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If you can't keep your blood sugar or your blood pressure under control, you can get erectile dysfunction. It's important that you take your medicines for these problems just the way your doctor tells you.
To get the most benefit, you should exercise at least 20 to 30 minutes, preferably on most days of the week. Current studies suggest that at least five times a week is best. If you are a beginner, exercise for a few minutes each day and build up to 30 minutes.
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Alprostadil, a synthetic PGE1, is the most common single agent used for intracavernosal injections. When combined with papaverine and Regitine, the mixture is called Trimix and it has roughly twice the efficacy of alprostadil alone. In one study of 683 men, 94% reported having erections suitable for penetration after alprostadil injections. The main adverse effects are a painful erection, priapism, or the development of scarring at the site of the injection. Alprostadil is now available in a gel and a patch. No long-term studies compare the efficacy and acceptance of these new forms of therapy with that of the oral agents.
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ViagraŽ dosages are usually 25mg to 100mg (50mg doses being the average), taken up to one hour before sexual intercourse. These dosages have produced side effects such as headache, flushing and dyspepsia. There have been some reports of disturbances, dizziness, and nasal congestion. Other rarer adverse effects reported include diarrhea, muscle pain, skin rashes, and urinary or respiratory-tract infection. (2)
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This agent, which is available in 5-mg, 10-mg, and 20-mg doses, became available in 2003. These lower doses are effective because this agent has a 9-fold increase in selectivity for the specific receptor responsible for NO release in the penis. This agent can act within 20 minutes. Vardenafil has similar efficacy, side effects, and limitations as sildenafil but may be less bothered by food.
Reality: Although the majority of diagnosed ED cases are a result of physical diseases that cause damage to nerves, fibrous tissues, and arteries (such as diabetes, MS, vascular disease, and neurological disease), experts theorize that up to 20 percent of ED cases are due to anxiety, stress, depression, and other psychological factors, according to the National Kidney and Urologic Disease Information Clearinghouse (NIDDK). One of the most common psychological causes of erectile dysfunction is performance anxiety that may result after several failed attempts at intercourse. The anxiety may increase, leading to more failed attempts, ultimately resulting in a cycle of anxiety and sexual failure.
PDE-5 inhibition increases cGMP activity, which increases vasodilatory effects of NO. Sexual stimulation is necessary to activate response. Because sexual stimulation is required to initiate local release of NO, tadalafil has no effect in absence of sexual stimulation. Increased sensitivity for erections may last 36 h with intermittent dosing. Low-dose daily dosing may be recommended for more frequent sexual activity (ie, twice weekly); men can attempt sexual activity at anytime between daily doses. Available as 2.5-, 5-, 10-, and 20-mg tabs.
If all of this sounds familiar, it should. It's reminiscent of the marketing tactics of cigarette manufacturers, who attempted for many years to sell cigarettes to younger people through youth-targeted advertising and lax enforcement of cigarette sales laws. This was an effort, of course, to hook younger children on cigarettes so that they would become lifetime smokers. The tobacco industry, of course, denies all of this, as would Pfizer if questioned about it. But, I think the pattern is quite similar -- and very much present today in the pharmaceutical industry.
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Serum creatinine: An abnormal serum creatinine may be the result of kidney damage due to diabetes.
"This is the time to treat your man as your best friend -- to be warm, to be friendly, to grab his hand, to give him hugs and kisses, to let him know that you care about him, that he is desirable, that physical closeness is important," says Foley.
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Behavioral methods are helpful for more than 95 percent of men who have premature ejaculation.
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Sadeghi-Nejad believes that doctors should screen men for erectile dysfunction. "It's an important quality-of-life issue, and the factors that help prevent cardiovascular disease and diabetes may help decrease erectile dysfunction," he added.
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