Impotency and Treatment: 2008

Friday, June 27, 2008

Impotency and Treatment

There are lots and lots of opinions on sex. For some, it is nothing; for some, it is something; for some others, it is everything. So, everything depends on the interest.

For powerful sexual activities, people often use bunny rabbit or horse as a symbolic representation. These symbols have been used for a long time since bunny rabbit is a symbol for Playboy in sex, due to its brisk, funny, jumping activities and its indulgence in sex, and the horse is an indicator of power, for gaining vim and vigour. Some others may show a masculine body to denote power. In olden days, men had multiple wives and they were also able to satisfy all of them with their physique, healthy food and good, hard work. But this era of white collar jobs with hurried and tensed lifestyle which does not allow for it

In our culture, man is often challenged for his manliness or maleness in all aspects a childless man is suspected to be an impotent. Actually, sex is somewhat different from fertility. It is a mutually pleasurable activity and nothing more than that. Infertility is the failure in producing an offspring. Impotency is the failure in performing sex. Impotency is a very sensitive topic since the person never wishes to discuss about it with his friends or family or even family doctor.

Any man will be ashamed of himself if his performance in sexual activity is not satisfactory to himself or his partner. In order to conceal his impotency, some men will keep away their wife and pose as if they are not enamoured of her beauty or her activities. The wives are also not so courageous to reveal this to the world due to their shyness. Men take this advantage and blame the women for everything. They also suffer silently, without going for any proper treatment.

Erectile dysfunction (impotency) is the leader of all the complaints which are often left untreated or maltreated. The worst nature is fear and lack of confidence. No excuses should be given in this world of science, as everything can be treated or managed well.

Sexology has become a money-minting zone for quacks who cheat and ruin the life of the patients. Even though there is no complaint at all, taking advantage of the fear and shyness of the patient, they do some costly treatments and recommend multiple drug cocktails, which initially boost the sexual activity but later on often hinder the sex health of the patient.

Generally, lots of impotency drugs are coming into market with attractive advertisement for increasing size, time and act. Are these attractive boosters really useful for the sufferers? No. Since they do not deal with the cause of the complaint or never drive the sufferer to a doctor for analysis or investigating the problem, but it makes them purchase the drugs directly from drug stores.Many young chaps, with lots of fear and lack of understanding, go for testing their maleness before marriage. They often go to a sexologist, sometimes they even go to prostitutes to rule out their fear and test their efficacy. There they get trapped and exploited with more fear and lot of investigations. Media advertisement is the major trap for youngsters to enter into the unwanted drug world.

Also, most of the young chaps turn up for treatment or drugs only after seeing erotic blue films. They try the same in their life. Sometimes, they could not meet the same in size, time and act, since the film must have been shot in many ways and it was a result of several days of shooting. Don't try to imitate anything or anyone, maintain your own originality. Also most of them admit or assume they have become impotent and lack confidence to regain their potency. To get rid of all the problems, everyone should know what sex is, how it occurs, what is behind it, what could cause problems, and how to rectify it, etc.

Sexology is the study of act of sex or sexual relationship. Sexual activity is a pleasure or treasure. The attitude and behaviour pertaining to sexual activity differ from person to person. The time and satisfaction also varies, depending upon the person or individual. While indulging in sex activity for the first time, fear of performance or tremor or shiver will be very common for everyone. With great fear or excitement, no one can do anything just right or perfect.

All about sex:

Sex is mainly influenced or driven by sex hormones androgen and oestrogen

Sex is one of the strongest and basic instincts which makes one crave for more

Sex is one of the recreations which can relax the mind and body

Sex appetite is common for everyone but its control varies

Sexual activity and interest can decline with age

Sex keeps everyone young in mind and thoughts

Sex is a pleasurable sportive act or exercise

Sex is really good for healthSex can bring offspring

Impotency

The most common male sexual dysfunction is impotence. Impotency or erectile dysfunction (ED) is means inability to perform the sexual activity. Almost all men experience this at some or the other time due to overindulgence or due to a lot of time gap. Even though there are many roots for impotency, the main stem is psychology. Even in a good mood, with desire and environment, impotency can occur if the person is stressed out or has problems in life. It can reflect in getting erection. Also, usually, older men need more time to attain firm erection, more time to ejaculate and much more time or days between two erections. Likewise, they will find difficulty in maintaining erection for more a long time. They have to accept Nature's laws. They could be able to perform better if they adapt to this.

Impotency can pose in different forms depending on the types of origin

Difficulty in getting erection (varies from occasional or partial or complete, etc.)

Difficulty in sustaining erection (varies from short span to zero time)
Difficulty in performing the sexual activity
Difficulty in ejaculation or early ejaculation
Sex without satisfaction in size, time and act.

Incidence - Impotence affects 15-20 per cent of males. Its occurrence is more common in depressed and psychologically upset persons than others of the same age groups. It is more common in smokers, alcoholics, drug addicts or persons suffering from diabetes or hypertension. Also its incidence increases with age, overindulgence in sex or craving for more. Now impotency is more common than ever before due to early pollution of the mind through the media or modern culture. Now teens get mature very early. This criterion also clinches a major cause for the increased incidences of impotency.

Before discussing the cause of impotency and its treatments, everyone should know about the organs involved in sexual activity in the right way.

Male reproductive organs

Testis - The two male gonads are small oval-shaped glands which hang in a scrotal sac of the inguinal region. They produce sperms. The testis originates in the abdomen and gets descended from the third month of uterine life to the scrotal sac. The ectopic or undescended testis may end in failure. The testis is mostly covered with convoluted seminiferous tubules. The secretions of seminal vesicles and bulbar glands add for the bulk or volume of semen. It is the responsible organ for manliness or maleness with its male hormones.

Sperm- is the spermatozoa of men. It is dispersed through semen. Semen is a mix of sperms and secretions which get ejaculated at the end of sexual act from the penis.

Prostate gland is located just below a male's bladder and surrounds the top portion of the urethra contributing to the sexual function with its secretions. It adds for the volume of the semen and it neutralises the acid suspension of the sperm and makes the sperm more capable of motion and increases the likelihood of fertilisation. Its secretion is continuous and more during the sexual act. The benign tumour of the prostate in old age will cause increased desire, priapism (persistent erection of the penis in night) and spermatorrhoea.Penis is a muscular & vascular organ which appears as a long slender shaft in a male. The penis is mainly composed of erectile tissues which are made of sponge-like work that can be filled with blood. The penis is capped with glans penis which is partially covered with prepuce. The glans penis has most sensitive receptors for stimulation of erection and ejaculation. The penis consists of two long columns of the corpus cavernosum and one column of corpus spongiosum. The corpus cavernosa has much arterial supply and blood vessels which usually get filled during erection and account for size enlargement. The centre of corpus spongiosum is pierced with urethra, the tube through which urine or semen get emerged. During sexual excitement, the penis gets engorged with blood and lubricating mucous gets poured into the urethra. Finally erected penis propels the semen deep into the vagina in a series of spurts followed by flaccidity of the penis.

The size and strength of the organ varies from person to person and races. Many males normally crave for long thick penis to satisfy their partner and go for unnecessary treatment. Even though science has proved that the size of the organ is not at all important in activity, as the vaginal canal of the female is sensitive for the initial 4-5cms only, males have a constant craving for it. But in extreme cases of small penis, surgery could help.

The tip or end of the penis has urethral opening. It is the common pathway or outlet for passing urine as well as semen, but never both at a time. If there is a leak of semen in urine, it is called spermatorrhoea which should be treated to avoid weakness.

Erection of penis Penis erection during sexual activity is important for penetrating the vagina. Also a firm erection is absolutely needed to lodge the semen deep in the vagina. The erection of the penis due to the filling up of the erectile tissue with blood makes it rigid and elevated. It depends upon the mental or physical make-up of the person. It gets varied depending upon the partner, places, stimulation and moods. The erected condition of the penis closes the opening of the bladder end and opens the opening of vas end. Normally, a male will have 2-3 erections in sleep (in REM type during dreams which occurs mostly in the early morning).

Mechanism of getting erection - Penile erection is mostly controlled by the autonomic nervous system, i.e. sympathetic and parasympathetic nerves. The stimulation can be from psychogenic or genital touch. On getting stimulation, from brain or genitals,

§ Penis blood supply is increased in many ways
§ Venous return of the penis is blocked for holding all incoming blood in the penis itself
§ The blood filled penis gets elevated and becomes firm

If anything goes wrong, the penis will be flaccid and not enable sexual activity.

Ejaculation - is the sudden forcible expulsion or throw or spurt of semen into the vaginal canal from the penis to reach the uterus. The erected penis will throw semen deep into the vagina. Or, otherwise, it oozes out. It is a reflex phenomenon which intensely makes it a pleasurable sensation for men. The stimulation of ejaculation arises from the glans penis which finally pours the sperm into the vagina with the contraction of the smooth muscles of various glands and ducts. Early ejaculation may occur prior to penetration, or before getting orgasm.
Nowadays, you can see advertisements from money-minting people who promise extra long time for ejaculation. Sometimes, this extra long time may cause failure in getting ejaculation and satisfaction.

Libido - is the psychological feeling for moods of sex. It drives and keeps us in sex.
Orgasm - is the height or apex in the sexual excitement. The violent muscular contractions and movement of the body including the changes in heart beat, respiration and blood pressure with excitement accounts for the orgasm which is followed by a pleasant fatigue.

Female reproductive organs
Vagina is the sheath-like structure forming vaginal canal of nearly three inches from vulva to cervix. It accepts penis during sexual activity. Inflammation may cause pain, loss of libido and white discharges. Itching and urinary tract infection can also spread infection inside the vagina and reflect in sex. Dryness of vagina will cause difficulty in sexual activity and painful sex.
Uterus is the hollow muscular pouch or organ which usually gets prepared during every period for providing lodging facility for the fertilised ovum (if any). It takes care for the accommodation, nourishment and development of the fertilised ovum. If fertilisation of egg doesn't occur, then it sheds its layers as menstrual bleeding.

Ovaries - are a pair of almond-sized organs which is kept loosely by the side of the uterus by a fold of peritoneum. They manufacture eggs for fertilisation and it is the organ responsible for the sexual moods and femininity of the female.

Fallopian tube - is a tube which leads the ovum from the ovaries to the uterus. Usually fertilization occurs in the middle of the fallopian tube. In case of blocked tubes, the egg or sperm will not be able to reach each other, for fertilisation which may result in infertility.

Ova or ovum - the egg of the female, which after getting fertilised have the ability to become an offspring.In the female reproductive organs, except the vagina, nothing else is involved in the sexual activity. Ovaries may account for moods.

Check how Potent you are

Please read the following questions, and answer true or false. Total the number of true, and false answers at the end of the questionnaire, and see how well you did.

Erectile dysfunction is often called the most common untreated medical disorder in the world.
Erectile Dysfunction may be caused by medications for high blood pressure, cigarette or recreational drug use, partner conflicts, or depression, to name a few.
Erectile dysfunction effects nearly 20 million men in the United States.
Erectile dysfunction is a difficult subject for many people to discuss. It is often accompanied by embarrassment, guilt, and lack of self-esteem.
Erectile dysfunction can be successfully treated over 95% of the time.
Erectile dysfunction is not merely a consequence of growing older, although it is often due to the consequences of medical conditions.

For scoring purposes, give yourself two points for each right answer. The answer to questions 1-6 are "True."

If your score is 8 or above, you have a pretty good understanding of Erectile Dysfunction. Read on…
I am confident that I can get and maintain an erection hard enough for penetration (entering your partner).
During sexual intercourse, I always maintain an erection to satisfactory completion.
In general, I rarely worry about successful sexual performance.
When I attempt sexual intercourse, it is almost always a satisfactory experience for me.
I would rate my overall level of desire for sex, as moderate to high.
I would rate my overall sex life as moderate to very satisfying.

If you answered "False" to two or more questions between 7-12, you may want to talk to your urologist about ED.

Impotence: Causes and Solutions

Impotence affects about one out of every ten American men, yet many of them don't seek help because they're embarrassed, they think there's no solution or they believe the problem is "all in their minds." Unfortunately, these men are missing out on a wide variety of treatment options.
Impotence, the persistent inability to achieve and maintain an erection for intercourse, affects as many as 18 million men in the United States between the ages of 40 and 70. Until recently, doctors thought impotence was mainly rooted in psychological causes. Now it is believed that 50 to 70 percent of all cases are caused by physical problems. Erection difficulties tend to increase with age, but that is not the only or even the most important factor. Your general physical and psychological health, as well as lifestyle habits and certain medications, can all cause impotence, but you don't have to live with this problem. In most cases, impotence can be successfully treated.

How Does an Erection Occur?
In order to get an erection, several parts of the body must work together. The brain sends a message of sexual arousal through the nervous system to the penis. This message causes the muscles along the penis to relax. At the same time, the artery to the penis dilates to twice its diameter, increasing the blood flow sixteen-fold, and the veins which carry blood away from the penis are blocked. As a result, the two spongy-tissue chambers in the shaft of the penis fill with blood and the penis becomes firm. A breakdown in any of these systems makes getting or keeping an erection difficult.

How is Impotence Diagnosed?
Virtually all men occasionally fail to get an erection. That's normal. But if a man has trouble getting or maintaining an erection about 25 percent of the time, he should see an urologist. These physicians specialize in disorders of the kidneys, bladder, prostate, penis and urethra.
Usually, after asking questions about when and how the impotence developed, the urologist will give the patient a complete physical exam to determine if his hormone levels are normal and if the blood vessels, nerves and tissues of his penis are working properly. If this initial work-up doesn't pinpoint the cause of the problem, a nocturnal penile tumescence test can be done.
Men with no physical abnormalities almost invariably have nightly erections during sleep. The patient may spend a few nights in a sleep laboratory where a gauge that measures the frequency and duration of nocturnal erections is attached to the base of the penis. A home version of this, the snap-gauge test, can also be used. Before going to sleep, the patient attaches the gauge to the base of his penis. During the night, the gauge will break at different degrees of penile rigidity and show whether a partial or full erection has taken place during sleep. If nocturnal erections do not occur, the impotence is most likely physical. Additional testing is then required to identify the precise cause of the problem.

To Help Prevent Impotence
Exercise regularly
Limit the amount of fat and cholesterol in your diet
Drink only in moderation
Don't smoke

What Are the Physical Causes of Impotence?

Physical impotence occurs when there is a problem with any of the systems needed to get or maintain an erection. The good news is that potency can usually be restored when a man is treated for underlying medical conditions, when medications are adjusted or when lifestyle habits are changed.

Here are some of the top causes of impotence:
Vascular Disease. Hardening of the arteries can affect the artery leading to the penis so that it cannot dilate enough to deliver all the blood necessary for an erection. Impotence can also occur if the nerves that control blood flow to the penis are damaged.

Diabetes. One out of every four impotent men has diabetes, which can cause nerve deterioration (diabetic neuropathy). Impotence may result if nerves or blood vessels that control the flow of blood to the penis are affected. In some cases, keeping the diet and blood sugar under control can decrease impotence. But permanent nerve damage can result in a chronic problem.

Disease of the Nervous System. Some conditions, such as multiple sclerosis, Parkinson's disease and spinal cord injuries, can affect or cause impotence.

Cancer Surgery. Surgery to remove cancer from the prostate, bladder, colon or rectal area can cause impotence if the nerves and blood vessels that control erections are damaged in the process of removing cancerous tissue.

Medications. Some prescription medications for high blood pressure, depression, spinal cord injury, diabetes and other conditions can cause temporary impotence by interfering with the nerve impulses or blood flow to the penis. Doctors may be able to adjust the dosage of a drug or change the medication to reverse or minimize the problem.

Smoking. A recent study at the New England Research Institute in Watertown, Massachusetts, found that impotence was equally common among smokers and non-smokers in general. However, among men with certain health problems, those who smoked were much more likely to have potency problems. For example, 56 percent of smokers with heart disease were completely impotent compared with only 21 percent of non-smokers with the disease.

Alcoholism. Excessive alcohol consumption disrupts hormone levels and can lead to nerve damage. This type of impotence may be reversible or permanent depending on the severity of the nerve damage. Some clinical studies suggest about 25 percent of all alcoholics become impotent -- even after they stop drinking.

Hormone Imbalance. Abnormal testosterone levels are rare, but they can cause impotence. In addition, other illnesses, such as kidney failure and liver disease, can disrupt the balance of hormones.

What Are the Psychological Causes of Impotence?
A man who is depressed, under stress, or worried about his "performance" during sex may not be able to have an erection. Qualified therapists or counselors who specialize in the treatment of sexual problems can often help diagnose and sort through these problems. Some impotence problems can be solved when a man understands the normal changes of aging and how to adapt to them. For example, as men get older they generally need more direct stimulation to achieve an erection. They may also have less firm erections, take longer to ejaculate and need more time between erections.

Relationship woes can interfere with potency and so can job stress, depression or financial worries. Impotence may also be the result of deep-seated emotional trauma, such as having been sexually abused as a child. Qualified psychotherapists can diagnose such problems and help men understand and overcome them.

What are the Treatment Options?

When treatment of underlying physical or psychological problems fails to restore potency, a man and his sexual partner can consider one of the following solutions:

Viagra. The most recent treatment for impotence approved by the FDA, this prescription drug is expected to benefit 70% of men with erectile dysfunction and has revolutionized the way impotence is treated. All a man needs to do is pop a Viagra pill an hour before sexual activity and the medication works on normal body chemistry to allow blood to rush into the penis when a man is sexually stimulated (men should take no more than one pill a day). Despite all the hype about Viagra, men should exercise caution in deciding whether this drug is right for them.

Vacuum Device. With this treatment, a man slips a hollow, plastic cylinder over his flaccid penis. He then attaches a hand pump to draw air out of the cylinder, creating a vacuum that draws blood into the penis. Once the penis is erect, the man slips an elastic ring over the cylinder onto the base of his penis and removes the cylinder. The ring will keep blood from flowing out, allowing intercourse.

Note: This device should only be used when seeing a doctor regularly since mishandling can damage the penis.

Self-Injection. One or more drugs (papaverine, phentolamine and prostaglandin-E1) can be injected into the penis to increase blood flow. The injection is nearly painless and produces a more natural erection than a vacuum device or implant. However, until the proper dose is worked out, a man might have a prolonged and painful erection. In rare instances, an erection that does not go down after ejaculation may require surgery.

Penile Implants. Surgical implants can be used as alternatives if the above treatments are unsatisfactory. Experts at the Mayo Clinic say there is a 10 to 15 percent chance that an implant will malfunction within five years, but the problem almost always can be corrected. Over 90 percent of patients are satisfied with these devices.

The two major types are:

Malleable Rods. Two long rods (also referred to as semi-rigid prostheses) are inserted into the outer channels of the penis through a small incision in the lower abdomen or scrotum. Each rod is one solid piece and so remains erect at all times. However, they can be bent close to the body for concealment. Because there are no moveable or inflatable parts, malfunctions are rare.

Inflatable Cylinders. These devices consist of one or two inflatable cylinders, a finger-activated pump and an internal reservoir that stores liquid used to inflate the tubes. All components -- the cylinders, pump and reservoir -- are implanted within the penis, scrotum and lower abdomen respectively. When the pump in the scrotum is manually squeezed several times, the fluid from the reservoir is released into the cylinders. They expand and create an erection, which is maintained until the release valve on the pump is squeezed to return the fluid to the reservoir.

Case Study

A study done at the Boston University School of Medicine linked overall health to impotence. Researchers studied the medical histories of 1300 men aged 40 to 70. They found some impotence in a total of 52%. Men who were being treated for heart disease, high blood pressure, or diabetes were one and a half to four times more likely than the overall group to be completely impotent later in life. The situation was even worse for men who had heart disease or hypertension and who smoked.
Alcohol intake decreases the body’s ability to produce testosterone. Research at Chicago Medical School revealed that drinking alcohol may cause the mormonal equivalent of menopause in men. Alcohol not only affects sexual function, but also helps set the stage for a heart attack and other dangerous conditions.
Arteriosclerosis, which restricts blood supply to the penis and to the nerves that govern sexual arousal, may result in a "failure to perform." If impotence is related to clogged blood vessels, a diet low in fats can actually help reverse the problem.
A study done at Boston University showed that men who smoked one pack of cigarettes a day for five years were 15 percent more likely to develop clogging in the arteries that serve the penis, a situation that can cause impotence. In addition, heavy smoking decreases sexual capability by damaging the tiny blood vessels in the penis. The use of marijuana and cocaine also can result in impotence.
Duplex untrasonography, a noninvasive method of measuring penile blood flow, is a reliable method of determining whether arterial occlusion plays a role in impotence. If you doctor believes atherosclerosis to be the underlying problem, he or she may advise vascular surgey to improve blood flow to the penis.
According to figures from impotence organizations, only about 5 percent of the estimated 30 million men affected are aware of therapy options.
Urologists differ in the types of treatment they recommend for impotence, but many opt first for nonsurgical treatment.
Injections of the drugs papaverine (Pavabid) and phentolamine (Regitine) or prostaglandin E1 (PGE1) into the base of the penis before intercourse have been shown to be roughly 80% effective in producing "satisfactory erection" in impotent men who have tried it. The drug alprostadil also is available in an injection kit (Caverject). These drugs work by relaxing smooth muscle, causing the blood vessels in the penis to dilate, promoting an erection that can last an hour or more. An estimated 300,000 men in the U.S. use this technique each year. Possible side effects include priaprism (prolonged, painful erections). Also, although the injections are done with a tiny needle, and are supposed to be painless when done properly (proper technique is crucial), this prospect is unappealing to many men. A less invasive technique, which involves instilling alprostadil into the urethra with a tiny plunger, is under development and is expected to become available in the near future.
Yohimbine (sold under the brand names Dayto, Yocon, and Yohimex) is a prescription drug that has been approved by the FDA for treatment of impotence. Its effectiveness is questionable, however. Many experts consider it to be, in essence, a placebo. Yohimbine has an effect on the body similar to that of adrenaline; it speeds up the heartbeat and elevates blood pressure. Beware of yohimbine if you have high blood pressure.
Three drugs may offer hope. Viagra has achieved very good results in men with psychogenic impotence and also in men with organic impotence. The intensity of the erection is enhanced as well as overall performance and there may be major side effects, and a risk of death for some patients. A doctor will be able to determine if Viagra is right for you. (For books on the subject, check "Books" "Issues" "Health-General".) Vasomax has been used for years as an injectable medication and is now being tested in pill form. It is another medication which works to dilate penile blood flow in men with mild vascular problems. Apo-Morphine is being evaluated for treatment of only psychogenic impotence.
Medical Urethral System for Erection (MUSE) is a cream which is absorbed through the urethra and dilates the cavernosal spongy tissue of the erectile chambers. It has about a 66% success rate and anxiously awaits approval to replace injectable forms of therapy.
Injection Therapies - Papaverine was the first effective medical treatment for ED. To date, there are two currently approved by the FDA. Caverject and Edex which are effective in about 85% of patients. Occasionally, Papaverine by itself or with Regitine and Prostaglandin E will be used, which is much better than any on eof them used alone. Some men will have erections lasting a few minutes to 45 minutes. Dosage determines this. Used immediately after radical prostatectomy or radiation therapy may prevent atrophy of the smooth muscle necessary for erection which is associated with non-use of the penis.
If impotence is linked to high levels of the hormone prolactin, bromocriptine (Parlodel) may be prescribed to correct the problem.
A number of vacuum devised are used to promote erection. With these devices, a cylinder is placed over the penis and a hand pump is used to create a vacuum in the cylinder. This in turn causes blood to flow into the penis, creating an erection. The user then puts a constriction band around the base of the penis, causing the erection to last up to thirty minutes. These devices are available by prescription only. Some 100,000 men in the U.S. choose this treatment each year. While this eliminates the need for medication, it does require some preparation time which decreases spontaneity. However, they work for many men and are covered by Medicare and many insurance companies. Problems abound with this technique, however.
Since the early 1970s, more than 250,000 American men have turned to inflatable penile implants to mechanically create erections. Penile implants are surgically installed devices that are made of silicone or polyurethane. One type is made of two semi-rigid but bendable rods; another type consists of a pump, a fluid-filled reservoir, and two cylinders into which the fluid is pumped to create an erection. Penile implants are now coming under FDA scrutiny. Since 1984, the FDA’s Center for Devices and Radiological Health has logged more than 6,500 reports of problems with inflatable devices - a large number for a medical device, according to the FDA. With the development of more effective agents, implants are now considered to be a last resort, to be tried only when all other methods have failed. Penile Prosthesis, rigid, semi-rigid or inflatable implants, can very a scary thing for many men. Getting your questions answered is most important because it is a serious decision. They are only necessary in about 10% of patients. For men who have become impotent following radical surgery, radiation or cryosurgery, or have arthritis and decreased manual dexterity, this procedure may be the last hope. The success rate is very high and they remain effective at a 90-95% rate 5 years after implantation.
Dr. Robert Frankt of Budapest University in Hungary found a great increase in sexual vitality and energy in men using a combination of two herbs, green oats (Avena sativa) and stinging nettle. "Feeling one’s oats" is an expression that originated centuries ago, and probably with good reason: a study by the Institute for Advanced Study of Human Sexuality found that men who suffered from reduced sexual desire and diminished performance were helped by green oats. Nettle if full of vital minerals and is good also for hypoglycemia, allergies, depressions, prostate and urinary tract disorders, and a host of other problems.

Recommendations

East a healthy, well-balanced diet. Include in the diet pumpkin seeds, bee pollen, or royal jelly. (Caution: Bee pollen may cause an allergic reaction in some individuals. Start with a small amount, and discontinue use if a rash, wheezing, discomfort or other symptom occurs.
Avoid alcohol, particularly before sexual encounters.
Do not consume animal fats, sugar, fried or junk foods.
Do not smoke. Avoid being around cigarette smoke.
Avoid stress.
Consult a urologist for testing to determine whether impotence is caused by an underlying illness that requires treatment.
Consider possible psychological factors that may be contributing to impotence, especially repressed anger or a fear of intimacy. Exploring psychological issues with a qualified therapist can help.
If you suspect impotence may be related to a drug you are taking, discuss this with your physician. There may be satisfactory, alternatives that will not cause this problem. Certain blood pressure medications and tranquilizers often cause erectile difficulties. The drugs cimetidine (Tagamet) and ranitidine (Zantac) which are used to treat ulcers and heartburn, also have significant side effects in some men. (Caution: Do not stop taking a prescription drug or change the dosage without consulting your physician.
Investigate the possibility of heavy metal intoxication. A hair analysis can reveal possible heavy metal poisoning. Keep in mind that sexual function changes with age. As you age, you may require more stimulation and a longer period of time to achieve an erection

Viagra: Time to Separate Reality from Hype

When Viagra-the first pill to conquer male impotence-was approved earlier this year, doctors couldn't keep up with their patients' demands for prescriptions. All the brou-ha-ha is easy to understand. If normal sexual function can be restored by simply swallowing a little pill, why bother with devices, injections or implants? Still, the wonder drug that can has its limits. And reports of deaths among men taking the sex pill is causing some alarm.

Viagra seemed to burst on the scene out of the blue, but it does have a track record. Sildenafil citrate, the active ingredient in Viagra, was originally developed to treat high blood pressure. It didn't work for that disorder, but in 1993, Pfizer Pharmaceuticals, the drug's manufacturer, started clinical trails of Viagra involving more than 3,000 men with varying degrees of impotence associated with diabetes, spinal cord injury, history of prostate surgery, and other illnesses. The results: 48 percent of men with severe impotence were almost always able to get aroused when using Viagra, and 70 percent of men with milder problems had success using the pill. Men with diabetes or radical prostate surgery had somewhat less improvement than did other groups.

One of the little love pill's major assets is that men who take it get turned on "naturally." That is, Viagra does not directly cause erections as do other impotence treatments. Rather it affects a man's response to sexual stimulation. Taken one hour before sexual activity, the drug acts by enhancing the effects of a chemical the body normally releases into the penis when sexually aroused. This increases blood flow into the penis, which results in an erection. (Viagra should not be taken more than once a day.)

On the down side, there have been reports of deaths and severe side-effects in some men taking Viagra. Men with a history of heart trouble, heart attacks, and low blood pressure should be examined carefully before getting a prescription for the drug, and heart patients taking nitroglycerin or other nitrate-based drugs must not take Viagra because the mix may cause a deadly dip in blood pressure. Other adverse effects of Viagra may include headache, flushing, indigestion, and temporary changes in vision -- including seeing a 'blue haze.' Opthalmologists are concerned that the long-term effects of Viagra on vision are not yet known. Men with sickle cell anemia, leukemia, or multiple myeloma should also avoid Viagra because it is feared that they may develop priapism -- a persistent, painful erection that can permanently damage the penis. Additionally, men are cautioned against using other treatments for impotence while taking Viagra as such combinations have not been tested yet.

Despite problems linked to the sex pill, enthusiasm for it among patients and doctors is still riding high. But men are cautioned to use common sense. They should not take it before having a thorough medical history, including a review of medications, and a physical examination. Viagra is a drug with potentially serious health consequences and is meant only for men diagnosed with impotence. It is not a novelty item for men who achieve normal erections and simply want to heighten their sexual prowess.

Information Regarding Impotency

American Foundation for Urologic Disease, Provides free information on impotence and how to assess treatment options. 800.242.2383

Impotence Information Center Provides free literature on impotence. 800.843.4315

National Kidney & Urologic Disease Clearinghouse Offers free literature on a number of

urological problems, including impotence. 800.669.1603

Impotence Institute of America, Offers literature on impotence and doctor referrals for a $3.00 shipping charge. 800.669.1603

What Lifestyle Changes May Help Prevent or Treat Impotence?

Maintaining General Health
Because many cases of impotence are due to reduced blood flow from blocked arteries, it is important to maintain the same lifestyle habits as those who face an increased risk for heart disease. Such good habits include a diet rich in fresh fruits and vegetables, whole grains, and fiber and low in saturated fats and sodium. Men who drink alcohol should do so in moderation. A regular exercise program is extremely important. Quitting smoking is essential.

Frequent Erections
Staying sexually active can help prevent impotence. Frequent erections stimulate blood flow to the penis. It may be helpful to note that erections are firmest during deep sleep right before waking up. Autumn is the time of the year when male hormone levels are highest and sexual activity is most frequent.

Kegel Exercises
The Kegel exercise is a simple exercise commonly used by people who have urinary incontinence and by pregnant women. It may also be helpful for men whose erectile dysfunction is caused by impaired blood circulation. The basic technique consists of tightening and releasing the pelvic muscle that controls urination. Since the muscle is internal and is sometimes difficult to isolate, doctors often recommend practicing while urinating on the toilet. The patient tries to contract the muscle until the flow of urine is slowed or stopped and then releases it. People should perform 5 to 15 contractions, attempting to hold each contraction for 10 seconds, three to five times daily.

Changing or Reducing Medications Causing Impotence
If medications are causing the problem, the patient and the physician should discuss alternatives or reduced dosages. In treating high blood pressure, for instance, ACE inhibitors are less likely to cause sexual dysfunction than many other medications.

Psychotherapy and Behavioral Therapy
Some form of psychological, behavioral, sexual, or combination therapy is often recommended for individuals suffering from impotence, regardless of cause. In such cases, it is beneficial to have the partner involved in this process whether sexual therapy is part of the treatment or not. The value of sex therapy itself is questionable. In one study 12 out of 20 of men whose dysfunction had a psychological basis and who were advised to enter a sex clinic resisted sex therapy out of embarrassment or because they felt it wouldn't help. Of the eight who entered therapy only one actually achieved satisfactory sex. Some kind of interpersonal, supportive, or behavioral therapy, however, can be of help to a patient during all phases of the decision-making process with regard to possible methods of treatment. Therapy may also ease the adjustment period after the initiation or completion of treatment.

In a totally unrelated development (unrelated to aging, that is), National Institute of Aging supported scientists from the University of South Carolina have found yet another compelling reason to avoid cholesterol. Men with lower blood cholesterol or higher amounts of the beneficial high-density lipoprotein (HDL) cholesterol may be less likely to develop erectile dysfunction or impotence.

According to the researchers, atherosclerosis (hardening of the arteries), which may impede blood flow to and from the penis, is one primary cause of impotence. While a positive link between blood cholesterol and atherosclerosis, the association between cholesterol and impotence has only been suggested until now. The South Carolina scientists conducted a study of more than 3,200 generally healthy men between the ages of 25 and 83. Data indicated that the men with total cholesterol over 240 milligrams per deciliter (mg/dl) of blood had nearly double the risk of penile dysfunction as men with readings of 180 mg/dl. A similar pattern held true in patients with significant amounts of HDL cholesterol. Those with HDL readings of 60 mg/dl or greater were one-third less likely to develop dysfunction than were men with less than 30 mg/dl HDL.

General Precautions with Viagra

What is Viagra used for?
Viagra is used to treat impotence in men. Viagra increases the body’s ability to achieve and maintain an erection during sexual stimulation. Viagra does not protect you from getting sexually transmitted diseases, including HIV.

Who should not take Viagra?
Men who are currently using medicines that contain nitrates, such as nitroglycerin should not use Viagra because taken together they can lower the blood pressure too much. Viagra should not be used by women or children.

General Precautions with Viagra:
You should have a complete medical history and exam to determine the cause of your impotence before taking Viagra.

Men who have medical conditions that may cause a sustained erection such as sickle cell anemia, leukemia or multiple myeloma or who have an abnormally shaped penis may not be able to take Viagra.

There are several medications that are known to interact with Viagra, so be sure to tell your doctor about all medications you are taking including those you can get without a prescription.

Viagra has not been studied with other treatments for impotence, so use in combination with other treatments is not recommended.

How should I take Viagra? Your healthcare provider may prescribe Viagra as one tablet once a day, about 1 hour before sexual activity. However, Viagra may be taken anywhere from 30 minutes to 4 hours before sexual activity.

What are some possible side effects of Viagra? (This list is NOT a complete list of side effects reported with Viagra. Your healthcare provider can discuss with you a more complete list of side effects.)

Viagra is generally well tolerated. If any side effects are experienced, they are usually mild and temporary. The following is a listing of the most common side effects:

Headache
Flushing
Upset stomach
Stuffy nose
Urinary tract infection
Visual changes such as mild and temporary changes in blue/green colors or increased sensitivity to light.
Diarrhea

For more detailed information on Viagra, ask your healthcare provider.

Other upcoming drugs

Dr. Robert Kramer of Boston University, and former president of the International Society of Impotence Research. He was chairman of a committee of leading scientists and researchers who reviewed the field of pharmacological therapy in a report to the meeting.

He mentioned two upcoming new oral medications:

Apomorphine - This compound acts on receptors in the brain. An FDA application has been made to market an oral version of this well-known compound. This follows completion of a number of clinical studies involving a total of about 1,000 patients which show a 50% success rate in improving erection. The tablet is placed under the tongue. It is expected to be available in the US by the end of 2000.

IC351- This is a compound similar to Viagra, but with a slightly different mechanism. It may not have the "blue haze" effect on the eyes that sometimes occurs with sildenafil. It is presently undergoing clinical trials.

Other upcoming drugs include:

Melanotan II- The mechanism is similar to apomorphine. This compound has shown good results in animal studies, and has been tested in small numbers of patients. It is still in the research phase.

Trazodone- This is also a well- known compound. "However, scientific data are lacking, and it seems to have little effect", notes, Dr Kramer.

Phentolamine- This medication is used in some combination therapies. However, clinical studies in Germany found no significant difference from placebo. In a US trial, it was found to have a modest effect on mild to moderate impotence.

Yohimbine- Dr. Kramer said his committee did not consider the available data sufficient to evaluate this drug.

Impotency and Treatment

Friday, June 27, 2008