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A thorough gentle physical examination of the genito urinary system is done. It is important to remember that ED and heart disease share certain comorbidities and hence a thorough evaluation of the heart lungs and abdomen is done. The penis is examined for plaques, curvatures, and the position of the meatal opening. Presence and size of both testis is determined. Features suggestive of hypogonadism(testis size, body hair, voice) are looked for.

Viagra doesn’t work automatically. You must feel sexually aroused to experience its effects. What impacts the effectiveness of Viagra? Several factors can influence how quickly and completely Viagra works once you take it. Those include: Taking it on a full stomach. If you take Viagra on a full stomach—particularly with a heavy, high-fat meal—the medication may take longer to work. A full stomach can delay your body’s absorption of Viagra, meaning your erection might come later than expected, be less strong than you wanted, and not last as long as you would’ve liked. (That doesn’t mean you need to take Viagra on an empty stomach.)

Here are some of the factors that could diminish the libido for women: hormonal imbalances: the period preceding menopause, can cause hormonal changes that will lead to a marked lack of interest in sexual activity. There may also be discomforts that occur during sexual contact due to decreased ability of vaginal tissues to lubricate the area. Depression and chronic stress: When you feel depressed or stressed, your libido can decrease greatly.

Premature ejaculation or lack of Ejaculatory control is the second most common reason men come to see me in my clinic. “It is over before it starts doctor”, they say. A feeling of anguish and the guilt of not being able to satisfy their partners lingers. Though a scientific definition of Premature Ejaculation may be ejaculating within one minute, partners of men who ejaculate slightly after one minute are not necessarily happy. So, what’s the story? What are they thinking? See extra details at instadocnow.com.

Viagra comes in different doses. While Viagra comes in 25mg, 50mg and 100mg tablets, the usual recommended dose is 50mg. Your doctor may recommend that you take more or less than the average dose depending on your personal situation. The maximum recommended dose is 100mg. Viagra doesn’t always work the first time you take it. Viagra isn’t magic; it does require sexual stimulation to result in an erection and it may not work the first time. You should allow at least two to three attempts to evaluate whether it is working for you. If you fear it is not working when you are with your partner, first try taking it on your own and self-stimulating. Direct stimulation of the penis after taking the tablet can also help.