Prostate Cancer Awareness Week
(pcaw.org) has compiled information on Impotency & Viagra.
Impotency and Viagra
What is Viagra used for?
Impotency and Viagra
Background and information on alternatives to Viagra
The penis is a vascular organ which requires exercise. A healthy
male will normally experience 3 to 4 erections during their sleep
which may last a hour or more each. They are a normal body function
whose purpose is to oxygenate the penile erectile tissue. Its
inability to achieve and maintain an erection suitable for vaginal
intercourse is called "male erectile dysfunction" (ED) or impotency,
for short. Impotency affects over 30 million men and their partners.
To some men impotency is a symbol of the loss of their manhood, and
can be critical to a man’s ego and self-image. And often,
because of this, some men are afraid to seek help. And, often when he
does, the physician feels uncomfortable or is unable to help because
many aren’t aware of the options. If the truth were known,
however, virtually 100% of impotency problems can be successfully
diagnosed and treated, whether physical or emotional, unless there is
permanent injury or severance of the nerves and or vascular supply
necessary in the erectile process.
The appropriate treatment for impotence depends upon whether the
cause is physical or psychological. A man whose impotence is
psychologically based generally still has erections during sleep,
whereas an individual whose impotence is physical in origin usually
does to. One easy, inexpensive way to test for nocturnal erections is
with postage stamps. Glue a strip of stamps around the shaft of the
penis before going to bed. If the ring of stamps is broken in the
morning, the cause of the impotence is likely psychological. If the
strip is unbroken, the impotence is likely physiological. You can
also purchase a kit called Snap Gauge from UroHealth Corporation.
This test is designed to detect the measure the rigidity of erections
experienced during sleep. Call 800.328.1103 for more information.
Considerations:
- 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.
Summary:
This will give you some background on the subject. Circumcised
men, it is said, have a much higher rate of impotency than
uncircumcised men. This will be examined as a separate subject and
the information will be presented soon. The important thing to
remember is "Don’t wait." The longer you wait, the greater the
worry, the more difficult the treatment and recovery, and you’ll
miss out on a lot of great evenings in bed, too. So, find a qualified
doctor who is knowledgeable of the latest medical therapies. If you
need help in locating someone, one of the following organizations can
help: Impotence Institute of America & Impotence Anonymous -
1.800.669.1603 or Male Potency Centers of America - 1.800.438.7683.
The Institute also offers anonymous groups where men can hear the
experiences of other men which usually relates to what they are going
through. And, there is an excellent tape discussing all of the causes
of impotence, diagnostic treatment options and therapies by Dr.
Aubrey Pilgrim for $15 + shipping by calling 1.714.644.7200.
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.
Sources
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
Health Pages. Publication: Impotence: Causes and Solutions. 1998.
www.thehealthpages.com/articles/ar-impot.html
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.
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