It is advisable to consult a specialist about Avana (avanafil) if you experience any of the following chronic issues:

1. Persistent Erectile Dysfunction: If you have ongoing difficulties achieving or maintaining an erection despite using Avana, it’s important to consult a specialist. This could indicate an underlying health issue that needs to be addressed.

2. Chronic Health Conditions: If you have chronic health conditions such as cardiovascular disease, diabetes, or hypertension, and you are using Avana, regular consultation with a specialist is crucial to ensure the medication is safe and effective for you.

3. Frequent Side Effects: If you experience frequent or severe side effects from Avana, such as headaches, dizziness, back pain, or vision changes, a specialist can help determine if the medication is appropriate or if adjustments are needed.

4. Lack of Effectiveness: If Avana does not seem to work as expected over time, consulting a specialist can help identify potential causes, such as medication interactions, dosing issues, or other health concerns.

5. Chronic Pain or Discomfort: If you experience ongoing pain or discomfort during or after taking Avana, this could be a sign of a more serious issue that requires specialist evaluation.

6. Psychological Concerns: If erectile dysfunction is causing significant anxiety, depression, or relationship issues, a specialist such as a urologist, endocrinologist, or even a psychologist may be needed to address both the physical and psychological aspects of the condition.

7. Combination with Other Treatments: If you are considering combining Avana with other treatments (such as other ED medications, supplements, or therapies), it is essential to consult a specialist to avoid potential interactions and side effects.

In any case where chronic issues are present, a specialist can provide a more detailed assessment, tailor treatment options to your specific needs, and ensure that you are using Avana safely and effectively.