Menstuff® has compiled the following on Erectile
Dysfunction.
Important: The information and images contained within this site
are of a sexually explicit nature. If you are under the age of 18, or
if it's illegal to view sexually explicit material in your area,
please LEAVE this website. Click Here To Leave Now.
Erectile Dysfunction
Affects 18 Million U.S. Men
The problem is particularly acute among men with cardiovascular disease, diabetes, and those who get little exercise, researchers at the Johns Hopkins Bloomberg School of Public Health report.
"The association of erectile dysfunction with diabetes and other cardiovascular risk factors can serve as a powerful motivator for men in whom diet and lifestyle changes are really indicated," said study author Elizabeth Selvin, a postdoctoral fellow at Johns Hopkins.
"If you control your diabetes, and treat existing risk factors and do things to prevent diabetes and control your blood pressure and cholesterol levels, not only will you reduce your risk of cardiovascular disease and diabetes, but you will also improve your sexual function," she said.
The findings are published in the Feb. 1 issue of the American Journal of Medicine.
In the study, Selvin's team collected data on more than 2,100 men who participated in the National Health and Nutrition Examination Survey. Men who said they were "sometimes able" or "never able" to achieve and keep an erection were classified as having erectile dysfunction, while men who said they were "always or almost always able" or "usually able" were not.
"There is a high prevalence of erectile dysfunction among men with cardiovascular risk factors and men with diabetes," Selvin said. "Screening for erectile dysfunction among men with hypertension and diabetes may be important," she added.
The researchers found that the overall prevalence of erectile dysfunction among U.S. men was 18.4 percent. Age was a strong risk factor -- men 70 and older accounted for 70 percent of those with erectile dysfunction. In contrast, just 5 percent of men with erectile problems were between the ages of 20 and 40.
Erectile dysfunction was especially linked to diabetes. "It's important for physicians to know that more than 50 percent of their male diabetic patients are affected by erectile dysfunction," Selvin said.
In addition, almost 90 percent of men with erectile dysfunction had at least one risk factor for heart disease, including diabetes, high blood pressure, high cholesterol or smoking.
"Moreover, men who are physically inactive and had high rates of sedentary behavior, such as watching three or more hours of TV per day, were much more likely to have erectile dysfunction compared with men who were physically active," Selvin said, so, "increasing exercise may be an effective non-pharmacologic treatment."
One expert agreed that erectile dysfunction is a widespread problem.
"This study reiterates what we know, that erectile dysfunction is highly prevalent in the Unites States," said Dr. Hossein Sadeghi-Nejad, director of the Center for Male Reproductive Medicine at Hackensack University Medical Center and an associate professor of urology at UMD New Jersey Medical School.
Sadeghi-Nejad believes that doctors should screen men for erectile dysfunction. "It's an important quality-of-life issue, and the factors that help prevent cardiovascular disease and diabetes may help decrease erectile dysfunction," he added.
By changing lifestyle and treating
underlying heart disease and diabetes, you can decrease the chances
of developing erectile dysfunction, Sadeghi-Nejad said. "Erectile
dysfunction is not a mandatory side effect of aging," he said. "Don't
think of it as a normal process of aging."
Source: www.nlm.nih.gov/medlineplus/news/fullstory_44724.html
Erectile dysfunction, or ED, can be a total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections. These variations make defining ED and estimating its incidence difficult. Estimates range from 15 million to 30 million, depending on the definition used. According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for ED in 1985. By 1999, that rate had nearly tripled to 22.3. The increase happened gradually, presumably as treatments such as vacuum devices and injectable drugs became more widely available and discussing erectile function became accepted. Perhaps the most publicized advance was the introduction of the oral drug sildenafil citrate (Viagra) in March 1998. NAMCS data on new drugs show an estimated 2.6 million mentions of Viagra at physician office visits in 1999, and one-third of those mentions occurred during visits for a diagnosis other than ED.
In older men, ED usually has a physical cause, such as disease, injury, or side effects of drugs. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED. Incidence increases with age: About 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience ED. But it is not an inevitable part of aging.
ED is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for ED. Urologists, who specialize in problems of the urinary tract, have traditionally treated ED; however, urologists accounted for only 25 percent of Viagra mentions in 1999.
The penis contains two chambers called the corpora cavernosa, which run the length of the organ (see figure 1). A spongy tissue fills the chambers. The corpora cavernosa are surrounded by a membrane, called the tunica albuginea. The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora cavernosa.
Erection begins with sensory or mental stimulation, or both. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the spaces. The blood creates pressure in the corpora cavernosa, making the penis expand. The tunica albuginea helps trap the blood in the corpora cavernosa, thereby sustaining erection. When muscles in the penis contract to stop the inflow of blood and open outflow channels, erection is reversed.
Figure 1. Arteries (top) and veins (bottom) penetrate the long, filled cavities running the length of the penis--the corpora cavernosa and the corpous sponglosum. Erection occurs when relaxed muscles allow the corpora cavernosa to fill with excess blood fed by the arteries, while drainage of blood through the veins is blocked.
Since an erection requires a precise sequence of events, ED can occur when any of the events is disrupted. The sequence includes nerve impulses in the brain, spinal column, and area around the penis, and response in muscles, fibrous tissues, veins, and arteries in and near the corpora cavernosa.
Damage to nerves, arteries, smooth muscles, and fibrous tissues, often as a result of disease, is the most common cause of ED. Diseases--such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease--account for about 70 percent of ED cases. Between 35 and 50 percent of men with diabetes experience ED.
Also, surgery (especially radical prostate surgery for cancer) can injure nerves and arteries near the penis, causing ED. Injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to ED by harming nerves, smooth muscles, arteries, and fibrous tissues of the corpora cavernosa.
In addition, many common medicines--blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug)--can produce ED as a side effect.
Experts believe that psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause 10 to 20 percent of ED cases. Men with a physical cause for ED frequently experience the same sort of psychological reactions (stress, anxiety, guilt, depression).
Other possible causes are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as not enough testosterone.
Patient History Medical and sexual histories help define the degree and nature of ED. A medical history can disclose diseases that lead to ED, while a simple recounting of sexual activity might distinguish between problems with sexual desire, erection, ejaculation, or orgasm.
Using certain prescription or illegal drugs can suggest a chemical cause, since drug effects account for 25 percent of ED cases. Cutting back on or substituting certain medications can often alleviate the problem.
Physical Examination A physical examination can give clues to systemic problems. For example, if the penis is not sensitive to touching, a problem in the nervous system may be the cause. Abnormal secondary sex characteristics, such as hair pattern, can point to hormonal problems, which would mean that the endocrine system is involved. The examiner might discover a circulatory problem by observing decreased pulses in the wrist or ankles. And unusual characteristics of the penis itself could suggest the source of the problem--for example, a penis that bends or curves when erect could be the result of Peyronie's disease.
Laboratory Tests Several laboratory tests can help diagnose ED. Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measuring the amount of testosterone in the blood can yield information about problems with the endocrine system and is indicated especially in patients with decreased sexual desire.
Other Tests Monitoring erections that occur during sleep (nocturnal penile tumescence) can help rule out certain psychological causes of ED. Healthy men have involuntary erections during sleep. If nocturnal erections do not occur, then ED is likely to have a physical rather than psychological cause. Tests of nocturnal erections are not completely reliable, however. Scientists have not standardized such tests and have not determined when they should be applied for best results.
Psychosocial Examination A psychosocial examination, using an interview and a questionnaire, reveals psychological factors. A man's sexual partner may also be interviewed to determine expectations and perceptions during sexual intercourse.
Most physicians suggest that treatments proceed from least to most invasive. Cutting back on any drugs with harmful side effects is considered first. For example, drugs for high blood pressure work in different ways. If you think a particular drug is causing problems with erection, tell your doctor and ask whether you can try a different class of blood pressure medicine.
Psychotherapy and behavior modifications in selected patients are considered next if indicated, followed by oral or locally injected drugs, vacuum devices, and surgically implanted devices. In rare cases, surgery involving veins or arteries may be considered.
Psychotherapy Experts often treat psychologically based ED using techniques that decrease the anxiety associated with intercourse. The patient's partner can help with the techniques, which include gradual development of intimacy and stimulation. Such techniques also can help relieve anxiety when ED from physical causes is being treated.
Drug Therapy Drugs for treating ED can be taken orally, injected directly into the penis, or inserted into the urethra at the tip of the penis. In March 1998, the Food and Drug Administration approved Viagra, the first pill to treat ED. Taken an hour before sexual activity, Viagra works by enhancing the effects of nitric oxide, a chemical that relaxes smooth muscles in the penis during sexual stimulation and allows increased blood flow.
While Viagra improves the response to sexual stimulation, it does not trigger an automatic erection as injections do. The recommended dose is 50 mg, and the physician may adjust this dose to 100 mg or 25 mg, depending on the patient. The drug should not be used more than once a day. Men who take nitrate-based drugs such as nitroglycerin for heart problems should not use Viagra because the combination can cause a sudden drop in blood pressure.
Additional oral medicines may soon be available to treat ED. Vardenafil and Cialis are being tested for safety and effectiveness. Both of these drugs work like Viagra by increasing blood flow to the penis. A third drug being tested, Uprima, works on the brain and nervous system to trigger an erection.
Oral testosterone can reduce ED in some men with low levels of natural testosterone, but it is often ineffective and may cause liver damage. Patients also have claimed that other oral drugs--including yohimbine hydrochloride, dopamine and serotonin agonists, and trazodone--are effective, but the results of scientific studies to substantiate these claims have been inconsistent. Improvements observed following use of these drugs may be examples of the placebo effect, that is, a change that results simply from the patient's believing that an improvement will occur.
Many men achieve stronger erections by injecting drugs into the penis, causing it to become engorged with blood. Drugs such as papaverine hydrochloride, phentolamine, and alprostadil (marketed as Caverject) widen blood vessels. These drugs may create unwanted side effects, however, including persistent erection (known as priapism) and scarring. Nitroglycerin, a muscle relaxant, can sometimes enhance erection when rubbed on the penis.
A system for inserting a pellet of alprostadil into the urethra is marketed as Muse. The system uses a prefilled applicator to deliver the pellet about an inch deep into the urethra. An erection will begin within 8 to 10 minutes and may last 30 to 60 minutes. The most common side effects are aching in the penis, testicles, and area between the penis and rectum; warmth or burning sensation in the urethra; redness from increased blood flow to the penis; and minor urethral bleeding or spotting.
Research on drugs for treating ED is expanding rapidly. Patients should ask their doctor about the latest advances.
Vacuum Devices
Mechanical vacuum devices cause erection by creating a partial vacuum, which draws blood into the penis, engorging and expanding it. The devices have three components: a plastic cylinder, into which the penis is placed; a pump, which draws air out of the cylinder; and an elastic band, which is placed around the base of the penis to maintain the erection after the cylinder is removed and during intercourse by preventing blood from flowing back into the body (see figure 2).
One variation of the vacuum device involves a semirigid rubber sheath that is placed on the penis and remains there after erection is attained and during intercourse.
Figure 2. A vacuum-constrictor device causes an erection by creating a partial vacuum around the penis, which draws blood into the corpora cavernosa. Pictured here are the necessary components: (a) a plastic cylinder, which covers the penis; (b) a pump, which draws air out of the cylinder; and (c) an elastic ring, which, when fitted over the base of the penis, traps the blood and sustains the erection after the cylinder is removed.
Surgery Surgery usually has one of three goals: to implant a device that can cause the penis to become erect to reconstruct arteries to increase flow of blood to the penis to block off veins that allow blood to leak from the penile tissues
Implanted devices, known as prostheses, can restore erection in many men with ED. Possible problems with implants include mechanical breakdown and infection, although mechanical problems have diminished in recent years because of technological advances.
Malleable implants usually consist of paired rods, which are inserted surgically into the corpora cavernosa. The user manually adjusts the position of the penis and, therefore, the rods. Adjustment does not affect the width or length of the penis.
Inflatable implants consist of paired cylinders, which are surgically inserted inside the penis and can be expanded using pressurized fluid (see figure 3). Tubes connect the cylinders to a fluid reservoir and a pump, which are also surgically implanted. The patient inflates the cylinders by pressing on the small pump, located under the skin in the scrotum. Inflatable implants can expand the length and width of the penis somewhat. They also leave the penis in a more natural state when not inflated.
Figure 3. With an inflatable implant, erection is produced by squeezing a small pump (a) implanted in a scrotum. The pump causes fluid to flow from a reservoir (b) residing in the lower pelvis to two cylinders (c) residing in the penis. The cylinders expand to create the erection.
Surgery to repair arteries can reduce ED caused by obstructions that block the flow of blood. The best candidates for such surgery are young men with discrete blockage of an artery because of an injury to the crotch or fracture of the pelvis. The procedure is less successful in older men with widespread blockage.
Surgery to veins that allow blood to leave the penis usually involves an opposite procedure--intentional blockage. Blocking off veins (ligation) can reduce the leakage of blood that diminishes the rigidity of the penis during erection. However, experts have raised questions about the long-term effectiveness of this procedure, and it is rarely done.
Advances in suppositories, injectable medications, implants, and vacuum devices have expanded the options for men seeking treatment for ED. These advances have also helped increase the number of men seeking treatment. Gene therapy for ED is now being tested in several centers and may offer a long-lasting therapeutic approach for ED.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) sponsors programs aimed at understanding the causes of erectile dysfunction and finding treatments to reverse its effects. NIDDK's Division of Kidney, Urologic, and Hematologic Diseases supported the researchers who developed Viagra and continue to support basic research into the mechanisms of erection and the diseases that impair normal function at the cellular and molecular levels, including diabetes and high blood pressure.
Erectile dysfunction (ED) is the repeated inability to get or keep an erection firm enough for sexual intercourse.
Source: www.whatiserectiledysfunction.com/
One-Third of Older Men Report Erection
Problems
The figures come from a survey of nearly 32,000 men, 53 to 90 years of age, who participated in the Health Professionals Follow-up Study. The results are reported in the Annals of Internal Medicine.
After excluding men with prostate cancer, Dr. Constance G. Bacon, from Harvard School of Public Health, and associates found that 33 percent of the men reported erection problems in the previous 3 months. Moreover, for each decade beyond 50 years of age, overall sexual function, desire, and orgasm frequency decreased sharply.
Physical inactivity and obesity had a lot to do with erection problems. Men who ran for at least 3 hours per week or engaged in a similar amount of exercise were 30 percent less likely to have erection difficulties than men who barely exercised at all.
Similarly, non-obese men were 30 percent less likely to develop these problems than obese men, the researchers note.
Other "risk factors" for erection difficulties included smoking,
drinking alcohol, and watching television.
Source: asia.reuters.com/newsArticle.jhtml?type=healthNews&storyID=3217926
Erectile Dysfunction: Learn More Because
It Could Save Your Life
You never thought it would happen to you -- or at least until you were a lot older.
But here you are, just hitting your midlife stride and suddenly, what was once an occasional problem brought on by overwork or too much wine is now occurring a lot more frequently -- and for what seems like no reason at all.
Erectile dysfunction or ED -- the inability to have an erection or sustain one long enough for intimate relations -- is a condition that regularly affects some 30 million American men.
That's a message worth sharing during National Men's Health Week in June.
While once believed to be a largely unavoidable rite of passage into the senior years, chronic erectile dysfunction is now showing up in much younger men, often beginning as early as 40 years old, experts say.
"It's an important barometer of a man's overall health -- particularly the health of the blood vessels. So if a man is at risk for any type of vascular disease, he is also at risk for ED, regardless of his age," says Dr. Andrew McCollough, director of Sexual Health, Fertility and Microsurgery at New York University Medical Center.
One reason: erections are closely tied to vascular health.
For an erection to occur, a man must experience a series of brain signals that combine with local nerve stimulation to relax a pair of smooth muscles that run the length of the inside of the penis. This, in turn, lets blood flow from nearby vessels, into two tissue-filled chambers, also located inside the organ.
The force of the blood creates a pressure that lets the penis expand, creating an erection. A thin membrane helps trap the blood and keep it in the penile chambers, long enough to sustain the erection.
The entire process reverses when the muscles in the penis contract, usually following orgasm. This halts the flow of any more blood into the chambers, while simultaneously opening several vascular ports that let the blood that caused the erection drain back into the nearby vessels, McCollough explains.
"Obviously, anything that impedes that entire process -- particularly anything which affects the ability of blood to flow freely into the penis -- has the potential to cause ED," he says.
While it was once believed that erectile dysfunction was largely the result of psychological problems, this is frequently not the case, particularly in men over 40.
Not only is the problem almost always the result of a physical condition, most men are surprised to learn that some very common conditions, including high blood pressure, high cholesterol, obesity and diabetes, are often a major cause, experts say.
"Frequently, erectile dysfunction is the first sign of these problems, and it can show up long before any typical symptoms develop," says Dr. Natan Bar-Chama, director of male reproductive medicine and surgery at Mount Sinai Medical Center in New York City.
What's more, he says, diagnosing and treating these common health problems, particularly in their early stages, can not only protect a man's overall health, it can often have a remarkable effect on erectile dysfunction.
Experts say most men are very surprised to discover that by simply lowering their cholesterol or their blood pressure -- often through simple measures such as diet and exercise -- they can also boost their virility, says Bar-Chama. The same is true, he says, of men who lose weight and cut back on cigarettes and alcohol.
"This is particularly true at the start of these conditions, before any real damage is done to the blood vessels," McCollough adds.
Still, experts say most men are resistant about seeing a doctor for erectile dysfunction, or even their general health. And doctors don't always make it easy for men to come forward with their problems.
"There is still a tremendous resistance to seeking treatment -- men have a problem asking physicians about ED. And doctors don't ask their patients if ED is a problem often enough," Bar-Chama says.
This, he says, not only means that erectile dysfunction goes untreated, but that sometimes, other health problems are also overlooked at their earliest, most easily treated stages.
Studies show that only between 10 percent and 15 percent of men with erectile dysfunction ever seek medical treatment -- or even mention the problem to their doctor.
Experts say they now have a virtual war chest of treatment options aimed specifically at erectile dysfunction, including mechanical devices that help bring blood into the penis and keep it there long enough to have an erection.
And, there are drugs designed to work on various aspects of penile physiology involved in the erection process.
While that "little blue pill" known as Viagra remains the breakthrough treatment, later this year two other similar medications -- Cialis and Levitra -- are likely to receive U.S. Food and Drug Administration approval, giving men even more options.
However, both Bar-Chama and McCollough warn men against obtaining drugs for treatment of erectile dysfunction without first receiving a physical examination, including important blood tests.
"You should never attempt to treat chronic ED on your own," McCollough says.
In addition, doctors also warn that just because your penis is working fine, it's not a reason to assume your overall health is also fine.
"While ED is often the first and earliest sign of other health problems, it can also be the last and final sign. So don't skip that annual physical and always make a point of discussing your sexual health with your doctor," Bar-Chama says.
More information
To learn more about erectile dysfunction, visit The American
Foundation for Urologic Disease or The National Library of
Medicine.
Source: Colette Bouchez, www.healthcentral.com/news/NewsFullText.cfm?id=513356
Learn About Levitra and Cialis, Newest ED
Oral Drugs Approved for US Sales
Erectile dysfunction, (ED), or impotence, is the inability for a sexually active male to obtain and sustain an erection for intercourse. This usually is an embarrassing subject for many men and their partners, and, in fact, there has been very little diagnostic testing or treatments available until 1973.
ED impacts 30 percent of all adult males and 50 percent of all males over 40 at some times. Some 85 percent of the causes are physical and are organic and due to an actual physical problem, disease entity, or complication of another illness. In general, 40 percent of all 40-year-olds, 50 percent of all 50-year-olds, and 60 percent of all 60-year-olds have some form of ED, on occasion. In general, only 15 percent are of the severe form, that is to say inability to obtain any erections under any circumstances.
Normal erection is the result of many factors working together. It requires good blood flow, normal nerves going to the penis, and good valve mechanisms in the blood vessels of the penis. The penis has two erectile bodies, the corpora caveronsae, which are two long blood filled balloons, that become filled with high pressure blood, and become rigid, and the urethra, which conducts urine.
With the advent of an effective oral and safe medication Viagra (sildenafil) the entire evaluation and treatments for male erectile dysfunction has been revolutionized. Other forms of therapy including self injection programs with vasoactive drugs, intraurethral placement of vasoactive drugs, external vacuum compression device, and implantation of inflatable penile prostheses also are available and have a place in the armamentarium of the urologist who deals in the problems of sexual dysfunction.
With the advent of Viagra in March of 1998 the numbers of impotent patients seen by physicians have increased two-fold, and 50 to 75 percent of the patients respond to Viagra treatment. The remainder will need other treatment modalities, some of which include combinations of other modalities with Viagra.
Any physician can prescribe Viagra; however, the specialists who know the most about ED are those who specialize in the field of male sexual dysfunction. In those cases in which Viagra does not work, where the results are sub-optimal, or in situations in which the cause for the impotence is not obvious, a patient should be seen by a urologic specialist.
Now there is a next generation of drugs. The next generation of Viagra-like drugs, known as PGE-5 inhibitors inhibits the production of a chemical whose job it is to bring blood flow back to normal thereby limiting the duration of an erection.
These new drugs will improve the lifestyle side effect issues associated with Viagra. Some possible improvements include increased potency, effectiveness for up to 100 hours and fewer restrictions on food and fat intake.
Bayer Pharmaceutical Company's new drug, vardenafil, (for drug called Levitra) is now available by prescription from a health care provider. Similarly Lilly-ICOS has an approval letter for their longer-acting drug, tadalafil (for a new ED drug called Cialis). Cialis is due on the marketplace by the end of the year. Both companies have done post-approval studies for the FDA in order to get final approval and acceptance of their new drug applications.
Levitra is more similar to Viagra than Cialis. Levitra is more potent and more specific than Cialis, still having a half-life of four to five hours; however, it appears not to be affected by dietary restrictions (eg.. having a heavy meal before using Viagra reduces its effectiveness). Many patients can respond to Levitra within 15 minutes, rather than usual one hour for Viagra. In the hard-to-treat patients, such as diabetics or post-nerve-sparing radical prostatectomy patients, Levitra appears to have an edge.
Although Levitra has the same half-life as Viagra, its new drug application will probably state an effectiveness up to 24 hours rather than the four to five hours for Viagra. Levitra appears to be six to nine times more potent to the PDE-5 enzyme system with a lower incidence of side effects, a better response for the harder-to-treat patients, and dosages approximately one-fifth of Viagra. Dosages will probably be 5, 10, and 20 mg.
Cialis (tadalafil) is basically a different class of PDE-5 inhibitor in that its half-life ranges from 16 to 22 hours (longer in the older population). Food appears to have no effect, it works rapidly with many patients getting a positive response within 15 minutes of oral intake, and it will probably have therapeutic levels and positive effects up to 100 hours. The entire paradigm of impotence treatment may change with the advent of Cialis. Patients may be able to take two pills per week with effectiveness lasting the entire week without worrying about timing, food, or lifestyle situations. Side effects appear to be lower than in Viagra and about the same as Levitra.
Cialis appears to have the negative of effecting PDE-11 and causing muscle/back discomfort. PDE-11 is found in large quantities in the male testicle, and even though studies have shown no effect on sperm production or function,there is some concern particularly to the fertile male who is interested in a family as to whether or not this drug should be used under those circumstances. The muscle/back discomfort occurs in 4 percent to 7 percent is relatively mild, and is relieved with simple analgesics such as Motrin, Tylenol, etc. Studies do not reveal inflammatory problems or muscle breakdown (rhabdomyolysis) as the source of this pain. Muscle discomfort is found in about 1 percent of patients taking Levitra and rarely found in patients taking Viagra. Interestingly enough the eye problems associated with Viagra are rare in Cialis patients and quite infrequently occur in Levitra patients.
Remember, even though German studies have shown no statistically significant problems with Levitra, Cialis, or Viagra simultaneously used with nitroglycerin, it is potentially dangerous to use any three of these drugs ; all are contraindicated and not to be taken if the patient is on any form of nitroglycerin. The side effects most commonly seen with these PDE-5 inhibitors include headaches, facial flushing, nasal congestion, stomach upset, and visual disturbances (mostly with Viagra). Muscle pain is more common in Cialis, followed by Levitra and rarely in Viagra.
A melanocyte antagonist taken intranasally is being developed by Palatin Corporation.According to Palatin, it's drug, called PT-141 in its testing phase, is a new, nasally administered peptide in development for the treatment of sexual dysfunction. Palatin research suggests that PT-141 works through a mechanism involving the central nervous system rather than directly on the vascular system. As a result, it may offer safety and efficacy benefits over currently available products. Approximately 30 minutes before intercourse, the patient will take a single nasal dose. The is a relatively rapid onset of PT-141 activity.
It appears to affect the periventricular nuclei of the brain inhibiting dopamine synthesis and stimulating sexual function. Preliminary studies show a positive effect of 92% with no significant side effects. Hypothetically. yawning and increased tanning may occur, but has not been found due to the specificity of this particular drug. The intra nasal technique of administration is unique, rapid, not affected by food, and appears to be very effective.
TAP Pharmaceuticals has already been approved in Europe for it's apomorphine drug to stimulate the periventricular nuclei and, in particular, the dopaminergic receptors in the brain. This drug works in approximately 50 percent of the patients, is taken sublingually (under the tongue),but has side effects of nausea, vomiting, blood pressure decrease, and fainting. The problem with the drug is that its side effect profile is significantly high and its impotence-reducing effects are relatively low. There is great question whether this drug will be approved by the United States Food and Drug Administration.
It certainly will have a place as an adjunct with other oral drugs or in those patients who are taking nitroglycerin. On the other hand, several of the major pharmaceutical companies are developing dopaminergic drugs that are specific for the #2 dopaminergic site in the periventricular nucleus of the brain. Basically these are a much more specific and potent apomorphine-like drugs that do not produce the nausea, vomiting, and blood pressure changes that are associated with the #5 dopaminergic site. These drugs appear to have many years left before final development and approval and represent along with the melanocyte antagonist agents the first centro-effective drugs for erectile dysfunction. They may, in fact, have a role in sexual desire in addition to their role in erectile function.
Creams applied to the penis containing Prostaglandin E-1 or nitroglycerin do not appear to be effective. Genetic therapy using viral vectors to transfer DNA and RNA into the body and particularly to the penile cells for ED have already been demonstrated to be effective in animal studies. Research continues in humans and is probably five to ten years away.
At this time that there are many "herbal" or "natural" products available claiming to be for erectile dysfunction and sexual desire. These herbal or natural medications have not been tested according to scientific or FDA standards. Therefore they may be detrimental to your health, may interact poorly with medications you are already taking, and may not be effective as promised. These drugs need not be FDA approved because of the food and drug laws in this country. Natural or herbal does not always mean safe. Many drugs we use today were originally found in plants and most poisons we have today originate from plants. Before taking any herbal medications, consult with your physician about safety and drug interactions.
Erectile dysfunction is a symptom, in most cases, of another medical problem, which may be more serious than your ED. You should always be seen by a qualified physician for evaluation and treatment of your sexual dysfunction.
(June 2003/Reviewed and updated August 2003, November 2003,)
Source: www.hisandherhealth.com/articles/newmaledrugs.shtml
Prevalence Of Erectile Dysfunction
Increases With Age
 |
|
 |
