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Erectile dysfunction (ED), also called impotence, affects most men at some point during their lifetime. However, chronic impotence may indicate a medical condition, such as heart disease, high blood pressure, high cholesterol, kidney disease, or diabetes.
"It's an important message to get out," said Dr. Ira Sharlip, a spokesman for the American Urological Association. "There's an increasing body of knowledge that tells us that erectile dysfunction is a form of cardiovascular disease and often predates the onset of other forms of clinical cardiovascular disease, specifically coronary disease."
The cardiac effects associated with sildenafil have been studied extensively. Sildenafil is absolutely contraindicated in patients taking nitrates such as nitroglycerin or isosorbide. This is because sildenafil, like the other PDE-5 inhibitor medications, can potentiate the vasodilatory effects of the nitrate-based medication, resulting in an exaggerated vasodilatory effect that is potentially dangerous. Patients with serious cardiac disease, with exertional angina, or taking multiple antihypertensive medications are advised to seek the advice of a cardiologist before beginning therapy with sildenafil. A number of studies examining the cardiac effects of sildenafil have conclusively shown that no adverse consequences exist under normal circumstances.
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To add to the problem, the penis contains much smaller blood vessels than the ones that carry blood to the heart and the brain, which is why men who have early heart disease may see the effects first in their penis and then in larger blood vessels.
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Avoid sugar, dairy products, refined foods, fried foods, junk foods, and caffeine.
Numerous alternative therapies are used to improve sexual function. Some include: niacin, zinc, copper, Korean red ginseng root, ginkgo, pine bark, Tribulus terrestris, arginine, Avena sativa, horny goat weed, maca root, muira puama, saw palmetto, and Swedish flower pollen. None of these however have been recognized as effective by the FDA.[30] While zinc deficiency may be a cause of lower testosterone levels in hemodialysis patients, which may benefit from zinc supplementation,[31] such supplements have no effect on the testosterone levels of healthy males who consume a zinc-sufficient diet.[32]
(NaturalNews) A recent study suggests that men who have diabetes and are having erectile dysfunction may have an increased risk of heart disease. It was discovered that diabetic men who had difficulty keeping an erection were twice as likely to develop heart disease as other men with diabetes.
We would like to thank Drs. Drew Pardoll, Elizabeth Jaffee, Katie Whartenby, Eduardo Sotomayor, Alessia Zoso, and Stephanie Mgebroff for their critical reading of the manuscript and Dr. Michael Lee for his assistance with the Western blot.
During the period following the licensing of sildenafil for use in ED, an increase in the number of patients seeking treatment for heretofore-untreated ED was widely anticipated. This institution did not find an increase in the number of men referred with ED in the year following 14 September 1998, compared to the year preceding this date. It is not clear though, if this anticipated increase in the number of men with ED have been dealt with in the primary care. Considering that the referral pattern from primary to secondary care has not changed in this institution, we do not feel that this has happened.
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One of the most common tests used to evaluate penile function is the direct injection of PGE1 into the corpora. If the penile vasculature is normal or at least adequate, an erection should develop within several minutes. The patient and the clinician can judge the quality of the erection. If successful, this test also establishes penile injections as one possible therapy.
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The present findings highlight the significance of partnered relationships and interpersonal factors in the management of erectile dysfunction, and empirically challenge a number of widely held stereotypes concerning men, masculinity, sex, and quality of life. Sand MS, Fisher W, Rosen R, Heiman J, and Eardley I. Erectile dysfunction and constructs of masculinity and quality of life in the multinational Men's Attitudes to Life Events and Sexuality (MALES) study. J Sex Med 2008;5:583-594.
bDivisione di Andrologia, Universita degli Studi di Pisa, Italia;
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