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In the late 1990s, the launch of the drug Viagra revolutionized treatment of impotence. The drugs Levitra and Cialis followed. All three medications enhance the effects of nitric oxide, a chemical that relaxes smooth muscles in the penis during sexual stimulation and allows increased blood flow.
Related Health News By Amanda Gardner HealthDay Reporter
About four percent of participants had RLS (944 of 23,119 men), and about 41 percent (9,433 men) had erectile dysfunction. Men with RLS were older and were more likely to be Caucasian. The prevalence of erectile dysfunction also increased with age.
It is this brain action that makes Uprima® a unique new approach to the treatment of ED. As Dr. Dula stated after being involved with a trial of 1472 patients using Uprima®; “From a urologist’s perspective, it is important to understand that this is an entirely novel agent and works totally different from Sildenafil (Viagra®). It is a centrally-acting agent. What’s more, apomorphine works fairly quickly, in 15-25 minutes. The main side effect is nausea, but over time and repeated dosages it rapidly dissipates. We think that it is a safe and efficacious treatment for erectile dysfunction.” (19)
Points to Remember
In the study, researchers administered small doses of sildenafil to hamsters before adjusting the cycles of light and dark they lived in. This reset their body clocks as if they'd taken a six-hour plane trip to the east.
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Related Health News By Randy Dotinga
Intracavernosal administration of alprostadil (Caverject) has reported success rates of 67 to 85 percent and has been used in the treatment of erectile dysfunction for several years.11 When injected directly into the corpus cavernosum, alprostadil (prostaglandin E1) acts on the arteriolar smooth muscle cells, causing them to relax and produce an erection, usually within several minutes. Its mechanism of action is to stimulate an increase in the levels of intracellular cyclic nucleotides that cause relaxation. The usual dose is between 5 and 40 µg per injection. The current average wholesale price ranges from about $86 for six of the 5-mg doses to approximately $163 for six of the 40-µg doses.12 Patients usually start at 2.5 µg and titrate up in 5-µg increments for effect, with a maximum dose of 60 µg. No more than three injections per week are recommended, with a minimum period of 24 hours between injections.13 Initial dosing and required adjustments should be carried out in the physician's office.
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Depression, guilt, worry, stress, and anxiety all contribute to loss of libido and erectile dysfunction. If a man experiences loss of erection, he may worry that it will happen again. This can produce anxiety associated with performance and may lead to chronic problems during sex. If the cycle is inescapable, it can result in impotence. Psychological factors in impotence are often secondary to physical causes, and they magnify their significance.
In fact, the most favorable risk/ benefit ratio is seen with a dose optimization regimen of 3mg, with the 3mg dose providing efficacy comparable to that of 4mg, but with fewer side effects. (15)
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Metabolism (breakdown) of vardenafil can be slowed by aging, liver disease, and concurrent use of certain medications (such as erythromycin, ketoconazole (Nizoral), and protease inhibitors). Slowed breakdown allows vardenafil to accumulate in the body and potentially increase the risk for side effects. Therefore, in men over age 65, with liver dysfunction, or who are also taking medication(s) that can slow the breakdown of vardenafil, the doctor will initiate vardenafil at low doses to avoid its accumulation. For example:
This is another test of nerve function in the shaft of the penis. This test uses electromagnetic vibration to evaluate sensitivity. A decreased perception of vibration may indicate nerve damage in the pelvic area, which can lead to impotence.
is a staff urologist at Naval Hospital Jacksonville. Dr. Green is a graduate of the University of Texas Health Science Center at San Antonio and completed his residency at Naval Medical Center, Portsmouth, Va.
Objective To assess the efficacy and safety of oral sildenafil citrate in the treatment of erectile dysfunction in men with diabetes.
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For example, television advertisements for Cialis, Levitra and Viagra have changed the perception of what it is to be a normal, healthy man, Metzl said. In that way, male sexual performance has been "medicalized."
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