I'm blessed with b/g twins my Ob stinks and has never told me but I know they had separate sacks and separate placentas so does that mean Di-Di fraternal?
My OBGYN did my first vaginal scan herself and we are having twins. She said that she could not tell if they were mono-di or di-di, but at the time I was so excited, the question did not come to mind. Does this mean I am having fraternal twins? Or is there still a chance of identical twins?
Tadalafil: Use, Dosage, Side Effects
Delicate Problem: Sexual Dysfunction
It can be argued with high probability that usually people don’t like to solve problems with their health by using chemical substances. Nevertheless, most effective modern medicines are based on chemical substances, and this should not frighten – in fact, absolutely the whole world around us, both living and non-living, is composed of the chemical elements, as well as we ourselves. The study, synthesis and discovery of various chemicals made it possible to invent antibiotics that saved the lives of millions of people, helped to eradicate smallpox, the plague. Drugs based on chemically synthesized substances are used to treat a great variety of diseases, from colds to cancer. Such a delicate problem of the male body as erectile dysfunction is not an exclusion.
In common speech, erectile dysfunction (ED) is usually called impotence. The scientific definition of erectile dysfunction is the inability of a man to achieve erection and (or) maintain it for a period of time sufficient for a successful sexual intercourse, as well as inability to achieve ejaculation. Impotence can be primary and secondary. Primary impotence is a disorder of sexual function, because of which a man never had successful sexual contact, while secondary impotence is characterized by the fact that problems with potency have appeared in a man after the successful commencement of sexual life. Much more common is secondary impotence.
Pathophysiology of erectile dysfunction has many causes: psychological and organic (hormonal, vascular, neurogenic, caused by drug use, drug addiction, cavernous impairment, urogenital infections etc.). The most frequent type of ED is a mixture of psychogenic and organic factors.
It is worth noting that there are objective conditions in which even a completely physically and psychologically healthy man can’t achieve an erection. These include the presence of nearby strangers, friends, relatives, the external unattractiveness of a partner, a stressful condition, a threat to life and many others.
Tadalafil: Use Against Erectile Dysfunction
One of best known medications used today for getting rid of erectile dysfunction is Cialis. It is the brand name of a chemical substance Tadalafil, which is the main ingredient of this drug. Tadalafil was synthesized by the scientists of an American pharmaceutical concern Elli Lilly in early 2000s. In 2002, during the meeting of the American Urological Association in Orlando, USA, the effectiveness and duration of action of Tadalafil were first reported.
Although Tadalafil is an artificial chemical substance, it influences only the natural mechanisms of the formation of an erection. It is not an aphrodisiac, so it doesn’t affect the appearance of sexual desire in a man. Neither it influences level of hormones, mood, sensitivity of erogenous zones, etc. Cialis belongs to inhibitors of PDE-5, and in order to clarify the mechanism of its action it’s necessary to shed light on the chemical side of the erection.
The enzyme PDE-5 (phosphodiesterase type 5) prevents occurrence of erection by cleavage of the cyclic guanosine monophosphate (cGMP). The function of the substance cGMP is to expand the arteries of the penis in order to allow them get better filled with a larger amount of blood and supplied with oxygen. PDE-6 inhibitors like Tadalafil prevent PDE-5 from cleaving cGMP, which results in the penis getting easily filled with blood and stay erect long enough for the sexual intercourse.
Unlike other medications for treating impotence, Cialis has a long elimination half-life from the body and remains active for a day or a day and a half. Due to its property the drug is sometimes called “medication for the weekend”. To date, it is the optimal drug against potency disorders by the ratio of effectiveness and safety.
Dosage of Tadalafil
Patients shouldn’t take Tadalafil more often than once a day. In case of an overdose, the medicine is harmful even to perfectly healthy young men.
Always take Tadalafil exactly in the dosage that was prescribed to you by the doctor (andrologist or sexologist). If you don’t follow these recommendations, it can lead to treatment failure or undesirable side effects. As a rule, 20 mg pill about an hour before sex is prescribed. The medicine starts to act sometimes in about fifteen minutes, but not in every men, so it is better to wait a little.
Patients with renal insufficiency are more likely to be prescribed 10 mg of Tadalafil. It is not necessary to divide the 20 mg pill into two parts, they are not intended for this. It is better to buy pills containing 10 mg of active ingredient in each one. The same applies to patients suffering from liver failure.
If Cialis is used not only for improving erections, but also for the treatment of benign prostatic hyperplasia (BPH), a daily dosage of 5 mg in courses is recommended. The patient should regularly undergo an ultrasound examination of the prostate and keep in touch with an urologist. It is not necessary to adjust the dosage in elderly men and men suffering from diabetes.
Tadalafil in the daily dosage of 5 mg is recommended to restore sexual function in men who underwent surgery to remove the prostate (prostatectomy). In this case, the duration of therapy can reach half a year.
Side Effects of Tadalafil
Cialis works against potency problems due to its property to dilate blood vessels in the penis. However, all the parts of the organism are connected with each other, and it is impossible to affect blood vessels only in one certain part of the body. Because of it, men quite often feel a slight headache and stuffiness in the nose.
Stomach upset, reddening of the eyes, pain in the back and allergic reactions take place much more seldom. These symptoms pass quickly enough, and are usually more manifested after the first intake of the drug.
Warning! Do not take Cialis with drugs that belong to the group of alpha-blockers and nitrates. This can lead to a sharp increase in side effects of Tadalafil.