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With the introduction of effective pharmacologic therapies for erectile dysfunction, more men are seeking treatment. The underlying cause of erectile dysfunction is usually a chronic medical illness or a side effect of certain drugs. Less commonly, the problem is psychogenic. Even after optimal treatment of common medical disorders such as diabetes mellitus and hypertension, erectile dysfunction may persist. Pharmacologic treatments, such as the intracavernosal or transurethral administration of alprostadil or the use of the new oral medication sildenafil, may offer patients substantial benefit. Before any of these drugs are prescribed, consideration should be given to existing medical illnesses and medications, partner satisfaction, comfort with the method of administration and the side effect profile. (Am Fam Physician 1999;60:1159-72.)
Excessive alcohol use has long been recognised as one cause of impotence, leading to the euphemism "brewer's droop"; Shakespeare made light of this phenomenon in Macbeth.
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If you have difficulty having or keeping an erection more than 25% of the time, it is considered a problem.
An increasing array of medications is available to assist in the management of erectile dysfunction (ED). New agents are still undergoing clinical testing, and more are in the early phases of development.
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For some couples sex therapy may be necessary to help you and your partner cope. It may also help you to hear from some men who have ED and learn about their experiences. Contact your doctor about local support groups in your area.
Sildenafil is available in 3 doses: 25 mg, 50 mg, and 100 mg. The starting dose depends on the clinical situation. A man in his fifth decade of life with mild sexual dysfunction that is probably related to psychological factors can start on the 25-mg dose. Men with moderate-to-severe ED can begin at the 50-mg dose, and, after testing the effect of the drug on at least 3 occasions (although 5-6 tries is recommended), the dose can be modified. Men with severe ED can start on the 100-mg dose; these men are not likely to achieve a satisfactory response, but they should make 3-4 attempts before starting another form of therapy.
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Author Affiliations: Creighton Diabetes Center, Omaha, Neb (Dr Rendell); Harbor-University of California, Los Angeles Medical Center, Torrance (Dr Rajfer); Pfizer Central Research, Groton, Conn (Dr Wicker) and Sandwich, England (Dr Smith). A complete list of the members of the Sildenafil Diabetes Study Group appears at the end of this article.
Practice yoga and meditation regularly to keep stress level low.
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For the study, Barst's team randomly assigned 405 pulmonary hypertension patients to Cialis or placebo once a day, or to Cialis and bosentan (Tracleer) a common treatment for pulmonary hypertension.
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Men with erectile dysfunction should be watched closely for coronary artery disease, the authors stated. Others agreed.
If this is often happening to you then you ought to take the primary step and talk to someone. If you can admit the matter to yourself and your partner then you'll be able to get the assistance you need. As a rule, your partner already knows there's a drawback but isn’t positive what they'll do about it. By talking it out you can research your options together. You aren’t the only one who is laid low with this, and knowing that there are others in your position could help you to get the help that you just need.
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