Manual Sildenafil Treatment Plan

Manual Sildenafil Treatment Plan

Thank you for choosing Manual. I have reviewed your questionnaire answers and we are happy to prescribe you Sildenafil 50mg. Now this is an initial step in your journey to improve your erectile dysfunction and general wellness, and we want to be here to support you through the whole process. Any worries, concerns, questions – we are here for you.

As a first step it’s important for you to take the time to read the manufacturer’s patient information leaflet (PIL) enclosed in your box. This gives you a lot of information about how to take the medication, what to avoid, side-effects and potential interactions with other medication.

Causes of Erectile Dysfunction (ED)

Now your Sildenafil is being freshly packed for you and it’s a good start, but we also advise exploring if there are any underlying causes that may need more specific treatment.

So broadly speaking there are two main causes of ED: physical (organic) and psychological causes. In most men usually it’s a combination of factors. Typically those over 40 years of age are more likely to have more physical elements limiting their ability to get erections, and those under 40 have a tendency to be impacted by more psychological factors. Now this is a generalisation, and so it’s always advisable to look a bit deeper into the causes.

Morning erections are also a good indication of the cause. They are the body’s way of providing oxygen to preserve the penis. Now loss of night time/morning erections strongly suggests a more physical (organic) cause.

When we say Physical (organic) causes this covers a spectrum of issues that include high blood pressure, diabetes, high cholesterol, thyroid conditions, prostate problems, abnormal hormone levels, and anatomical issues such as a tight foreskin.

Psychological causes range from new relationship anxiety, depression, stress, porn-addiction. Typically this ED is improved during holidays or reduced stress. Often you still have morning erections with these causes.

As part of a full assessment of your ED, if you haven’t had these tests before (or in the last year), we advise arranging to see your regular GP/doctor for a number of checks which include:

  • Cardiovascular health: Blood pressure measurements and a cholesterol blood test. There is now overwhelming evidence that erectile dysfunction is strongly associated with cardiovascular disease. The penile blood vessels gradually get narrower over time, and this limits the blood flow needed to sustain an erection.
  • Diabetes: A blood sugar level test also known as HbA1C. Diabetes is a cause of ED.
  • Hormone imbalance: Check your testosterone, prolactin and thyroid levels. Hormonal imbalances may contribute to ED.  
  • Prostate assessment: This may be advised in your case, especially if you have prostate symptoms (such as poor urinary stream, frequency of urinating etc.). This can involve a blood test and physical examination of your prostate gland.
  • Depression/Anxiety/Psychosexual issues: If you believe you may have underlying problems which could be leading to a psychological cause for your ED, its best to explore this further with your GP or seek psychosexual counselling. It’s good to talk.
  • Smoking: May cause damage to your blood vessels, affecting blood flow and hence contributing to erectile dysfunction. If you are a smoker, It is worth quitting to improve your overall health too. Joining a smoking cessation service has been shown to be a more effective way to quit smoking.
  • Alcohol: Drink within limits! The combination of excessive alcohol and sildenafil may cause a drop in blood pressure, lower testosterone and impact your erections.  
  • BMI: A healthy BMI (Body Mass Index) not only helps improve ED but your overall health. Having a healthy weight reduces risks of developing diabetes, high blood pressure and high cholesterol. As outlined above,  all these factors may contribute to the physical causes of ED. It is important to maintain a healthy weight by eating a balanced diet and exercise regularly!

More about Sildenafil and Erections?

Sildenafil is a tablet that is given to people who need help with erectile dysfunction. It’s very commonly prescribed and has helped countless men across the globe. It’s safe and effective, and proven to help guys with all degrees and most causes of ED.

It’s the generic unbranded version of Viagra and it’s just as effective. Sildenafil is the most common treatment for ED and clinically proven to be a highly effective treatment for most men. Take it as you need it. Enjoy sex, and reduce your worries about not getting an erection!

It’s hard to get hard: your brain, heart, hormones and a few other bits and bobs all need to come together – this can be tricky at any age. Sometimes this all breaks down and you can’t get or stay hard enough to have satisfactory sexual intercourse – a condition known as erectile dysfunction. Sildenafil is for men with erectile dysfunction, whatever the cause it usually helps.

How Sildenafil works?

It works by inhibiting an enzyme known as PDE5 associated with muscle contraction in penile tissue. Sildenafil allows the blood vessels to relax and expand, leading to increased blood flow into the penis and Voila you have an erection! Don’t forget it works only when you are sexually stimulated and there is some va va voom.

Be aware Sildenafil does not protect you from STDs (sexually transmitted diseases), a condom does.

How do I take it?

  • Take one tablet of Sildenafil 30-60 minutes before sex
  • It is best to take the medicine on an empty stomach as onset of effect may be delayed if taken with food.
  • Drink within limits (14 units per week). More than 2 units of alcohol will make sildenafil less effective.
  • Do not take more than one tablet within 24 hours, if Sildenafil is not effective please speak to our clinicians.
  • Sildenafil should not be taken within 24 hours of taking other ED medication such as Cialis, Levitra, Viagra, Tadalafil or Spedra.
  • If you are taking any other medications whether over the counter or prescription only medications, please make sure the clinicians are aware (if not already mentioned in your clinical questionnaire).
  • It is important that you are aware certain ‘street drugs’ may interact with Sildenafil. If you are using illicit drugs e.g. ‘Aromas, Poppers or Odorisers’, please make sure the clinicians are aware as the combination could be dangerously fatal!

How effective is Sildenafil?

Studies has proven Sildenafil is significantly effective in improving erections and allowing successful penetrative sexual intercourse when compared to placebo. Sildenafil remains the first-line therapy for most erectile dysfunction. If Sildenafil does not work for you, please do not give up and get in contact with our clinicians who are happy to help. Patients are usually advised to try sildenafil 8 times before evaluating if its been effective or not.

What are the side-effects?

Phosphodiesterase inhibitors are generally safe and well tolerated however all medicines have the potential for causing side-effects. The good news is, the majority of these are mild and not all men get them.

Side-effects include lightheadedness, headaches, indigestion, muscle aches, facial flushing and nasal congestion. Symptoms should last not last more than a few hours after taking a sildenafil dose. More serious side-effects, which are rare include; breathing difficulties, visual disturbances, kidney or liver dysfunction, widespread rashes, agitation, chest pain, anaphylaxis (a severe allergic reaction) and priapism (a painful and persistent erection that lasts for > 4 hours). If any of the rare but serious side-effects happen please go to your local Accident and Emergency Immediately or call 999. If you have any concerns regarding the side-effects, please stop taking the medication and contact us via your Manual record.

What if I am taking other medicines?

It is important that you are completely honest with us when completing the questionnaire as some medicines are not safe to take with Sildenafil.

Interactions include:

Alpha blockers (such as tamsulosin, alfuzosin, doxazosin or terazosin). You must leave at least 6 hours between your alpha-blocker and Sildenafil, to avoid a dangerous drop in blood pressure.

Nitrates (such as GTN (Glyceryl trinitrate) commonly used to manage chest pain associated with angina, or rectal GTN ointment used for anal fissures). The combination of nitrates with sildenafil may result to your blood pressure to drop dangerously low. DO NOT TAKE Sildenafil if you have been prescribed Nitrates.

Please inform our clinicians via your patient account messaging facility: if you start taking any new medicines or if there are any significant changes to your medical history. Also if you experience any significant side-effects or want further advice on your treatment.

It is also important you inform your GP about the medicines you take, so they are fully informed. So it is advisable that you inform them of what you have been prescribed.

Until then, we hope to see you back again!