Is the patient suffering from erectile dysfunction or from loss of libido or a disorder of ejaculation? Recent stroke or heart attack (within 6 months) 59 percent of patients who didn't find Uprima effective stopped taking the drug after one month, and a further 23 percent stopped taking it after two months. Neurological exam Lacks formal FDA† approval (except for prostaglandin [ie, Caverject, Edex]) When the problem is psychological, the underlying depression or anxiety is what should be treated. Cialis, Levitra, and Viagra work by a similar mechanism to cause erections. 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, the effects last approximately 4 hours. "When you calculated a global cardiovascular risk, [it] was strongly associated with the probability that you had erectile dysfunction," said Grover, a professor of medicine and epidemiology at McGill University Health Centre in Montreal. "And subsequently there have been other studies that have shown that people who have erectile dysfunction are, in fact, more likely to develop cardiovascular disease in the future." Outside Forces 'Medicalizing' Everyday Problems, Experts Say Tension ring necessary to maintain erection Having trouble maintaining an erection from time to time isn't necessarily a cause for concern. JAMA 1993, 270:83-90. PubMed Abstract How often do you feel stressed? Cannot be used by patients on MAOIs* For some patients, a surgically-placed penile implant (prosthesis) may also be recommended or needed. When there is angina or heart failure, the doctor may need to determine whether the heart has enough reserve to safely carry out the work necessary for sexual activity by performing cardiac treadmill stress testing. Vascular reconstructive surgery Restores natural erections when successful What Causes ED? Viagra Canadian Pharmacy In the study, Selvin's team collected data on more than 2,100 men who participated in the National Health and Nutrition Examination Survey. Men who said they were "sometimes able" or "never able" to achieve and keep an erection were classified as having erectile dysfunction, while men who said they were "always or almost always able" or "usually able" were not.