Archive for May, 2009
Impotence: Treatment Development and Outlook
Due to the high prevalence rate of erectile dysfunction, the responsibility of ED management has been shifted to the primary care physicians. As a result, primary care physicians now need to add questions about sexual functioning and satisfaction during the initial patient workup. Patients with ED is treated by the primary care physician, or referred to other health care professionals, depending on the problem presented. Treatment and management of individuals with ED includes patient education, particularly focusing on general sex education and sexually transmitted diseases. Counseling and providing an appropriate treatment of impotence, basing on its main cause are also included in the program. Up to 85% of impotence cases are caused by medical or physical problems, and so, it is essential that a healthy lifestyle and avoidance or moderation in smoking and alcohol are emphasized
Advances in suppositories, injectable medications, implants, and vacuum devices have stretched out the options for men seeking treatment for ED. The medical and surgical advancement in treating erectile dysfunction has helped increase the number of men to seek consult and treatment. Gene therapy for ED is now being tested in several centers in US, and may offer a long-lasting therapeutic approach for ED.
Most research now is focused on using organic sources of treatments and enhancing of the existing ones. Organic sources such as watermelon are being looked into as alternative means to treat impotence. You can read this at http://www.webmd.com/erectile-dysfunction/news/20080701/watermelon-a-natural-viagra. Institutes such as the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) sponsors programs that aim at understanding the causes of erectile dysfunction and at finding treatments to reverse its effects. NIDDK’s Division of Kidney, Urologic, and Hematologic Diseases supported the researchers who developed Viagra and up to this time, it continuously supports basic research regarding the mechanisms of erection. In addition, continuous support is given in the research of diseases that impair the normal body functions at the cellular and molecular levels, such as diabetes and high blood pressure. These are signs of a growing awareness and acceptance of the problem ED in the society.
History of Treatments on Impotence
Before urologists recognized the physical nature of impotence, treatments generally fell into three categories—aphrodisiacs, surgery or transplants, and mechanical treatments.
Innumerable substances called aphrodisiacs have been used to increase sexual performance. Oysters, lobsters, eggs, and spices are some known aphrodisiacs. Noteworthy to mention, these sources are now recognized to do nothing more than irritate the genital organs. The user interprets this irritation as an increased sexual sensitivity, thereby creating the impression of increased performance.
In the 1880s, French physiologist Charles Edouard Brown-Sequard injected himself with an extract from a dog’s testicles that he claimed to have made him smarter, stronger, and more virile. In the 1920s, Eugen Steinach pioneered a surgical treatment of impotence called vasectomy. In the early twentieth century, Swiss professor Paul Niehans treated men with testicular cell injections. Another surgeon, Dr. Leo Stanley removed the testicles of recently executed prisoners and transplanted them into impotent prisoners. When the supply ran low, he substituted them with goat, ram, boar, and deer testicular tissues. It remains unclear whether any of these early attempts to treat impotence through the use of human or animal testicular tissue have actually worked. Most of the researchers mentioned eventually fell into disrepute.
In the US, Dr. John R. Brinkley broadcasted male impotence cures in his radio programs. He recommended expensive goat gland implants and “mercurochrome” injections as the paths to restore male virility. His medical license was revoked, and his radio license was not renewed.
For mechanical devices, many types of splints have been used to treat impotence, including hollowed-out antlers and horns. Although these initial attempts failed, penile prostheses are recently proven to be particularly reliable. During the 70s, surgeons began providing patients with inflatable penile implants.
The use of medications started in the ninth century until the sixteenth century. Muslim physicians and pharmacists in the medieval Islamic world were the first to prescribe medications for ED. They developed several methods of therapy, which include a single or a combination of drugs and food. Most were oral medications, though a few patients were also treated through topical and transurethral means. In 1983, modern drug therapy for ED made a significant exploit when British physiologist Giles Brindley, Ph.D. dropped his trousers and demonstrated to a shocked American Urological Association audience his phentolamine-induced erection. The drug he injected into his penis was a vasodilator, and the mechanism of action was muscle relaxation. This discovery established the fundamentals for the later development of orally-effective drug therapies. In 1998, a breakthrough in medicine occurred with the introduction of Viagra in the market as an effective drug against erectile dysfunction. The drug was originally researched for its beneficial effects in chronic increase in blood pressure and chest pains. A few years later, vardenafil and tadalafil are introduced as effective erections drugs.
Physiology of Erection
How Does Erection Occur?
During sexual arousal, the genital organs relax and become engorged with blood. In men, transmission of nerve impulses from the brain to the penis causes an increased blood flow to the male organ. This sudden influx of blood expands the muscles of the penis and produces an erection by straightening and stiffening its muscles. Continued sexual arousal maintains a higher rate of blood flow into the genital organ and limits the blood flow out of it, causing firmness of the penis. After ejaculation or sexual climax, the excess blood drains out, and the penis returns to its non-erect size and shape.
In women, the enlargement of the clitoris and the surrounding tissues are comparable to the erection of the penis. Physiology of orgasm in female can be categorized in four distinct stages. The first stage is the excitement stage. The heart and respiration rates increase, and the blood pressure goes up. The clitoris swells and the vagina begins to lubricate itself. The blood vessels narrow, and when this is coupled with an increased heart rate, flushing of the skin occurs. Breasts may swell and the nipples harden and taut. The entire excitement process can happen in a matter of seconds from the onset of sexual stimulation. Stage two is called the plateau. The body continues to experience the aforementioned changes. Further stimulation will cause the inner lips of the vagina to darken due to the increased blood flow to the genital area. By the end of this stage, the pulse and respiration rates have peaked, pushing the body into the third stage. The third stage is the actual orgasm, when the clitoris retracts and the vagina tightens and lengthens. Spasms of the vaginal and anal muscle occur rhythmically like wavelike contractions that move from the top of the uterus to the cervix. Other changes related to the female orgasm include muscle contractions throughout the body, more notably in the neck, pelvis, arms and legs. The fourth and final stage of the physiology of orgasm is often referred to as the resolution stage. The excess blood will drain from the genital area, and the clitoris returns to its normal size. The body returns to its previous, non-stimulated state.
Alternative Ways to Manage Impotence
Posted by admin in male impotence, treatment on May 7th, 2009
Can Herbs Treat Impotence?
The use of herbal supplements in treating impotence is rapidly growing in popularity. Herbal use offers an alternative and effective treatment option for sexual dysfunction management. In addition to their spectacular healing properties, many alternative health supplements can promote general well-being and overall health, which cost a lot less than synthetic drugs. Most herbal products out in the market contain potent combinations of rejuvenating herbs that act in a synergistic manner for a more effective impotence management. They fight off fatigue and general and sexual weakness. More so, herbal formulation has many side benefits on overall health, other than sexual health.
The most commonly used herbs in impotence
Ø Gingko biloba: Gingko biloba improves blood supply to muscles of the penis without causing an increase in blood pressure, increases the male hormone, testosterone, and improves endurance
Ø Yohimbe: This herb from Africa improves transmission of nerve impulses that encourage sexual arousal
Ø Panax ginseng: This herb commonly seen in Eastern Asia improves endurance and increases sperm count and motility
Ø Fo – ti: A dried root of a twining vine, this herb increases sexual desire.
Ø Muira puama, damiana and sarsaparilla: These known herbs from the South America increases sexual desire
Ø Milk thistle and shizandra: These herbs cleanse and re – model the liver since liver damage can greatly decrease the production of the male hormone, testosterone
Ø Saw palmetto: Mainly used to treat benign prostatic hypertrophy, this herb increases sexual desire
What Are the Limitations and Drawbacks of Herbal Supplements?
Herbal supplements contain active components that can affect the way your body functions. Like synthetic drugs, herbal supplements are not for everyone. Some herbs may not be recommended to certain individuals with pre – existing medical conditions. Individuals taking herbal supplements, in conjunction with prescription or over-the-counter (OTC) medications are at risk for adverse reactions. The effects of the combination of these drugs are often lacking in clinical research, and so, its safety and compatibility are not fully determined.
Some herbs are contraindicated in pregnant or breast-feeding mothers since some of the herbal components have the ability to cross the placenta, a group of tissues that nourishes the child in the womb and are transferred through the breast milk. Herbal use is also avoided at least two weeks before surgeries. It was observed that a regular use of herbs causes decreased anesthetic effects and increases the risk for bleeding associated to surgeries.
It is emphasized that herbal remedies are considered dietary supplements, or add - ons by the FDA. They do not have the same rigorous testing and labeling process as over-the-counter and prescription medications. It is best that you consult your physician before deciding on herbal use. These herbs do not replace the medications prescribed to you by your physician.
The Good, The Bad and the Ugly: Benefits and Drawbacks of Conventional Drug Therapy in Male Impotence
Posted by admin in male impotence, treatment on May 7th, 2009
Is drug therapy beneficial in erection dysfunctions?
Sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) are the three most commonly prescribed oral medications for ED treatment. These drugs enhance the release of nitric oxide, a chemical that causes relaxation of the muscles of the penis, resulting in erections. Based on the testimonials of their users, these drugs seem to have truly lived up to their promise of bringing in new hope to those who suffer with ED. For so many years, various treatments have assured the public, time and time again that they have all the answers to bout your fight against ED, only to leave futile efforts and empty promises. But in 1998, a ground breaking event was made when Viagra was approved by the FDA for the treatment of ED. This breakthrough in medicine has paved the way for the release of other erection drugs, Levitra and Cialis in 2003.
These drugs are the treatment of choice for healthy men in any age, without limitations to any ethnic group. For as long as you have a healthy heart, a stroke – free medical history with normal and controlled blood pressure and blood sugar, you can be a candidate for this therapy. It is best that you consult your physician for further evaluation. Never try any of these drugs without the assistance and prescription of your physician.
Erection drugs are generally effective within 15 - 45 minutes of use, with the duration of erections occurring in hours. The effects of these drugs may last for 4 to 36 hours, depending on the dose. They should not be used more than once a day. Success rates increase with the number of attempts, so a man should not be discouraged if the drug does not work at first.
According to dailystrength.org, a website focused on people’s experience about ED, out of 124 members, 73% finds Viagra helpful; 79% for Cialis and 75% for Levitra.
Do these drugs have limitations and drawbacks?
Erection drugs are not absolute. These drugs do not assure full proof protection against side effects and adverse reactions. Though these drugs are 75% effective most of the time, erections drugs are not for everyone. They are contraindicated in people with heart diseases, history of strokes, constant increase in blood pressure and uncontrolled blood sugar levels.
Common side effects include flushing, upset stomach, headache, nasal congestion, back pain, and dizziness. There have been reports of fatal heart attacks and strokes in a small percentage of men taking Viagra. About 2.5% of men have temporary vision problems. In 2007, the FDA added a warning about potential hearing loss associated with the above mentioned oral drugs. A small number of men have experienced sudden hearing loss in one ear, which is sometimes accompanied by ringing and dizziness. There also have been a few reports of seizures in men taking sildenafil. These are rare occurrences, and it is not clear if there is any causal association with the drugs. Men taking erections drugs are predisposed to priapism. Priapism is a medical emergency, described as a sustained, painful, and unwanted erection. In addition to serious interactions with nitrates (nitroglycerides), ED oral drugs may also interact with certain antibiotics.
The Diagnosis and Management of Female Impotence
Posted by admin in diagnosis, female impotence on May 7th, 2009
How is Female Sexual Arousal Disorder Diagnosed?
Diagnosis of FSAD is initiated by taking a complete medical history. It is important to that FSAD is differentiated from inadequate genital stimulation disorder and drug abuse. These two should be ruled out to establish a precise diagnosis. Sexual orientation is often determined, as it is necessary to come up with appropriate evaluation and management.
When all important information is obtained, diagnostic and laboratory examinations are done to check out if there’s alteration or an imbalance in your body that is probably causing the impotence.
A pelvic examination is usually done to visualize for any structural changes that have probably occurred in your reproductive system, causing your unresponsiveness and discomfort in sexual stimulations. Blood results are also done to check on the levels of your hormones, which could possibly be the root cause of
female impotence.
What Are Your Treatment Options?
The treatment and management of female stimulation arousal disorder is approached in various ways. Conservative management or nonsurgical intervention FSAD includes the use of drugs. Tibolone, a new drug mainly used to treat osteoporosis has shown beneficial effects. It increases vaginal lubrication and increases arousal. This drug is not yet found in Europe and in Asia. Since hormonal imbalances most frequently result in female impotence, hormonal replacement therapies are usually recommended. Various creams and jellies are suitable lubricants and may help to alleviate the discomfort. Warm baths or use of non-steroidal anti-inflammatory drugs can minimize pain before sex while trying different positions during sex. Hormones are key elements in a woman’s sexual drive and sexual function. Women in menopause or who have had a complete hysterectomy are likely to experience imbalances in estrogen and progesterone levels that can be related to sexual enjoyment.
Because the mind and the body are closely interconnected, hypnosis may offer another avenue of treatment for FSAD. Using techniques of deep relaxation as well as self-hypnosis can help resolve any unconscious conflict that may act as a block to healthy sexual function. The psychological portion of treatment is directed at teaching how to focus on pleasurable thoughts and feelings about sex through counseling or psychotheraphy. Because self-help is difficult when it comes to sexual dysfunction, sex therapists help men and women, as individuals and as couples, with sexual expression.
Sensual massages can be recommended where the partner provides the massage and the receiving patient provides feedback to what feels good. This would promote comfort and communication between partners.
Female Impotence: Women Can Be Impotent, Too
Posted by admin in female impotence on May 7th, 2009
What is Female Sexual Arousal Disorder?
Female impotence, also known as female sexual arousal disorder or FSAD, is a condition wherein women experience a lack of sexual arousal and desire, brought about by recurrent problems in sexual responses. A woman with FSAD does not achieve sufficient vaginal lubrication to initiate sexual intercourse, or does not sustain an ample amount of lubrication until orgasm, the sexual climax. In some women, muscles of the vagina contract or tighten excessively, allowing no muscle expansion to accommodate the engagement of the penis. Erotic sensations may be lacking, which in turn, results in vaginal dryness and tightness.
Some women may find physical contact repulsive. Often, these women with FSAD experience great pain with intercourse that avoidance of sexual contact with their partner is the only way they can rid of this sexual dysfunction.
FSAD may be an existing, lifelong condition or an acquired sexual disorder. In lifelong FSADs, women have never been responsive to any form of sexual stimulation. In acquired FSADs, the once responsive and sexually active woman is now unresponsive and uninterested with sex. FSADs can be situational or generalized. Situational FSADs have sporadic and isolated occurrences of impotence, while generalized FSADs occur regardless of the situation.
What Causes Female Impotence?
Female sexual arousal disorder may be due to a physical problem, a psychological crisis or a combination of both. Women with FSAD typically report a lack of interest, and sometimes, disgust in sex. Arousal is next to impossible, and the attainment of orgasm, a complete sexual satisfaction is far from reach.
Most common psychological causes of FSADs are guilt, anxiety and hostility. Guilt usually involves an internal conflict between a desire to enjoy sex and an unconscious fear of doing so. Other psychological causes are depression, stress and overwork. Unresolved childhood issues, such as sexual abuse or lesbianism may manifest in adulthood as FSAD.
Medical conditions that predispose one woman to FSAD are as follows: anemia, infection of the bladder, vaginal infection, an underactive thyroid gland, diabetes mellitus, multiple sclerosis, or muscular dystrophy. Conditions that cause hormonal changes and imbalances may also cause a decreased desire for sex. Unhealthy behaviours, particularly excessive alcohol intake and smoking can also result in FSAD.
FSAD may develop as women age. During menopause, the muscular walls vagina thin and dry out as a result of decreased estrogen levels. This can further result in diminished sexual arousal and desire. An intake of some prescribed medications, such as oral contraceptives, antihypertensive, antidepressants, or sedatives can also cause FSAD.
Diagnosing and Treating Erectile Dysfunction
How is Erectile Dysfunction Diagnosed?
Before erectile dysfunction is diagnosed, several steps should be taken to come up with an accurate diagnosis. It starts by taking your complete medical history. Information about your current medications, prior surgeries, past medical diagnoses, physical traumas and radiation exposures are obtained to form an objective opinion about your condition and possibly, to find the root cause of the problem. Stress factors and tensions at work and at home are explored. The patient’s psychological state is intensively assessed.
Specialized tests are used to confirm the diagnosis of ED. An ultrasound determines the adequacy of blood supply to the penis through the analysis of the emitted sound waves. To check for a possible damage of your nerves, a complete neurological evaluation is done by your physician. Dynamic infusion and cavernosometry and cavernosonography or DICC, is another accurate tool that analyzes the supply of blood to the penis through injection of a dye in the vessels that supply the male organ. The nocturnal turnescence test is indicated to determine if erectile dysfunction is caused by a physical problem or a psychological setback. A special perforated tape is wrapped around the penis before sleep to determine if erections have occurred during the night, which can be manifested by the separation of tape in the morning. Normally, men without erectile dysfunctions have numerous erections during sleep.
What are Your Treatment Options?
A variety of treatment options are available for ED. Conservative management includes the use of medications. Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) and alpostradil (Caverject), a synthetic prostaglandin hormone are the most commonly used drugs to treat ED. These drugs promote relaxation of the muscles in the penis, increasing the amount of blood flow, which encourages erections.
A penis pump can effectively cause erections by functioning as a vacuum to draw blood into the penis. In cases where blockages of the blood vessels that supply the penis occur, a vascular surgery is indicated. Penile implants are also used to manage impotence. These implants allow you to have erections, wherever and whenever.
If ED has a psychological origin, your physician may suggest that you and your partner visit a psychologist or counselor with years of experience in sexual problem management (sex therapist). Even if it is caused by something physical, erectile dysfunction can create stress and tensions in relationships. Counseling can be of great help, most especially if you and your partner go through it all together.
The cause and severity of your condition are important factors in determining the best treatment approach for you. It is best that you visit your physician and avoid self – medication.
Male Impotence: A Man’s Greatest Downfall?
Posted by admin in male impotence on May 7th, 2009
What is Erection Dysfunction?
When a man cannot initiate an erection to have sex or cannot sustain an erection long enough to achieve sexual climax, it is called erectile dysfunction or male impotence. The degree of impotence varies from one man to another. Some men experience chronic and complete erectile dysfunction, while others experience impotence in isolated and brief occurrences. A complete erectile dysfunction is established if erections during sleep do not occur, in addition to the failure to initiate or sustain sex. Frequent and constant erectile dysfunction causes emotional turmoil and severed relationships, which often leads to diminished self-esteem. Erectile dysfunction has many causes, and most of which are treatable and modifiable. Though it has a close association with aging, male impotence is not an inevitable incapacity.
What Causes Male Impotence?
The cause of impotence is multi-factorial since the ability to attain and maintain erections involve the interplay of the physical, hormonal and psychological aspects of one’s life. Generally, impotence can either be a consequence of a physical or biological irregularity, or an outcome of a psychological impediment. Pre – existing medical conditions are the most common causes of impotence.
Clinicians used to believe that impotence is entirely caused by psychological unrest, but for the past years, physical and biological alterations in our body are recognized as the most common causes of male impotence. Reduced blood flow to the penis and damage to the nerves that transmit impulses to the male organ are the most common physical causes. Medical conditions that commonly result in a decrease of blood supply to the penis are diabetes mellitus and cardiovascular disorders. Any condition that damages the blood vessels and disrupts the normal transmission of nerve impulses increases the risk for male impotence. Underlying conditions associated with erectile dysfunction include the following: cancer or prostate operations, spinal cord fractures, multiple sclerosis (MS) and hormonal imbalances.
Your mental health and your frame of mind can greatly affect the buildup of sexual excitement and desires. Any factor that switches off the brain from any sexual stimulation can result in impotence. Stress, anxiety, fatigue, depression, resentment, hostility and a genuine lack of interest in sex are only some of the psychological causes of erectile dysfunction.
To sum it up, cases of erection dysfunction increase as men age. No man is safe from this condition since it can affect them at any age and at any time in their lives. Physical causes are more common in older men, while psychological causes are more common in younger men. Sometimes erectile dysfunction may be a symptom of a more serious medical problem, and so it is best that you consult your physician for proper management.
The Emergence of Sexual Dysfunctions: An Introduction to Impotence
Sexual dysfunction, also termed impotence, is one of the most prevalent conditions seen in the population, most particularly among the older males. A condition which may have a physical or a psychological origin, impotence continues to be one of the most “humiliating and demeaning” health concerns worldwide.
Impotence is outstandingly prevalent as the age advances. Roughly, in the United States alone, 18 to 30 million American males are likely affected by impotence. A survey was conducted by the Male Aging Study (MMAS) among men ages 40 to 70 years, with a purpose to determine the prevalence of male impotence. Astoundingly 52% of the participants revealed some erectile dysfunctions of various magnitude and extent. In 2007, approximately 10.4% of men, ages 18 to 59 were unable to attain or sustain an erection, as revealed by the National Health and Social Life Survey. Both surveys showed a close association between aging and impotence, which support the idea that this condition is indeed physical in origin, and not purely psychological.
According to MMAS, 17% of men whose ages range from 40 to 70 years have mild cases of erectile dysfunction. Around 25% of men in this age group report moderate manifestations of male impotence. A cause for concern is the tripling percentage of cases with complete erectile dysfunction. A complete erectile dysfunction is described as the total inability to initiate or sustain erections during sexual stimulations with the absence of nocturnal erections.
It was once thought that impotence exclusively occurs in males, but researchers revealed that women, too can suffer from impotence. What’s more, female impotence is not as rare as we used to think. According to the California Association of Marriage and Family Therapists, 40% of women have cases of female sexual dysfunction or FSD. Undeniably, the prevalence of impotence is eminent and spans both genders and off all different age groups.
According to Abraham Maslow’s Hierarchy of Needs, sexual satisfaction is a physiological need – a fundamental and basic need for a human being to survive. Without a satisfying sexual relationship and expression, you cannot fully attain your other needs as a person. These include security, love and self – esteem. This might probably explain why people with impotence are often insecure with poor insight of their worth as a person. Without a doubt, the interference of the normal sexual activities has a great impact on the quality of your quality of life. Impotence may not sound as grave as the other medical conditions we know, but it can greatly incapacitate one’s psychological and emotional state. Sexual dysfunctions may not be as severe as the other diseases but it is a condition that needs medical help and intervention.
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