Are you struggling to see results from ED pills like Sildenafil or Tadalafi? In this video, Dr. Rena Malik explains why these ...

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ED Pills Not Working? How to Make Sildenafil &amp; Tadalafil Work for You!

you tried the little blue pill and it didn't work now what I'm Dr Reena Malik urologist and pelvic surgeon and today we're going to talk about how you can take these medications like selenophile and tadalfil so that they work every single time let's start with the basics when a man is aroused his body releases a chemical called nitric oxide or n when the body senses this no it triggers the production of yet another chemical called cyclic guanosine mono phosphate or cgmp now this relaxes the blood vessels in the penis allowing blood to flow into the penis and engorge the erectile bodies and this causes an erection now in erectile dysfunction men who have Ed they have a certain enzyme called phosphodiesterase 5 which then breaks down that cgmp too quickly this then quickly reduces blood flow to the penis making it difficult to achieve an erection or even maintain an erection that you've already gotten and so medications like cenil or tadalfil also known as viaga or Calis are pd5 Inhibitors and they block the action of pd5 this then allows that cgmp to build up and stay in the system longer this keeps the the blood vessels open and relaxed with blood flowing into the penis and remaining into the penis longer allowing you to have an erection and maintain it for the purposes of intercourse however many people will try these medications and they might not have success the first time and then they give up so what makes it more likely that you will have success that you will optimize your response to soen film number one don't give up if it doesn't work the first time try again and again and now this sounds simple right why would it but why would it be any different after the first time well in fact they've looked at this in a study and they looked at 1,76 men who had erectile dysfunction and they were enrolled in what we call a double blind Placebo controlled trial a multiple studies actually between the years of 1996 and 1998 and they looked at what happens when they took selenophile if they had sexual stimulation and if they had successful intercourse so what they found was that on the first and second instance of using selenophile the medication only about 54% half and 64% on the second try were able to have successful intercourse however by the eighth time they tried using selenophile 86% of people achieved success so what that tells me is that you know what the first time you use it you might be nervous you might be anxious you might get it wrong in terms of timing you might eat too much whatever there's a whole bunch of reasons that can affect your ability to use henail appropriately and as you get more comfortable using it your stress level goes down and you're able to then get an erection stress is an erection killer so let's move on to the next thing second is increase the dose very often when you prescrib these medications your primary doctor or even some of these online companies that give erectile dysfunction medications will start you on a lower dose of these medications and often there are higher doses available in fact in a study that looked at 137 men who had been referred to Urology for quote unquote unsuccessful treatment with selenop about half of those 55% had only been given 50 mgram doses now cenil goes up to 100 Mig so these men who then came to the urology clinic were educated on how to use it increase their dose and 54% of the men who were considered unsuccessful with cenil eventually became successful after receiving proper education and appropriate dosing number three take it the right way now you might be wondering what do I even mean the right way well you basically just put it in your mouth and swallow it right that's that's the easy the right way well not exactly so there's a few things that have to happen for you to get the desired result meaning get an erection and first off is sexual stimulation sexual stimulation is necessary for the medication to work it's not just going to give you a random erection because you took a pill you need to hear something see something feel something even smell something that is arousing to you that turns you on to begin that release of nitric oxide that we talked about you need to take the medication at least 30 to 60 minutes before sexual activity but up to 4 hours before so these medications take some time they need to be absorbed into the bloodstream they need to be broken down into their active form and they need to start working so when you take it 30 to 60 minutes before four SE that allows enough time for all these things to happen essentially it's going to get absorbed in the bloodstream which can take about 30 minutes then it's going to be broken down into its active form which occurs in the liver that takes another 15 to 30 minutes and then it will start blocking pde5 and allow that cgmp to build up so about another 15 to 30 minutes that's where the timing comes from 30 to 60 minutes so the typically Al the medication is at its peak effectiveness at around 1 hour and if it doesn't always work out to take it 30 to 60 minutes before you can even take it 2 to 4 hours before it's not always something that it has to be perfectly timed but there has to be enough time for that action to occur so that it starts working next avoid high fat meals now high fat meals can slow down the absorption of selenophile into the bloodstream now this is because fat that takes longer to digest than other nutrients that you eat and it can then subsequently delay the release of sophy from the stomach into the bloodstream if you take seleny with a high fat meal it might take one longer for the medication to start working or it might not work at all and so you might still even get the side effects associated with selenop but not the actual effects you want generally I also recommend avoiding excessive alcohol use because sometimes that can make it more challenging to get an erection I've talked about whiskey dick in a previous video so check that out lastly improve your overall health now this is the one thing most people don't appreciate erectile dysfunction happens most commonly because of things like vascular dysfunction so anything that affects blood flow so that's things like diabetes high blood pressure high cholesterol and I can't tell you the number of times where I found diabetes high cholesterol or high blood pressure when they just came to see me for Ed in fact when they did a study of 521 men with erectile disfunction who were counseled and treated to optimize their other lifestyle factors they then had a success rate of 82% while taking healthy now in the study how do they optimize their health they check their medications to make sure they weren't on any medications that would interfere with erections for example men who are were on metalol or propanolol for high blood pressure were replaced with medications like Atenolol which don't have as much of a side effect with sexual dysfunction and if they had high blood pressure or high cholesterol they were then put on medications to treat those issues and obviously if they were smoking they were encouraged to stop smoking or at least reduce their cigarette intake if you guys didn't already know cigarettes are erection killer so you absolutely have to quit smoking if you want to maintain your erections they were also counseled in the study to limit their alcohol intake to one drink per day on the days that they took SEL denail and up to two drinks per day on other days obviously the recommendation is to drink less than seven drinks in a week ideally they also had a hormonal assessment if they found that their testosterone levels were below age appropriate levels patients were then treated to increase their testosterone to normal levels lastly bring up your issues to your doctor now I realize this is difficult talking about sex is difficult talking about issues you're having is difficult but if you want to have success with medications and it's not working make sure you review this with your doctor because unfortunately sometimes they might not even think to bring it up in a survey of 1,600 primary care physicians only 45% routinely ask their patients about Ed symptoms so a lot of people are not getting these questions asked and as I mentioned earlier I see lots of people coming in with low doses of seleny or tadalfil and they never even knew that there were higher doses available to them so it could be as simple as asking your doctor for a higher dose or maybe to try tadalfil instead of seleny or an alternative option bottom line don't get discouraged if it doesn't work perfectly the first time give it a solid College try meaning try it at least eight times and bring it up to your doctor don't hesitate to ask questions ask if there's a higher dose if there's other Alternatives if you could be referred to a specialist if they don't have anything else to offer you okay guys before you leave I just want to make sure that you are all following me on your favorite podcast platform whether that's Apple Spotify overcast whatever it is make sure you find my podcast it's the Reena Malik MD podcast and I cover many many topics in significant detail have experts on each and every week obviously the videos are here on my YouTube channel as well but sometimes honestly we don't have an hour to sit down and watch a video but you can absolutely listen to me on your commute or while you're out for a walk and still learn all this wonderful educational content so do me a favor and subscribe or follow or whatever it is on that particular platform leave me a rating or review if you're liking the content because that helps other people find my content as well and as always remember to take care of yourself because you are worth it

Dr.

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