flow.Tadalafil works by helping to relax the blood vessels in your penis and the erectile tissue itself, allowing blood to flow into your penis when you get sexually excited. It does not have an effect on your sexual desire but can greatly improve your erection when you become sexually aroused.

Is tadalafil more effective than sildenafil (generic Viagra)?

Both medications have a high success rate, helping the majority of men to regain control over their erection and have an improved sex life. Clinical trials have indicated that both are equally effective.

Does tadalafil have fewer side effects than sildenafil?

As both drugs work in the same way, they share many of the same side effects. These include facial flushing, headaches and indigestion.  However, sildenafil has an effect on your vision that doesn’t seem to affect users of tadalafil to the same extent, as it may produce a green-blue visual tinge.  Headaches also occur more commonly with sildenafil but may last longer with tadalafil.  Any side-effects experienced may last longer with tadalafil.

Is tadalafil a safe medication?

Generally, tadalafil is a safe drug but is not recommended to be taken if you have certain conditions or are taking specific medications that might interact with tadalafil. This is the same for all other phosphodiesterase type 5 inhibitors like Spedra, Viagra, Cialis, Levitra and sildenafil.

Sildenafil and tadalafil should not be taken by men who take medicines or recreational drugs containing nitrates.

Nitrates interact very adversely with all phosphodiesterase type 5 inhibitors like Spedra, Viagra, Cialis, Levitra and sildenafil. They can cause a FATAL lowering of blood pressure and should NEVER be used together.

Nitrates include medications like GTN spray, isosorbide mononitrate, nitrate patches, gel or ointment and nicorandil. These are usually prescribed for heart conditions. If you take nitrates you should consult your GP for other options for your ED. Also, the recreational drugs called "poppers" should be avoided.

Tadalafil should not be taken by men who are on medicines called alpha blockers which are sometimes used to treat prostate problems or high blood pressure. Men who take alpha blockers can use Viagra, sildenafil, Levitra or Spedra but must allow at least a six hour gap between taking the alpha blocker and the ED medication.

There is a full list of the contra-indications and interactions on the website and on the medical questionnaire that is sent to our doctor for approval.

Can I drink alcohol with tadalafil?

Having just one or two drinks is unlikely to affect tadalafil (or any other similar ED medication) or cause any health risks. However, if you drink excessively while taking tadalafil you may experience some adverse effects and not achieve as firm an erection.

The main problem you may experience by drinking too much alcohol while you take tadalafil is orthostatic hypotension. This can cause a headache, dizziness, and fainting, which can lead to you injuring yourself. Hypotension may also make your heart beat at a faster rate which can lead to severe heart problems.

This effect can occur because tadalafil and alcohol both act as vasodilators. Vasodilators are substances that lower your blood pressure by relaxing the walls of your blood vessels, which allow the blood vessels to open wider.

Orthostatic hypotension can be even more likely with tadalafil than with the other erectile dysfunction drugs as it stays in your system longer than the other ED drugs.

Does tadalafil have any advantages over other ED medications of a similar type?

The main differences between tadalafil and other ED medications of a similar type is three-fold.

1) Tadalafil’s long duration of action - 36 hours. Where other Ed products only last for 4 to 6 hours.

2)  Low dose tadalafil can be taken on a daily basis, called Tadalafil Daily, so that you don’t have to plan ahead and can be ready for any sexual activity at any time.

3) It's not affected by food.

Conclusion

Tadalafil is unique in that it can either be taken when required or on a daily basis so that no planning ahead is needed and enables spontaneity. It’s also not affected by food and since it’s now off patent it can be bought at a much lower price than Cialis.

Due to all of these advantages, tadalafil will probably knock sildenafil off the number one spot as the drug of choice for men with erectile dysfunction.

Medically reviewed by: Superintendent Pharmacist Margaret Hudson BSc(Hons)MRPharmS 19/12/17

Erectile dysfunction, or impotence as it’s sometimes called, is a very common condition that distresses men of all ages. It’s the inability to achieve or maintain an erection that is sufficient for satisfactory sexual activity.

Listen to our Superintendent Pharmacist, Margaret Hudson, discuss ED in a recent radio interview

In the UK erectile dysfunction, or ED, is thought to affect more than 50% of men over 40 years of age.¹

Most men are unaware that ED could be a symptom of a more serious underlying medical condition, and so if you suffer from ED you should get a health check from your GP. The most common of these conditions are high blood pressure, high cholesterol and diabetes.

ED can have a range of causes but the main culprits are physical problems, psychological factors and the side-effects of certain medications.

Physical problems include narrowing of the blood vessels going to the penis; commonly associated with high blood pressure (hypertension), high cholesterol or diabetes. Hormonal problems such as an over or under active thyroid gland and surgery or injury to the penis, pelvis or surrounding area can also cause it.

Some examples of causative neurological conditions are Parkinson’s disease and multiple sclerosis while the psychological causes of ED include stress, anxiety, depression and relationship problems.

Lifestyle can also cause ED and so if you’re overweight, smoke, drink excessively or take recreational drugs, you are more likely to suffer from these symptoms.

In younger men, it may be caused by anxiety, nervousness about having sex, inexperience in using a condom or even fear of causing an unwanted pregnancy.

The most common health conditions causing ED are cardiovascular disease and diabetes but the medications for high blood pressure, prostate problems, high cholesterol, depression and anxiety can also cause ED and therefore compound the situation. For example, you might have high blood pressure which causes ED, then you take a medication for your blood pressure which also causes ED making your symptoms even worse! ²

In fact, there is a long list of medications that may cause ED, including:

• Diuretics - “Water tablets”
• Beta-blockers - used to treat high blood pressure
• H2-antagonists - used to treat stomach ulcers
• Antihistamines - used to treat allergic health conditions, such as hay fever
• Antipsychotics - used to treat some mental health conditions, such as schizophrenia
• Anticonvulsants - used to treat epilepsy
• Corticosteroids - medication that contains steroids, which are a type of hormone

Speak to your GP if you are concerned that a prescribed medicine is causing erectile dysfunction as alternative medication may be available. However, it is important never to stop taking a prescribed medicine unless you are advised to do so by a qualified healthcare professional who is responsible for your care.

Most men blame themselves for having ED as they think it’s a reflection of their masculinity and don’t realise that it’s caused by a health problem that they may or may not be aware of.

It is believed that if more men were aware of this fact then they would be much more willing to go to their GP for a health check. Not only would the individual find out if they have an important health condition but they would also be more confident about seeking a solution to their ED.

Most men don’t talk about ED when they meet up with their friends for a drink or for any other social activity. It’s a topic that they would rather avoid at all costs!

In fact, most men even find it difficult to speak to their partner about it and it’s thought that ED causes the breakdown of about 20% of all relationships. ³ It seriously impacts on all aspects of a man’s quality of life and his self esteem. It can also affect how a man interacts with his friends and co-workers as it may cause him to lose confidence, reduce his morale and enjoyment of life generally. Furthermore, since ED is not openly discussed, a man may feel isolated and alone as he struggles with these symptoms.

Some men find counselling helpful as a means of exploring psychological causes for ED. Some sexual health clinics (also known as GUM clinics) offer this service or your GP may be able to direct you to someone who can help. ⁴

If someone was too embarrassed to go to their GP about ED, there are other options. The first line treatment for ED is a group of drugs called phosphodiesterase -5 inhibitors (PDE-5 inhibitors) that dilate the blood vessels leading to the penis and, with sexual stimulation, give a much firmer and longer lasting erection.

In the UK there are four PDE-5 inhibitors available for treating erectile dysfunction.

They are:

• Sildenafil – sold under the brand name Viagra or generic name sildenafil
• Tadalafil – sold under the brand name Cialis
• Vardenafil – sold under the brand name Levitra
• Avanafil – sold under the brand name Spedra

There are differences between the various products available. They differ in the time it takes for them to act and how long they act for. This is due to the different pharmacokinetics* of the active ingredient. The pharmacokinetics, which include the half-life** of a medication, dictates how long it stays in the blood.

* Pharmacokinetics – How the drug moves through the body

**Half-life – The time taken for the levels of medicine in your blood to fall by half. This directly relates to how long the medicine acts for.

Sildenafil (Viagra) has a half-life of 4 hours and vardenafil (Levitra) has a half-life of 4-6 hours while tadalafil (Cialis) has a half-life of 17.5 hours and is active for up to 36 hours.

This means that vardenafil (Levitra) should act longer than sildenafil (Viagra) but the clinical significance is not known although some studies have shown that vardenafil (Levitra) is more suitable for diabetics. Tadalafil (Cialis) has the longest half-life and duration of action and so allows you to take the medication and not relate the sexual activity to its immediate use. It’s been called the “week-end pill” because of its long duration of action and in lower doses can be taken continuously each day, for those who are more sexually active and struggle to plan ahead.

The most recently introduced Avanafil (Spedra) has the quickest onset of action and only takes about 15 minutes but its effects last about the same time as vardenafil and sildenafil.  

ED drugs: How soon they start working and how long they last

It’s very important that men realise that they don’t have to suffer in silence as ED is a very common condition that’s easily treated, in most cases, with oral medication that can dramatically improve their performance and general well-being. 

References

1 NHS. Choices. Department of Health. Erectile dysfunction (impotence); 2016 Jun 21 [cited 2016 Sep 21]. Available from: http://www.nhs.uk/Conditions/Erectile-dysfunction/Pages/Introduction.aspx

2 Miller S. Medline Plus. Drugs that may cause impotence: MedlinePlus medical encyclopedia; 2015 Jan 21 [cited 2016 Sep 21].
Available from: https://medlineplus.gov/ency/article/004024.htm

3 Health Centre. Access to health & medical information on Internet; 2016 [cited 2016 Sep 21]. Available from: http://www.healthcentre.org.uk

4 Charitable Company. Sexual Advice Association. Sexual Advice Association. Factsheets [cited 2016 Sep 21].
Available from: http://sexualadviceassociation.co.uk/factsheets/

Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 23/09/16

We have all become familiar with the great convenience and ease of buying goods online but what about when it comes to medicines?

Buying medicines online, in the comfort of your own home, without having to take time off work or interrupt your busy schedule to visit your GP is a service we would all like to access. It becomes even more attractive if the nature of your treatment is for sensitive or intimate conditions.

How do you know if you are buying genuine medicines from a reputable registered seller?

It is illegal to buy any prescription only medicine unless a doctor has written a prescription specifically for you.

More importantly, if a website or indeed any supplier is willing to sell you a prescription only medicine without a prescription then these unscrupulous dealers do not have any concerns about the dire consequences of supplying you fake, potentially harmful medicines.

Fake medicines range from being useless to highly dangerous as they often contain the wrong amount of active ingredient or a completely different ingredient to the one advertised. Some fake medicines have even been found to contain highly toxic substances such as rat poison, lead paint, floor wax and printer ink. The medicines may be made in dirty factories with no quality control and so the person taking the counterfeit medicine may find they are putting their health, even their life, at risk. These fake medicines may look identical to the genuine article and are often packaged to a high standard, making it very difficult to tell the difference.

The  World Health Organization (WHO) estimates that up to 1 per cent of medicines available in the developed world are likely to be counterfeit. This figure rises to 10 per cent globally, but in some areas of Asia, Africa and Latin America counterfeit goods can form up to 30 per cent of the market.

This does not mean that all websites which sell medicines are doing so illegally or without a prescription but it’s very important to be sure that the website that YOU are using is selling genuine medicines from a UK regulated and registered pharmacy.

How can you check that the website you want to use to obtain medicines is a legitimate online pharmacy?

All websites selling prescription medication in England should be registered with the Care Quality Commission (CQC), who are a government appointed independent regulator of health and social care.

All fully approved and regulated websites should have a clickable link that will take you to the CQC register to show that they are compliant.

All medicines must be supplied from a pharmacy that is registered with the General Pharmaceutical Council (GPhC). 

If you are thinking of obtaining medicines from an online pharmacy, we would advise you to check if the website is legitimately registered by looking for the General Pharmaceutical Council, GPhC, voluntary logo and the mandatory EU common logo. 

We would then recommend that you click on each logo which should take you through to that particular pharmacy’s entry on the GPhC register and the Medicines and Healthcare products Regulatory Agency (MHRA) register.

All websites operating in the UK, but outside of England, must be registered with the CQC equivalent body in each country: Healthcare Improvement Scotland, Healthcare Inspectorate Wales, and Regulation and Quality Improvement Authority (Northern Ireland).

The common logo for legally operating online pharmacies/retailers in the EU Member States was introduced by Directive 2011/62/EU (the Falsified Medicines Directive) as one of the measures to fight against falsified medicines.

Therefore, since 1st of July 2015, all online pharmacies or retailers legally operating in the EU have to display the following logo:-

How does the logo work?

The logo links to the website of the national competent authority listing all legally operating online pharmacies/retailers. National websites are listed with the European Medicines Agency. By simply clicking on the logo a purchaser of the medicines online will be sent to the entry of the pharmacy on that national list, thus completing the verification process.

The logo can be trusted only if a purchaser, after clicking, is redirected to the entry of that pharmacy on the list of legally operating on-line pharmacies and retailers registered in that Member State on the national authority web-page

Also, all pharmacies in Great Britain, including those providing internet services, must be registered with the GPhC and meet their standards for registered pharmacies.

 
The GPhC operates a voluntary internet pharmacy logo scheme to provide reassurance to patients and the public that they are purchasing medicines online from registered pharmacies who have to meet GPhC standards.

Therefore, anybody buying medicines from an online pharmacy can check if the pharmacy is legitimately registered by clicking on the logo or going directly to the GPhC website and searching their online register.

The EU common logo is a legal requirement across Europe that applies to all retailers of medicines whilst the GPhC voluntary logo is applicable only to UK registered pharmacies.

What other checks can be made?

You should be able to easily find the name and address of the pharmacy operating the website, as an online supplier who conceals its physical address is a warning sign that their products could be dangerous. The WHO estimates that 50 per cent of medicines available from such websites are counterfeit.

You should avoid websites which offer to supply prescription only medicines without a prescription as registered pharmacies are required to check that a medicine is suitable for a patient before selling it. Therefore, if you are not asked to provide information about your health before making a purchase then you would be wise to go elsewhere.

When you order any medication from our UK registered and regulated pharmacy you can be assured that you are doing so safely, legally and discreetly.

WebMed Pharmacy Ltd, a fully approved and Regulated UK Pharmacy (http://www.pharmacyregulation.org/registers/pharmacy/registrationnumber/1126048), only supplies medicines from a MHRA accredited wholesaler. You can confidently order from us, knowing that you can complete an online medical questionnaire in the comfort of your own home and if suitable can be prescribed by our GMC regulated doctor.

WebMed Pharmacy specialises in treatments where patients may feel embarrassed or awkward talking to their GP or simply find it difficult to get an appointment or don’t want to take time off work. We provide a confidential, discreet next working day delivery, of your chosen medicine, within a 1 hour time slot to the vast majority of postcodes in the UK or New Click & Collect from a store near you, with a choice of 2,500+ stores nationwide.

Quick easy links to our most popular pages with the confidence of knowing we are a fully approved and regulated pharmacy, only supplying UK sourced medication:

Erectile dysfunction | Sildenafil | Tadalafil

Gonorrhoea treatment | Chlamydia treatment

Hair Loss treatment | Finasteride

STI Tests | HIV Test Kits

Medically reviewed by: Super intendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 17/03/16. Updated and reviewed 02/05/17.

Erectile dysfunction (ED) can affect men of all ages. In the UK, ED is thought to affect 1 in 10 men and more than 50% of men over the age of 40 will experience some form of ED. It can also be a symptom of an underlying health condition and if it becomes a chronic problem then it is best to consult your GP.

ED can be caused by physical conditions that restrict the flow of blood to the penis, such as narrowing of the blood vessels, high blood pressure, heart disease and diabetes.

It’s also caused by conditions involving the nervous system, e.g. Multiple Sclerosis, Parkinson’s disease, after a stroke and diabetes (which also involves the nervous system).

Hormonal problems can also cause it; deficiencies in testosterone production, an overactive or underactive thyroid gland and Cushing’s syndrome (where the body doesn’t produce enough of the steroid, cortisol).

Furthermore, depression and anxiety are psychological problems that can cause ED.

There are a whole range of medications that can cause ED and even more frustratingly, a lot of the treatments for the aforementioned medical conditions can make existing ED even worse!

Some members of a group of drugs called ACE inhibitors, used for high blood pressure, such as Ramipril and Lisinopril cause it. Also, other medications for hypertension, called Calcium-channel blockers; amlodipine,felodipine and Nifedipine. Other culprits are beta-blockers, used for angina and hypertension, such as carvedilol, metoprolol and atenolol.

Another group of drugs causing this unwanted side-effect are diuretics (used to treat high blood pressure, kidney disease or heart failure), for example, bendoflumethazide and furosemide. The widely used statins and fibrates used for high cholesterol and commonly used antihistamines, for hayfever and other allergic conditions, also cause ED. Treatments for urinary retention such as Tamsulosin and Doxazosin are guilty too. Anticonvulsants used for epilepsy, cytotoxics used in chemotherapy and medications for ulcers may cause ED.

This list is not exhaustive but gives you an indication of the large number of medications that do cause this sensitive and embarrassing condition. However, it is extremely important never to stop your prescribed medication if you suspect it may be the cause of your ED but go and speak to your GP as an alternative medication may be available that doesn’t cause this unwanted side effect.

There is a huge stigma surrounding ED and many men find it embarrassing and awkward to even talk to their partners about it never mind discussing it with their GP. Although attitudes to gender have improved greatly over the years and the division of labour in the home is now far more evenly distributed than in our parents’ days, we still live in a society where the majority of men like to appear as “macho” and dislike discussing anything that may have a negative impact on their perceived masculinity or sexual prowess.

As a result, when men have difficulties achieving an erection, the majority would rather avoid intimacy and suffer in silence rather than bring attention to the problem and try to find a solution. This attitude is alien to the way a typical man would normally deal with a problem in his everyday life where he usually tries to be the problem solver!

I think if more men were aware that their medical condition and/or their medication was responsible for their ED then they would be more willing to discuss it with their partner and seek out a remedy.

The vast majority of men with ED can be optimistic and anticipate a return to satisfying sexual activity with the various treatments now available and successfully transform their lives.

Medically reviewed by: Superintendent Pharmacist Margaret Hudson BSc(Hons)MRPharmS 29/08/15