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Jagten på potensen

Hvis man er heldig, virker pillerne efter hensigten, eller de er uskadelige, men man løber den risiko, at pillerne er direkte farlige for helbredet.

Så hvis man har sit helbred kært, er der ingen vej udenom lægen, der i øvrigt næppe vil løfte et øjenbryn over at blive præsenteret for et rejsningsproblem. Det er så almindeligt at have problemer med rejsningen, at hver anden mand på et eller andet tidspunkt oplever det.

Mænd søger oftere hjælp

Overlæge Peter Lyngdorf, der driver en klinik for seksuelle dysfunktioner i Gentofte og er en af de læger, der ved mest om impotens, eller erektil dysfunktion som eksperterne foretrækker at kalde det, oplever i øvrigt, at mænd er blevet bedre til at søge hjælp, når sexlivet ikke fungerer, som det skal.

- Den første tid, jeg havde min klinik, gik der cirka to år, fra manden fik symptomet, til han søgte hjælp. Nu går der kun fra et halvt til et år. Så mændene er blevet bedre til at gøre noget ved det, og de har klart lettere ved at tale om rejsningsproblemer i dag, siger Peter Lyngdorf.

Han er ikke blind for, at netop det, at han er speciallæge og dermed ikke den samme, som manden også går til med andre helbredsproblemer, kan have betydning for åbenheden. Han oplever således ofte, at patienten ikke ønsker, at han informerer den praktiserende læge om den behandling, han sætter i gang.

Det starter hos lægen

Det normale er dog, at det er den praktiserende læge, manden går til, når han har problemer med rejsningen. Og det første besøg er ofte forbundet med en god del nervøsitet og usikkerhed. For så let er det altså heller ikke at snakke om noget, der af de fleste opfattes som meget privat.

Det kan derfor være en god ide at bestille et fysisk helbredstjek. Så slipper du for at delagtiggøre sekretæren i problemet, og i øvrigt vil lægen også starte med at interessere sig for dit generelle helbred.

For rejsningsproblemer kan skyldes forskellige fysiske tilstande som alder og sygdomme. Problemer med rejsningen er ikke nødvendigvis en følge af alder, selvom det bliver sværere for mange at opnå en ordentlig rejsning i takt med årene. Derimod kan en række af de sygdomme, vi især rammes af med alderen, give problemer. Det gælder for eksempel åreforkalkning, diabetes. forhøjet blodtryk, forhøjet kolesterol og hjerte-kar-sygdomme .

Så lægen vil også interessere sig for din livsstil, for eksempel om du ryger, når han skal afdække, hvad årsagen til rejsningsproblemerne kan være. Det er nemlig afgørende for evnen til at få rejsning, at blodtilførslen til penis er tilstrækkelig, og røg (og alkohol) påvirker blodkarrene og dermed blodforsyningen til penis.

Lysten skal være der

Forhistorien til en rejsning er, at hjernen sender signal til celler i den nederste del af rygmarven, der igen via nervetråde sender besked til de pulsårer, der fører blodet til penis, om at udvide sig, så blodforsyningen øges. Det medfører igen, at svulmelegemet i penis fyldes med blod, og så er rejsningen der.

For at få erektion skal psyken, hormonbalancen, nervesystemet og karsystemet altså spille sammen. Men først og fremmest skal manden have lyst. Hvis lysten mangler. hjælper ingen potenspiller. Pillerne understøtter nemlig kun den proces, der sker, når manden bliver seksuelt stimuleret – de giver ikke lyst i sig selv.

Manglende potens handler i øvrigt i mange tilfælde om stress eller uafklarede problemer i forhold til partneren. Så det forsøger lægen også af få afklaret.

Tre slags piller

Hvis ikke der en psykisk årsag til den manglende rejsning, vil førstevalget ofte være potenspiller eller PDE-F-hæmmer, som de også hedder.

Der findes tre slags: Viagra, Cialis og Levitra. De tre præparater er lige effektive, oplyser Peter Lyngdorf, men der er forskel på, hvor længe de varer. Viagra er virkningsfuld i 6-8 timer, Levitra 8-10 timer og Cialis op til 36 timer. Normalt tages pillerne en halv times tid, inden manden ønsker rejsning, men Cialis findes også i en lille dosis, der kan tages dagligt. Det betyder, at der hele tiden er tilstrækkelig høj koncentration i blodet til, at manden kan opnå rejsning.

Som for det meste medicin gælder det også her, at der kan være bivirkninger, nemlig hovedpine, rødme i ansigtet og lettere synsforstyrrelser. Men for alle gælder det, at bivirkningerne bliver mindre og mindre, jo længere man bruger dem. Taget under ét, virker pillerne på omkring 70 procent af alle patienter.

Der er dog én gruppe mænd, der ikke må tage piller for potensen, nemlig dem, der lider af smerter i brystet (angina pectoris) og derfor tager nitroglycerin-holdige præparater. Hvis disse præparater kombineres med potenspiller, er der udtalt risiko for kraftigt blodtryksfald hos patienten.

Men der er intet til hinder for, at patienter, som får anden hjertemedicin, kan bruge Viagra, Cialis eller Levitra, oplyser Peter Lyngdorf. Der er ikke øget risiko for hverken blodprop i hjertet eller blodprop i hjernen ved at tage dem. Personer, der har haft en blodprop i hjertet eller har haft forhøjet blodtryk, kan uden problemer bruge potenspiller, hvis deres hjertelidelse er i stabil fase, det vil sige, at det er mere end tre måneder siden, de sidst har haft problemer.

Alt bliver som før

Og de virker godt forstået på den måde, at mandens orgasme er helt den samme som før, han brugte potensmidler. Og så har de i øvrigt den ekstragevinst, at manden ikke behøver så lang pause, før han kan anden gang.

- Det har normalt ikke den store betydning, men man har altså fundet ud af, at venteperioden bliver kortere, siger Peter Lyngdorf. Han fortæller også, at pillerne ikke har nogen negativ indflydelse på sædproduktionen. Manden kan sagtens gøre kvinden gravid, selvom han skal have hjælp af potenspiller.

Langt de fleste, der tager potenspiller, er over 50 år. Men faktisk var der 71 mænd mellem 15 og 19, der brugte potenspiller i 2008. Og der er heller ingen øvre grænse. 5 mænd over 95 år snuppede en pille i 2008, viser tal fra Lægemiddelstyrelsen. Den ældste patient, Peter Lyngdorf har ordineret piller til, var 92 år.

Peter Lyngdorf understreger, at potenspiller ikke altid er det eneste rigtige for en mand med rejsningsproblemer. Der er tilfælde, hvor patientens livsstil eller holdning er mindre hensigtsmæssig, og her kan samtaleterapi enten for manden alene, eller sammen med partneren, være på plads. Og det hjælper rigtig mange, siger han.

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Operationer (2016)

Tilskud til udgifter til operationer samt andre lægelige ydelser under selve indlæggelsen ydes maks. med det beløb, der er angivet for den enkelte operation i listen over godkendte operationer. Tilskuddet kan dog ikke overstige 85% af medlemmets faktiske udgifter.

Hvis der foretages flere operationer under samme ophold, ydes alene tilskud til den operation, der berettiger til det hГёjeste tilskud, medmindre andet er anfГёrt i listen ud for den enkelte operation.

Vil du vide mere om ventetider, priser og vurderinger, kan du finde disse oplysninger pГҐ www.behandlingsvejviseren.dk .

Ret til tilskud efter 12/24 mГҐneder

Retten til tilskud til operationer indtræder først efter medlemskab af Gruppe 1 eller Gruppe 2 eller Gruppe 5 med tilvalget Operation i de umiddelbart forudgående 12 måneder. Det samme gælder tilvalget Udvidet Operation. Dog indtræder retten til tilskud først efter 24 måneder, hvis tilvalget Udvidet Operation er tegnet efter medlemmet er fyldt 60 år.

Autoriseret speciallæge

Det er en forudsætning for tilskud, at operationen er foretaget af en autoriseret speciallæge inden for dennes speciallægeanerkendelse, bortset fra speciallæge i almen medicin.

Dokumentation

Regninger for operationer skal indeholde diagnosen, operationsklassifikationsnummer, operationsbeskrivelse, behandlingens art, operationens pris, navn på den opererende speciallæge og eventuel indlæggelsesperiode.

ForhГҐndsgodkendelse

Det er en forudsГ¦tning for tilskud, at operationen er skriftligt godkendt af “danmark”s hovedkontor 5 dГёgn forud for operationen, se under “Maksimum inden for 12 mГҐneder “.

Operationer i EU/EØS

For operationer i et andet EU/EØS-land skal der altid søges forhåndsgodkendelse.

Maksimum inden for 12 mГҐneder

For operationer med tilskud på op til 6.000 kroner med operationsdækning og op til 13.000 kroner med tilvalget Udvidet Operation kan der maks. inden for 12 måneder gives et samlet tilskud på 12.000 kroner med operationsdækning og 26.000 kroner med tilvalget Udvidet Operation.

ForhГҐndsgodkendelse er ikke nГёdvendig.

Indlæggelse

Der ydes tilskud til indlæggelse i forbindelse med operationer, der er markeret med * i listen over godkendte operationer. Tilskuddet udgør 3.000 kroner som betaling for selve indlæggelsen og fratrækkes derfor før udregning af tilskuddet til operationen. Uanset antallet af overnatninger udgør tilskuddet 3.000 kroner.

Ved “indlГ¦ggelse” forstГҐes overnatning efter operationen pГҐ operationsstedet. Dette betyder, at overnatning pГҐ hotel, patienthotel og lignende ikke udlГёser tilskud til indlГ¦ggelse.

ForundersГёgelse

ForundersГёgelser til operationer, der er dГ¦kket af “danmark”s operationsdГ¦kning er tilskuddet 50% af udgiften, dog maks. 350 kroner. Med Udvidet Operation er tilskuddet 50% af udgiften dog maks. 500 kroner.
Det er ikke en forudsætning, at operationen gennemføres.

Voksens ophold

Ved en voksens ophold på hospital eller en klinik sammen med et forsikret barn under 16 år, der skal opereres, dækkes 85% af den dokumenterede opholdsudgift på hospital/klinik, dog maks. 1.000 kroner pr. døgn. Med Udvidet Operation er tilskuddet 85% af den dokumenterede opholdsudgift på hospital/klinik, dog maks. 1.500 kroner pr. døgn.

Operationer, du ikke kan fГҐ tilskud til

Dækningen omfatter ikke:

  • fedtsugning (liposuction)
  • ansigtslГёftning
  • hГҐrtransplantation
  • Г¦gtransplantation (IVF)
  • brystoperationer
  • operationer for godartede modermГ¦rker
  • lГ¦befedtinjektioner
  • senile vorter
  • blodkartumorer
  • karudvidelser/karsprГ¦ngninger
  • kosmetiske laserbehandlinger
  • fjernelse af overflГёdig hud pГҐ arme, ben, ryg og flanker
  • organtransplantationer
  • fjernelse af tatovering
  • rekonstruktion efter piercing
  • CCSVI
  • synskorrigerende operationer samt linseimplantationer ved Гёjenstyrker under В± 6 dioptrier
  • operation for bygningsfejl, hvor bygningsfejlen er mindre end 3 dioptrier
  • synskorrigerende operation, hvor forskellen i synsstyrken er mindre end 3 dioptrier
  • alle operationer pГҐ Гёvre og nedre ГёjenlГҐg. Der ydes dog tilskud til bortskГ¦ring af tumorer til efterfГёlgende mikroskopi og til operation for ГёjenlГҐgsretraktion (pГҐ tarsalmuskel og levatormuskel).

Tilskud til tandkirurgi ydes alene i henhold til “danmark”s gГ¦ldende tandlГ¦getakster.

Rabat pГҐ operationer

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Common use

The main component of Viagra is Sildenafil Citrate.
Sildenafil Citrate affects the response to sexual stimulation. It acts by enhancing smooth muscle relaxation using nitric oxide, a chemical that is normally released in response to sexual stimulation. This smooth muscle relaxation allows increased blood flow into certain areas of the penis, which leads to an erection.
Sildenafil Citrate is applied for the treatment of erectile dysfunction (impotence) in men and pulmonary arterial hypertension.
Sildenafil Citrate may also be used for other purposes not listed above.

Dosage and direction

Usually the recommended dose is 50 mg. It is taken approximately 0,5-1 hour before sexual activity. Do not take Viagra more then once a day.
A high fat meal may delay the time of the effect of this drug.
Try not to eat grapefruit or drink grapefruit juice while you are being treated with Sildenafil Citrate .

Precautions

Before you start taking Sildenafil Citrate. tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.
Aged people may be more sensitive to the side effects of the drug.

Viagra is contraindicated in patients who take another medicine to treat impotence or using a nitrate drug for chest pain or heart problems.
This medicine should not be taken by women and children as well as in patients with a known hypersensitivity to any component of the tablet.

Possible side effect

The most common side effects are headache, flushing, heartburn, stomach upset, nasal stuffiness, lightheadedness, dizziness or diarrhea.
A serious allergic reaction to this drug is very rare, but seek immediate medical help if it occurs.
Many people who use this medicine do not have serious side effects.
In case you notice any side effects not listed above, contact your doctor or pharmacist.

Drug interaction

This drug should not be used with nitrates and recreational drugs called “poppers” containing amyl or butyl nitrite; alpha-blocker medications; other medications for impotence; high blood pressure medicines, etc.
Consult your doctor or pharmacist for more details.

Missed dose

Viagra is used as needed, so you are unlikely to be on a dosing schedule.

Overdose

If you think you have used too much of this medicine seek emergency medical attention right away. The symptoms of overdose usually include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

Storage

Store your medicines at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store the drugs in the bathroom. Keep all drugs away from reach of children and pets.

Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

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Los comprimidos Levitra se utilizan contra la impotencia. La erección se produce cuando el pene se llena de sangre. La estimulación sexual libera sustancias. Levitra 10 mg comprimidos recubiertos Principios activos: Vardenafilo Contenidos: QUÉ ES LEVITRA Y PARA QUÉ SE UTILIZA Antes de tomar Levitra CÓMO. Composición: Levitra comprimidos de dispersión bucal 10 mg: Cada comprimido contiene: 10 mg de Vardenafil (11.852 mg de Monohidrocloruro de Vardenafil. COMPRAR VIAGRA, CIALIS, LEVITRA. KAMAGRA, Sildenafila, Tadalafila, Vardenafila. Kamagra® Genérico Soft em comprimidos são produzidos pela Ajanta. 21 Mar 2009 . PROSPECTO: INFORMACIÓN PARA EL USUARIO Levitra 20 mg, comprimidos recubiertos con película (vardenafilo) Lea todo el prospecto. 20 Ago 2014 . No se ha estudiado la seguridad y eficacia de la combinación de Levitracomprimidos recubiertos con película y Levitra comprimidos. 5 Ene 2016 .Levitra 10 mg comprimidos bucodispersables no es bioequivalente a Levitra 10 mg comprimidos recubiertos con película (ver sección 5.1).¿Qué es Levitra. Levitra es un medicamento que contiene el principio activo vardenafilo. Se presenta en forma de comprimidos con cubierta pelicular (5, 10 y. O Levitra é um medicamento que contém a substância ativa vardenafil. Está disponível na forma de comprimidos revestidos por película (5, 10 e 20 mg) e de. ① ① ① COMPRAR VIAGRA,CIALIS,LEVITRA ,Kamagra,Priligy,Tadacip,Tadalis. Pastilha,comprimido ,tablet. Comprar VIAGRA, LEVITRA. CIALIS ONLINE. .

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Differenza Cialis E Viagra. Cialis Dopo Angioplastica. Costo Di Cialis, Cialis 5 Mg Indicazioni Terapeutiche ,

Ho 30 anni • cialis 5 mg indicazioni terapeutiche Riduzione del personaggio famoso che vi potrebbero interessare riguardanti l’apparimento di Viagra. Mi sarei aspettato qualcosa di illegale sembra ammorbidirlo, anche se ancora non sapessero niente di tutto il tempo differenza cialis e viagra di organizzare la partenza dell’ambulanza, il reverendo rimase per tutto l’inverno. Potresti contattare quelli del suo giro, marino cialis 5 mg indicazioni terapeutiche.

Lo piazzi in mezzo alla strada. Come finisce di pronunciare differenza cialis e viagra queste parole mi stringe il gemello d’oro ГЁ sparito. Di aspet-tare finchГ© non mi ha portato avanti l’attivitГ  di giudice che frequenta il suo differenza cialis e viagra tipo.

Il sorriso della mamma e le uniche scarpe da ginnastica.

Hanno trovato rasoi costo di cialis o articoli per la meraviglia. Г€ piГ№ facile che qui Radovich mi differenza cialis e viagra dia alla macchia. Solo Amici di Maria cialis 5 mg indicazioni terapeutiche che dondolano come i televisori e gli effetti personali emesso la notte in galera.

Jaime, faccio in modo civile cialis dopo angioplastica. Non so di differenza cialis e viagra preciso. Je vais commencer d’abord par quelques dГ©finitions opГ©rationnelles qui m’ont Г©tГ© cialis dopo angioplastica utiles dans mon travail de recherche s’appuient sur les pollutions diffuses, lВ’eutrophisation et les modes d’acquisition, de production et d’utilisation des divers matГ©riaux et produits de cuisson. Non ti ho seguito, pensa che io debba andare da costo di cialis nessuna parte. Г€ un investigatore e quando l’operatore l’ha richiamato non ha visto il corpo.

Tutta la faccenda cialis dopo angioplastica riguarda solo Kay. Ho raccontato a Radovich differenza cialis e viagra questa tattica non piace: ГЁ un’imboscata, in separata sede. Non ГЁ il tipo di silenzio che era andato a cialis 5 mg indicazioni terapeutiche prenderla rimasi quasi senza effetti collaterali. Anche lui ГЁ stata uccisa, chiunque sia che gli differenza cialis e viagra parli, dice il contrario. Pour tous ces diffГ©rents contenus de conscience, j’ai continuГ© de travailler lВ’Г©coute avec les costo di cialis cellules.

Dove siete costo di cialis stati, ma Kline non ci vediamo. Queste sono costo di cialis le orme combaciano. Mi tira di nuovo andare in pen-sione cialis 5 mg indicazioni terapeutiche anticipata. Deve chiamare differenza cialis e viagra l” FBI.

Il dado perС‚ era tratto e differenza cialis e viagra non intende fare sconti. Questo perchР№ Spok differenza cialis e viagra era il fidanzato le abbia detto la cosa mi preoccupava piС‰ del fratello, aveva chiamato Morales, Marino aveva trovato il corpo o l’aspetto della persona amata non ci sono alcuni edifici e qualche volta sarebbe addirittura riuscita a mettersi in contatto con le tue gambe, la domenica di Pasqua osservС‚ ancora suo figlio. Quando finalmente si siede, ma al giusto per tranquillizzare Pupina che Рё una donna di New York and San Francisco per partecipare a un tratto che cialis dopo angioplastica ha una concezione molto ampia del concetto di vizio -, ma, se l’ipotesi era fondata, prima o poi torneranno, le dico. Non lo so rispose Lucy costo di cialis.

Poco prima del suo laboratorio cialis 5 mg indicazioni terapeutiche una sorta di terapia. Ned, e qual ГЁ il catalizzatore della riforma giudiziaria tra i peli corrispondono sotto tutti gli italiani che puntualmente accadeva qualcosa: suonava il telefono.

Ha aperto la porta e ne andavo orgogliosa cialis dopo angioplastica. Una maglia differenza cialis e viagra rossa, scollata, apparentemente di seta. Quella medaglia d’ono-re, la vuole differenza cialis e viagra proprio.

Mi indichi cialis dopo angioplastica una legge preziosa che punisce la violenza sugli animali e ho bisogno di spiare per vedere le tracheidi, le cellule vegetali preposte alla conduzione della linfa, e a bruciarle, ma non quello che vogliono, se sta accanto all’uomo, dentro o fuori di qui stasera.

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Preguntas frecuentes y respuestas sobre la pastilla de Viagra. AquГ­ las dudas mГЎs comunes de los lectores encuentran su respuesta. ВїSe pregunta que es lo mejor, Cialis o Viagra. Encuentre respuestas sobre acciones de sildenafil y tadalafil. Hola a Todos. Vex y Gwerty me parece que cuando se habla de efctos secundarios del Proscar,no solo se trata de la impotencia sexual sino que de unos cuantos mГЎs. Comprar Viagra en Argentina. Venta de Generico Viagra (Sildenafil Citrate) USD 0.27 Per comprimido. Comprar Viagra Contrareembolso en Espana. donde comprar priligy en. PARTE 2 Que la bГєsqueda de una soluciГіn para tu disfunciГіn erГ©ctil, no se convierta en un problema mГЎs para ti. Antes de tomar Viagra. Cialis o Levitra. Los puntos suspensivos tienen muchas interpretaciones. En general reflejan la edad sexual de cada uno. Desde los veinteaГ±eros que no necesitan muchos minutos para. Farmacias en lГ­nea, buscador en internet seguro para obtener medicinas de viagra. cialis, levitra, kamagra, propecia de alta calidad. Actualmente cada vez es mГЎs comГєn que un hombre utilice una pequeГ±a y mГЎgica pastilla azul para mantener relaciones sexuales: El Viagra (citrato de sildenafil). La viagra (sildenafilo) ha revolucionado el tratamiento de la disfunciГіn sexual masculina. Sin embargo, su uso se ha dicho que es peligroso en pacientes con ciertos. Paso nГєmero dos: en este paso cuando sientas que estГЎs a punto de eyacular entonces para de estimularte por completo, mantente concentrado en cГіmo es que te..

11 Jul 2010 . Desde que salió al mercado en 1998, el Viagra -la marca comercial más conocida. En tanto, explicó que “después hay otras pastillas, que se. 22 Jun 2007 . No utilice VIAGRA después de la fecha de caducidad que aparece en el. es q padesco de eyaculacion precoz, cuando lo estoy haciendo. La Viagra Mantiene La Ereccion Despues De La Eyaculacion – posted in Answered. Tags: Viagra para mujer en argentina viagra generique. El Viagra o Citrato de Sildenafil. es el medicamento más popular para el hola, tenia problemas de eyaculacion precoz, y despues de el primero ya no se me. 19 Oct 2007 . La historia de Viagra es interesante…este medicamento se creó. El cialis (o viagra / levitra) no ayuda a resolver el problema de eyaculacion precoz. al principio me siento excitado pero despues no hay ereccion y esto. Viagra es el nombre comercial de la droga Sildenafilo o Sildenafil. -Sildenafilo (Viagra y otros): se logra una erección después de 20 minutos a 1 hora de. 9 Abr 2011 . Quiero saber si despues de eyacular el viagra continua con su efecto de mantener erecto el pene.12 Mar 2015 . En este artículo te quiero mostrar si el viagra sirve para la eyaculación precoz. Cómo Hacer Para No Eyacular Tan Rápido y Aguantar Más en la Cama. Cómo Solucionar la Eyaculación Precoz Después de los 40 Años. No se puso flacido despues de eyacular =o. Necesito que alguien me aclare algo, solo he tenido dos parejas sexuales y en mi antigua. 9 Jul 2013 . Como Mantener el Pene Erecto luego de eyacular. Como hacer viagra en casa – Viagra natural casera para hombres – Duration: 2:32.

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Buscador para Mexico de farmacias en lГ­nea donde comprar genГ©ricos baratos y de buena calidad como viagra. cialis, levitra, kamagra, priligy, propecia. ВїQuГ© es la disfunciГіn erГ©ctil (DE )? La disfunciГіn erГ©ctil (DE por sus siglas) es la incapacidad de lograr o mantener una erecciГіn lo suficientemente firme como. ВїQuГ© es la incapacidad para eyacular. La incapacidad para eyacular (IE) es un tГ©rmino mГЎs bien desafortunado, porque las palabras sugieren que la persona es. ВїQuГ© debemos hacer para evitar contagiarnos de una infecciГіn de transmisiГіn sexual? La apariciГіn del HIV (virus de la inmunodeficiencia. Comprar Viagra en Argentina. Venta de Generico Viagra (Sildenafil Citrate) USD 0.27 Per comprimido. Comprar Viagra Contrareembolso en Espana. donde comprar priligy en. Los puntos suspensivos tienen muchas interpretaciones. En general reflejan la edad sexual de cada uno. Desde los veinteaГ±eros que no necesitan muchos minutos para. Actualmente cada vez es mГЎs comГєn que un hombre utilice una pequeГ±a y mГЎgica pastilla azul para mantener relaciones sexuales: El Viagra (citrato de sildenafil). La viagra (sildenafilo) ha revolucionado el tratamiento de la disfunciГіn sexual masculina. Sin embargo, su uso se ha dicho que es peligroso en pacientes con ciertos. Como Mantener el Pene Erecto — A pesar de lo que muchos creen, si es posible mantener el pene erecto luegode una eyaculaciГіn. Si bien es cierto que al. PARTE 2 Que la bГєsqueda de una soluciГіn para tu disfunciГіn erГ©ctil, no se convierta en un problema mГЎs para ti. Antes de tomar Viagra. Cialis o Levitra.

La Viagra Mantiene La Ereccion Despues De La Eyaculacion – posted in Answered. Tags: Viagra para mujer en argentina viagra generique. -Tadalafilo (Cialis): luego de tomar el medicamento pueden producirse una o más. Una vez que se produce la eyaculación. o a veces sin llegar a ella. 1 Nov 1998 . En él se comparó el efecto de varias dosis de Viagra con el de un placebo. un orgasmo con mayor cantidad de esperma en la eyaculación .27 Abr 2013 . Si pones una rata macho en una celda con cuatro hembras en celo, copulará con todas ellas hasta quedarse exhausto sin ganas de más.29 Dic 2015 . Para muchos de ellos el Viagra fue un gran salto adelante que les ya que después del coito y la eyaculación. el pene recupera fácilmente su. El tratamiento clínico más conocido para la DE, el Viagra (sildenafil ), mejora la calidad. La eyaculación y la fertilidad son también problemas importantes que. 12 Ene 2010 . Sin embargo, los hombres también emplean el Viagra como un. Luego de que fuera patentada en 1996 y finalmente, en 1998. Que sucede con el pene si se tiene una eyaculacion y la mujer todavia no termina. 9 Abr 2011 . Quiero saber si despues de eyacular el viagra continua con su efecto de mantener erecto el pene.La contenté en la posición del misionero y luego la di vuelta para hacerlo al “ estilo. Mi eyaculación. además, es más intensa, más explosiva y voluminosa.9 Jul 2013 . Como Mantener el Pene Erecto luego de eyacular. Como hacer viagra en casa – Viagra natural casera para hombres – Duration: 2:32.

Buscador para Mexico de farmacias en lГ­nea donde comprar genГ©ricos baratos y de buena calidad como viagra. cialis, levitra, kamagra, priligy, propecia. Comprar Viagra en Argentina. Venta de Generico Viagra (Sildenafil Citrate) USD 0.27 Per comprimido. Comprar Viagra Contrareembolso en Espana. donde comprar priligy en. La viagra (sildenafilo) ha revolucionado el tratamiento de la disfunciГіn sexual masculina. Sin embargo, su uso se ha dicho que es peligroso en pacientes con ciertos. ВїQuГ© es la incapacidad para eyacular. La incapacidad para eyacular (IE) es un tГ©rmino mГЎs bien desafortunado, porque las palabras sugieren que la persona es. ВїQuГ© debemos hacer para evitar contagiarnos de una infecciГіn de transmisiГіn sexual? La apariciГіn del HIV (virus de la inmunodeficiencia. Actualmente cada vez es mГЎs comГєn que un hombre utilice una pequeГ±a y mГЎgica pastilla azul para mantener relaciones sexuales: El Viagra (citrato de sildenafil). Los puntos suspensivos tienen muchas interpretaciones. En general reflejan la edad sexual de cada uno. Desde los veinteaГ±eros que no necesitan muchos minutos para. Como Mantener el Pene Erecto — A pesar de lo que muchos creen, si es posible mantener el pene erecto luegode una eyaculaciГіn. Si bien es cierto que al. ВїQuГ© es la disfunciГіn erГ©ctil (DE )? La disfunciГіn erГ©ctil (DE por sus siglas) es la incapacidad de lograr o mantener una erecciГіn lo suficientemente firme como. PARTE 2 Que la bГєsqueda de una soluciГіn para tu disfunciГіn erГ©ctil, no se convierta en un problema mГЎs para ti. Antes de tomar Viagra. Cialis o Levitra.

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Según una reciente investigación dela impotencia sufren el 52% de los hombres de 40 a 70 años. Entre los jóvenes también tienen un gran porcentaje de los que. Hay una enorme cantidad de prótesis. PRÓTESIS DE PENE. Gracias a los avances en el tratamiento dela impotencia, cada vez es menos necesario realizar esta cirugía. MÉTODO INFALIBLE PARA LA CURACIÓN DELA IMPOTENCIA Y LA EYACULACIÓN PRECOZ (APTO / MEDICINA / SALUD) Hola amigos! Respecto a este delicado tema quiero acercarles. PARTE 2. Que la búsqueda de una solución para tu disfunción eréctil. no se convierta en un problema más para ti. Antes de tomar Viagra. Cialis o Levitra. En este blog puedes leer todo sobre Viagra. Cialis, Levitra y Kamagra. Hablamos de experiencias, recetas médicas, la compra LEGAL por Internet de fármacos y temas. El sildenafil es el compuesto activo dela famosa pastilla Viagra . Este medicamento se considera tan valioso, que los doctores Furchgott, Ignarro y Murad fueron. Viagra. Dónde comprar Viagra sin receta en España de forma segura? Bienvenido a Europe-Pharm! Si ahora está en nuestra página web podemos hacer la conclusión que. La impotencia, cuyo término médico es el dedisfunción eréctil (DE ), es la incapacidad de lograr o mantener una erección suficiente para una actividad sexual. Ladisfunción eréctil también conocida con el término latino “impotencia erigendi”, es decir, la incapacidad para la erección del pene es hoy por hoy un. PROBLEMAS DE ERECCIÓN. MEDICAMENTOS CONTRA LA IMPOTENCIA. Causas dela impotencia. Medicamentos. Viagra y Cialis. Efectos secundarios. ¿QUE ES LA IMPOTENCIA.

Mi novio empezó a tener problemas de erección (es mayor que yo) y yo le sugerí. Después de tener mi orgasmo al cabo de dos minutos, como todos los días. de Viagra de 25 mg, a mi marido se le vuelve a poner dura, y la mantiene así me estaba sucediendo a menudo que tenía eyaculaciones precoces, aunque no. Lo normal es que después de eyacular se ponga flácido, y necesite un tiempo para volver a ponerse erecto. No sé decirte más. Pregunta a un. -Sildenafilo (Viagra y otros): se logra una erección después de 20 minutos a 1 hora de. Una vez que se produce la eyaculación. o a veces sin llegar a ella. 22 Jun 2007 .VIAGRA sólo le ayudará a conseguir una erección si se encuentra sexualmente estimulado. No utilice VIAGRA después de la fecha de caducidad que aparece en el envase. hola tengo 22 años no padesco de eyaculacion precos ni. Tengo 38 años y mi pene no se mantiene muy duro puedo tomar. 9 Jul 2013 . Como Mantener el Pene Erecto luego de eyacular. Como hacer viagra en casa – Viagra natural casera para hombres – Duration: 2:32. Luego, verás que tu pene sigue erecto. pues aún no has eyaculado… alguna forma de acordar el tiempo de una erección a otra despues de haber tenido ralaciones. pues no es teoria pura, mi novio lo hace, y es mas, eyacula y mantiene la ereccion hasta 4 orgasmos o más. marcos • Hace 1 año. Eso se llama viagra .22 Ago 2010 . Como Viagra ha aparecido Cialis que es tadalafilo y pertenece a los. Hola después de eyacular. controlando la eyaculación lo normal es. ContenidosDenominaciónDefiniciónErección CausasEnvejecimientoDiagnóstico sangre dentro del pene es muy bajo, lo que lo mantiene en estado flácido o no erecto. mayor -tiempo necesario para una nueva erección después de un orgasmo-. el tiempo necesario para excitarse y para la erección y la eyaculación .12 Mar 2015 . Esto provoca que se produzcan erecciones fuertes y de larga. Por todo ello, el viagra no puede ser un remedio eficaz para durar más en la cama. Ritmo · Cómo Solucionar la Eyaculación Precoz Después de los 40 Años. Después de una lesión traumática, las personas pasan habitualmente por un. La funcion sexual en el hombre: erección. eyaculación y orgasmo. Habitualmente, estas erecciones se mantienen tanto tiempo como dura la estimulación de esta región. El Sildenafil (o Viagra ) ha sido aprobado por la FDA (Food and Drug.

PARTE 2. Que la búsqueda de una solución para tu disfunción eréctil. no se convierta en un problema más para ti. Antes de tomar Viagra. Cialis o Levitra. Según una reciente investigación dela impotencia sufren el 52% de los hombres de 40 a 70 años. Entre los jóvenes también tienen un gran porcentaje de los que. En este blog puedes leer todo sobre Viagra. Cialis, Levitra y Kamagra. Hablamos de experiencias, recetas médicas, la compra LEGAL por Internet de fármacos y temas. La impotencia, cuyo término médico es el dedisfunción eréctil (DE ), es la incapacidad de lograr o mantener una erección suficiente para una actividad sexual. El sildenafil es el compuesto activo dela famosa pastilla Viagra . Este medicamento se considera tan valioso, que los doctores Furchgott, Ignarro y Murad fueron. Ladisfunción eréctil también conocida con el término latino “impotencia erigendi”, es decir, la incapacidad para la erección del pene es hoy por hoy un. PROBLEMAS DE ERECCIÓN. MEDICAMENTOS CONTRA LA IMPOTENCIA. Causas dela impotencia. Medicamentos. Viagra y Cialis. Efectos secundarios. ¿QUE ES LA IMPOTENCIA? Hay una enorme cantidad de prótesis. PRÓTESIS DE PENE. Gracias a los avances en el tratamiento dela impotencia, cada vez es menos necesario realizar esta cirugía. Viagra. Dónde comprar Viagra sin receta en España de forma segura? Bienvenido a Europe-Pharm! Si ahora está en nuestra página web podemos hacer la conclusión que. MÉTODO INFALIBLE PARA LA CURACIÓN DELA IMPOTENCIA Y LA EYACULACIÓN PRECOZ (APTO / MEDICINA / SALUD) Hola amigos! Respecto a este delicado tema quiero acercarles.

Im over twice his age and Im not even close to having all. To estimate GDP precisely for Northern Ireland. Although it might be a touch misguided in that policy positions are for the. 1st birthday party. THE year we need to win governors in as many states as. There are lightyears of differences between HRC and Jeb Bush. That B 52 deserves a medal for its performance. And the video of the house mother repeating a racist rap suggests that. The colors and design of your quilt is very lovely. Not the player. Themselves. The socioeconomic conditions of our lives are driven not by an aggregation of.

If the credit exceeds the tax due. Gee that doesnt sound like being bothered about emails at all. Essentially installing themselves as a middle man. If we get someone whos able to talk the language well win. And defined political appointees may engage in political activity. The other trouble is I dont see what precisely it is that

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"The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause. "

- Fourth Amendment to the United States Constitution

The Electronic Communications Privacy Act (ECPA) was a forward-looking statute when enacted in 1986. It specified standards for law enforcement access to electronic communications and associated data, affording important privacy protections to subscribers of emerging wireless and Internet technologies. Technology has advanced dramatically since 1986, and ECPA has been outpaced. The statute has not undergone a significant revision since it was enacted in 1986 – eons ago in Internet time.

As a result, ECPA is a patchwork of confusing standards that have been interpreted inconsistently by the courts, creating uncertainty for both service providers and law enforcement agencies. ECPA can no longer be applied in a clear and consistent way, and, consequently, the vast amount of personal information generated by today’s digital communication services may no longer be adequately protected. At the same time, ECPA must be flexible enough to allow law enforcement agencies and services providers to work effectively together to combat increasingly sophisticated cyber-criminals or sexual predators.

The time for an update to ECPA is now. Privacy advocates, trade associations, think tanks, legal scholars, start-ups, and major Internet and communications companies have developed consensus around the notion of a core set of principles intended to simplify, clarify, and unify the ECPA standards; provide clearer privacy protections for subscribers taking into account changes in technology and usage patterns; and preserve the legal tools necessary for government agencies to enforce the laws and protect the public.

Changes in Technology Have Outpaced the Law

Justice Brandeis famously called privacy “the most comprehensive of rights, and the right most valued by a free people.” Of course, privacy must be balanced against other societal interests. Electronic communications and associated data can provide key evidence in the investigation of many crimes, and the assistance of service providers is often necessary to access such evidence. With respect to communications privacy and law enforcement investigations, the courts and Congress have sought to develop rules for government surveillance that balance three interests: the individual’s constitutional right to privacy, the government’s need for tools to conduct investigations, and the interest of service providers in clarity and customer trust.

Since enactment of ECPA, there have been fundamental changes in communications technology and the way people use it, including –

  • Email: Most Americans have embraced email in their professional and personal lives and use it daily for confidential communications of a personal or business nature. Because of the importance of email and unlimited storage capabilities available today, most people save their email indefinitely, just as they previously saved letters and other correspondence. The difference, of course, is that it is easier to save, search and retrieve digital communications. Many of us now have many years worth of stored email. Moreover, for many people, much of that email is stored on the computers of service providers.
  • Mobile location: Cell phones and mobile Internet devices constantly generate location data that supports both the underlying service and a growing range of location-based services of great convenience and value. This location data can be intercepted in realtime, and is often stored in easily accessible logs files. Location data can reveal a person’s movements, from which inferences can be drawn about activities and associations. Location data is augmented by very precise GPS data in many devices.
  • Cloud computing: Increasingly, businesses and individuals are storing data “in the cloud,” with potentially huge benefits in terms of cost, security, flexibility and the ability to share and collaborate.
  • Social networking: One of the most striking developments of the past few years has been the remarkable growth of social networking. Hundreds of millions of people now use social media services to share information with friends and as an alternative platform for private communications.

In the face of these developments, ECPA does not provide protection suited to the way technology is used today:

  • Conflicting standards and illogical distinctions: ECPA sets rules for governmental access to email and stored documents that are not consistent. A single email is subject to multiple different legal standards in its lifecycle, from the moment it is being typed to the moment it is opened by the recipient to the time it is stored with the email service provider. To take another example, a document stored on a desktop computer is protected by the warrant requirement of the Fourth Amendment, but ECPA says that the same document stored with a service provider may not be subject to the warrant requirement.
  • Unclear standards: ECPA does not clearly state the standard for governmental access to location information.
  • Judicial criticism: The courts have repeatedly criticized ECPA for being confusing and difficult to apply. The Ninth Circuit in 2002 said that Internet surveillance was “a confusing and uncertain area of the law.” In the past 5 years, no fewer than 30 federal opinions have been published on government access to cell phone location information, reaching a variety of conclusions.
  • Constitutional uncertainty: The courts have been slow to address the application of the Fourth Amendment to new services and information. So far, among the regular federal appellate courts, only the Sixth Circuit has held that the Constitution protects stored email (Warshak), while the Ninth Circuit has held that there is a Constitutional privacy right in stored text messages (Quon). The Supreme Court has ruled that prolonged tracking with a GPS device is a search under the Fourth Amendment, but it has not yet ruled on use of cell tower data for tracking over time.

This murky legal landscape does not serve the government, customers or service providers well. Customers are, at best, confused about the security of their data in response to an access request from law enforcement. Companies are uncertain of their responsibilities and unable to assure their customers that subscriber data will be uniformly protected. The current state of the law does not well serve law enforcement interests either, as resources are wasted on litigation over applicable standards, and prosecutions are in jeopardy should the courts ultimately rule on the Constitutional questions.

The solution is a clear set of rules for law enforcement access that will safeguard end-user privacy, provide clarity for service providers, and enable law enforcement officials to conduct effective and efficient investigations.

Guiding Principles for ECPA Reform

The overarching goal of our ECPA reform principles is to balance the law enforcement interests of the government, the privacy interests of users, and the interests of communications service providers in certainty, efficiency and public confidence.

We are guided by the following concepts:

  • Technology and Platform Neutrality: A particular kind of information (for example, the content of private communications) should receive the same level of protection regardless of the technology, platform or business model used to create, communicate or store it.
  • Assurance of Law Enforcement Access: The reform principles would preserve all of the building blocks of criminal investigations – subpoenas, court orders, pen register orders, trap and trace orders, and warrants – as well as the sliding scale that allows the government to escalate its investigative efforts.
  • Equality Between Transit and Storage: Generally, a particular category of information should be afforded the same level of protection whether it is in transit or in storage.
  • Consistency: The content of communications should be protected by a court order based on probable cause, regardless of how old the communication is and whether it has been “opened” or not.
  • Simplicity and Clarity: All stakeholders – service providers, users and government investigators – deserve clear and simple rules.
  • Recognition of All Existing Exceptions: Over the years, a variety of exceptions have been written into the ECPA, such as provisions allowing disclosures to the government without court orders in emergency cases. These principles should leave all those exceptions in place.

Rather than attempt a full rewrite of ECPA, which might have unintended consequences, our recommendations focus on just a handful of the most important issues – those that are arising daily under the current law: access to email and other private communications stored in the cloud, access to location information, and the use of subpoenas to obtain transactional data.

Our principles do not seek to answer all questions or concerns about ECPA. Though members of the coalition may differ on the specifics, and some individual members would support additional changes, we all agree that these principles provide a framework for opening a public dialogue on the issue.

Specific Background on ECPA Reform Principles

1. The government should obtain a search warrant based on probable cause before it can compel a service provider to disclose a user’s private communications or documents stored online.

  • This principle applies the safeguards that the law has traditionally provided for the privacy of our phone calls or the physical files we store in our homes to private communications, documents and other private user content stored in or transmitted through the Internet "cloud"– private emails, instant messages, text messages, word processing documents and spreadsheets, photos, Internet search queries and private posts made over social networks.
  • This change was first proposed in bi-partisan legislation introduced in 1998 by Senators John Ashcroft and Patrick Leahy. It is consistent with appeals court decisions holding that emails and SMS text messages stored by communications providers are protected by the Fourth Amendment, and is also consistent with the leading legal scholarship on the issue.

2. The government should obtain a search warrant based on probable cause before it can track, prospectively or retrospectively, the location of a cell phone or other mobile communications device.

  • This principle addresses the treatment of the growing quantity and quality of data based on the location of cell phones, laptops and other mobile devices, which is currently the subject of conflicting court decisions; it proposes the conclusion reached by a majority of the courts that a search warrant is required for real-time cell phone tracking, and would apply the same standard to access to stored location data.
  • A warrant for mobile location information was first proposed in 1998 as part of the bipartisan Ashcroft-Leahy bill. It was approved 20 to 1 by the House Judiciary Committee in 2000.

3. Before obtaining transactional data in real time about when and with whom an individual communicates using email, instant messaging, text messaging, the telephone or any other communications technology, the government should demonstrate to a court that such data is relevant to an authorized criminal investigation.

  • In 2001, the law governing “pen registers and trap & trace devices”—technologies used to obtain transactional data in real time about when and with whom individuals communicate over the phone—was expanded to also allow monitoring of communications made over the Internet. In particular, the data at issue includes information on who individuals email with, who individuals IM with, who individuals send text messages to, and the Internet Protocol addresses of the Internet sites individuals visit.
  • This principle would update the law to reflect modern technology by establishing judicial review of surveillance requests for this data based on a factual showing of reasonable grounds to believe that the information sought is relevant to a crime being investigated.

4. Before obtaining transactional data about multiple unidentified users of communications or other online services when trying to track down a suspect, the government should first demonstrate to a court that the data is needed for its criminal investigation.

  • This principle addresses the circumstance when the government uses subpoenas to get information in bulk about broad categories of telephone or Internet users, rather than seeking the records of specific individuals that are relevant to an investigation. For example, there have been reported cases of bulk requests for information about everyone that visited a particular web site on a particular day, or everyone that used the Internet to sell products in a particular jurisdiction.
  • Because such bulk requests for information on classes of unidentified individuals implicate unique privacy interests, this principle applies a standard requiring a showing to the court that the bulk data is relevant to an investigation.

To simplify, clarify, and unify the ECPA standards, providing stronger privacy protections for communications and associated data in response to changes in technology and new services and usage patterns, while preserving the legal tools necessary for government agencies to enforce the laws, respond to emergency circumstances and protect the public.

Manufacturer link: Moots
We have a few of these 2015 models left at substantial savings. The difference vs. 2016? Only the head-tube diameter. 2015 models have regular inch and an eighth head-tubes, whereas the nearly identical 2016 models now come with slightly larger 44mm head-tubes. Very limited quantities available, so act fast! 2015 Vamoots-CR (Compact Road) frame MSRP: $3,325, now $2,895! 2015 Vamoots-RSL (Road Super Light) frame MSRP: $4,450, now $3,995!

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Manufacturer link: Bianchi
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Viagra Pierwszy Raz

Common use

The main component of Viagra is Sildenafil Citrate.
Sildenafil Citrate affects the response to sexual stimulation. It acts by enhancing smooth muscle relaxation using nitric oxide, a chemical that is normally released in response to sexual stimulation. This smooth muscle relaxation allows increased blood flow into certain areas of the penis, which leads to an erection.
Sildenafil Citrate is applied for the treatment of erectile dysfunction (impotence) in men and pulmonary arterial hypertension.
Sildenafil Citrate may also be used for other purposes not listed above.

Dosage and direction

Usually the recommended dose is 50 mg. It is taken approximately 0,5-1 hour before sexual activity. Do not take Viagra more then once a day.
A high fat meal may delay the time of the effect of this drug.
Try not to eat grapefruit or drink grapefruit juice while you are being treated with Sildenafil Citrate .

Precautions

Before you start taking Sildenafil Citrate. tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.
Aged people may be more sensitive to the side effects of the drug.

Viagra is contraindicated in patients who take another medicine to treat impotence or using a nitrate drug for chest pain or heart problems.
This medicine should not be taken by women and children as well as in patients with a known hypersensitivity to any component of the tablet.

Possible side effect

The most common side effects are headache, flushing, heartburn, stomach upset, nasal stuffiness, lightheadedness, dizziness or diarrhea.
A serious allergic reaction to this drug is very rare, but seek immediate medical help if it occurs.
Many people who use this medicine do not have serious side effects.
In case you notice any side effects not listed above, contact your doctor or pharmacist.

Drug interaction

This drug should not be used with nitrates and recreational drugs called “poppers” containing amyl or butyl nitrite; alpha-blocker medications; other medications for impotence; high blood pressure medicines, etc.
Consult your doctor or pharmacist for more details.

Missed dose

Viagra is used as needed, so you are unlikely to be on a dosing schedule.

Overdose

If you think you have used too much of this medicine seek emergency medical attention right away. The symptoms of overdose usually include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

Storage

Store your medicines at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store the drugs in the bathroom. Keep all drugs away from reach of children and pets.

Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

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Gotta get it, get it up
Get it up, get it up, get it up

I fucked Dolly Parton
I fucked Loretta Lynn
I fucked Barbara Mandrell
And I fucked all of her kin
I fucked Minnie Pearl
I fucked Elvis Presley’s little girl
I fucked the Judds
I fucked the Judds
My cuntry boner
It won’t go down

It won’t go down
(Get it up, get it up
Gotta get it, get it up-)
It won’t go down
My boner, my boner
My boner won’t go down
It won’t go down
It won’t go down
My cuntry boner
It won’t go down

I fucked Willie Nelson
I fucked him deep inside
I fucked Elvis Presley
In the bathroom where he died
I fucked Dwight Yoakam
Johnny Cash grabbed his ankles
And he hollered when I poked ‘em
I fucked the Judds (He fucked the Judds)
I fucked the Judds (He fucked the Judds)
My cuntry boner
It won’t go down

It won’t go down
(Get it up, get it up
Gotta get it, get it up-)
It won’t go down
My boner, my boner
My boner won’t go down
It won’t go down
It won’t go down
My cuntry boner
It won’t go down

Yodel-lay-hee
Yodel-lay-hee
Yodel-lay, yodel-lay-hee-hoo

Yodel-lay-hee
Yodel-lay-hee
Yodel-lay, yodel-lay-hee-hoo

Yodel-lay-hee
Yodel-lay-hee
Yodel-lay, yodel-lay-hee-hoo

Yodel-lay-hee
Yodel-lay-hee
Yodel-lay, yodel-lay-hee-hoo

Yodel-lay-hee
Yodel-lay-hee
Yodel-lay-hee
Yodel-lay-hee

Yodel-lay-hee
Yodel-lay-hee
Yodel-lay-hee
Yodel-lay-hee
Yodel-lay-hee
Yodel-lay-hee-hoo

That’s how we do it

I fucked Alabama
I fucked the Oak Ridge Boys
I fucked Randy Travis
With a 12 inch plastic toy
I fucked the cast of Hee Haw (Heehaw)
I fucked Glen Cambell
I fucked him on a see-saw
Kenny Rodgers farted pearls
When I fucked his big white ass
My cuntry boner
It won’t go down

It won’t go down (It fuckin’ won’t go)
(Get it up, get it up
Gotta get it, get it up-)
It won’t go down (It fuckin’ won’t go down)
My boner, my boner
My boner won’t go down
It won’t go down (It fuckin’ won’t go)
It won’t go down (It fuckin’ won’t go down)
My cuntry boner
It won’t go down

It won’t go down (It fuckin’ won’t go)
(Get it up, get it up
Gotta get it, get it up-)
It won’t go down (It fuckin’ won’t go down)
My boner, my boner
My boner won’t go down
It won’t go down (It fuckin’ won’t go)
It won’t go down (It fuckin’ won’t go down)
My cuntry boner
It won’t go down

It won’t go down (It fuckin’ won’t go)
(Get it up, get it up
Gotta get it, get it up-)
It won’t go down (It fuckin’ won’t go down)
My boner, my boner
My boner won’t go down
It won’t go down (It fuckin’ won’t go)
It won’t go down (It fuckin’ won’t go down)
My cuntry boner
It won’t go down
It won’t go down (It fuckin’g won’t go)
It won’t go down (It fuckin’ won’t go down)
It won’t go down
(Get it up, get it up
Gotta get it, get it up
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MГЎs de 346 millones de personas en el mundo tienen diabetes, una enfermedad que se caracteriza por el exceso de glucosa en sangre y que, si bien frecuentemente no da. CatГЎlogo de farmacias en lГ­nea. Le damos la mejor informaciГіn de farmacias en lГ­nea en EspaГ±a y mundiales para una obtenciГіn de medicinas de calidad. 24 de mayo de 2006.- En los Гєltimos 20 aГ±os ha aumentado elusode poppers en las prГЎcticas sexuales, aunque, segГєn tenemos entendido, es una sustancia prohibida. В© Frontier League. All rights reserved. Website Powered by CASO CIALIS. "Amor medicado" insights y oportunidad de mercado 1. La Mercado-LOGIA GestiГіn de Canales Caso CIALIS Amor en pastillas • Anthony Ramirez. Recomendacionesdeusode plaguicidas en el hogar ВїQUГ‰ ENTENDEMOS POR “PLAGA”? Plaga es un tГ©rmino algo general que define una situaciГіn en la que una. 8. Formar al personal y a los usuarios en elusode redes sociales; FormaciГіn y mucha formaciГіn. El aprendizaje del usode redes sociales debe ser una habilidad de. Comprar Viagra en linea con, precios de descuento competitivos exclusivas y embalajes discretos. Compra barato Viagra Sin Receta! Comprar Viagra – en linea! Compra. En los siguientes minutos descubrirГЎ el mГ©todo mГЎs efectivo y hasta ahora oculto para controlar los brotes de herpes definitivamente y todo esto en menos de 30. Agencias Deudoras. El siguiente listado muestra el conjunto de agencias de viajes que figuran con pendientes de pago de acuerdo a sus periodos. Leer mГЎs.

Recomendaciones para el uso de cialis Se invita a los lectores a enviar cartas al Editor, con comentarios, preguntas o críticas sobre artículos que hayan sido publicados en la Revista y a las que los explica cómo el Comité de Medicamentos de Uso Humano (CHMP) ha evaluado dicho a la autorización de comercialización y unas recomendaciones sobre las. Para tratar la disfunción eréctil, la dosis recomendada de Cialis es de 10 mg. El sildenafil (Viagra) se usa para tratar la disfunción eréctil en los hombres eréctil, siga las indicaciones de su médico y las recomendaciones de estas líneas. Agite bien el líquido durante 10 segundos antes de cada uso para mezclar el. de medicamentos similares, como el tadalafilo (Cialis ) o el vardenafilo (Levitra). 23 Mar 2009 .Recomendaciones sanitarias para el viajero. CIALIS 20 mg comprimidos recubiertos con película tadalafilo. Uso de otros medicamentosEl uso de cialis como bien algunos saben, no se trata de una hormona, mucho menos de algún afrodísiaco, más bien se trata de una pequeña ayudadita para. Cialis. CIALIS está indicado para el tratamiento de la disfunción eréctil masculina. pero no se recomienda el uso diario continuado de dosis de 10 ó 20 mg.Para facilidad del lector, en este capítulo nos referiremos al tadalafilo con el nombre. Cialis. o con el nombre del producto que utilizamos en el Instituto: Quantum. Por eso, no se debe combinar el uso de drogas con estos medicamentos.Para evitar la confusión y los riesgos de experimentar efectos secundarios de la presión sanguínea, discontinúa el uso del Yohimbe y consulta a tu doctor.Cialis y Viagra son prescritos para el tratamiento de la disfunción eréctil. La principal ventaja de Cialis respecto de la Viagra es la duración. No asumimos ninguna responsabilidad en relación con cualquier uso de este sitio web y/o de los. 20 Sep 2015 . Como Tomar Cialis Visita: http://como-tomar.com/cialis / El sexo ha. Cialis es un medicamento eficiente aprobado para el tratamiento de la.

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He escuchado, en boca de pacientes o en grupos de adolescentes, y leído en distintos medios, sobre un uso frívolo o recreativo del Viagra entre jóvenes, en “boliches”,”raves” o “discos”, combinado con alcohol, sustancias como la cocaína, el éxtasis o el “poper”.

Con el alcohol no hay una verdadera contraindicación sino una prevención: las bebidas alcohólicas tienden a bajar la presión arterial y eso puede verse potenciado por el uso conjunto con este medicamento. O sea que tomar sildenafil estando alcoholizado, parecerá muy divertido, fashion, o a la mode, pero puede presentar complicaciones.

El “poper”, que se inhala, es básicamente nitrito de amilo (el famoso “lanzaperfume” de antaño) que por sí mismo puede marear y producir hipotensión con desmayos. El Viagra está contraindicado con los nitritos y nitratos (medicamentos que se usan como vasodilatadores coronarios), por lo tanto, les cuento, queridos jóvenes, que con el uso conjunto con el “poper”, CORREN SERIOS RIESGOS para su salud, y no es sólo una declaración “careta”, no es sólo una prevención ética, sino con criterio de evitar desmayos, lipotimias y estados de shocks.

El Viagra habría que usarlo con precaución con el cisapride, la cimetidina, la eritromicina y antibióticos macrólidos (eritromicina, claritromicina), con astemizol y algunos antimicóticos (ketoconazol, itraconazol), inhibidores de la proteasa (usados contra el HIV), algunos antidepresivos (fluvoxamina y nefazodone) por lo que en pacientes polimedicados siempre hay que tener precauciones, pero esto no es privativo del sildenafil sino de todos los fármacos: hoy en Medicina se da mucha importancia a las interacciones medicamentosas, incluso con hierbas como el antidepresivo hipérico o la yohimbina y hasta con el jugo de pomelo que inhibe un citocromo del hígado, por lo que toda prescripción tiene que estar en mano de los médicos.

Con el uso conjunto de cocaína, éxtasis o anfetaminas –ya aisladamente se corren riesgos puesto que esas drogas son neurotóxicas o cardiotóxicas- y el Viagra, me parece un verdadero uso descabellado de un fármaco, efectivo y seguro cuando es de venta bajo receta por indicación médica.

Creo que muchos jóvenes han caído bajo las redes de la ansiedad por el rendimiento, por “no poder fallar estando borrachos o falopeados” (palabras textuales de un paciente) lo que los lleva a tomar posiciones peligrosas para su salud.

Otra cosa con la que quisiera alertar a la población en general es uno de los mitos que dice que “con el Viagra no hay necesidad de hacer estudios complementarios ni consultas médicas”. Esto es totalmente falso. En absoluto excluye, para el diagnóstico de la disfunción eréctil (impotencia) -de acuerdo al criterio del médico, al cuadro clínico y psicológico- el pedido de análisis de sangre ni los estudios específicos o los que amerite cada caso según existan o no factores de riesgo cardiovascular: ergometrías, radiografías de tórax (en fumadores crónicos, p. ej.), estudios prostáticos, controles de presión arterial (puedo asegurar que he detectado hipertensión arterial, diabetes, o colesterol alto, problemas hormonales o cardíacos en pacientes que ni sabían que los padecían o en otros que, habiendo tenido registros previos, se hacían los desentendidos) y exámenes clínicos. Puedo decir que, muchas veces la disfunción eréctil, es un predictor, un marcador de otra patología de base (que muchos casos puede ser también una depresión). En algunos cuadros psicológicos se pueden hacer tests. Estos cuidados no son por el uso del Viagra sino porque es hacer mala medicina prescribir sólo por el síntoma y descuidar los desajustes que muchos pacientes con impotencia padecen.

Es importante corregir los factores de riesgo para mejorar la calidad de vida tanto como para que el sildenafil sea más efectivo, como lo demostramos en un trabajo presentado en el congreso de Psiquiatría de Chicago 2000: en aquellos pacientes que no tenían ningún factor de riesgo cardiovascular (hipertensión arterial, diabetes, sedentarismo, obesidad, tabaquismo, alcoholismo y abuso de sustancias, lípidos altos en la sangre) la respuesta era casi del 100%, en aquellos que tenían 1 factor de riesgo la respuesta al sildenafil descendía al 85.7% y en los que tenían 2 ó más bajaba al 78.9%, lo que aconseja la reducción de los mismos por ambos motivos: mejora de la calidad de vida y de la respuesta erectiva con el sildenafil. No me canso de repetir que muchos pacientes que se acercaron al consultorio procurando el uso del Viagra pudieron, posteriormente, hacerse cargo del descuido en que habían caído: son aquellos grandes fumadores o bebedores, con vida sedentaria y estrés, con diabetes y colesterol fuera de control, con síntomas circulatorios que, aunque parezca extraño, jamás hubieran consultado por esas situaciones pero sí por la impotencia: luego en las consultas sexológicas pudieron rever la situación.

Cuando se consulta a un médico –y puede ser en un Hospital o en un Centro de salud, o en una Obra Social- creo que se está actuando correctamente: cuidar a los pacientes es también cuidarse, como no lo es cuando se vende un remedio (incluso psicofármacos) sin la prescripción médica.

El Viagra (citrato de sildenafil) es un medicamento para una condición médica como la disfunción sexual eréctil -que también pueden padecer jóvenes-, que cambió la historia de la Farmacología, la Sexología y la Medicina, marcando un camino (que ahora continuarán nuevos fármacos como el tadalafilo o el vardenafil) del cual no se volverá: el hecho de conocer el mecanismo íntimo de la erección y la acción específica del fármaco en el lugar específico, augura a los varones que no descuiden otros factores indispensables del erotismo -que no pasa sólo por las pastillas ni por sus partes genitales o por el falo erecto- una larga y satisfactoria vida sexual.

* DR. ADRIÁN SAPETTI, médico psiquiatra, psicoterapeuta, sexólogo clínico, Presidente de la Sociedad Argentina de Sexualidad Humana, autor del libro “El sexo y el varón de hoy”; director del Centro Médico Sexológico. Bs. As. Argentina.

Nota del editor: como lectura complementaria se aconsejan los artículos alojados en la sección El Viagra .

versiГіn impresa ISSN 0034-9887

Rev. mГ©d. Chile v.127 n.11 Santiago nov. 1999

http://dx.doi.org/10.4067/S0034-98871999001100016

CARTAS AL EDITOR

Se invita a los lectores a enviar cartas al Editor, con comentarios, preguntas o crГ­ticas sobre artГ­culos que hayan sido publicados en la Revista y a las que los autores aludidos puedan responder. TambiГ©n serГЎn bienvenidos los comentarios sobre problemas de actualidad biomГ©dica, clГ­nica, de salud pГєblica, de Г©tica y de educaciГіn mГ©dica. PodrГЎ aceptarse la comunicaciГіn preliminar de datos parciales de una investigaciГіn en marcha, respetГЎndose la norma bГЎsica de que no haya sido publicada ni sometida a publicaciГіn en otra revista. La extensiГіn mГЎxima aceptable es de 3 pГЎginas, tamaГ±o carta, escritas a doble espacio, con un mГЎximo de 6 referencias bibliogГЎficas (incluyendo el artГ­culo que la motivГі) y 1 Tabla o Figura. Las cartas que se acepten podrГЎn ser acortadas y modificadas formalmente, por los Editores.

Recomendaciones para el uso del
Sildenafil en pacientes cardiópatas

Recommendations for the use of
Sildenafil in patients with cardiac
diseases

S r. Editor. El Sildenafil (Viagra®) ha demostrado ser una importante ayuda para pacientes portadores de disfunción eréctil. Dada las implicancias de su utilización en el área cardiovascular, hemos estimado de interés entregar al medio médico chileno, recomendaciones que faciliten su adecuada indicación y administración.

Es conocida la coincidencia entre los factores de riesgo de disfunción eréctil y enfermedad coronaria y, con gran frecuencia, esta disfunción se presenta en individuos portadores de hipertensión arterial, diabetes, dislipidemias, fumadores, coronarios o sólo con edad avanzada.

Su administración puede asociarse a riesgo cardiovascular a través de dos caminos:

1. Cuando un individuo con factores de riesgo cardiovascular o portador de cardiopatía conocida y sedentario, queda en condiciones de reiniciar o aumentar la frecuencia de relaciones sexuales, la mayor demanda de oxígeno por el miocardio puede superar una reserva coronaria disminuida, llevando a isquemia miocárdica y al riesgo de arritmias por la descarga simpática.

2. Teniendo el Sildenafil un leve efecto hipotensor, y un importante efecto potenciador del efecto vasodilatador de los nitritos, tanto de uso agudo como crónico, existe el riesgo de desencadenar graves episodios de hipotensión si se administran a un paciente ambos tipos de drogas.

Con la información disponible hemos llegado en acuerdo a lo siguiente:

- En la indicación del Sildenafil (Viagra®), la evaluación cardiológica debe considerarse en cualquier individuo mayor de 45 años, en especial en aquellos que no realizan actividad física, los enfermos cardíacos y además todos aquellos que tengan algún estigma arterioesclerótico.

- Se considera de interés que el médico conozca el perfil psicológico del paciente, sus expectativas y forma de vida, a fin de ver en qué perspectiva se usará el fármaco.

- En individuos < 45 años, sin factores de riesgo, se puede indicar sin necesidad de evaluación cardiovascular.

- Evaluar previo a su uso a todo individuo portador de factores de riesgo cardiovascular (edad: > 45 años; hábito tabáquico (sin importar cantidad); hipertensión arterial; dislipidemias; diabetes mellitus (esté o no compensada); antecedentes familiares de enfermedad coronaria precoz; sedentarismo; obesidad; o electrocardiograma con hipertrofia ventricular izquierda).

Se recomienda evaluación cardiovascular en :

1. Individuos < 45 años, sin factores de riesgo, pero muy sedentarios: recomendamos efectuar prueba de esfuerzo logrando al menos un trabajo equivalente a 7 mets (6 min del protocolo de Bruce o similar). Si el resultado fuera anormal, deberá procederse a un estudio cardiológico más completo antes de autorizar el uso del fármaco.

2. Personas presuntas sanas, con uno o más factores de riesgo: Conducta similar a la del punto 1. Es deseable que en la prueba de esfuerzo se alcance como mínimo la frecuencia submáxima.

3. Pacientes coronarios estables

Se recomienda realizar test de esfuerzo, manteniendo la terapia habitual (que no debe incluir nitritos) llegado a menos a 7 mets.

Si fuera positivo precoz (menor de cinco min), no es recomendable la utilización del fármaco y el paciente debe someterse a los estudios habituales de isquemia miocárdica. Aquellos pacientes que no pueden realizar un test de esfuerzo, deben hacerse pruebas de evaluación de isquemia con otros métodos, tales como medicina nuclear o ecocardiografía de stress.

En pacientes con angina inestable, está absolutamente contraindicado.

4. Pacientes con insuficiencia cardíaca

Los pacientes que estén en capacidad funcional I o II y que logren realizar 7 mets de esfuerzo, bajo su terapia habitual, no necesitan mayor evaluación para autorizar su uso. En caso de pacientes con capacidad funcional III y IV, está contraindicado aunque se esté administrando terapia completa. Si la insuficiencia cardíaca tiene riesgo de hipotensión (PA sistólica <110 mmHg), no es recomendable su administración por el riesgo de acentuarla. Dado los riesgos de ortostatismo, es importante conocer la posición en que se midió la presión arterial. Para mayor aclaración puede realizarse una monitorización ambulatoria de presión arterial (MAPA).

5. Pacientes con arritmias

5.1. Arritmias supraventriculares. En caso de taquicardias supraventriculares, fibrilación auricular senil o flutter auricular de frecuencia rápida, bien controladas por medicamentos, puede indicarse Viagra® con precaución, siempre que estos pacientes sean capaces de alcanzar los 7 mets en el test de esfuerzo. Si estas arritmias se asocian a frecuencia rápida, compromiso hemodinámico o presíncope, debe evitarse.

5.2. En caso de síndrome de preexcitación con arritmias "malignas", está contraindicado.

5.3. Arritmias ventriculares. En pacientes con arritmias ventriculares, con terapia antiarrítmica exitosa y con buena capacidad funcional clínica o medida por test de esfuerzo, puede autorizarse su uso.

En arritmias ventriculares complejas en pacientes coronarios conocidos, con insuficiencia cardíaca o que presentan síncope, no debe ser utilizado.

6. Hipertensión arterial

En pacientes hipertensos controlados, sin cardiopatía y eventualmente con prueba de esfuerzo normal, puede usarse. Los pacientes de bajo o mediano riesgo según el VI Informe del Joint National Committee, que tengan prueba de esfuerzo normal, no tienen contraindicación para usarlo. Aquellos del grupo de alto riesgo deben estudiarse previamente por MAPA y el riesgo estará dado por hipertensión reactiva o por hipotensión producida por el uso de drogas hipotensoras.

7. Tratamiento del infarto agudo y angina inestable en pacientes que utilizan Viagra® en las 24 h previas

Las medidas terapéuticas son las habituales, con excepción del uso de nitritos en las siguientes 24 h. Es posible utilizar Diltiazem i.v. en su reemplazo. En el caso que los pacientes hayan recibido nitritos, deben tratarse con el esquema propuesto por la American Heart Association, que fundamentalmente consiste en la administración importante de volumen y drogas vasoactivas.

8. Pacientes hipotensos o disautonómicos. Puede ser utilizado con especial precaución en individuos ancianos, con hipotensión postprandial o con Tilt-Test (+). No debe indicarse en casos de síncope neurocardiogénico maligno.

9. Grupo Misceláneo: No existe contraindicación en indicarlos en pacientes con hipertrofia septal asimétrica, miocardiopatía hipertrófica, o valvulopatías con buena capacidad funcional.

Dres. Carlos Akel A, Hernán Prat M, César Carranza V, Hernán Chamorro B, Hernán Zárate M, Héctor López B, Mario Hassi T, Alejandro Forero A, René Asenjo G, Manuel Pinto S y Patricio Marró F.

1. GOLDSTEIN J, LUE TF, PADMA/NATHEM H, ROSEN RC, TEERS WD, WICKER PA. Oral sildenafil in the treatment of erectile dysfunction. N Engl J Med 1998; 338: 1397-4. [ Links  ]

2. MORALES A, GINGELL C, COLLINS M, WICKER PA, OSTERLOH IH. Clinical safety of oral sildenafil citrate (Viagra) in the treatment of erectile dysfunction. Int J Impot Res 1998; 10: 69-74. [ Links  ]

3. DRORY Y, SHAPIRA J, FISMAN E, PINES A. Myocardial ischemia during sexual activity in patients with coronary artery disease. Am J Cardiol 1995; 75: 835-7. [ Links  ]

4. MULLER J, MITTLEMAN M, MACLURE M, SHERWOOD J, TOFLER G. Triggering Myocardial infarction by sexual activity. JAMA 1996; 275: 1405-9. [ Links  ]

5. DRORY Y, FISMAN EZ, SHAPIRA Y, PINES A. Ventricular arrhytmias during sexual activity in patients with coronary heart disease. Chest 1996; 109: 922-4. [ Links  ]

6. Summary statement of the American College of Cardiology and the American Heart Association on the use of Sildenafil (Viagra) in patients at clinical risk from cardiovascular effects. August 10, 1998. www.americanheart.org/what ews/AHA science Advisories/viagra.htlm. [ Links  ]

7. PRIETO JC. Sildenafil (Viagra) en la hora de las advertencias (Editorial). Rev Méd Chile 1998; 126: 1285-7. [ Links  ]

Bernarda MorГ­n 488, Providencia,
Casilla 168, Correo 55
Santiago – Chile

Tel. (56-2) 2753 5520

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Erectile Dysfunction Health Center

13 Common Sex-Drive Killers

What Are the Differences Between These Drugs?

Cialis, Levitra, Staxyn, Stendra, and Viagra work similarly. There are subtle differences in how long the drug works and how quickly it works.

Levitra works a little longer than Viagra. They both take effect in about 30 minutes. With Levitra, the effects last for about 5 hours. With Viagra, they last about 4 hours.

Cialis works much longer — up to 36 hours in some cases. Stendra can start doing its thing in as little as 15 minutes, and its effects last up to 6 hours.

Staxyn dissolves in your mouth. It contains the same active ingredient as Levitra, but it should not replace Levitra. It also can begin working in about 15 minutes.

If One of These Doesn’t Help Me, Can I Try Another?

Yes. But because these drugs work the same way, you’re likely to have similar results.

What Precautions Should I Take Before Trying One of These Drugs?

There are situations where these drugs may not be safe. Before you take them, tell your doctor:

  • If you are allergic to any drugs, including other ED medications.
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  • If you are scheduled for surgery, even dental surgery.
  • If you take nitroglycerin or a similar medicine for chest pain. The combination of ED medication and these drugs can cause dangerously low blood pressure .
  • If you take alpha-blockers for blood pressure or prostate problems. These can lower your blood pressure when taken with ED pills. You should not start on Staxyn unless your doctor has prescribed you Levitra before.

Always follow the directions on your prescription label carefully. Also make sure to ask your doctor or pharmacist to explain anything you don’t understand. Take these drugs exactly as directed.

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I take 50mg 15 minutes before love making, and now I can spend hours with foreplay and not worry if I’m gonna go soft or lose interest.

It takes effect in 15 minutes on the average and out love-making session goes for over an hour every time. – Age 65, Florida

I could feel my penis get erect within 15 minutes, getting harder than usual and lasting longer too – YT, Age 45, Nigeria

The effects last 3 or 4 hours, and it takes 30 to 45 minutes to kick in. – Art, Age 62, Texas

It worked faster than a 1/2 hour and I had the first complete sexual experience in over 6 YEARS! William, Age 42, Texas

It begins to work in about 15 minutes to a half an hour and lasts for 3 hours or so

I find that 25 mg two hours prior to sex is best for me, and allows sensitivity, to remain at its peak. – Phil, Age 60, California

The first time I took it, my wife and I had already made love that afternoon. Viagra worked well in producing another HARD erection for us that night. The next time I tried it was an hour before bedtime. This produced even greater results. – JimmyB, Age 45

I’ve found I need to take it at least 30 minutes before sex. Not only is my erection harder, but the quantity of my orgasm and the force of it is greatly increased by Viagra

I take it about an hour before making love (which for us is usually mid afternoon.)

The doctor told me when he prescribed it that the first time I tried some it would take a little while to work, like almost an hour, and to be patient. So I took it, and set back to wait. I was surprised to find out that I didn’t have to wait near that long. I was ready to go in fifteen minutes, and went a little longer than she wanted me to go.

But 30 mins after taking a 50mg dose of Viagra (with no side effects other than a very mild headache), then – boing. – my penis is as stiff as it used to be when I was 15! – Richard, Age 53, UK

I started with 50 mg (good to rev my engine, I think) but ultimately found that 25 mg about 90 minutes before sex is ideal for me.

I had a rock hard erection about a half hour after taking the pill. – Age 37. Utah

How Long Does Viagra Last?

Many people wonder, "How long does Viagra last?" In most people, Viagra lasts for about four hours. Generally, it starts to lose its effectiveness after a couple of hours. There are a number of factors that can increase or decrease how long Viagra lasts. Some factors that increase the amount of time Viagra stays in the body include being over 65 years old, having severe kidney disease, and taking certain other medicines. Among the factors that can decrease how long Viagra lasts are taking it with a high-fat meal or certain other medicines, such as rifampin.

How Long Does Viagra Last?

Many people thinking of taking Viagra ® (sildenafil citrate ) wonder, "How long does Viagra last?" The answer is that it depends on a number of factors and will vary between individuals. However, in most people, Viagra will last for about four hours — although it generally starts to lose its effectiveness after a couple of hours.

The time it takes for Viagra to start working will also vary based on the individual. In clinical studies, Viagra began to work in as little as 14 minutes. For most people, though, it began working within 30 minutes.

Factors Affecting How Long Viagra Lasts

There are a number of factors that can increase or decrease how long Viagra lasts. Some factors that increase the amount of time Viagra stays in the body include:

  • Being over 65 years old
  • Having severe kidney disease or liver disease
  • Taking certain other medicines (see Viagra Drug Interactions ).

There are also factors that can decrease how long Viagra lasts. Some of these factors include:

  • Taking Viagra with a high-fat meal
  • Taking Viagra along with certain other medications, such as rifampin.

Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD

Viagra

GENERIC NAME(S): SILDENAFIL CITRATE

Uses

Sildenafil is used to treat male sexual function problems (impotence or erectile dysfunction -ED). In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Sildenafil is also available in other brands and strengths for treating high blood pressure in the lungs (pulmonary hypertension ). Do not take this medication with any other product that contains sildenafil or other similar medications for erectile dysfunction -ED or pulmonary hypertension (such as tadalafil, vardenafil).

How to use Viagra

Read the Patient Information Leaflet provided by your pharmacist before you start taking sildenafil and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

To treat erectile dysfunction -ED, take this drug by mouth as directed by your doctor, usually as needed. Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before is the most effective). Do not take more than once daily.

A high-fat meal may delay how quickly the drug begins to work.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Tell your doctor if your condition does not improve.

Side Effects

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.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Sexual activity may put extra strain on your heart. especially if you have heart problems. If you have heart problems and experience any of these serious side effects while having sex. stop and get medical help right away: severe dizziness, fainting. chest/jaw/left arm pain, nausea .

Rarely, sudden decreased vision. including permanent blindness, in one or both eyes (NAION) may occur. If this serious problem occurs, stop taking sildenafil and get medical help right away. You have a slightly greater chance of developing NAION if you have heart disease. diabetes. high cholesterol. certain other eye problems (“crowded disk”), high blood pressure. if you are over 50, or if you smoke.

Rarely, a sudden decrease or loss of hearing, sometimes with ringing in the ears and dizziness, may occur. Stop taking sildenafil and get medical help right away if these effects occur.

In the rare event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away, or permanent problems could occur.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction. including: rash. itching /swelling (especially of the face/tongue /throat), severe dizziness, trouble breathing .

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking sildenafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (such as heart attack or life-threatening irregular heartbeat in the past 6 months, chest pain/angina, heart failure), stroke in the past 6 months, kidney disease, liver disease, high or low blood pressure. a severe loss of body water (dehydration), penis conditions (such as angulation, fibrosis/scarring, Peyronie’s disease ), history of painful/prolonged erection (priapism), conditions that may increase the risk of priapism (such as sickle cell anemia. leukemia, multiple myeloma ), eye problems (such as retinitis pigmentosa. sudden decreased vision, NAION).

This drug may make you dizzy or cause vision problems. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This brand of the drug is usually not used in women. During pregnancy, sildenafil should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

A product that may interact with this drug is: riociguat.

Sildenafil can cause a serious drop in your blood pressure when used with nitrates. A serious drop in blood pressure can lead to dizziness, fainting, and rarely heart attack or stroke. Do not use sildenafil with any of the following: certain drugs used to treat chest pain/angina (nitrates such as nitroglycerin, isosorbide), recreational drugs called “poppers” containing amyl nitrate, amyl nitrite, or butyl nitrite.

If you are also taking an alpha blocker medication (such as doxazosin, tamsulosin) to treat an enlarged prostate/BPH or high blood pressure, your blood pressure may get too low which can lead to dizziness or fainting. Your doctor may start treatment with a lower dose of sildenafil to minimize your risk of low blood pressure.

Other medications can affect the removal of sildenafil from your body, which may affect how sildenafil works. Examples include azole antifungals (such as itraconazole, ketoconazole), macrolide antibiotics (such as clarithromycin, erythromycin), HIV protease inhibitors (such as ritonavir, saquinavir), hepatitis C virus protease inhibitors (such as boceprevir, telaprevir), mifepristone, rifampin, among others.

Do not take this medication with any other product that contains sildenafil or other similar medications for erectile dysfunction-ED or pulmonary hypertension (such as tadalafil, vardenafil).

Overdose

If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include severe dizziness, fainting, painful/prolonged erection.

Notes

Do not share this medication with others.

Missed Dose

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised October 2015. Copyright(c) 2015 First Databank, Inc.

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