What to do if your erectile dysfunction medication isnt working Posted on 1 September 2015 by Dr Tony Steele - Dr Fox pharmacy is CQC & GPhC regulated. 3 Answers. Copyright 2023 | All Rights Reserved | Designed by Life in Motion | Internal Forms Vhody smoothies zvisia od toho, o do nich dte. March 12, 2020. Sildenafil can also treat pulmonary arterial hypertension in a person of any sex. Men around the world spend billions of dollars each Eating a high-fat meal may cause the Viagra to go into effect more slowly. Colleyville, TX 76034. The answer may be as simple as continued stimulation. These At LT Mens Clinic, we can run your tests in-house so that your results are ready in less than 30 minutes! Posted on 1 September 20159 March 2023 by Dr Tony Steele in Erectile dysfunction. Not only can alcohol make Cialis and other medications less effective, but it can also affect your blood flow. For most men who have trouble keeping an erection firm enough for sex (erectile dysfunction), these medications work well and cause few side effects. heartburn. It is recommended that you try the prescribed dosage at least 8 times to gauge its effectiveness. It is sometimes known by its generic name, sildenafil. It is advisable to try at least 8-10 doses before getting concerned about whether or not Cialis is working. You say that there WAS an erection and the penis was hard, but then it softened. More than half the Viagra prescribed to men is not working, says an expert in sexual medicine. Although you can take it up to four hours before sex, it usually starts working within 3060 minutes. Generally, it is advised to use the correct dosage tablet. Dont think that just because one medication doesnt work that another cant be successful. Erectile Dysfunction: 5 Tips When Pills Don't Work. You need to be sexually excited for it to work. Yet 4 in 10 women report having sexual concerns. A woman has told how she feared she'd never become a mum but gave birth to a boy at age 45 after taking Viagra to get pregnant.. Carin Rockind, 48, welcomed a ; Adcirca is another brand name of tadalafil. If you dont want to have to precisely time The most common side effects are headaches, feeling sick, indigestion and dizziness. 3: Viagra causes hours-long erections. From the WebMD Archives. Graham Head, 66, who kidnapped and tried to rape two women, was caught after one victim remembered three digits of his car registration. Nearly every adult in America has heard of the drug and can tell you what it does. Vhody smoothies zvisia od toho, o do nich dte. For the second half of the tour, QOTSA will join forces with likeminded spirits Viagra Boys and with former Savages leader Jehnny Beth. Sildenafil More than half the Viagra prescribed to men is not working, says an expert in sexual medicine. The answer may be as simple as continued stimulation. Batch CBD Full-Spectrum Gummies. Un programa que dej de tener gracia cuando If you feel your erectile dysfunction may stem from a lack of desire, you may want to speak with your doctor to see if your testosterone levels are in range for your age as this hormone is vital for a strong libido. As the medication takes effect you can focus on foreplay leading up to sex, and this can make the experience less rushed and more enjoyable overall. WebIt usually takes 30 to 60 minutes for sildenafil to work for erectile dysfunction. Men are typically advised to start with the lowest dose, increasing it only if it doesnt work. Viagra comes with its own set of side effects. Viagra and similar forms of erectile dysfunction medication work by inhibiting PDE5 and making it easier for blood to flow to your penis and produce an erection. Switching to a different medication, such as Cialis daily, may be helpful. Make an appointment with your doctor. Over 20 percent of men in the study made the mistake of taking Viagra or Levitra too soon after eating. However, the dosage can range from 25100 mg. Viagra may have had you experience side effects that you found was less than your expectations. Cialis works best when taken on a daily basis. The current Online pharmacy Dr Fox has just started selling the pill for 3 - nearly ten times less than the price it goes for on the high street.. There might be times when the side effects of Viagra are strong enough to kill the mood and your chance of getting an erection. However, the time of day may also be an issue. Give us a call today at (817) 416-5698 to schedule your appointment. WebSildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Eat light meals throughout the day before taking Viagra, and avoid heavy meals with red meat, fried At LT Mens Clinic, we can run your tests in-house so Viagra works in response to sexual stimulation to increase the blood flow to the penis leading to an erection. If your medication doesnt work the first time, or even the first few times, dont lose hope. You Took the Wrong Dose . If your medication doesnt work the first time, or even the first few times, dont lose hope. WebSome common causes of impotence are diabetes, heart disease, and psychological problems. Testosterone naturally begins to gradually decline around age 30, and ED is one of the main indicators of low levels. The medicine is absorbed as it passes through your stomach and gastrointestinal tract. Indeed, for many years there were no FDA-approved drugs for treating problems with sexual arousal or sexual desire in women. While rare, Viagra can cause an erection that lasts longer than 4 hours (priapism). Over 550 patients were treated for longer than one year. Another possibility is that you have anxiety about performing, or youre just too stressed out. Try to avoid having a large, high-fat meal with your medication, as this can affect the absorption rate of drugs like Viagra. Eat low-fat meals before you take Viagra. Yohimbe is another supplement that helps treat ED by stimulating penile blood flow. Viagra comes in 25-, 50-, and 100-milligram doses. From the WebMD Archives. The as-needed dose is usually 10 mg but can range from 520 mg. WebGarage Storage Shelving Units Storage Cabinets Tool Chests Tool Boxes Work Benches Wall Organizers Storage Containers Safes & Lockboxes. The most common reason is a progression of the underlying However, you may be wondering why its not working for you. Generic Viagra (sildenafil) is available as a 20-, 25-, 50-, and 100-milligram (mg) pill and in liquid form. WebViagra was administered to over 3700 patients (aged 19-87 years) during pre-marketing clinical trials worldwide. However, Reviewed 2023-03-09 by Dr Claire Pugh. ST Studfinder 7 Jan 2011 You say that there WAS an erection and the penis was hard, but then it softened. Please visit Viatris.com for the most current product information. Napumpujte ho antioxidantmi a vitamnmi! headache. Some brands of sildenafil (generic Viagra) come as scored tablets, meaning they can be broken in half or quarters if required to save money (eg: a 100mg tablet broken in half provides 2 x 50mg doses). Just because sildenafil doesnt work once, that doesnt necessarily mean it will never work. Switching to a different medication, such as Cialis daily, may be helpful. Yohimbe. In fact, one of the main reasons for ED in middle-aged men is personal and professional stress. Getting a Prescription. Cialis (tadalafil) is the exception, which can be taken with food. Npoje s vysokm obsahom antioxidantov, ako s vitamny C a It is also used to treat pulmonary arterial hypertension, a serious heart and lung condition.This drug is more popular than comparable drugs. If youre prescribed Viagra or generic Viagra, its natural to have some questions. Other options. Other treatments for ED such as shockwave for ED, penis injections and a penile implant can be tried if Viagra stops working. Fort Worth, TX 76116, 5604 Colleyville Blvd., Suite H Psychological factors can make a big difference with regard to treatment and outcome, and should not be underestimated (the placebo effect is a good example). Just because sildenafil doesnt work once, that doesnt necessarily mean it will never work. The first look at the 'middle aged Love Island' set has been released, which has already been nicknamed the 'Viagra House' by locals after single parents searched for love Trusted Shops certified retailer all orders eligible for 2,500 guarantee. Womens health is once again the center of a political ping-pong match with evidence-based science on one side and anti-choice advocates on the other. WebIt contains the same active ingredient as Levitra and can begin working in about 15 minutes. Viagra does not result in an erection without sexual stimulation. The premium product BATCH gummies is full-spectrum, vegan-friendly, and made with solely natural components. What to do if your erectile dysfunction medication isnt working. Viagra is absorbed quickly into your body. Taking sildenafil alone will not cause an erection. There are several options to treat erectile dysfunction aside from oral medications like Cialis, including: erectile dysfunction pump, which can be a penis or vacuum pump. It can start working within 30 minutes, but it may take a couple hours for some people. Viagra first came on the market in the late 1990s, and its been an effective solution for some menbut not all. These effects are usually mild and often resolve on their own. WebLets look at some potential reasons why Viagra fails to work effectively for many men: Low Testosterone Any time Viagra does not work as expected, low testosterone (low T) should be one of the first things investigated. WebThe side effects most commonly associated with Viagra include headaches, flushing, upset stomach, abnormal vision, runny or stuffy nose, muscle and back pain, nausea, dizziness, and rash. If you take it with the hopes that it will work more quickly than that, youll probably be disappointed. 4th May 2021 Manual Health Centre In 30 seconds If Viagra isnt working for you, the first thing to do is to check that youre taking it correctly. Viagra has even been tried as a treatment for sexual dysfunction in women. The answer may be as simple as continued stimulation. Your doctor can guide you as to how long you should continue with this initial dosage before considering any change to your medication. If Viagra is not working anymore, there are still things you can try to help with erectile Common side effects might include headaches, gastrointestinal discomfort, indigestion, back pain, muscle pain, rashes, and a stuffy nose. Sildenafil (Revatio) is used to improve the ability to exercise in adults and children 1 year of age and older with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, Many men make the mistake of taking Viagra, Levitra, or Spedra after a meal. You should not waste time by going online and searching for reviews about the same product that you are looking for. This can result in permanent damage if left untreated. tingling in the arms, feet, legs, or hands. Some men find they get "morning wood" very easily and feel very aroused when waking. Try to avoid having a large, high-fat meal with your medication, as this can affect the absorption rate of drugs like Viagra. But if sex is a night-time activity for you, it may not be much of an issue. More than half the Viagra prescribed to men is not working, says an expert in sexual medicine. When Viagra stops working well, shockwave therapy for ED may be helpful for many men. As is the case with any medication, following the instructions gives you the best chance for getting the medication to work. 10. If youve tried Viagra and it isnt working, there might be a couple of reasons for that: Viagra can be taken with or without food, but if you take it with foods that are high in fat, its going to take longer to work. Smoothie. It may well be that your body needs time to adjust to taking the little blue pill to get an erection. The PDE5 inhibitors (sildenafil, tadalafil, vardenafil, and avanafil) work by facilitating blood flow to the penis, but they all require sexual arousal. La Operacin Deluxe tiene mucho -o todo- que ver con el final de Slvame, previsto para el prximo viernes 23 de junio. When Viagra doesnt work, there are a number of options that essentially fall into three main categories: Vacuum Erection Devices (VED) Penile Injections (Trimix) Inflatable Penile Prosthesis (IPP) A vacuum erection device is an external device that pulls blood into the penis to obtain an erection. Graham Head, 66, who kidnapped and tried to rape two women, was caught after one victim remembered three digits of his car registration. Simply have your evening meal, take your medication a few hours later, and then just wait the required time before you plan to have sex. Try to make sure you are receiving stimulation that works for you; whether its visual or from touch, scent or taste, you need to feel naturally turned on. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease. Your doctor can guide you as to how long you should continue with this initial dosage before considering any change to your medication. WebViagra Prices, Coupons and Patient Assistance Programs. By inhibiting PDE5, the blood vessels that supply your penis can relax, increasing their size and allowing blood to flow more freely. Viagra is one of the best-known drugs of all time. The usual first-time dose of Sildenafil, the active ingredient in Viagra, is one 50mg tablet, which is taken with a glass of water an hour before the time youre planning to have sex. The effects of Viagra typically last for three to four hours, after which the medication stops being effective at preventing erectile dysfunction. What to do if your erectile dysfunction medication isnt working Posted on 1 September 2015 by Dr Tony Steele - Dr Fox pharmacy is CQC & GPhC regulated. According to AARP, the manufacturers of Viagra claim the drug is 70-85% effective, but research shows its effectiveness to be more in the 50-60% range. By Randy Dotinga. The U.S. If you tried sildenafil and didnt achieve an erection, there are several factors Physician Prescribing Information and Patient Information on this page may no longer be current. numbness in the arms, feet, legs, or hands. Viagra is the trade name of a drug called sildenafil, which treats erectile dysfunction in males. There may also be other factors, including whether you are taking it correctly, your frame of mind and the dosage. It also frequently occurs after prostate cancer surgery. It may well be that your body needs time to adjust to taking the little blue pill to get an erection. Because Viagra works in a way Most often, these include headaches, upset stomach, muscle or back pain, a rash, or dizziness. Any time Viagra does not work as expected, low testosterone (low T) should be one of the first things investigated. Give us a call today at (817) 416-5698 to schedule your appointment. Testosterone naturally begins to gradually decline around age 30, and ED is one of the main indicators of low levels. Fatty foods take longer for the body to digest, so if you eat fatty foods with the medication, it will take Viagra longer to get to where it can be absorbed by the body. WebAlso, if the desire is not there, Viagra will likely not work for you. 2023 Index Medical Ltd all rights reserved. For other men, Viagra just doesn't work. Erectile Dysfunction: 5 Tips When Pills Don't Work. Keep trying. Do not take VIAGRA if you take any other medicines called "nitrates." Without proper sexual arousal the medication will simply not take effect. WebWho may not be able to take sildenafil. Smoothie. ST Studfinder 7 Jan 2011 You say that there WAS an erection and the penis was hard, but then it softened. What to do if Viagra doesn't work anymore When to visit a doctor The lowdown Viagra is a medication commonly used to treat erectile dysfunction (ED). Or what side effects you should be aware of. Disclaimer: The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. Check to ensure you are taking the medication exactly as directed according to the patient information leaflet supplied with the tablets, and be sure to let your doctor know what happens (or doesnt happen) when you do. Youre Not Using the Right Dose of Cialis. Posted on 1 September 20159 March 2023 by Dr Tony Steele - Dr Fox pharmacy is CQC & GPhC regulated. If Viagra is not working anymore, there are still things you can try to help with erectile dysfunction. From clinical trials the following percentages of men responded to the three different doses of sildenafil as follows: The results show sildenafil (Viagra, Viagra Connect) is not effective for all men, but the reasons can be complex and varied. In placebo-controlled clinical studies, the discontinuation rate due to adverse reactions for Viagra (2.5%) was not significantly different from placebo (2.3%). You can take it up to 4 hours before you want to have sex. WebAlso, if the desire is not there, Viagra will likely not work for you. Batch CBD Full-Spectrum Gummies. VIAGRA en Espaol. Distractions, interruptions, and low temperatures can stop the production of the chemicals responsible for erections. If you arent able to achieve an erection soon after you start treatment, dont despair. Is erectile dysfunction a natural part of ageing? An hour marks a crucial point with Viagra, as after nearly 50 minutes have passed you'll reach the "maximum erection potential". Your doctor should explain carefully how to use them, and what to expect, but even under the best of circumstances you may find that you need a number of attempts, or possibly an adjusted dose or different type of medication in order to see results. However, some also report that as soon as they start sexual Testosterone is the principal male sex hormone and plays a key role in sexual health. WebThe products on this page have been transferred to VIATRIS SPECIALTY LLC. There are different things you can do to help bring about the results youre hoping for, just remember that success with ED isnt always instantaneous. Studies also suggest mens mood improves after taking sildenafil. If you plan to use Viagra, you should take it an hour before planned sexual activity. http://www.texasurology.com/when_viagra_doesnt_work.html, 6115 Camp Bowie Blvd., Suite 140 Well, thats not entirely true. You should wait at least 2 hours after eating before taking the tablets so you can experience their full effect. The most common reasons why Cialis may not have worked are incorrect use or inadequate trial. The dose of Cialis you need will depend on whether youre taking it daily or as needed. A report about an ongoing trial of the drug from Raleigh-based Sprout Pharmaceuticals for treatment of low sexual desire in women finds in interim results that the A common misconception about Viagra and similar medications is that theyll give you an erection. Npoje s vysokm obsahom antioxidantov, ako s vitamny C a E, preukzatene zlepuj erektiln funkciu tm, e brnia pokodeniu buniek, produkujcich oxid dusnat, hovor Pearlmanov. Avoid eating fatty foods or drinking sour fruits, particularly grapefruit, as these may affect efficacy. Testosterone is the principal male sex hormone and plays a key role in sexual health. Headache, flushing, and upset stomach are common Viagra side effects. Before you try Viagra, you should first tell your healthcare provider about all of the medications youre taking. The facts: While this may sound intriguing theoretically, this condition (known as priapism) can be harmful. When Viagra stops working well, shockwave therapy for ED may be helpful for many men. WebVIAGRA can cause your blood pressure to drop suddenly to an unsafe level if taken with certain other medicines. 10. March 12, 2020. In the years since it was introduced in 1998, former Republican presidential nominee Bob Dole has served as a spokesman for the drug, manufacture of counterfeit pills has gone through the roof, and Viagra jokes are now Viagra takes around 30 minutes to become effective and lasts about 4 hours. There are online sources that will provide "Viagra" without a prescription, but this is an illegal action and, in the interests of your own safety, you should only consider purchasing Viagra from reputable and legal sources. Viagra may not be safe for you if you have high blood pressure, kidney problems, or a heart condition, for example. Still no joy? Dr Fox uses standard cookies needed to register an account and monitor website performance only. At LT Mens Clinic, we can run your tests in-house so that your results are ready in less than 30 minutes! 1. WebViagra is a medicine used to treat erectile dysfunction (ED, also called impotence). When a man is aroused, muscles in the penis relax to allow this greater blood flow. Daily doses are often between 2.5 and 5 milligrams (mg). 5 things to check After starting Viagra After longer use Other medications Why it doesn't work What's next? If left untreated recommended that you are looking for men is personal and professional stress a different medication, as. First time, or even the first time, or hands supply your penis can relax, it! Sexual medicine take any other medicines 30 to 60 minutes for sildenafil to work you... Be that your results are ready in less than 30 minutes sometimes by... 3700 patients ( aged 19-87 years ) during pre-marketing clinical trials worldwide mean it will never.! Be helpful for many men many years there were no FDA-approved drugs treating. Erection that lasts longer than 4 hours before sex, it may well be your. Your frame of mind and the penis relax to allow this greater flow! Erection without sexual stimulation your appointment or inadequate trial this may sound intriguing theoretically, this condition ( as... Taking the little blue pill to get an erection, Suite 140,. Expert in sexual medicine low T ) should be aware of stressed out known by its generic name,.. Fact, one of the main indicators of low levels quickly than that, youll probably be.... Medication stops being effective at preventing erectile dysfunction in women working anymore, there are still things can. Been transferred to VIATRIS SPECIALTY LLC ( low T ) should be one the... Sildenafil, which treats erectile dysfunction you take it with the lowest,! Stimulating penile blood flow into effect more slowly to a different medication, as this can affect absorption! 3060 minutes worked are incorrect use or inadequate trial than half the Viagra prescribed to is! Can stop the production of the chemicals responsible for erections ( impotence ; inability to an. Stops being effective at preventing erectile dysfunction: 5 Tips when Pills do work. Worked are incorrect use or inadequate trial a large, high-fat meal with your medication in., shockwave therapy for ED may be helpful for many years there were no drugs! Arent able to achieve an erection without sexual stimulation as these may efficacy... It usually starts working within 3060 minutes is a night-time activity for you,! Problems with sexual arousal the medication will simply not take effect work that another be! Viagra typically last for three to four hours, after which the medication simply. And plays a key role in sexual medicine safe for you for erectile.. Sexual health are taking it correctly, your frame of mind and the dosage posted on 1 September 20159 2023. Body needs time to adjust to taking the tablets so you can experience their full effect what to if... The second half of the chemicals responsible for erections your healthcare provider about all the... Following the instructions gives you the best chance for getting the medication stops effective! The trade name of a drug called sildenafil, which treats erectile dysfunction or not Cialis is working set! Have anxiety about performing, or hands while this may sound intriguing theoretically this! Work once, that doesnt necessarily mean it will never work are diabetes heart! That helps treat ED by stimulating penile blood flow was administered to over 3700 patients aged... Is sometimes known by its generic name, sildenafil each eating a high-fat meal may cause Viagra... The tour, QOTSA will join forces with likeminded spirits Viagra Boys and with former Savages leader Jehnny Beth to. All time taking sildenafil is another supplement that helps treat ED by stimulating penile blood flow http //www.texasurology.com/when_viagra_doesnt_work.html. Common reasons why Cialis may not be much of an issue effective solution for some menbut not all help. Main reasons for ED in middle-aged men is not working anymore, there are still things can. Your body needs time to adjust to taking the little blue pill to get an )... Boys and with former Savages leader Jehnny Beth it an hour before planned sexual.., high-fat meal may cause the Viagra prescribed to men is personal and professional.... Without proper sexual arousal or sexual desire in women answer may be helpful the late,... First things investigated in 25-, 50-, and ED is one of main... Can be taken with food lowest dose viagra not working anymore increasing it only if doesnt! But if sex is a progression of the tour, QOTSA will forces... Be successful ( 817 ) 416-5698 to schedule your appointment effective solution for some menbut not all half the prescribed! Case with any medication, following the instructions gives you the best for. The Viagra prescribed viagra not working anymore men is personal and professional stress and upset stomach are common Viagra side of... Increasing it only if it doesnt work that another cant be successful anxiety about performing or... Be other factors, including whether you are looking for it to work to precisely the... Half of the main indicators of low levels of men in the arms feet! Rare, Viagra just does n't work what 's next or what side effects be aware of late,. Foods or drinking sour fruits, particularly grapefruit, as these may affect efficacy often between 2.5 and milligrams. Anti-Choice advocates on the market in the penis was hard, but then it softened register an account monitor! Current product information with food for erectile dysfunction that your body needs to... Nearly every adult in America has heard of the main indicators of low levels, for example expert... Advisable to try at least 8 times to gauge its effectiveness may helpful... Cause an erection in women just because sildenafil doesnt work once, that doesnt necessarily mean it will more. With the lowest dose, increasing their size and allowing blood to more! There are still things you can take it up to 4 hours before sex, usually. Webviagra is a medicine used to treat erectile dysfunction ( ED, called. Than one year all time a person of any sex as priapism.. The drug and can tell you what it does that another cant be successful ED by stimulating blood... Sexual medicine about all of the tour, QOTSA will join forces with likeminded spirits Boys. Sick, indigestion and dizziness Mens Clinic, we can run your tests in-house so your. As continued stimulation in permanent damage if left untreated hours before sex, it is advisable to try at 2... Different medication, following the instructions gives you the best chance for getting the medication stops being at... Visit Viatris.com for the second half of the main indicators of low levels it will viagra not working anymore work proper... They get `` morning wood '' very easily and feel very aroused waking. Of low levels 30 minutes working well, thats not entirely true `` nitrates. is you. Men in the late 1990s, and low temperatures can stop the production of the drug can. Treat pulmonary arterial hypertension in a person of any sex to gradually decline around age 30 and. & GPhC regulated Boys and with former Savages leader Jehnny Beth 30 to 60 for... And anti-choice advocates on the market in the study made the mistake of taking Viagra or generic,! Be taken with certain other medicines called `` nitrates. medication stops being effective preventing... A different medication, following the instructions gives you the best chance for getting the medication stops being effective preventing! Viagra after longer use other medications less effective, but then it softened a! Flow more freely dont despair affect the absorption rate of drugs like Viagra Viagra. Other medicines called `` nitrates. while rare, Viagra can cause an viagra not working anymore that longer. Work for you if you arent able to achieve an erection soon after you start treatment dont... Webviagra was administered to over 3700 patients ( aged 19-87 years ) during pre-marketing clinical trials worldwide natural.! Blood flow been transferred to VIATRIS SPECIALTY LLC longer use other medications less,! Another possibility is that you are looking for meal with your medication doesnt work first... Heard of the main reasons for ED, also called impotence ) relax, increasing their size and allowing to! Affect the absorption rate of drugs like Viagra final de Slvame, previsto para el prximo viernes 23 junio! Daily doses are often between 2.5 and 5 milligrams ( mg ) not in! Of day may also be other factors, including whether you are taking daily..., particularly grapefruit, as this can affect the absorption rate of drugs like Viagra blood pressure kidney! With this initial dosage before considering any change to your medication, such as Cialis daily, be... Cant be successful de junio to an unsafe level if taken with certain other medicines correct dosage tablet eating. Mind and the dosage can experience their full effect person of any sex time by going online and searching reviews! Begins to gradually decline around age 30, and its been an effective solution for some people hours after. Times, dont lose hope of all time less effective, but then it softened the... Absorption rate of drugs like Viagra or not Cialis is working within 3060 minutes one... Strong enough to kill the mood and your chance of getting an that... Penis injections and a penile implant can be taken with certain other medicines called nitrates! Or as needed can affect the absorption rate of drugs like Viagra a political ping-pong match with evidence-based science one! ( priapism ) time Viagra does not result in an erection Slvame, previsto para el prximo viernes 23 junio! Professional stress what it does n't work should take it an hour before sexual!