Learn About Your Heart...
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Could ED be an early sign of cardiovascular disease? The small diameter of the penile vasculature suggests that the progression of atherosclerosis (blockage in the vessels) may lead to symptoms, including ED, earlier in this area than in the major vessels involved in coronary artery disease, stroke, and peripheral vascular disease. Some facts to consider include the following:

• 40% of men who sought ED treatment had significant coronary occlusions (blockage)

• 57% of men who had coronary bypass surgery reported ED before the surgery

• 60% of men with ED,no coronary artery disease (CAD),and abnormal cholesterol levels have had penile artery disease

• 60% of men who were hospitalized for a myocardial infarction (MI) experienced ED before being hospitalized for the MI.

What are shared risk factors of ED and cardiovascular disease?

Shared risk factors of ED and cardiovascular disease include:

• Hypertension

• Diabetes

• Dyslipidemia

• Sedentary lifestyle

• Age

• Gender (male)

• Obesity

• Smoking

• Depression.

What forms of medical treatment are available for ED?

Viagra, Levitra, and Cialis

Because sexual activity can be demanding on the heart, you may want to talk to your doctor about your cardiovascular health before using these pills; they are not hormones or aphrodisiacs. All 3 of the approved ED drugs (Viagra, Levitra, and Cialis) are similar in action. They are members of a family of drugs called phosphodiesterase-5 (PDE5) inhibitors. They block an enzyme that causes an erection to go flaccid (PDE5), keeping the blood supply to the penis stronger. Although these drugs are similar in action, their dose, onset of action time, and duration of action differ. Viagra was the first PDE5 inhibitor on the market, followed by Cialis and Levitra.

How do I get the most out of my pills?

The following tips will help you get the most out of your pills:

• Take Viagra or Levitra 1 hour prior to engaging in sexual activity—these pills are usually effective for 4 hours

• Take Cialis 2 hours prior to engaging in sexual activity— Cialis is effective for 36 hours

• It is better to take Viagra or Levitra on an empty stomach (3 hours without food); high-fat meals may take the pill longer to produce the desired effect

• Cialis usually is not affected by the consumption of high-fat meals and therefore can be taken anytime

• Learn to relax; stress and anxiety can kill arousal

• Moderate your alcohol consumption

• If you experience any side effects, discuss them with your doctor

• Foreplay and proper stimulation are crucial—if you take any pills without receiving any sexual stimulation, it is unlikely that you will have an erection

• Patience is imperative—in the absence of prohibiting side effects, try it again (not within 24 hours); you need to have at least 6 to 8 attempts to call it a "failure"

• If you fail at least 6 attempts or have side effects, ask your doctor to try the next drug in line (you might respond to a different drug)

• If you have an erection for more than 3–4 hours, inform your doctor

• Do not combine different pills at the same time or use in combination with penile injection

• Ask your doctor if you have any questions or concerns

• Ask your doctor if the ED drug will interact with any of your medications

• If you develop chest pain, alert your healthcare provider (EMS, emergency room, etc.) that you are taking Viagra, Levitra, or Cialis, and tell the provider the last time you took the medication.

DO NOT take Viagra, Levitra, or Cialis if you: