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This is the recommended dose if you found 50mg effective, but you experienced side effects at this strength. Erectile dysfunction ED is caused by a range of physiological and psychological conditions like stress, anxiety, or depression. The mechanical problem is commonly the same: insufficient blood flow or nervous stimulation, which is required to enable enough blood into the penis to achieve a full and sustained erection. ED can be the first sign of heart or other health conditions, including cardiovascular disease and diabetes. However, ED can also affect younger men - in a recent study it was found that one in four patients seeking first medical help for new onset ED was younger than 40 years.

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