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If counseling alone does not help treat the psychological issue, medications through a qualified psychiatrist may be prescribed.
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Congestive heart failure with borderline low blood pressure and borderline low blood volume is a contraindication to PDE5 inhibitors, as is high blood pressure requiring multiple medications to treat the blood pressure as PDE5 inhibitors could lead to lowering of the blood pressure and medical problems.

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The recommended starting dose is 100 mg taken as early as 15 minutes prior to sexual activity, no more than once a day. The maximum dose is 200 mg. Avanafil may be taken with or without food. As with the other PDE5 inhibitors, sexual stimulation is necessary for avanafil to work.

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    More than two drinks a day is considered a risk factor for ED. Alcohol can lower testosterone levels, decrease flowing blood to the penis, and cause nerve and hormonal imbalances. Low testosterone from alcohol or drug abuse can also affect your libido and performance, potentially leading to further psychological ED complications.

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    Both the 100mg and 200mg dosages take effect in about 15 minutes, which is even faster than BlueChew’s chewable sildenafil. It lasts about six hours, which is basically on par with sildenafil (and Viagra).

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    The central nervous system is responsible for releasing nitric oxide, an essential chemical for producing and maintaining an erection, and heavy alcohol consumption depresses the central nervous system, causing it to function less efficiently. Not enough nitric oxide translates to erectile dysfunction.
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    The various PDE5 inhibitors for the treatment of ED share several common side effects, including headache, flushing, nasal congestion, nausea, dyspepsia (stomach discomfort), and diarrhea. Differences exist in side effects of the different PDE5 inhibitors, and thus it is important to be familiar with the prescribing information of the PDE5 inhibitor you are prescribed.
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Mild and moderate ED affects about 10 percent of men per decade of life. That means 50 percent of men in their fifties suffer, 60 percent of men in their sixties, and so on.

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30 minutes of cardio followed by two-sets of Kegel exercises can not only up the level of testosterone in the body but can also strengthen the bulbocavernosus muscle that provides blood flow to the penis and engorge it during erection.

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