Erectile dysfunction, or ED, is when it is hard to get or keep an erection that's firm enough for sex. ED affects as many as 30 million men.
Most men have problems with erections from time to time. But when this happens more than half of the time, then ED is present. ED can happen when health problems limit blood flow or damage nerves in the penis. ED can also be caused by stress or emotional reasons. ED can be an early warning of a more serious illness. Heart disease, high blood pressure and high blood sugar can all cause ED. Finding and treating the cause(s) of your ED can help your overall health and well-being.
How Erections Work
When you are not sexually aroused, your penis is soft and limp. During sexual arousal, nerve messages release chemicals that increase blood flow into the penis. The blood flows into 2 erection chambers made of spongy tissue (the corpus cavernosum) in the penis. The "smooth muscle" in the erection chambers relaxes, which lets blood enter and stay in the chambers. The pressure of the blood in the chambers makes the penis firm, giving you an erection. After you have an orgasm, the blood flows out of the chambers and the erection goes away.
Sunday, July 12, 2015
Impotence - Treatment
Treating erectile dysfunction
If you have erectile dysfunction (ED), treatment will depend on what's causing it.
Read on to learn about the different treatments you may be offered.
You can also read a summary of the pros and cons of these treatment options, allowing you to compare your treatment options.
Treating underlying conditions
If your erectile dysfunction is caused by an underlying health condition, such as heart disease or diabetes, that condition may need to be treated first. In some cases, treating the underlying cause may also resolve the problem.
If you are taking medication that can cause erectile dysfunction, there may be an alternative. It is important never to stop taking a prescribed medication unless you are advised to do so by your GP or another qualified healthcare professional responsible for your care.
Lifestyle changes
Erectile dysfunction can often be improved by making changes to your lifestyle, such as:
losing weight if you are overweight
giving up smoking
cutting back your alcohol consumption
not taking illegal drugs
exercising regularly
reducing stress
As well as helping to improve your erectile dysfunction, these changes can also improve your general health and may help to reduce your risk of cardiovascular disease (conditions that affect your heart and blood vessels).
Read more about preventing cardiovascular disease.
Phosphodiesterase-5 (PDE-5) inhibitors
Phosphodiesterase-5 (PDE-5) inhibitors are one of the most widely used and effective types of medication for treating erectile dysfunction. They work by temporarily increasing the blood flow to your penis.
In England, four PDE-5 inhibitors are available for treating erectile dysfunction. They are:
sildenafil – sold under the brand name Viagra
tadalafil – sold under the brand name Cialis
vardenafil – sold under the brand name Levitra
avanafil - sold under the brand name Spedra
Sildenafil, vardenafil and avanafil work for about eight hours and they are designed to work 'on demand'. Tadalafil lasts for up to 36 hours and is more suitable if you require treatment for a longer period of time, for example, over a weekend.
Depending on the type of PDE-5 inhibitor you are taking and the dose, it should take about 30-60 minutes before it starts to work. With sildenafil, vardenafil and avanafil, you should be able to have sex from one to 10 hours after taking the medicine. After taking tadalafil, the effects will last for up to 36 hours.
It may take longer to notice the effects if the tablet is taken with food, so it's best to take it on an empty stomach. You can then eat after an hour without affecting the medicine.
Only take one tablet within a 24-hour period.
Your GP should explain the benefits of each medication and how it works. The choice may depend on:
how often you are sexually active
whether you have tried any of the medications before
There have been many studies to test the effectiveness of these medications. In general, at least two-thirds of men report having improved erections after taking one of these medicines.
If you do not find that PDE-5 inhibitors are effective it may be because:
you have not waited long enough after taking the dose
you have waited too long after taking the dose
the dose is not high enough
you have not had enough sexual stimulation
These medications are triggered by sexual stimulation, so you also need to be aroused for it to work.
Warnings
PDE-5 inhibitors should be used with caution in men who have cardiovascular disease, such as coronary heart disease. However, sexual activity is also likely to be beneficial for your cardiovascular health. You should discuss the risks and benefits with your GP.
PDE-5 inhibitors should also be used with caution in men who have anatomical problems with their penis, such as Peyronie's disease (a condition that affects the tissue of the penis).
PDE-5 inhibitors should also be used with caution in men who:
are at risk of priapism – a painful erection that lasts for several hours
are also taking long lasting alpha-blockers – a medication used to treat a number of conditions, such as high blood pressure (hypertension)
Do not take PDE-5 inhibitors if you are also taking medicines or recreational drugs that contain nitrates. The combination of the two substances can have a dangerous effect on your heart.
Organic nitrates are often used to treat angina, and butyl nitrate is a recreational drug that is more commonly known as 'poppers'.
You are also warned not to take PDE-5 inhibitors if you:
have been advised not to take part in sexual activity or in activities that widen your blood vessels
have low blood pressure (hypotension)
have recently had a stroke – a medical emergency that occurs when the blood supply to the brain is interrupted
have unstable angina – an underlying heart condition that causes symptoms such as chest pain
have had a heart attack – a medical emergency where the blood supply to the heart is suddenly blocked
have a history of non-arteritic anterior ischaemic optic neuropathy – an eye condition that causes a sudden loss of vision
Side effects
PDE-5 inhibitors can cause some side effects, including:
headaches and migraines
flushing (redness)
indigestion
nausea (feeling sick)
vomiting (being sick)
a blocked or runny nose
back pain
vision disturbances
muscle pain
See the medicines information for erectile dysfunction.
NHS prescriptions
Your GP can prescribe sildenafil to anyone with erectile dysfunction as long as it is safe to do so (see warnings above). Other PDE-5 inhibitors may only be prescribed based on your individual circumstances.
In some cases you may need to pay the full cost of the medication. The exact price will depend on the dosage and your local pharmacy but four PDE-5 tablets usually cost between £17 and £30.
Read more about help with prescription costs.
Men with the following medical conditions are entitled to NHS prescriptions for PDE-5 inhibitors:
diabetes
multiple sclerosis
Parkinson’s disease
polio
prostate cancer
spina bifida
certain genetic conditions, such as Huntington's disease
Men who are receiving or have received certain medical treatments may also be entitled to NHS prescriptions for PDE-5 inhibitors. These treatments include:
pelvic surgery – which is often used to remove tumours (growths) or to treat conditions such as incontinence
surgical removal of the prostate gland (prostatectomy) – which is often used to treat prostate cancer
dialysis for kidney failure
kidney transplant
In certain circumstances, some specialist centres may provide an NHS prescription for PDE-5 inhibitors. For example, if ED is causing you severe distress.
Vacuum pumps
A vacuum pump consists of a clear plastic tube that is connected to a pump, which is either hand or battery operated.
You place your penis in the tube and pump out all of the air. This creates a vacuum that causes the blood to fill your penis, making it erect. You then place a rubber ring around the base of your penis to keep the blood in place, allowing you to maintain an erection for around 30 minutes.
It may take several attempts to learn how to use the pump correctly, but they are usually effective. After using a vacuum pump, nine out of 10 men are able to have sex, regardless of the cause of their ED.
Considerations
You should not use a vacuum pump if you have a bleeding disorder or if you are taking anticoagulant medicines, which reduce the ability of your blood to clot.
Side effects of vacuum pumps include pain or bruising, although these occur in less than a third of men.
Men who qualify for NHS prescriptions for erectile dysfunction treatments may be able to get a vacuum pump on the NHS (see above for more details). However, some men will need to buy one.
The Sexual Advice Association produces a number of factsheets, including one on vacuum pumps that provides details of companies that supply them.
Alprostadil
If your erectile dysfunction doesn't respond to treatment, or you are unable or unwilling to use PDE-5 inhibitors or a vacuum pump, you may be given a medicine called alprostadil. This is a synthetic (man-made) hormone that helps to stimulate blood flow to the penis.
Alprostadil is available as:
an injection directly into your penis – this is called an intracavernosal injection a small pellet placed inside your urethra (the tube that carries urine from your bladder to the tip of your penis) – this is called urethral application
You may be trained to correctly inject or insert alprostadil. If your partner is pregnant, use a condom during sex if you are inserting alprostadil into your urethra.
Alprostadil will usually produce an erection after five to 15 minutes. How long the erection lasts will depend on the dose.
In men who did not respond to PDE-5 inhibitors, alprostadil injections were successful in 85 out of 100 men. Alprostadil inserted into the urethra is successful for up to two-thirds of men.
Warnings
Alprostadil should not be used:
in men at risk of priapism (a painful erection that lasts for several hours) – for example, those with sickle cell anaemia
alongside other erectile dysfunction medications
if you have a penile implant or if you have been advised to avoid sexual activity
Urethral application may also not be used in:
some men who have anatomical problems with their penis (conditions that affect the physical structure of the penis) men who have infections of their penis, such as balanitis (inflammation of the head of the penis)
Side effects
Alprostadil can cause some side effects including:
changes in your blood pressure
dizziness
headache
pain in your penis
urethral burning or bleeding
reactions at the site of the injection, such as swelling
See the Alprostadil medicines information for more information about this medicine.
NHS prescriptions
As with PDE-5 inhibitors, NHS prescriptions for alprostadil may only be available for men with particular health conditions or those receiving some types of medical treatments. If you need to pay the full prescription cost, a single injection of alprostadil costs around £8 to £22, depending on the dose. A single dose of alprostadil for urethral application is around £10.
Hormone therapy
If a hormonal condition is causing erectile dysfunction, you may be referred to an endocrinologist (who specialises in the treatment of hormonal conditions).
Hormones are chemicals produced by the body. Many hormonal conditions can be treated using injections of synthetic (man-made) hormones to restore normal hormone levels.
Surgery
Surgery for erectile dysfunction is usually only recommended if all other treatment methods have failed. It may also be considered in:
younger men who have experienced serious injury to their pelvic area – for example, in a car accident
men with a significant anatomical problem with their penis
In the past, surgery was used if there was clear evidence of a blockage to the blood supply of the penis. The surgeon could unblock the blood vessels to restore a normal supply of blood. However, research now suggests that the long-term results of this type of surgery are poor, so it's unlikely to be used.
Penile implants
Penile implants are a type of surgery that may be considered. These can be:
semi-rigid implants – which may be suitable for older men who do not have sex regularly
inflatable implants – which consist of two or three parts that can be inflated to give a more natural erection
Penile implants are not usually available on the NHS and inflatable implants may be very expensive. However, around three-quarters of men report being satisfied with the results of this type of surgery.
Complications
As with all types of surgery, having penile implants inserted carries a risk of infection. If you take preventative antibiotics, the rate of infection is around two or three in 100. Mechanical problems with the implants may occur within five years in five per cent of cases. Psychological treatments
If your erectile dysfunction has an underlying psychological cause then you may benefit from a type of treatment called sensate focus.
If conditions such as anxiety or depression are causing your erectile dysfunction, you may benefit from counselling (a talking therapy). Sensate focus
Sensate focus is a type of sex therapy that you and your partner complete together. It starts with you both agreeing not to have sex for a number of weeks or months. During this time, you can still touch each other, but not in the genital area (or a woman’s breasts). The idea is to explore your bodies knowing that you will not have sex.
After the agreed period of time has passed, you can gradually begin touching each other’s genital areas. You can also begin to use your mouth to touch your partner, for example, licking or kissing, them. This can build up to include penetrative sex.
You can find out more about sensate focus from the College of Sexual and Relationship Therapists (COSRT).
Psychosexual counselling
Psychosexual counselling is a form of relationship therapy where you and your partner can discuss any sexual or emotional issues that may be contributing to your erectile dysfunction. By talking about the issues, you may be able to reduce any anxiety that you have and overcome your erectile dysfunction.
The counsellor can also provide you with some practical advice about sex, such as how to make effective use of other treatments for erectile dysfunction to improve your sex life. For information and advice about sexual arousal, read about good sex.
Psychosexual counselling may take time to work and the results achieved have been mixed.
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy (CBT) is another form of counselling that may be useful if you have erectile dysfunction. CBT is based on the principle that the way you feel is partly dependent on the way you think about things. CBT helps you realise that your problems are often created by your mindset. It is not the situation itself that is making you unhappy, but how you think about it and react to it.v Your CBT therapist can help you to identify any unhelpful or unrealistic thoughts that may be contributing to your erectile dysfunction – for example, to do with:
your self-esteem (the way you feel about yourself)
your sexuality
your personal relationships
Your CBT therapist will be able to help you to adopt more realistic and helpful thoughts about these issues.
Read more about cognitive behavioural therapy.
Pelvic floor muscle exercises
Some studies have suggested that, in a few cases, it may be beneficial to exercise your pelvic floor muscles. These are a group of muscles around the underside of the bladder and rectum, as well as at the base of the penis.
Pelvic floor muscle exercise involves strengthening and training the muscles used to control the anus (back passage) and urinate. If your GP feels this type of exercise could be beneficial, then you may want to discuss it with a physiotherapist to learn it correctly.
By strengthening and training these muscles, you may be able to reduce the symptoms of erectile dysfunction.
Complementary therapies
Some complementary therapies, such as acupuncture, have claimed to treat erectile dysfunction. However, there is little evidence they are useful.
In some cases, they may even include ingredients that could interact with other medications and cause side effects.
Always speak to your GP before using any complementary therapies.
If you have erectile dysfunction (ED), treatment will depend on what's causing it.
Read on to learn about the different treatments you may be offered.
You can also read a summary of the pros and cons of these treatment options, allowing you to compare your treatment options.
Treating underlying conditions
If your erectile dysfunction is caused by an underlying health condition, such as heart disease or diabetes, that condition may need to be treated first. In some cases, treating the underlying cause may also resolve the problem.
If you are taking medication that can cause erectile dysfunction, there may be an alternative. It is important never to stop taking a prescribed medication unless you are advised to do so by your GP or another qualified healthcare professional responsible for your care.
Lifestyle changes
Erectile dysfunction can often be improved by making changes to your lifestyle, such as:
losing weight if you are overweight
giving up smoking
cutting back your alcohol consumption
not taking illegal drugs
exercising regularly
reducing stress
As well as helping to improve your erectile dysfunction, these changes can also improve your general health and may help to reduce your risk of cardiovascular disease (conditions that affect your heart and blood vessels).
Read more about preventing cardiovascular disease.
Phosphodiesterase-5 (PDE-5) inhibitors
Phosphodiesterase-5 (PDE-5) inhibitors are one of the most widely used and effective types of medication for treating erectile dysfunction. They work by temporarily increasing the blood flow to your penis.
In England, four PDE-5 inhibitors are available for treating erectile dysfunction. They are:
sildenafil – sold under the brand name Viagra
tadalafil – sold under the brand name Cialis
vardenafil – sold under the brand name Levitra
avanafil - sold under the brand name Spedra
Sildenafil, vardenafil and avanafil work for about eight hours and they are designed to work 'on demand'. Tadalafil lasts for up to 36 hours and is more suitable if you require treatment for a longer period of time, for example, over a weekend.
Depending on the type of PDE-5 inhibitor you are taking and the dose, it should take about 30-60 minutes before it starts to work. With sildenafil, vardenafil and avanafil, you should be able to have sex from one to 10 hours after taking the medicine. After taking tadalafil, the effects will last for up to 36 hours.
It may take longer to notice the effects if the tablet is taken with food, so it's best to take it on an empty stomach. You can then eat after an hour without affecting the medicine.
Only take one tablet within a 24-hour period.
Your GP should explain the benefits of each medication and how it works. The choice may depend on:
how often you are sexually active
whether you have tried any of the medications before
There have been many studies to test the effectiveness of these medications. In general, at least two-thirds of men report having improved erections after taking one of these medicines.
If you do not find that PDE-5 inhibitors are effective it may be because:
you have not waited long enough after taking the dose
you have waited too long after taking the dose
the dose is not high enough
you have not had enough sexual stimulation
These medications are triggered by sexual stimulation, so you also need to be aroused for it to work.
Warnings
PDE-5 inhibitors should be used with caution in men who have cardiovascular disease, such as coronary heart disease. However, sexual activity is also likely to be beneficial for your cardiovascular health. You should discuss the risks and benefits with your GP.
PDE-5 inhibitors should also be used with caution in men who have anatomical problems with their penis, such as Peyronie's disease (a condition that affects the tissue of the penis).
PDE-5 inhibitors should also be used with caution in men who:
are at risk of priapism – a painful erection that lasts for several hours
are also taking long lasting alpha-blockers – a medication used to treat a number of conditions, such as high blood pressure (hypertension)
Do not take PDE-5 inhibitors if you are also taking medicines or recreational drugs that contain nitrates. The combination of the two substances can have a dangerous effect on your heart.
Organic nitrates are often used to treat angina, and butyl nitrate is a recreational drug that is more commonly known as 'poppers'.
You are also warned not to take PDE-5 inhibitors if you:
have been advised not to take part in sexual activity or in activities that widen your blood vessels
have low blood pressure (hypotension)
have recently had a stroke – a medical emergency that occurs when the blood supply to the brain is interrupted
have unstable angina – an underlying heart condition that causes symptoms such as chest pain
have had a heart attack – a medical emergency where the blood supply to the heart is suddenly blocked
have a history of non-arteritic anterior ischaemic optic neuropathy – an eye condition that causes a sudden loss of vision
Side effects
PDE-5 inhibitors can cause some side effects, including:
headaches and migraines
flushing (redness)
indigestion
nausea (feeling sick)
vomiting (being sick)
a blocked or runny nose
back pain
vision disturbances
muscle pain
See the medicines information for erectile dysfunction.
NHS prescriptions
Your GP can prescribe sildenafil to anyone with erectile dysfunction as long as it is safe to do so (see warnings above). Other PDE-5 inhibitors may only be prescribed based on your individual circumstances.
In some cases you may need to pay the full cost of the medication. The exact price will depend on the dosage and your local pharmacy but four PDE-5 tablets usually cost between £17 and £30.
Read more about help with prescription costs.
Men with the following medical conditions are entitled to NHS prescriptions for PDE-5 inhibitors:
diabetes
multiple sclerosis
Parkinson’s disease
polio
prostate cancer
spina bifida
certain genetic conditions, such as Huntington's disease
Men who are receiving or have received certain medical treatments may also be entitled to NHS prescriptions for PDE-5 inhibitors. These treatments include:
pelvic surgery – which is often used to remove tumours (growths) or to treat conditions such as incontinence
surgical removal of the prostate gland (prostatectomy) – which is often used to treat prostate cancer
dialysis for kidney failure
kidney transplant
In certain circumstances, some specialist centres may provide an NHS prescription for PDE-5 inhibitors. For example, if ED is causing you severe distress.
Vacuum pumps
A vacuum pump consists of a clear plastic tube that is connected to a pump, which is either hand or battery operated.
You place your penis in the tube and pump out all of the air. This creates a vacuum that causes the blood to fill your penis, making it erect. You then place a rubber ring around the base of your penis to keep the blood in place, allowing you to maintain an erection for around 30 minutes.
It may take several attempts to learn how to use the pump correctly, but they are usually effective. After using a vacuum pump, nine out of 10 men are able to have sex, regardless of the cause of their ED.
Considerations
You should not use a vacuum pump if you have a bleeding disorder or if you are taking anticoagulant medicines, which reduce the ability of your blood to clot.
Side effects of vacuum pumps include pain or bruising, although these occur in less than a third of men.
Men who qualify for NHS prescriptions for erectile dysfunction treatments may be able to get a vacuum pump on the NHS (see above for more details). However, some men will need to buy one.
The Sexual Advice Association produces a number of factsheets, including one on vacuum pumps that provides details of companies that supply them.
Alprostadil
If your erectile dysfunction doesn't respond to treatment, or you are unable or unwilling to use PDE-5 inhibitors or a vacuum pump, you may be given a medicine called alprostadil. This is a synthetic (man-made) hormone that helps to stimulate blood flow to the penis.
Alprostadil is available as:
an injection directly into your penis – this is called an intracavernosal injection a small pellet placed inside your urethra (the tube that carries urine from your bladder to the tip of your penis) – this is called urethral application
You may be trained to correctly inject or insert alprostadil. If your partner is pregnant, use a condom during sex if you are inserting alprostadil into your urethra.
Alprostadil will usually produce an erection after five to 15 minutes. How long the erection lasts will depend on the dose.
In men who did not respond to PDE-5 inhibitors, alprostadil injections were successful in 85 out of 100 men. Alprostadil inserted into the urethra is successful for up to two-thirds of men.
Warnings
Alprostadil should not be used:
in men at risk of priapism (a painful erection that lasts for several hours) – for example, those with sickle cell anaemia
alongside other erectile dysfunction medications
if you have a penile implant or if you have been advised to avoid sexual activity
Urethral application may also not be used in:
some men who have anatomical problems with their penis (conditions that affect the physical structure of the penis) men who have infections of their penis, such as balanitis (inflammation of the head of the penis)
Side effects
Alprostadil can cause some side effects including:
changes in your blood pressure
dizziness
headache
pain in your penis
urethral burning or bleeding
reactions at the site of the injection, such as swelling
See the Alprostadil medicines information for more information about this medicine.
NHS prescriptions
As with PDE-5 inhibitors, NHS prescriptions for alprostadil may only be available for men with particular health conditions or those receiving some types of medical treatments. If you need to pay the full prescription cost, a single injection of alprostadil costs around £8 to £22, depending on the dose. A single dose of alprostadil for urethral application is around £10.
Hormone therapy
If a hormonal condition is causing erectile dysfunction, you may be referred to an endocrinologist (who specialises in the treatment of hormonal conditions).
Hormones are chemicals produced by the body. Many hormonal conditions can be treated using injections of synthetic (man-made) hormones to restore normal hormone levels.
Surgery
Surgery for erectile dysfunction is usually only recommended if all other treatment methods have failed. It may also be considered in:
younger men who have experienced serious injury to their pelvic area – for example, in a car accident
men with a significant anatomical problem with their penis
In the past, surgery was used if there was clear evidence of a blockage to the blood supply of the penis. The surgeon could unblock the blood vessels to restore a normal supply of blood. However, research now suggests that the long-term results of this type of surgery are poor, so it's unlikely to be used.
Penile implants
Penile implants are a type of surgery that may be considered. These can be:
semi-rigid implants – which may be suitable for older men who do not have sex regularly
inflatable implants – which consist of two or three parts that can be inflated to give a more natural erection
Penile implants are not usually available on the NHS and inflatable implants may be very expensive. However, around three-quarters of men report being satisfied with the results of this type of surgery.
Complications
As with all types of surgery, having penile implants inserted carries a risk of infection. If you take preventative antibiotics, the rate of infection is around two or three in 100. Mechanical problems with the implants may occur within five years in five per cent of cases. Psychological treatments
If your erectile dysfunction has an underlying psychological cause then you may benefit from a type of treatment called sensate focus.
If conditions such as anxiety or depression are causing your erectile dysfunction, you may benefit from counselling (a talking therapy). Sensate focus
Sensate focus is a type of sex therapy that you and your partner complete together. It starts with you both agreeing not to have sex for a number of weeks or months. During this time, you can still touch each other, but not in the genital area (or a woman’s breasts). The idea is to explore your bodies knowing that you will not have sex.
After the agreed period of time has passed, you can gradually begin touching each other’s genital areas. You can also begin to use your mouth to touch your partner, for example, licking or kissing, them. This can build up to include penetrative sex.
You can find out more about sensate focus from the College of Sexual and Relationship Therapists (COSRT).
Psychosexual counselling
Psychosexual counselling is a form of relationship therapy where you and your partner can discuss any sexual or emotional issues that may be contributing to your erectile dysfunction. By talking about the issues, you may be able to reduce any anxiety that you have and overcome your erectile dysfunction.
The counsellor can also provide you with some practical advice about sex, such as how to make effective use of other treatments for erectile dysfunction to improve your sex life. For information and advice about sexual arousal, read about good sex.
Psychosexual counselling may take time to work and the results achieved have been mixed.
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy (CBT) is another form of counselling that may be useful if you have erectile dysfunction. CBT is based on the principle that the way you feel is partly dependent on the way you think about things. CBT helps you realise that your problems are often created by your mindset. It is not the situation itself that is making you unhappy, but how you think about it and react to it.v Your CBT therapist can help you to identify any unhelpful or unrealistic thoughts that may be contributing to your erectile dysfunction – for example, to do with:
your self-esteem (the way you feel about yourself)
your sexuality
your personal relationships
Your CBT therapist will be able to help you to adopt more realistic and helpful thoughts about these issues.
Read more about cognitive behavioural therapy.
Pelvic floor muscle exercises
Some studies have suggested that, in a few cases, it may be beneficial to exercise your pelvic floor muscles. These are a group of muscles around the underside of the bladder and rectum, as well as at the base of the penis.
Pelvic floor muscle exercise involves strengthening and training the muscles used to control the anus (back passage) and urinate. If your GP feels this type of exercise could be beneficial, then you may want to discuss it with a physiotherapist to learn it correctly.
By strengthening and training these muscles, you may be able to reduce the symptoms of erectile dysfunction.
Complementary therapies
Some complementary therapies, such as acupuncture, have claimed to treat erectile dysfunction. However, there is little evidence they are useful.
In some cases, they may even include ingredients that could interact with other medications and cause side effects.
Always speak to your GP before using any complementary therapies.
6 Ways To Naturally Overcome Impotence
Men can judge themselves pretty harshly when it comes to their performance in between the sheets. The unsettling fear of not being able to rise to the occasion becomes a reccurring nightmare for men that is often equated with failure, loss of dignity, and masculinity. If you suffer from erectile dysfunction (ED), don’t be so hard on yourself, since impotence can almost always be improved with treatment, without having to rely on Viagra or other medications. Whether you suffer from ED, or hope to prevent the condition, here are six tips to overcome impotence without the side effects of the little blue pill.
1. Walk 2 Miles in Your Own Shoes
When it comes to boosting sexual performance, many men will walk all over God’s green earth looking for ways to maintain a good sex life. Luckily men, all you have to do is walk — not run — 2 miles a day. This, along with other healthier lifestyle interventions can help obese men reduce their risk of ED, or even “reverse” current impotence, according to a 2005 study. This comes of importance, since maintaining a trim waistline is a good defense for ED, as men with a 42-inch waist are 50 percent more likely to have ED than those with a 32-inch waist. Getting to a healthy weight and maintaining it is a good strategy for preventing and treating ED.
2. Move Your Nether Regions
The phrase “use it before you lose it” can be applied when it comes to helping men with ED regain normal erectile function. Pelvic exercises, more commonly known as kegel exercises, are used to promote urinary continence and sexual health. They help to strengthen the bulbocavernosus muscle, which does three things: allows the penis to engorge with blood during erection, it pumps during ejaculation, and it helps empty the urethra after urination, according to Healthline.
In a 2005 study, three months of twice-daily sets of kegel exercises combined with biofeedback and advice on lifestyle changes, such as quitting smoking, losing weight, and limiting alcohol, worked far better than just giving the participants advice. “Wearing tight pants will affect impotence along with some other medical conditions like diabetes and heart disease,” which can also affect a man’s degree of impotence, Dr. Jennifer Burns, specializing in family practice with an emphasis on gastrointestinal health at the BienEtre Center, told Medical Daily.
3. Get Needled
The art of acupuncture has become the new treatment for everything from back pain, depression, and even ED. Impotence could be more of a state of mind, and acupuncture may help. Through this alternative therapy, fine needles are placed in various parts of the body to relieve pain or stress. Although there are many mixed studies for acupuncture and ED, many tend to confirm positive results. A 1999 study found acupuncture improved the quality of erection and even restored sexual activity in 39 percent of participants.
4. Take Some 'Herbal Viagra'
Ginseng, specifically “red ginseng,” is known as the “herbal Viagra” that helps puts to rest men’s bedroom woes. Red ginseng is when the root has been steamed and then dried. The ginseng root is the part of the plant that is mostly used as a natural remedy when in its supplement form. However, the plant must be grown for a minimum of five years before it can be used. In a 2008 review, seven studies on red ginseng and ED, ranging in dosages from 600 to 1,000 milligrams three times a day, were found to provide evidence for the effectiveness of the herb in ED treatment.
5. Take This Amino Acid Found in Your Body
L-arginine, an amino acid that is naturally present in the body and helps make nitric oxide, supports a successful erection. Nitric oxide is responsible for making the blood vessels relax, which helps sustain an erection for men. A 1999 study, observed the effects of six weeks of high-dose (5 grams/day) orally administered nitric oxide (NO) donor L-arginine on men with organic ED. Thirty-one percent of those who took 5 grams/day of L-arginine experienced significant improvements in sexual function. Burns told Medical Daily, “l-arginine and deer antler velvet” have been the most popular go-to natural treatments for men.
6. Drink Watermelon Juice
A cold slice of watermelon can do more than just satisfy thirst and hunger during the warm summer months; it can help with bedroom satisfaction. Citrulline, the amino acid found in high concentrations of watermelon, is found to improve blood flow to the penis. A 2011 study revealed men who suffered from mild to moderate ED and took L-citrulline supplementation showed an improvement with their erectile function and were very satisfied. Natural watermelon juice, or “nature’s Viagra,” can also be easier on the stomach, since taking pills like Viagra can cause nausea and diarrhea.
Burns cautions men and says, “Not all natural treatments are a safe alternative to Viagra. Like with everything herbs have side effects just like drugs do. Depending on the person there might be drug-herb interaction and sometimes people overdose thinking more is better.”
These six natural ED treatments could potentially help to prevent and fix impotence in men, but it’s always best to check with your doctor first to see if these are safe for you.
1. Walk 2 Miles in Your Own Shoes
When it comes to boosting sexual performance, many men will walk all over God’s green earth looking for ways to maintain a good sex life. Luckily men, all you have to do is walk — not run — 2 miles a day. This, along with other healthier lifestyle interventions can help obese men reduce their risk of ED, or even “reverse” current impotence, according to a 2005 study. This comes of importance, since maintaining a trim waistline is a good defense for ED, as men with a 42-inch waist are 50 percent more likely to have ED than those with a 32-inch waist. Getting to a healthy weight and maintaining it is a good strategy for preventing and treating ED.
2. Move Your Nether Regions
The phrase “use it before you lose it” can be applied when it comes to helping men with ED regain normal erectile function. Pelvic exercises, more commonly known as kegel exercises, are used to promote urinary continence and sexual health. They help to strengthen the bulbocavernosus muscle, which does three things: allows the penis to engorge with blood during erection, it pumps during ejaculation, and it helps empty the urethra after urination, according to Healthline.
In a 2005 study, three months of twice-daily sets of kegel exercises combined with biofeedback and advice on lifestyle changes, such as quitting smoking, losing weight, and limiting alcohol, worked far better than just giving the participants advice. “Wearing tight pants will affect impotence along with some other medical conditions like diabetes and heart disease,” which can also affect a man’s degree of impotence, Dr. Jennifer Burns, specializing in family practice with an emphasis on gastrointestinal health at the BienEtre Center, told Medical Daily.
3. Get Needled
The art of acupuncture has become the new treatment for everything from back pain, depression, and even ED. Impotence could be more of a state of mind, and acupuncture may help. Through this alternative therapy, fine needles are placed in various parts of the body to relieve pain or stress. Although there are many mixed studies for acupuncture and ED, many tend to confirm positive results. A 1999 study found acupuncture improved the quality of erection and even restored sexual activity in 39 percent of participants.
4. Take Some 'Herbal Viagra'
Ginseng, specifically “red ginseng,” is known as the “herbal Viagra” that helps puts to rest men’s bedroom woes. Red ginseng is when the root has been steamed and then dried. The ginseng root is the part of the plant that is mostly used as a natural remedy when in its supplement form. However, the plant must be grown for a minimum of five years before it can be used. In a 2008 review, seven studies on red ginseng and ED, ranging in dosages from 600 to 1,000 milligrams three times a day, were found to provide evidence for the effectiveness of the herb in ED treatment.
5. Take This Amino Acid Found in Your Body
L-arginine, an amino acid that is naturally present in the body and helps make nitric oxide, supports a successful erection. Nitric oxide is responsible for making the blood vessels relax, which helps sustain an erection for men. A 1999 study, observed the effects of six weeks of high-dose (5 grams/day) orally administered nitric oxide (NO) donor L-arginine on men with organic ED. Thirty-one percent of those who took 5 grams/day of L-arginine experienced significant improvements in sexual function. Burns told Medical Daily, “l-arginine and deer antler velvet” have been the most popular go-to natural treatments for men.
6. Drink Watermelon Juice
A cold slice of watermelon can do more than just satisfy thirst and hunger during the warm summer months; it can help with bedroom satisfaction. Citrulline, the amino acid found in high concentrations of watermelon, is found to improve blood flow to the penis. A 2011 study revealed men who suffered from mild to moderate ED and took L-citrulline supplementation showed an improvement with their erectile function and were very satisfied. Natural watermelon juice, or “nature’s Viagra,” can also be easier on the stomach, since taking pills like Viagra can cause nausea and diarrhea.
Burns cautions men and says, “Not all natural treatments are a safe alternative to Viagra. Like with everything herbs have side effects just like drugs do. Depending on the person there might be drug-herb interaction and sometimes people overdose thinking more is better.”
These six natural ED treatments could potentially help to prevent and fix impotence in men, but it’s always best to check with your doctor first to see if these are safe for you.
Saturday, July 11, 2015
Natural Remedies for Erectile Dysfunction
Erectile dysfunction, formerly called impotence, is the inability to obtain an adequate erection for satisfactory sexual activity. Research suggests that 50% of men have ED. It's more common in men over age 50, but it can occur at any age.
Remedies for Erectile Dysfunction:
So far, scientific support for the claim that any remedy can safely treat erectile dysfunction is fairly lacking. If you're considering the use of any remedy, it's important to consult your physician first and avoid self-treating with alternative medicine.
Here are ten natural remedies to consider:
1) L-Arginine
L-arginine is an amino acid that increases nitric oxide levels in the body. Nitric oxide is a molecule that signals smooth muscle surrounding blood vessels (including those in the penis) to relax, which dilates blood vessels and increases blood flow – a necessity for maintaining erections.
Found naturally in protein foods such as meat, chicken, fish, walnuts and peas, L-arginine is also a fairly popular supplement for sports concerns and bodybuilding as it is used for protein synthesis in the body.
There have only been two studies evaluating the effectiveness of L-arginine for ED. One small study published in the British Journal of Urology International found that L-arginine supplementation (5g daily) was not beneficial for men with ED, however there was improvement in the subset of men who had low urinary nitrate and nitrite levels (markers for nitric oxide levels in the body). Further research is needed -- it may be that L-arginine is effective for this subset of men with ED.
The second study used a smaller dose of L-arginine, 500mg daily, and shorter treatment duration of 17 days and found no benefit.
Several studies have used a combination supplement that includes L-arginine. In one study, a combination of L-arginine, glutamate and yohimbine was used and in another, a combination supplement including L-arginine, carnitine, acetyl carnitine and ginseng was used. Although there were improvements, the effect of L-arginine isn't clear because the studies used combination products.
Find out more about using L-Arginine.
2) Red Korean Ginseng
Red Korean ginseng is Panax ginseng, generally from Korea, that has been prepared in a special way by steaming followed by drying. In herbal medicine, this type of ginseng is used to stimulate sexual function and boost energy more so than “cooler” types of ginseng such as white or North American ginseng. It is also different from Asian ginseng due to its preparation.
Red Korean ginseng may boost blood flow to the penis. Although study quality has generally been low, human trials suggest that red ginseng may improve erection quality in men with ED. Studies have typically used three divided doses daily providing a daily total of between 1.8g and 3g ginseng per day.
3) Zinc
Zinc is a mineral involved in regulating many enzymes and hormones. It is found in a wide variety of foods such as red meat, poultry, oysters, beans, and fortified cereal. Low levels of zinc have been associated with sexual dysfunction. Certain medical conditions and medications put people at risk of zinc deficiency and may lead to sexual dysfunction. These conditions include digestive disorders (such as ulcerative colitis, Crohn’s disease, short bowel syndrome), chronic liver or kidney disease, sickle cell disease, diabetes, cancer, alcoholism, and chronic diarrhea. People on a vegetarian diet are more susceptible because of reduced bioavailability of zinc and also because of greater intake of phytates from legumes and whole grains, which bind zinc and inhibit its absorption.
Zinc deficiency has been associated with reduced serum testosterone levels. Mild zinc deficiency is often overlooked because symptoms, such as impaired immune function, weight loss, hair loss, altered sense of taste and smell, and reduced appetite, can be overlooked. Zinc supplementation appears to increase serum testosterone, dihydrotestosterone, and insulin-like growth factor-I levels in human studies. It appears to only raise testosterone levels in people who are deficient in zinc.
4) L-Carnitine
L-carnitine is a compound involved in energy metabolism in the body. It is produced naturally in the body but it is also found in food, particularly in animal products, and in supplement form. Although there are various forms of carnitine supplements, propionyl L-carnitine has been used for blood flow issues and has been explored for erectile dysfunction.
Two forms of L-carnitine (propionyl-L-carnitine and acetyl-L-carnitine) may benefit men with erectile dysfunction according to a study published in Urology. The study compared testosterone undecanoate, L-carnitine and placebo in the treatment of male aging symptoms, including erectile dysfunction. Testosterone and the carnitines significantly improved symptoms.
Another study published in Current Medical Research and Opinion examined the effectiveness of propionyl-L-carnitine supplements plus sildenafil (Viagra) in men with erectile dysfunction and diabetes who were previously unresponsive to Viagra alone. After 24 weeks of treatment with propionyl-L-carnitine (2g daily) plus Viagra (50mg twice weekly) or Viagra alone, therapy with propionyl-L-carnitine plus Viagra was more effective than Viagra alone. Further research is needed, as the effect of L-carnitine isn’t clear when it is given as a combination treatment.
5) Niacin
According to a study published in the Journal of Sexual Medicine, niacin, or vitamin B3 – found in chicken, fish and grains — may help men with erectile dysfunction if they also have high cholesterol. The results indicate that the men in the study, who had moderate or severe erectile dysfunction, reported an improvement in their ability to maintain an erection after taking a niacin supplement for 12 weeks. The initial dose was 500mg niacin taken nightly to ensure that they had no adverse side effects from taking the vitamin. The dose was increased to 1000mg daily and then to 1500mg at week six, if tolerated, and then continued until the end of the study. The most common side effect was skin flushing and itching. Further studies are warranted.
Read more about Niacin.
6) Muira Puama
Used historically as a folk remedy in Brazil for erectile dysfunction, joint pain and digestive complaints, muira puama is a flowering bush or tree native to the Brazilian Amazon. It is now mainly used as a treatment for erectile dysfunction and as a male aphrodisiac.
Three preliminary case-series (by the same author) suggest that it may be effective, but well-designed studies on the effectiveness and safety of muira puama are lacking.
Read more about Muira Puama
7) Cure Gum Disease to Treat ED
Bad breath, bright red, swollen or tender gums are all signs of periodontal disease, also known as gum disease. Gum disease can trigger inflammation that can result in erectile dysfunction. According to one study, 53% of men with ED had chronic periodontitis compared to 23% of men without it. Men who treated their periodontal disease had significantly improved erectile dysfunction after three months. Professional cleaning and dental treatment and daily brushing and flossing is recommended for gum disease. Natural remedies for gum disease may also help.
8) Weight Loss and ED
Excess body fat appears to be involved in erectile dysfunction, by promoting inflammation and converting testosterone to estrogen. According to one study, one-third of obese men with erectile dysfunction regained sexual function after participating in a two-year weight loss program.
Regular exercise appears to reduce the risk of erectile dysfunction. Research shows that men who exercise more in midlife have a 70% lower risk of erectile dysfunction compared to sedentary men.
9) ED and Heart Disease
ED may be a sign of heart disease. Men with Ed are more likely to have heart disease and diabetes. Diuretics and alpha blockers for high blood pressure may worsen ED; angiotensin receptor blockers may improve it. 10) Low Testosterone and ED
Men in midlife who have ED accompanied by low libido may have testosterone deficiency. Testosterone products should only be used under a doctor’s guidance, as it’s important to monitor one’s testosterone levels. Too much and the body’s own production of testosterone declines. A Note About Yohimbe
Found naturally in the bark of the west African yohimbe tree, yohimbine is a herbal supplement that was used as a folk remedy for ED. However the bark extract often contains very low concentrations of yohimbine. More importantly, yohimbine has the potential for serious side effects and drug interactions, even at small doses. Common side effects include a drastic changes in blood pressure, heart arrhythmias, respiratory depression, heart attach and death. The United States’ Food and Drug Administration has deemed yohimbe extract unsafe for over-the-counter sale.
There is a prescription drug available in the United States, yohimbine hydrochloride, that is a standardized form. A meta-analysis of seven clinical trials of the yohimbine drug demonstrated that yohimbine hydrochloride was more effective than a placebo in the treatment of erectile dysfunction. It is thought to enhance blood flow to the penis.
Remedies for Erectile Dysfunction:
So far, scientific support for the claim that any remedy can safely treat erectile dysfunction is fairly lacking. If you're considering the use of any remedy, it's important to consult your physician first and avoid self-treating with alternative medicine.
Here are ten natural remedies to consider:
1) L-Arginine
L-arginine is an amino acid that increases nitric oxide levels in the body. Nitric oxide is a molecule that signals smooth muscle surrounding blood vessels (including those in the penis) to relax, which dilates blood vessels and increases blood flow – a necessity for maintaining erections.
Found naturally in protein foods such as meat, chicken, fish, walnuts and peas, L-arginine is also a fairly popular supplement for sports concerns and bodybuilding as it is used for protein synthesis in the body.
There have only been two studies evaluating the effectiveness of L-arginine for ED. One small study published in the British Journal of Urology International found that L-arginine supplementation (5g daily) was not beneficial for men with ED, however there was improvement in the subset of men who had low urinary nitrate and nitrite levels (markers for nitric oxide levels in the body). Further research is needed -- it may be that L-arginine is effective for this subset of men with ED.
The second study used a smaller dose of L-arginine, 500mg daily, and shorter treatment duration of 17 days and found no benefit.
Several studies have used a combination supplement that includes L-arginine. In one study, a combination of L-arginine, glutamate and yohimbine was used and in another, a combination supplement including L-arginine, carnitine, acetyl carnitine and ginseng was used. Although there were improvements, the effect of L-arginine isn't clear because the studies used combination products.
Find out more about using L-Arginine.
2) Red Korean Ginseng
Red Korean ginseng is Panax ginseng, generally from Korea, that has been prepared in a special way by steaming followed by drying. In herbal medicine, this type of ginseng is used to stimulate sexual function and boost energy more so than “cooler” types of ginseng such as white or North American ginseng. It is also different from Asian ginseng due to its preparation.
Red Korean ginseng may boost blood flow to the penis. Although study quality has generally been low, human trials suggest that red ginseng may improve erection quality in men with ED. Studies have typically used three divided doses daily providing a daily total of between 1.8g and 3g ginseng per day.
3) Zinc
Zinc is a mineral involved in regulating many enzymes and hormones. It is found in a wide variety of foods such as red meat, poultry, oysters, beans, and fortified cereal. Low levels of zinc have been associated with sexual dysfunction. Certain medical conditions and medications put people at risk of zinc deficiency and may lead to sexual dysfunction. These conditions include digestive disorders (such as ulcerative colitis, Crohn’s disease, short bowel syndrome), chronic liver or kidney disease, sickle cell disease, diabetes, cancer, alcoholism, and chronic diarrhea. People on a vegetarian diet are more susceptible because of reduced bioavailability of zinc and also because of greater intake of phytates from legumes and whole grains, which bind zinc and inhibit its absorption.
Zinc deficiency has been associated with reduced serum testosterone levels. Mild zinc deficiency is often overlooked because symptoms, such as impaired immune function, weight loss, hair loss, altered sense of taste and smell, and reduced appetite, can be overlooked. Zinc supplementation appears to increase serum testosterone, dihydrotestosterone, and insulin-like growth factor-I levels in human studies. It appears to only raise testosterone levels in people who are deficient in zinc.
4) L-Carnitine
L-carnitine is a compound involved in energy metabolism in the body. It is produced naturally in the body but it is also found in food, particularly in animal products, and in supplement form. Although there are various forms of carnitine supplements, propionyl L-carnitine has been used for blood flow issues and has been explored for erectile dysfunction.
Two forms of L-carnitine (propionyl-L-carnitine and acetyl-L-carnitine) may benefit men with erectile dysfunction according to a study published in Urology. The study compared testosterone undecanoate, L-carnitine and placebo in the treatment of male aging symptoms, including erectile dysfunction. Testosterone and the carnitines significantly improved symptoms.
Another study published in Current Medical Research and Opinion examined the effectiveness of propionyl-L-carnitine supplements plus sildenafil (Viagra) in men with erectile dysfunction and diabetes who were previously unresponsive to Viagra alone. After 24 weeks of treatment with propionyl-L-carnitine (2g daily) plus Viagra (50mg twice weekly) or Viagra alone, therapy with propionyl-L-carnitine plus Viagra was more effective than Viagra alone. Further research is needed, as the effect of L-carnitine isn’t clear when it is given as a combination treatment.
5) Niacin
According to a study published in the Journal of Sexual Medicine, niacin, or vitamin B3 – found in chicken, fish and grains — may help men with erectile dysfunction if they also have high cholesterol. The results indicate that the men in the study, who had moderate or severe erectile dysfunction, reported an improvement in their ability to maintain an erection after taking a niacin supplement for 12 weeks. The initial dose was 500mg niacin taken nightly to ensure that they had no adverse side effects from taking the vitamin. The dose was increased to 1000mg daily and then to 1500mg at week six, if tolerated, and then continued until the end of the study. The most common side effect was skin flushing and itching. Further studies are warranted.
Read more about Niacin.
6) Muira Puama
Used historically as a folk remedy in Brazil for erectile dysfunction, joint pain and digestive complaints, muira puama is a flowering bush or tree native to the Brazilian Amazon. It is now mainly used as a treatment for erectile dysfunction and as a male aphrodisiac.
Three preliminary case-series (by the same author) suggest that it may be effective, but well-designed studies on the effectiveness and safety of muira puama are lacking.
Read more about Muira Puama
7) Cure Gum Disease to Treat ED
Bad breath, bright red, swollen or tender gums are all signs of periodontal disease, also known as gum disease. Gum disease can trigger inflammation that can result in erectile dysfunction. According to one study, 53% of men with ED had chronic periodontitis compared to 23% of men without it. Men who treated their periodontal disease had significantly improved erectile dysfunction after three months. Professional cleaning and dental treatment and daily brushing and flossing is recommended for gum disease. Natural remedies for gum disease may also help.
8) Weight Loss and ED
Excess body fat appears to be involved in erectile dysfunction, by promoting inflammation and converting testosterone to estrogen. According to one study, one-third of obese men with erectile dysfunction regained sexual function after participating in a two-year weight loss program.
Regular exercise appears to reduce the risk of erectile dysfunction. Research shows that men who exercise more in midlife have a 70% lower risk of erectile dysfunction compared to sedentary men.
9) ED and Heart Disease
ED may be a sign of heart disease. Men with Ed are more likely to have heart disease and diabetes. Diuretics and alpha blockers for high blood pressure may worsen ED; angiotensin receptor blockers may improve it. 10) Low Testosterone and ED
Men in midlife who have ED accompanied by low libido may have testosterone deficiency. Testosterone products should only be used under a doctor’s guidance, as it’s important to monitor one’s testosterone levels. Too much and the body’s own production of testosterone declines. A Note About Yohimbe
Found naturally in the bark of the west African yohimbe tree, yohimbine is a herbal supplement that was used as a folk remedy for ED. However the bark extract often contains very low concentrations of yohimbine. More importantly, yohimbine has the potential for serious side effects and drug interactions, even at small doses. Common side effects include a drastic changes in blood pressure, heart arrhythmias, respiratory depression, heart attach and death. The United States’ Food and Drug Administration has deemed yohimbe extract unsafe for over-the-counter sale.
There is a prescription drug available in the United States, yohimbine hydrochloride, that is a standardized form. A meta-analysis of seven clinical trials of the yohimbine drug demonstrated that yohimbine hydrochloride was more effective than a placebo in the treatment of erectile dysfunction. It is thought to enhance blood flow to the penis.
Friday, July 10, 2015
Levitra vs Viagra
A new pill for erectile dysfunction will be on the market in September. The new pill is called Levitra. Levitra's makers say a major plus is that it works quickly. In clinical trials, some men using Levitra achieved an erection in 16 minutes. Viagra's maker has responded with studies showing half of men taking Viagra were able to have sex within 20 minutes.
Comment: No denying that 4 minutes is 4 minutes.
Erectile dysfunction affects millions of men in the United States. Levitra acts by relaxing muscles in the penis and blood vessels, allowing increased blood flow into the penis, which produces an erection.
Levitra was evaluated in randomized, placebo-controlled trials involving more than 2000 men with erectile dysfunction. In two of the trials men had erectile dysfunction associated with diabetes mellitus or following radical prostatectomy for prostate cancer.
The drug's effectiveness was assessed using a sexual function questionnaire. In addition, patients were asked to report if they were able to achieve an erection adequate for intercourse and whether the erection was maintained to allow completion of intercourse. In all of the trials, Levitra improved patients' ability to achieve and maintain a penile erection.
The recommended dose is 10 mg taken 1 hour before sexual activity. A higher dose of 20 mg is available for patients whose response to the 10 mg dose is not adequate. Two lower doses (2.5 mg and 5.0 mg) are also available and may be necessary for patients taking other medicines or having medical conditions that may decrease the body's ability to metabolize vardenafil (Levitra). Levitra should not be used more than once a day.
Levitra should not be used with nitrates (such as nitroglycerin tablets or patches) or with alpha-blockers (medicines that may be used to treat benign prostatic hyperplasia and/or high blood pressure such as tamsulosin, terazosin, doxazosin, and alfuzosin) because the combination of an alpha-blocker with Levitra may significantly lower the blood pressure and lead to fainting in some men. Currently, there is no information available to support the safety of even the lower doses of vardenafil taken together with alpha-blockers. In addition, Levitra should not be used in patients who have a rare heart condition known as "prolongation of the QT interval" because of the possibility of producing abnormal heart rhythm.
Because some drugs may affect the metabolism of Levitra, patients should inform their doctors that they are taking Levitra and they should not begin taking new medicines without informing their doctor. For example, patients taking erythromycin should not take more than a 5 mg dose of Levitra and a maximum dose of 2.5 mg Levitra once every 72 hours is the maximum recommended dose for patients who are taking the protease inhibitor ritonavir (Norvir) for HIV/AIDS.
Levitra should not be taken by men in whom sexual activity is inadvisable because of their underlying cardiovascular status (heart condition). Patients should inform their doctor about any heart problems they have experienced before taking Levitra.
Levitra is not recommended in patients who have suffered a heart attack or stroke within the last six months, or patients who have significantly low blood pressure, uncontrolled high blood pressure, unstable angina, severe liver impairment, end stage renal disease requiring dialysis, or the eye disorder retinitis pigmentosa.
The most common side effects reported in clinical trials included headache, flushing, rhinitis (runny nose), and indigestion. Dizziness was reported in about 2% of patients. A small number of patients taking Levitra also reported abnormal vision.
Before taking Levitra, patients are advised to undergo a thorough medical history and physical examination to diagnose the underlying cause of the erectile dysfunction and to identify appropriate treatment.
Levitra confers no protection against AIDS or other sexually transmitted diseases.
Levitra is manufactured by Bayer Corporation in Germany and will be distributed by Glaxo Smith Kline. The drug is currently available in Europe.
Comment: No denying that 4 minutes is 4 minutes.
Erectile dysfunction affects millions of men in the United States. Levitra acts by relaxing muscles in the penis and blood vessels, allowing increased blood flow into the penis, which produces an erection.
Levitra was evaluated in randomized, placebo-controlled trials involving more than 2000 men with erectile dysfunction. In two of the trials men had erectile dysfunction associated with diabetes mellitus or following radical prostatectomy for prostate cancer.
The drug's effectiveness was assessed using a sexual function questionnaire. In addition, patients were asked to report if they were able to achieve an erection adequate for intercourse and whether the erection was maintained to allow completion of intercourse. In all of the trials, Levitra improved patients' ability to achieve and maintain a penile erection.
The recommended dose is 10 mg taken 1 hour before sexual activity. A higher dose of 20 mg is available for patients whose response to the 10 mg dose is not adequate. Two lower doses (2.5 mg and 5.0 mg) are also available and may be necessary for patients taking other medicines or having medical conditions that may decrease the body's ability to metabolize vardenafil (Levitra). Levitra should not be used more than once a day.
Levitra should not be used with nitrates (such as nitroglycerin tablets or patches) or with alpha-blockers (medicines that may be used to treat benign prostatic hyperplasia and/or high blood pressure such as tamsulosin, terazosin, doxazosin, and alfuzosin) because the combination of an alpha-blocker with Levitra may significantly lower the blood pressure and lead to fainting in some men. Currently, there is no information available to support the safety of even the lower doses of vardenafil taken together with alpha-blockers. In addition, Levitra should not be used in patients who have a rare heart condition known as "prolongation of the QT interval" because of the possibility of producing abnormal heart rhythm.
Because some drugs may affect the metabolism of Levitra, patients should inform their doctors that they are taking Levitra and they should not begin taking new medicines without informing their doctor. For example, patients taking erythromycin should not take more than a 5 mg dose of Levitra and a maximum dose of 2.5 mg Levitra once every 72 hours is the maximum recommended dose for patients who are taking the protease inhibitor ritonavir (Norvir) for HIV/AIDS.
Levitra should not be taken by men in whom sexual activity is inadvisable because of their underlying cardiovascular status (heart condition). Patients should inform their doctor about any heart problems they have experienced before taking Levitra.
Levitra is not recommended in patients who have suffered a heart attack or stroke within the last six months, or patients who have significantly low blood pressure, uncontrolled high blood pressure, unstable angina, severe liver impairment, end stage renal disease requiring dialysis, or the eye disorder retinitis pigmentosa.
The most common side effects reported in clinical trials included headache, flushing, rhinitis (runny nose), and indigestion. Dizziness was reported in about 2% of patients. A small number of patients taking Levitra also reported abnormal vision.
Before taking Levitra, patients are advised to undergo a thorough medical history and physical examination to diagnose the underlying cause of the erectile dysfunction and to identify appropriate treatment.
Levitra confers no protection against AIDS or other sexually transmitted diseases.
Levitra is manufactured by Bayer Corporation in Germany and will be distributed by Glaxo Smith Kline. The drug is currently available in Europe.
How Young Is Too Young?
Rafael Palmeiro seems an unlikely Viagra pitchman. The Texas Rangers slugger is only 37 and won't admit to having erection problems, yet he recently agreed to appear in ads promoting the drug. The deal has made people wonder whether Palmeiro really represents men with erectile dysfunction, or whether Pfizer, the company that makes Viagra, wants to persuade young men to try it for fun.
It's true that erectile dysfunction is more common in older men, but many potential Viagra users are hardly senior citizens: About 40% of 40-year-old men in the U.S. have some degree of erectile dysfunction. Most Viagra users today, according to Pfizer, are in their early to mid 50s. So it makes sense that the company would want to reach more men around Palmeiro's age.
It's true that erectile dysfunction is more common in older men, but many potential Viagra users are hardly senior citizens: About 40% of 40-year-old men in the U.S. have some degree of erectile dysfunction. Most Viagra users today, according to Pfizer, are in their early to mid 50s. So it makes sense that the company would want to reach more men around Palmeiro's age.
The Scary Side Effect of Viagra
The same pill that gives you a lift in the sack could also raise something much more serious: your risk of a deadly form of skin cancer. Taking an erectile-dysfunction (ED) drug may increase your likelihood of developing melanoma, finds a new study published in the journal JAMA Internal Medicine.
Researchers followed over 25,000 men over the course of 10 years, and found that those who reported using sildenafil—more commonly known by its brand name, Viagra—in the 3 months before the study’s start were 84 percent more likely to get melanoma during the follow-up.
Plus, the guys who reported using the drug some time before the start were 92 percent more likely to be diagnosed with the cancer compared to men who said they never used it.
More research is needed to determine what may be responsible for the increased risk, says study author Wen-Qing Li, Ph.D. But his team has one theory: The drug, which suppresses the PDE5A enzyme to help you get an erection, also mimics the activation of a mutation commonly seen in melanoma. This may spark the development of the skin cancer.
Before you toss your little blue pill, it’s important to understand that the findings don’t necessarily show a cause-and-effect relationship between Viagra use and melanoma. Plus, the actual cases of melanoma in Viagra users were very small—only 14 in 1,378 men.
Right now, Li says the results aren’t enough to alter current clinical recommendations for Viagra or other common ED drugs like Levitra and Cialis. (These weren’t included in the study since they hadn’t yet received FDA approval at its start.) Instead, more research needs to be done first on how dosage and frequency of use are related to melanoma risk.
Researchers followed over 25,000 men over the course of 10 years, and found that those who reported using sildenafil—more commonly known by its brand name, Viagra—in the 3 months before the study’s start were 84 percent more likely to get melanoma during the follow-up.
Plus, the guys who reported using the drug some time before the start were 92 percent more likely to be diagnosed with the cancer compared to men who said they never used it.
More research is needed to determine what may be responsible for the increased risk, says study author Wen-Qing Li, Ph.D. But his team has one theory: The drug, which suppresses the PDE5A enzyme to help you get an erection, also mimics the activation of a mutation commonly seen in melanoma. This may spark the development of the skin cancer.
Before you toss your little blue pill, it’s important to understand that the findings don’t necessarily show a cause-and-effect relationship between Viagra use and melanoma. Plus, the actual cases of melanoma in Viagra users were very small—only 14 in 1,378 men.
Right now, Li says the results aren’t enough to alter current clinical recommendations for Viagra or other common ED drugs like Levitra and Cialis. (These weren’t included in the study since they hadn’t yet received FDA approval at its start.) Instead, more research needs to be done first on how dosage and frequency of use are related to melanoma risk.
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