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Stress: A lot of chronic stress can also wreak havoc on a man s desire. These factors can all adversely affect a man s libido.

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However, the manufacturer states that patients with age-related macular degeneration were included in clinical trials with sildenafil, and long-term treatment with the drug was not associated with a deterioration in vision.

The theoretical possibility that heterozygote carriers of a PDE 6 gene defect also may have an accentuated risk for adverse visual effects of sildenafil should be considered. Patients should inform their clinician of the presence of retinitis pigmentosa or history of severe vision loss. Sildenafil should be used with caution in patients with retinitis pigmentosa, does viagra cause erectile dysfunction retinal disorder that may be accompanied by a genetic disorder of retinal phosphodiesterases in some patients, since data establishing the safety and efficacy of the drug in these patients currently are lacking.

Pending accumulation of such data, other clinicians suggest does viagra cause erectile dysfunction sildenafil not be used at all in these patients or be used with particular or extreme caution and at the lowest possible dose; such precautions also have been suggested for patients with other retinal conditions such as macular degeneration or diabetic retinopathy.

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