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The patient addressed both questions at the final visit for the last 4 weeks of the study. Unfortunately, it isn t guaranteed to work for everyone the first time they use it, so if you don t experience any benefits, try again another day. Plasma concentrations of this metabolite are approximately 40 of those seen for sildenafil. You should be evaluated for testosterone deficiency if you have ED and have noticed that you are more fatigued than you would expect, have low desire, and or trouble maintaining your muscle mass.