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III. Concluding Remarks: The Future of “Phosphodiesterase Pharmacology”?
Sildenafil is the first oral agent to be well documented as an effective form of treatment for men experiencing ED. Since its introduction in March, 1998, no other therapy for ED has achieved such prominent public recognition. Of the 250,000 American physicians who have written prescriptions for sildenafil, 14% have been written by urologists and 82% by nonurologists.
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In older men, ED usually has a physical cause, such as disease, injury, or side effects of drugs. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED. Incidence increases with age: About 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience ED. But it is not an inevitable part of aging.
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While many doctors may use this to try to push statins and other drugs on patients, there are many natural approaches that include dietary changes, quitting smoking, and exercise that can be tried to lower cholesterol and blood pressure and improve heart health without the awful side effects of medications. Unfortunately, guys who smoke cigarettes generally aren't "smokin' hot" in the boudoir due to the fact that smoking increases the risk of coronary heart disease and the build-up of those fatty substances in the arteries that can lead to erectile dysfunction, according to an article by the American Heart Association. Concerning drugs that treat erectile dysfunction, pharmacist Suzy Cohen cautions in her nationally-syndicated column that sometimes the reason for erectile dysfunction is that men have too much estrogen in their cells which can't be solved by male enhancement pills. She jokingly compares using these pills in this situation to a guy jump-starting his car every two miles when he really needs a new battery! Of course, there are certain side effects of traditional medications that guys should discuss with their doctors. For example, in her book The 24-Hour Pharmacist, an excellent read, Suzy Cohen notes that a decreased sex drive is a common side effect of many medications which include statin cholesterol drugs and almost all blood pressure medications. If the wifey is unhappy about the erectile dysfunction, she's just going to be thrilled about the lack of libido.
Carmine Gazzaruso, MD; Stefano Giordanetti, MD; Emanuela De Amici, MD; Gianandrea Bertone, MD; Colomba Falcone, MD; Diego Geroldi, MD; Pietro Fratino, MD; Sebastiano B. Solerte, MD; Adriana Garzaniti, MD
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Effectiveness of tadalafil in these studies was assessed using a sexual function questionnaire. Study participants also were asked if they were able to achieve vaginal penetration and to maintain erections long enough for successful intercourse.
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Explain your medical condition in a clear and truthful way. Your doctor can give you literature on the condition for you to share with your partner.
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Among BPA workers, the higher the exposure, the more likely they were to have sexual difficulties.
"What I see as a problem is the public has been educated to believe that good sex requires an erect penis that stays hard through the entire sexual encounter," Shaw tells WebMD. "This definition of good sex changes the basic nature of an encounter from intimacy and pleasure to achievement and performance."
In most men, erection difficulties do not affect their sex drive.
"The response time to the nanoparticles was very short, just a few minutes, which is basically what people want in an ED medication," study co-author Dr. Joel M. Friedman, a professor of physiology, biophysics and medicine, said in a news release from the university. "In both rats and humans, it can take 30 minutes to one hour for oral ED medications to take effect."
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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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Whether the cause is physiological or psychological, homeopathic remedies can help resolve the problem of erectile dysfunction. According to the Law of Similars at the core of homeopathic medicine, “like cures like”—that is, small amounts of a substance that would cause a symptom will also cure that symptom in a patient. The natural substances, usually derived from a plant or herb, are diluted many times so that they are nearly harmless. Homeopaths believe that this dilution makes them a very potent remedy.
Interventions Patients were randomized to receive sildenafil (n=136) or placebo (n=132) as needed, but not more than once daily, for 12 weeks. Patients took the study drug or placebo 1 hour before anticipated sexual activity. The starting dose of sildenafil citrate was 50 mg, with the option to adjust the dose to 100 mg or 25 mg based on efficacy and tolerability, to be taken as needed.
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