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The risk of heart attack or abnormal heart rhythms during sex is higher in men with unstable angina (angina that occurs at rest or with minimal exertion), poorly controlled hypertension, moderate to severe heart failure, moderate to severe disease of the heart's valves, recent heart attack (less than 2 weeks previously), potentially life threatening disorders of heart rhythm such as recurrent ventricular tachycardia, and moderate to severe disease of the heart's muscle. In these men, doctors usually stabilize or treat the heart conditions before prescribing sildenafil.
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"For men getting a high dose of radiation in a shorter amount of time than is typical -- meaning getting higher doses per day for fewer days -- a loss of sexual function is the chronic side effect that concerns most," noted study co-author Dr. Eric Horwitz, a clinical director in the department of radiation oncology at Fox Chase Medical Center in Philadelphia.
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A detailed medical history may reveal that the disorder is due to a chronic disease such as atherosclerosis, hypertension or diabetes mellitus. Inquiry about decreased libido and symptoms of hypothyroidism or hyperthyroidism may reveal a reversible cause (Table 1).5-7
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Smoking, which can lead to any of the above risk factors, is perhaps the most significant risk factor for impotence related to arteriosclerosis.
To get the most benefit, you should exercise at least 20 to 30 minutes, preferably on most days of the week. Current studies suggest that at least five times a week is best. If you are a beginner, exercise for a few minutes each day and build up to 30 minutes.
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