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Your first step is speaking with a doctor. Many men are understandably reluctant to bring up the topic of erectile dysfunction, but it is no longer the taboo it once was. Your doctor, of course, will want to know your medical history, and whether you have a personal or family history of heart disease, or are otherwise at elevated risk.

That said, Viagra has been taken safely and successfully by men worldwide, and it wouldn’t be the blockbuster drug it’s been for nearly 20 years if there wasn’t extensive data on its effectiveness and safety.

Start that conversation. Your doctor won’t be offended or surprised. On the contrary, he or she will probably be happy that you have shared a medical concern and are willing to work on treating it.

Doctors advise taking Viagra one-half to one hour before you expect to have sex. You can take it up to four hours before sex and still have it be effective, but the half-life of Viagra is usually four to six hours, so if you wait too long, you might not get to enjoy the effects for very long. If you take Viagra during or soon after a heavy meal, you should probably give it a little more time to work. Sometimes consuming a lot of high-fat foods can slow down the effectiveness a bit. Viagra will still work, but it may take a little longer.

Premature ejaculation and erectile dysfunction seem like disorders that would be at odds with each other. Yet there are men who suffer from both disorders, and it can be profoundly frustrating.

For some men, the issues of erectile dysfunction and premature ejaculation go together.

However, anecdotal evidence and some preliminary studies are finding that rather than making premature ejaculation worse, drugs like Viagra that help men have stronger erections can actually help with premature ejaculation. It’s something that men with either or both disorders should discuss with a physician to see if taking Viagra for premature ejaculation is reasonable.

The main way to ensure the best experience with Viagra is to follow your doctor’s instructions. Particularly if you see a urologist or a practitioner with significant experience prescribing Viagra, you’ll want to listen to what he or she has to say, in terms of problems people report, and tips for maximum effectiveness.

For some men, a big meal, particularly with alcohol, can delay Viagra’s effectiveness.

Typically, you’ll want to take Viagra 30 minutes to one hour before sexual activity, though it’s effective for up to four hours. Don’t take more than one dose of Viagra in any 24-hour period. Swallow the tablet whole. Don’t crush it up or chew it up. The tablets are designed to give you a predictable experience with minimum risk of unpleasant side effects.

Though Viagra can be taken with or without food, you should avoid eating a high-fat meal (like a cheeseburger and fries) when you take it, because this can cause effectiveness to be delayed. Take Viagra on an empty stomach each time if you want the most predictability about time to effectiveness.

Finally, in order to be effective for its intended purpose, sexual stimulation is required. Viagra isn’t designed to magically produce an erection out of nowhere, but rather to optimize physiological conditions so that you’ll have an erection while engaging in sexually stimulating activity.

Typically, you’ll want to take Viagra 30 minutes to one hour before sexual activity, though it’s effective for up to four hours. Don’t take more than one dose of Viagra in any 24-hour period. Swallow the tablet whole. Don’t crush it up or chew it up. The tablets are designed to give you a predictable experience with minimum risk of unpleasant side effects.

Though Viagra can be taken with or without food, you should avoid eating a high-fat meal (like a cheeseburger and fries) when you take it, because this can cause effectiveness to be delayed. Take Viagra on an empty stomach each time if you want the most predictability about time to effectiveness.

Finally, in order to be effective for its intended purpose, sexual stimulation is required. Viagra isn’t designed to magically produce an erection out of nowhere, but rather to optimize physiological conditions so that you’ll have an erection while engaging in sexually stimulating activity.

Acquaint yourself with possible side effects before taking Viagra.

The first time you take Viagra in particular, you should watch for signs of unwanted side effects. Some men experience headaches, ringing in the ears, hearing loss, or changes in vision. In some men, an irregular heartbeat is a side effect. If you are at risk for a heart attack, it’s imperative that you talk with your doctor about what you should do if you experience certain side effects, because serious side effects, though very rare, aren’t unheard-of.

Also, whether or not you experience headaches or other side effects mentioned above, seek immediate medical help if you have an erection that lasts longer than four hours. If this problem (known medically as priapism) is not treated, you could experience permanent damage. Don’t try to treat it yourself: this is a situation that warrants a trip to the emergency department.

Some plans cover a limited supply of erectile dysfunction drugs like Viagra per month, and some do not. The first thing to determine is whether your healthcare policy includes prescription drug coverage. If so, you need to search your policy documents (which you can often do online) for its drug formulary. Your insurance policy’s drug formulary is a list of prescription drugs (generic and name brand) that the insurer has identified as offering the greatest overall value.

Formularies often divide drugs into classes, or “tiers” depending on how expensive they are, and limit coverage for drugs that are costlier. If you locate your policy’s formulary online, do a page search for “Viagra” or whichever drug you’re interested in. This way you can find out whether your policy offers any coverage, and if so how many pills in a given time period, and how much of the cost they cover.

Don’t be shocked if your policy does not cover prescription erectile dysfunction drugs. Not all policies do. Those that do generally limit users to a certain number of pills per month. You can get more, if you have a prescription for more, but you’ll be paying for them out of your own pocket.

The third way to keep costs for erectile dysfunction drugs down is indirect, but worthwhile, and that is to do what you can to ensure you get the best possible results from your medications. Erectile dysfunction drugs work by allowing greater blood flow to the penis, and if they’re working against blood vessels that are narrowed by cholesterol plaques, or because you smoke a pack a day or don’t keep your diabetes under control, you’re not going to get the best results.

Many doctors who prescribe erectile dysfunction drugs recommend that you take steps to improve cardiovascular health, including having a healthy diet, kicking the smoking habit, keeping your weight under control, exercising regularly, and if you’re diabetic, maintaining tight blood glucose control. These steps improve your overall cardiac health, often improving erectile health at the same time, and helping drugs like Viagra work optimally.

Erectile dysfunction is a physiological issue for the vast majority of men who have it. That’s why drugs like Viagra work so well: they address the underlying issue, which is blood flow. When you do your part to improve your cardiac health, you’re also doing your part to improve your erectile health, whether or not you take prescription erectile dysfunction drugs.

Insurance coverage for Viagra and other drugs in its class is not great. When the name brand drugs go off-patent in the United States (which won’t start happening until the end of this year), it’s possible that generic competition could bring costs down enough that more insurance plan drug formularies will offer coverage. In the meantime, work with your doctor, compare prices, and do what you can to make your heart healthy, and you’ll get the absolute most out of the investment you make in erection health.