I can sometimes guess. If the guy is not obese yet sweating like mad despite very little exertion and finishing is a bit laborious, then it's a good bet. I've had a few mention it at the end and the tendency I noticed is that in their cases, it was one and done, but with no need to restrain from coming before appointment end (the opposite, often enough).
I wouldn't give advice, but I will say that those who only take a portion of the pill (or the minimal effective dose) seem to have an easier time with minimizing side effects.
that works best for you. Your Doc should work with you on this.
Assuming your Doc can safely prescribe these meds, note that although they all do the same thing in the same manner, they have some different characteristics:
FOOD AND DOSE TIMING (CONVENIENCE AND EFFECTIVENESS):
"As with sildenafil, a high-fat meal delays the absorption of vardenafil by up to 1 h and decreases the maximal concentration of vardenafil by approximately 20% compared with the fasted state.[19]"
"None of the three PDE5 inhibitors act immediately. Most studies have illustrated that the drugs have an onset of action between 30 and 60 min, but the rate of onset of each drug varies between individuals. The prescribing information for sildenafil recommends dosing 60 min before sexual activity,[21,22]"
"Sildenafil and vardenafil both have a terminal half-life of approximately 4 h,[15,16] and tadalafil has a half-life of 17.5 h."
So if you take your Levitra near a meal, it may take up to 2 hrs to reach maximum absorption, may not reach the intended peak concentrations, and will cease to work in something less than the 4 hr window expected. Cialis may be a good option for "consistency of action", as it is unaffected by food, is active within 20 mins and remains active for an extended time.
Cialis has dosing regimens for daily use and "as needed".
Daily dose is typically 5 mg for a healthy individual, and 2.5 mg for folks who respond at a lower dose or those with certain health risks or who are taking other drugs that may interact.
The "as needed" dose is typically started at 10 mg every 72 hrs, and may be increased up to 20 mg every 72 hrs. Similarly, a 5 mg or 7.5 mg dose may be fine for those who respond to a lower dose.
The other ED drugs (Viagra - sildenafil citrate; Levitra - vardenafil) both have shorter terminal half-lives (windows of effectiveness) of around 4-5 hours, while Cialis has a half-life of about 72 hrs. Cialis is also more selective for the PDE-5 enzyme (the target of action for each ED med), has a shorter onset of action (15 mins versus 30-60 minutes) and its absorption and effectiveness is unaffected by food intake - unlike the other two ED meds, which are significantly affected by timing of meals and diet. In quite a few studies, Cialis was chosen over either Viagra or Levitra by the large majority of patients who had tried more than 1 ED drug.
REFRACTORY PERIOD:
After ejaculating, your body will produce a hormonal cascade. Oxytocin and Prolactin are released, cholinesterase and norepinephrine are released, etc... This cascade leads to an erectile refractory period, that prevents a repeat erection until the pre-ejaculatory hormonal milieu is restored. The average for all males is about 30 minutes, but can range from almost no time at all to 20 hours for the average man in his 70's.
There are no approved drugs in the US for reducing refractory periods, but cabergoline (cabaser) has been used off-label to reduce prolactin let-down after ejaculation and thus to shorten refractory period. Yohimbine (Rauwolscine) has also been used to block alpha-adregenergic receptors and reduce adregenergic vasoconstriction. Alpha blockers such as Flomax, Cardura, Uroxatraal and Rapaflo may also be helpful in a similar manner - although again, they are not approved for this use and may cause ejaculatory issues (retrograde ejaculation, primarily).
DELAYED EJACULATION:
I could not locate anything that clearly established a link between either premature or delayed orgasm/ejaculation associated with ED drugs. Typically, ejaculatory latency disorders are related to other types of medications (antidepressants being notorious for this), performance anxiety, lack of psychosexual stimulation (the "too much porn syndroome") and other factors unrelated to the ED drugs per se.
Not the Medical kind of Doc. Just offering some info to discuss with your GP or Urologist
Tried V and C... V kept giving me extreme heartburn. Then saw that my insurance would pay for low dosage C, and the urologist said I could take several at once, if I didn't want to take daily... Still, couldn't find that magic combination that would make it work without getting extreme heartburn... The closest I could get was to take a very low dosage about 4 hours prior...
Have tried some of the OTC (Over the Counter, vice Off The Clock, or Over The Clothes) supplements and they work better for me.
The higest dose, but we break them in half......last lonher that way as they are so damn expensive. .....we use about 3 or 3 a month......yoy will dwff notice a difference in hardness and width.....or so the wife says......and yes it will take you longer to get there......the only side effects that i have is a headache after cumming, but it goes away fast....and our provider's knew because we told them. Good luck.
Posted By: Demcc3
Good morning. My question is in regards to ED meds such as cialis, Levitra and viagra. Ladies first. Can you usually tell if a date has taken any of these for your date?
Now for the guys. If you have used them do you have a preference or whatever the dr. has given you? For those of you that have used them (or are using them) has there been any notice of earlier or delayed ejaculation?
To be honest, I'm going through the sample stage right now....trying out different samples to find out which, if any, would be right for me.
I realize I'm opening myself up to unnecessary comments from a few of you but hey, ya gotta roll with the punches!
At least I'm not behind an alias lol.
Thanks
D.
