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What are intracavernosal injections? Medications can be injected directly into the corpora cavernosa to attain and maintain erections. Medications such as papaverine hydrochloride, phentolamine, and prostaglandin E1 (alprostadil) can be used alone or in combinations to attain erections. Combining small amounts of each drug is preferred over using a single drug because of increased efficacy and fewer side effects. Even though such injections can be effective in the management of erectile dysfunction (success rate of around 80%), they are not widely used because of their potential complications. These injections are painful, can cause scarring of the penis, and have a higher risk of developing priapism. Substance abuse: Marijuana, heroin, cocaine, methamphetamines, crystal meth, and alcohol abuse contribute to erectile dysfunction. Alcoholism, in addition to causing nerve damage, can lead to atrophy (shrinking) of the testicles and lower testosterone levels. What are intraurethral suppositories? Prostaglandin E1 (intraurethral alprostadil or MUSE) can be inserted in a pellet (suppository) form into the urethra to attain erections. This technique also is not popular because of occasional side effects of pain in the penis and sometimes in the testicles, mild urethral bleeding, dizziness, and vaginal itching in the sex partner. Men also need to remain standing after inserting the pellet in order to increase blood flow to the penis, and it may take 15-30 minutes to attain an erection. Prostaglandin can cause uterine contractions and should not be used by men having intercourse with pregnant women unless condoms or other barrier devices are used. This drug is now rarely used since the introduction of oral medications, however, it may play a role in management of erectile dysfunction in those who are not a candidate for oral PDE5 medications. Erectile dysfunction, heart disease and other vascular diseases: The root cause of the narrowing of the arteries is caused by atheroma. Atheroma is like fatty patches or plaques that develop within the inside lining of arteries. (This is similar to water pipes that get furred up with scale.) Plaques of atheroma may gradually form over a number of years in one or more places in the body, commonly in arteries going to the heart, brain, legs and penis. In time, these can become bigger and cause enough narrowing of one or more of the arteries to cause symptoms and problems. viagra for sale What are the side effects of vardenafil (Levitra)? Vardenafil is generally well tolerated with only mild side effects. These side effects include headache, flushing, nasal congestion, dyspepsia, body aches, dizziness, nausea, and increased blood levels of the muscle enzyme creatine kinase. Treatment for erectile dysfunction on the NHS: The Department of Health states: "From 1 July 1999 only those patients suffering from one of the specified medical conditions are eligible to receive drug treatments for impotence on the NHS. Other men can receive a private prescription from their own GP." viagra for sale cialis online online buy cialis online Sildenafil is used for the treatment of erectile dysfunction of either physical or psychological cause. It has been found to be effective in treating erectile dysfunction in men with coronary artery disease, diabetes mellitus, hypertension, depression, coronary artery bypass surgery, and men who are taking antidepressants and several classes of anti-hypertensives. buy online viagra brand name buy viagra buy propecia fda approved buy propecia online