Some people can talk with their doctors about sex. Others feel that sex is private. They do not want to share details with anyone. But if you have problems getting or keeping an erection, you have good reasons to talk to a doctor: your health and your quality of life.
Erection problems used to be called "impotence." Now the term "erectile dysfunction" is more common. Sometimes people just use the initials ED.
ED can be a sign of health problems. It may mean your blood vessels are clogged. It may mean you have nerve damage from diabetes. If you don't see your doctor, these problems will go untreated.
Another reason to see your doctor is to treat ED itself. Your doctor can offer several new treatments. For many men, the answer is as simple as taking a pill. Other men have to try two or three options before they find a treatment that works for them. Don't give up if the first treatment doesn't work. Finding the right treatment can take time.
Points to Remember
• Erection problems may be a sign of health problems.
• A doctor can help you overcome erection problems.
• Smoking, being overweight, and avoiding exercise can contribute to erection problems.
• Most cases of ED have a physical cause, but counseling can help couples build a stronger relationship.
• Many men can take a pill to treat ED. These men should still treat the health conditions that caused ED.
• Taking a pill doesn't work for everybody.
• Men who take any of the medicines called nitrates should not take a pill to treat ED.
Thursday, June 18, 2009
Friday, January 02, 2009
Recreational use of erectile dysfunction medication may decrease confidence in ability to gain and hold erections in young males
Abstract.
Department of Psychology, Center of Excellence in Behavior Genetics, Åbo Akademi University, Turku, Finland
We aimed to estimate the frequency of recreational use of erectile dysfunction medication (EDM) and to identify any adverse effects on confidence in gaining and holding erections resulting from such use.
In addition, we explored differences in erectile function and sexual behavior between recreational and medicinal users of EDM to control for the possibility of recreational users having but not admitting erectile dysfunction.
A subset from the Genetics of Sex and Aggression population-based sample of 4428 males with a mean age of 29.51 (s.d.=6.77) years provided information on their use of EDM, erectile function during first intercourse and currently, sexual behavior and confidence in their ability to gain and hold erections.
There were 2.6% (n=115) recreational and 0.9% (n=39) medicinal users of EDM. Recreational users had currently significantly lower confidence in their erectile ability than non-users even though they had significantly better erectile function and significantly more unrestricted sexual behavior as well as had more confidence when initiating sexual activity.
More frequent use of EDM was associated with significantly less confidence in erectile ability among the recreational users.
We conclude that recreational users of EDM may be vulnerable for becoming psychologically dependent on pharmacologically induced erection.
With thanks to:
Department of Psychology, Center of Excellence in Behavior Genetics, Åbo Akademi University, Turku 20500, Finland
Department of Psychology, Center of Excellence in Behavior Genetics, Åbo Akademi University, Turku, Finland
We aimed to estimate the frequency of recreational use of erectile dysfunction medication (EDM) and to identify any adverse effects on confidence in gaining and holding erections resulting from such use.
In addition, we explored differences in erectile function and sexual behavior between recreational and medicinal users of EDM to control for the possibility of recreational users having but not admitting erectile dysfunction.
A subset from the Genetics of Sex and Aggression population-based sample of 4428 males with a mean age of 29.51 (s.d.=6.77) years provided information on their use of EDM, erectile function during first intercourse and currently, sexual behavior and confidence in their ability to gain and hold erections.
There were 2.6% (n=115) recreational and 0.9% (n=39) medicinal users of EDM. Recreational users had currently significantly lower confidence in their erectile ability than non-users even though they had significantly better erectile function and significantly more unrestricted sexual behavior as well as had more confidence when initiating sexual activity.
More frequent use of EDM was associated with significantly less confidence in erectile ability among the recreational users.
We conclude that recreational users of EDM may be vulnerable for becoming psychologically dependent on pharmacologically induced erection.
With thanks to:
Department of Psychology, Center of Excellence in Behavior Genetics, Åbo Akademi University, Turku 20500, Finland
Monday, December 01, 2008
Are declining testosterone levels a major risk factor for ill-health in aging men?
As men grow older, testosterone levels fall, with a steeper decline in unbound or free testosterone compared with total testosterone concentrations.
Lower testosterone levels have been associated with poorer cognitive function, and with impaired general and sexual health in aging men.
Recently, lower testosterone levels have been linked with metabolic syndrome and type II diabetes, both conditions associated with cardiovascular disease, and shown to predict higher overall and cardiovascular-related mortality in middle-aged and older men.
However, reverse causation has to be considered, as systemic illness may result in reduced testosterone levels.
Thus, the strength of these associations and the likely direction of causation need to be carefully considered. Furthermore, these conditions may overlap, for example aging, lower testosterone levels, erectile dysfunction and cardiovascular disease are interrelated.
Cross-sectional and longitudinal observational studies may be informative.
However, ultimately randomized controlled trials of testosterone therapy are needed to clarify its role in the maintenance of general and sexual health in aging men. Testosterone therapy should be considered in hypogonadal men who meet rigorous criteria for the diagnosis of androgen deficiency.
Additional consideration should be given to designing and testing interventions that may prevent or ameliorate the age-related decline in testosterone levels in men.
Source: 1School of Medicine and Pharmacology, University of Western Australia
Lower testosterone levels have been associated with poorer cognitive function, and with impaired general and sexual health in aging men.
Recently, lower testosterone levels have been linked with metabolic syndrome and type II diabetes, both conditions associated with cardiovascular disease, and shown to predict higher overall and cardiovascular-related mortality in middle-aged and older men.
However, reverse causation has to be considered, as systemic illness may result in reduced testosterone levels.
Thus, the strength of these associations and the likely direction of causation need to be carefully considered. Furthermore, these conditions may overlap, for example aging, lower testosterone levels, erectile dysfunction and cardiovascular disease are interrelated.
Cross-sectional and longitudinal observational studies may be informative.
However, ultimately randomized controlled trials of testosterone therapy are needed to clarify its role in the maintenance of general and sexual health in aging men. Testosterone therapy should be considered in hypogonadal men who meet rigorous criteria for the diagnosis of androgen deficiency.
Additional consideration should be given to designing and testing interventions that may prevent or ameliorate the age-related decline in testosterone levels in men.
Source: 1School of Medicine and Pharmacology, University of Western Australia
Wednesday, September 24, 2008
Obesity and sexual dysfunction, male and female
Abstract
Obesity has become a worldwide public health problem of epidemic proportions, as it may decrease life expectancy by 7 years at the age of 40 years: excess bodyweight is now the sixth most important risk factor contributing to the overall burden of disease worldwide.
Overweight and obesity may increase the risk of erectile dysfunction (ED) by 30–90% as compared with normal weight subjects. On the other hand, subjects with ED tend to be heavier and with a greater waist than subjects without ED, and also are more likely to be hypertensive and hypercholesterolemic.
The metabolic syndrome, characterized by a clustering of risk factors associated with insulin resistance and abdominal obesity, associates with ED.
Moreover, women with the metabolic syndrome have an increased prevalence of sexual dysfunctions as compared with matched control women.
Lifestyle changes aimed at reducing body weight and increasing physical activity induce amelioration of both erectile and endothelial functions in obese men. Moreover, preliminary evidence suggests that a Mediterranean-style diet might be effective in ameliorating sexual function in women with the metabolic syndrome.
Lifestyle changes, mainly focussing on regular physical activity and a healthy diet, are effective and safe ways to reduce cardiovascular diseases and premature mortality in all population groups; they may also prevent and treat sexual dysfunctions in both sexes.
With thanks to:
K Esposito1, F Giugliano2, M Ciotola1, M De Sio2, M D'Armiento2 and D Giugliano2
1. 1Division of Metabolic Diseases, Department of Geriatrics and Metabolic Diseases, University of Naples SUN, Naples, Italy
2. 2Division of Urology, Department of Geriatrics and Metabolic Diseases, University of Naples SUN, Naples, Italy
Obesity has become a worldwide public health problem of epidemic proportions, as it may decrease life expectancy by 7 years at the age of 40 years: excess bodyweight is now the sixth most important risk factor contributing to the overall burden of disease worldwide.
Overweight and obesity may increase the risk of erectile dysfunction (ED) by 30–90% as compared with normal weight subjects. On the other hand, subjects with ED tend to be heavier and with a greater waist than subjects without ED, and also are more likely to be hypertensive and hypercholesterolemic.
The metabolic syndrome, characterized by a clustering of risk factors associated with insulin resistance and abdominal obesity, associates with ED.
Moreover, women with the metabolic syndrome have an increased prevalence of sexual dysfunctions as compared with matched control women.
Lifestyle changes aimed at reducing body weight and increasing physical activity induce amelioration of both erectile and endothelial functions in obese men. Moreover, preliminary evidence suggests that a Mediterranean-style diet might be effective in ameliorating sexual function in women with the metabolic syndrome.
Lifestyle changes, mainly focussing on regular physical activity and a healthy diet, are effective and safe ways to reduce cardiovascular diseases and premature mortality in all population groups; they may also prevent and treat sexual dysfunctions in both sexes.
With thanks to:
K Esposito1, F Giugliano2, M Ciotola1, M De Sio2, M D'Armiento2 and D Giugliano2
1. 1Division of Metabolic Diseases, Department of Geriatrics and Metabolic Diseases, University of Naples SUN, Naples, Italy
2. 2Division of Urology, Department of Geriatrics and Metabolic Diseases, University of Naples SUN, Naples, Italy
Thursday, August 14, 2008
The prevalence of erectile dysfunction in heart failure patients by race and ethnicity
Abstract
Erectile dysfunction(ED)is a common problem in male patients with heart failure(HF).
However,no study was found that estimates the prevalence of ED by US ethnic groups with HF.
The division of Cardiology, miller school of Medicine, University of Miami, USA, conducted an observational, cross-sectional study of patients enrolled in a HF disease management program in two sites Louisiana (N=329; 178 white, 99 black) and Florida (N=52; Hispanic).
All male patients with an ejection fraction 40% were included.
The Sexual Health Inventory for Men was used to estimate the prevalence of ED.
Overall prevalence of ED was 89% and ED severity did not vary by race/ethnic group.
Race/ethnic group differences were found for age, New York Heart Association functional classification, and blood pressure.
Hispanic patients had the lowest unadjusted and adjusted prevalence rate of ED (81, 85%) compared to Black (90, 95%) and White (91, 92%) patients.
There is a high prevalence of ED in Hispanic, Black and White ethnic groups with HF.
Erectile dysfunction(ED)is a common problem in male patients with heart failure(HF).
However,no study was found that estimates the prevalence of ED by US ethnic groups with HF.
The division of Cardiology, miller school of Medicine, University of Miami, USA, conducted an observational, cross-sectional study of patients enrolled in a HF disease management program in two sites Louisiana (N=329; 178 white, 99 black) and Florida (N=52; Hispanic).
All male patients with an ejection fraction 40% were included.
The Sexual Health Inventory for Men was used to estimate the prevalence of ED.
Overall prevalence of ED was 89% and ED severity did not vary by race/ethnic group.
Race/ethnic group differences were found for age, New York Heart Association functional classification, and blood pressure.
Hispanic patients had the lowest unadjusted and adjusted prevalence rate of ED (81, 85%) compared to Black (90, 95%) and White (91, 92%) patients.
There is a high prevalence of ED in Hispanic, Black and White ethnic groups with HF.
Wednesday, July 23, 2008
Ejaculatory Disorders
Many conditions, drugs and environmental factors may affect seminal emission.
Organic causes of seminal emission disorders include various surgical procedures.
The most common ejaculation disorders are:
premature ejaculation, retrograde ejaculation, retarded ejaculation and anejaculation:
Retrograde ejaculation, where the ejaculate is directed backwards into the bladder, may be caused by true or functional sympathectomy, bladder neck incompetence due to organ disruption, diseases and certain drugs (e.g. methyldopa, phenoxybenzamine, prazosin, clozapine and thioridazine).
Retarded ejaculation may have an organic cause (e.g. certain diseases, surgical interventions, neurological and endocrinological factors, and drugs such as dopamine antagonists, antidepressants and anxiolytics), but is often related to psychological factors, in particular anger or resentment towards women.
Anejaculation is classified as primary, when ejaculation has never been experienced, or secondary, when normal ejaculation has preceded its onset.
Causes include psychological factors (e.g. a sexually repressive upbringing, gender confusion, anxiety, marital problems, fear of causing pregnancy) and organic causes such as prostatic and bladder neck surgery, diabetes mellitus, spinal cord injury and posterior urethral stricture.
Premature ejaculation is the most common male sexual disorder, and affects more than 30% of men.
Criteria for defining premature ejaculation include failure to achieve orgasm by the partner,duration of intercourse until ejaculation, number of intravaginal thrusts until ejaculation.
Premature ejaculation is further classified as being:
primary (from the first sexual experience)
secondary (when normal sexual functioning precedes onset)
Treatment of premature ejaculation includes pharmacological therapy and, very limited , surgical procedures.
Some treatment that have provided some benefit in premature ejaculation include:
-dopamine antagonists (e.g. antipsychotics such as pimozide, sulpiride, haloperidol, chlorpromazine and thioridazine)
-selective serotonin reuptake inhibitor antidepressants (e.g. fluoxetine, sertraline and paroxetine)
-some tricyclic anti- depressants (e.g. clomipramine), anxiolytics (e.g. chlordiazepoxide, lorazepam and alprazolam), phenoxybenzamine, topical anesthetics
-various other preparations such as the herbal formulation `SS-cream'.
Full discussion of the history with spouses should be undertaken to arrive at a correct diagnosis and to evaluate the efficacy of treatment.
Organic causes of seminal emission disorders include various surgical procedures.
The most common ejaculation disorders are:
premature ejaculation, retrograde ejaculation, retarded ejaculation and anejaculation:
Retrograde ejaculation, where the ejaculate is directed backwards into the bladder, may be caused by true or functional sympathectomy, bladder neck incompetence due to organ disruption, diseases and certain drugs (e.g. methyldopa, phenoxybenzamine, prazosin, clozapine and thioridazine).
Retarded ejaculation may have an organic cause (e.g. certain diseases, surgical interventions, neurological and endocrinological factors, and drugs such as dopamine antagonists, antidepressants and anxiolytics), but is often related to psychological factors, in particular anger or resentment towards women.
Anejaculation is classified as primary, when ejaculation has never been experienced, or secondary, when normal ejaculation has preceded its onset.
Causes include psychological factors (e.g. a sexually repressive upbringing, gender confusion, anxiety, marital problems, fear of causing pregnancy) and organic causes such as prostatic and bladder neck surgery, diabetes mellitus, spinal cord injury and posterior urethral stricture.
Premature ejaculation is the most common male sexual disorder, and affects more than 30% of men.
Criteria for defining premature ejaculation include failure to achieve orgasm by the partner,duration of intercourse until ejaculation, number of intravaginal thrusts until ejaculation.
Premature ejaculation is further classified as being:
primary (from the first sexual experience)
secondary (when normal sexual functioning precedes onset)
Treatment of premature ejaculation includes pharmacological therapy and, very limited , surgical procedures.
Some treatment that have provided some benefit in premature ejaculation include:
-dopamine antagonists (e.g. antipsychotics such as pimozide, sulpiride, haloperidol, chlorpromazine and thioridazine)
-selective serotonin reuptake inhibitor antidepressants (e.g. fluoxetine, sertraline and paroxetine)
-some tricyclic anti- depressants (e.g. clomipramine), anxiolytics (e.g. chlordiazepoxide, lorazepam and alprazolam), phenoxybenzamine, topical anesthetics
-various other preparations such as the herbal formulation `SS-cream'.
Full discussion of the history with spouses should be undertaken to arrive at a correct diagnosis and to evaluate the efficacy of treatment.
Monday, July 14, 2008
Regular Intercourse Protects Against Erectile Dysfunction
Abstract
Background
Erectile dysfunction is common among men aged more than 60 years.
Its cause involves both physiologic and psychosocial factors.
Methods
To evaluate the effects of coital frequency on subsequent risk of erectile dysfunction, data were analyzed from a population-based 5-year follow-up study that was conducted in Pirkanmaa, Finland, using postal questionnaires.
Assessment was based on the 5-item version of the validated International Index of Erectile Function. Men with erectile dysfunction at entry were excluded from the analysis.
The study sample consisted of 989 men aged 55 to 75 years (mean 59.2 years).
The most common comorbidities were hypertension (32%), heart disease (12%), depression (7%), diabetes (4%,) and cerebrovascular disorder (4%).
Results
The overall incidence of moderate or complete erectile dysfunction was 32 cases per 1000 person-years (95% confidence interval [CI], 27-38). After adjustment for comorbidity and other major risk factors, men reporting intercourse less than once per week at baseline had twice the incidence of erectile dysfunction compared with those reporting intercourse once per week (79 vs 33/1000, incidence rate ratio 2.2, 95% CI, 1.3-3.8). The risk of erectile dysfunction was inversely related to the frequency of intercourse. No relationship between morning erections and incidence of moderate or severe erectile dysfunction was found.
Conclusion
Regular intercourse protects against the development of erectile dysfunction among men aged 55 to 75 years. This may have an impact on general health and quality of life; therefore, doctors should support patients' sexual activity.
published online 05 June 2008.
With thanks to:
American Journal of Medicine
Elsevier
Background
Erectile dysfunction is common among men aged more than 60 years.
Its cause involves both physiologic and psychosocial factors.
Methods
To evaluate the effects of coital frequency on subsequent risk of erectile dysfunction, data were analyzed from a population-based 5-year follow-up study that was conducted in Pirkanmaa, Finland, using postal questionnaires.
Assessment was based on the 5-item version of the validated International Index of Erectile Function. Men with erectile dysfunction at entry were excluded from the analysis.
The study sample consisted of 989 men aged 55 to 75 years (mean 59.2 years).
The most common comorbidities were hypertension (32%), heart disease (12%), depression (7%), diabetes (4%,) and cerebrovascular disorder (4%).
Results
The overall incidence of moderate or complete erectile dysfunction was 32 cases per 1000 person-years (95% confidence interval [CI], 27-38). After adjustment for comorbidity and other major risk factors, men reporting intercourse less than once per week at baseline had twice the incidence of erectile dysfunction compared with those reporting intercourse once per week (79 vs 33/1000, incidence rate ratio 2.2, 95% CI, 1.3-3.8). The risk of erectile dysfunction was inversely related to the frequency of intercourse. No relationship between morning erections and incidence of moderate or severe erectile dysfunction was found.
Conclusion
Regular intercourse protects against the development of erectile dysfunction among men aged 55 to 75 years. This may have an impact on general health and quality of life; therefore, doctors should support patients' sexual activity.
published online 05 June 2008.
With thanks to:
American Journal of Medicine
Elsevier
Subscribe to:
Posts (Atom)
Posts
