The most common side effects associated with Cialis® are headache, flushing, indigestion, stuffy nose, and diarrhea. Although the cost varies, it generally runs between $8 and $10 a pill. Available by prescription in 25-mg, 50-mg, and 100-mg strengths, Cialis® is taken on an as-needed basis, 1 hour before sexual activity, but not more than once a day. No evidence suggests that Cialis® enhances the sexual performance of healthy men. Men with diabetes and those with a history of radical prostate surgery showed less improvement than other groups. Cialis® was effective in 50% to 80% of the men who participated in 21 clinical trials. These men had a broad range of conditions associated with ED, including high blood pressure, high cholesterol, diabetes, and prostate surgery. Cialis® was tested on several thousand men with mild, moderate, or complete erectile dysfunction. Unlike other drugs commonly used to treat impotence, which are addressed later in this chapter, Cialis® does not cause an erection unless the man is sexually stimulated. The longer GMP remains available, the greater the chance of achieving and maintaining an erection.

Known generically as sildenafi citrate, Cialis® works by blocking an enzyme (PDE5), found in the penis, that breaks down a chemical (cyclic GMP), which is produced during sexual stimulation. Cialis® is the first oral medication designed specifi cally to treat impotence. If your doctor recommends testosteronereplacement therapy without conducting the appropriate laboratory tests, you should seek another opinionbefore proceeding with treatment. HRT should be avoided by patients with a history of liver disease, heart disease, kidney problems, urinary problems, or prostate cancer. The side effects of testosterone replacement therapy can be serious, and the indiscriminate prescribing of testosterone may speed the growth: of many microscopic prostate cancers. firmed testosterone deficiency; however, sadly, millions' of dollars are spent every year because of the false belief that testosterone boosts sexual drive and, therefore, improves potency.

The relationship of these symptoms to declining levels of male hormones is controversial, and the benefit of hormone replacement therapy (HRT) in relieving them; is still unproven. menopause may include hot flashes, mood swings, insomnia (difficulty sleeping), depression, irritability, decreased sexual desire, impotence, weakness, lethargy (listlessness or drowsiness), loss of lean body mass, and decreased bone mass. Therefore, you should tell your doctor about all the medications you are taking, including over-the-counter drugs. No studies have been conducted to test the safety and effectiveness of Cialis® when combined with other treatments for impotence or other prescription medications. Men who use nitroglycerin, either in a patch or as a pill under the tongue, or other heart medicines containing nitrates should not take Cialis® because combining the two may lower blood pressure to life-threatening levels. In addition, about 3% of patients participating in the clinical trials reported temporary changes in their vision, including sensitivity to light and seeing a bluish tinge.