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Urology/Young with erectile dysfunction- Questions on Cialis


QUESTION: Greetings doctor, I am a 24 year old hypertensive male and have ED the last two years. It took me three different visits to urologists tO find one who was willing to treat my problem, or even believed me for that matter. I will be starting a trial dose of cialis 2.5 daily and had a few questions.

1. In your experience with young men who suffer from vascular ED "Arterosclerosis, Endothelial Dysfunction" what treatment regiment do you typically use and is it generally effective for a prolonged period of time? Are they able to return to normal sexual function?

2. Does Cialis lose its effectiveness over months, years, decades? For instance do most of your patients return often to increase the dose or does cialis become an effective lifelong treatment in most cases.


ANSWER: Kevin:

I don't use daily cialis that much because most of my patients are older and cannot afford it.  However, it's a great drug and very suitable for someone in your age group who intends to be sexually active.

Most of the time I tend to use cialis, viagra or levitra intermittently or as needed.  Such a treatment regiemn is quite effective in most patients.

Cialis does not "lose effectgiveness" over time, but your underlying problem will probably tend to get worse which may make it seem that the problem is getting worse and the cialis is no longer working.  In most cases, once a treatment like cialis starts, some sort of ongoing therapy needs to continue or the ED returns.

---------- FOLLOW-UP ----------

QUESTION: Thanks Much doctor, just some final questions.

1. How long does it typically take for the underlying problem to get worse and for someone to need an increased dose?

2. When you spoke of ongoing therapy do you mean a daily drug such as Cialis, or ongoing therapy for my High Blood Pressure etc? In other words, if I control my hypertension is it possible I will not need to increase my Cialis dose ever?

Thanks Doc, Science bless you


There is no "average time for the problem to get worse" because it is highly variable and obviously depends on the nature of the underlying problem.

Controlling your high blood pressure helps, but the most common cause for high blood pressure is ateriosclerosis which is a condition that affects blood flow in smaller arteries like those in the penis.  The high blood pressure can be controlled, but the arteriosclerosis remains and may worsen over time.  This is where cholesterol comes in.  Talk to your physician about what you can do to stay healthy.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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