Cialis promotes erections by relaxing the smooth muscle of the blood vessels thus increasing blood flow in the penis in response to sexual stimulation. It does this by specifically blocking a particular enzyme (protein that assists chemical reactions) called phosphodiesterase type 5 (PDE 5). This is the enzyme that normally breaks down chemicals causing the erectile response. Therefore, by blocking the breakdown of erectile chemicals, the drug promotes a harder and more prolonged erection. Cialis promotes penile erection only in response to sexual stimulation and has no effect in the absence of sexual stimulation.

Having a problem maintaining an erection can be socially embarrassing - 2.3 million men in the UK are predicted to have erectile dysfunction- and most are too embarrassed to even talk about it. Most men experience erectile dysfunction at some point in their lives, usually by age 40, and the vast majority are not psychologically affected by it. Previously associated with middle age, it has now been established that impotence affects younger men too. Recent studies in the Uk show that 93% of all men think that erectile dysfunction is something psychological. This is not true: in order to have an erection the arteries must have a sufficient blood flow. In most cases erectile dysfunction indicates a hardening of the arteries, mainly caused by cholesterol. Men with low cholesterol are less likely to develop impotence.

Like high cholesterol and high blood pressure, diabetis (beacuse of its impact on the blood flow which is essential to a normal erectile function) can contribute to ED as well. It can lead to the thickening of your arteries and consequently leaves less space for a healthy bloof flow. More than 50% of the men with diabetes will, experience ED at some point in their lives.

There are two potential dosages of Cialis: 10mg and 20mg. This dosage may have to be adjusted should the desired effect not be achieved. A 20mg tablet may be split up into two 10mg dosages.
The usual maximum dose of Cialis is one tablet (dosage) approximately one hour before sexual activity, with or without meals. The maximum dose is one tablet in any 24-hour period. The dosage instructions on the label must be followed. Please read carefully any leaflet supplied with your medication.

Prior to taking Cialis for the first time you must check with your physician that your heart is healthy. If you have a heart condition and you are using nitrate drugs do not take Cialis. This combination can make your blood pressure plummet. This can lead to faintness, dizziness or even a heart attack. All prescription medicines used to treat angina (chest pain due to heart disease) should be checked for nitrates. The following are examples of such medication:
· Isosorbide mononitrate
· Isosorbide dinitrate
· Nitroglycerin
· Amyl Nitrate or Nitrite. These are recreational drugs known as poppers.

Consult your physician if you are not sure whether your medication contains nitrates.