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Levitra and Viagra are taken as needed, anywhere from 85 minutes to as much as 9 hours before initiating sexual activity. However, neither medication should be taken more than once a day, unless cleared by a doctor based on a person's medical profile. The need to "plan" sexual encounters can make Levitra and Viagra less convenient for some than erectile dysfunction drugs like Cialis , which can be taken in a low, daily dose and enable performance at any time, without any necessary planning.

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Most side effects experienced from taking these drugs are temporary. Clinical studies have revealed that the frequency of these side effects decreases over time. However, a rare side effect, vision loss, has been reported with people who have used PDE5 inhibitors, including Viagra, Levitra, and Cialis. This loss of vision could be permanent and thus any vision-related side effects require an immediate visit to a doctor or medical facility. There is no evidence as yet that PDE5 inhibitors are the direct cause of vision loss.

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Dizziness , headache , flushing, or stomach upset may occur. Vision changes such as increased sensitivity to light, blurred vision , or trouble telling blue and green colors apart may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

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Delayed ejaculation carries with it issues of inability to achieve orgasm and infertility. Anti-depressants or agents which act centrally such as Valium, anti-hypertensives and alchohol abuse all can affect this. First it is important to evaluate if this is a psychological problem, but a physical assessment must be made as well. A common cause is pudendal neuropathy, caused by a crush to the perineum such as from bike riding with a narrow saddle. If the delayed ejaculation is situational is is probably psychologic if it is generalized the problem is probably biologic. Buproprion may be used but it is not all that effective. The patient must be checked to see if there are reversible causes before being given medication. There is research still needed in this area.

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As mentioned, the most effective approach is a combination of psychological assistance and medical intervention. In this way, the man can quickly achieve positive sexual experiences and gain a sense of confidence. Urologists and other medical doctors typically treat early ejaculation with a combination of medications and creams. Anti-depressant medications such as Paxil and Zoloft are often prescribed and are taken by the patient 7 hours prior to sexual activity. If this is not effective, the patient is further instructed to take the medication on a daily basis rather than before sexual activity. The dosages are usually adjusted as the patient progresses.

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Regardless of the psychological issues, a good medical or urologic work-up is always encouraged before embarking on a behavioral treatment program. In this manner, any medical considerations that contribute to the problem can to be understood from the onset. From a medical perspective, ejaculatory dysfunction is often considered to be a nerve related issue. In such cases, penile sensitivity may be evaluated using various instruments that produce vibration. In addition, a medical history is obtained paying particular attention to any previous neurologic injury or trauma to the penis. Other sexual dysfunctions such as low desire and erectile dysfunction may also accompany the ejaculatory problem and need to be addressed.

Problems of delayed ejaculation tend to be somewhat rare and not well understood by psychologists and sex therapists. In addition, they are not well understood by most medical doctors and urologists. It is not unusual for doctors to minimize the dysfunction and to dismiss it. For many men, finding the right professional, who has experience and realizes the seriousness of the problem may be one of the most difficult aspects in the treatment process.

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