Drugs to treat erectile dysfunction need stronger warnings on their packaging about the risk of blindness, U.S. consumer group Public Citizen said in October, 2005, in a petition filed with health regulators. The U.S. Food and Drug Administration should "immediately add a black box warning regarding the risks of drug-induced blindness for the three phosphodiesterase 5 (PDE5) inhibitors that are prescribed for the treatment of erectile dysfunction," Public Citizen's Health Research Group wrote. Pfizer Inc.'s pulmonary hypertension drug Revatio, which has the same active ingredient as its impotence drug Viagra, should also carry a similar black box warning -- the strongest warning the agency can require, the advocacy group said. Earlier in 2005 drugmakers agreed to put information on their impotence drug labels about the possible vision loss, called non-arteritic anterior ischemic optic neuropathy. Viagra, Cialis, sold by Eli Lily & Co. and Icos Corp., and Levitra, sold by GlaxoSmithKline , Bayer AG and Schering-Plough Corp., now carry the new labels, which say the condition "has been reported rarely."

In diabetic men with erectile dysfunction, the severity of their sexual performance problem increases as control of blood sugar levels worsens.

Erectile dysfunction may serve as an early warning of heart disease down the road, even in men without traditional risk factors for heart trouble. In a study of 143 middle-aged men, Italian researchers found that those with vascular erectile dysfunction (ED) were nearly four times as likely as those without the condition to show high levels of calcification in the heart arteries. Calcium deposits, along with fat and other substances, are part of the artery-clogging "plaque" that accumulate in atherosclerosis, a "hardening" and narrowing of coronary arteries that can lead to heart attack and stroke. Computed tomography (CT), a specialized X-ray technique, can detect these calcium deposits, and it is sometimes used to screen for heart disease before symptoms are apparent. In the new study, CT scans revealed that arterial calcium deposits were more common and more extensive in men with erectile dysfunction -- even though traditional heart risk factors, like high blood pressure and high cholesterol, were not.

Exercises that focus on strengthening the muscles at the base of the penis, known as the pelvic floor, appear to be a useful treatment for erectile dysfunction. The findings, which appear in the medical journal BJU International, are based on a study of 55 men with erection difficulties who were randomly selected to receive lifestyle advice, such as quitting smoking, with or without training in pelvic floor exercises. After three months, subjects in the non-exercise group who showed no response were treated with the exercise intervention. The exercise training was provided by a physiotherapist who instructed the men to tighten their pelvic floor muscles as if they were trying to prevent gas passing. In addition, emphasis was placed on the ability to retract the penis and lift the scrotum using pelvic muscles. After three months of training, the men were encouraged to continue the exercises at home for three additional months. At that point, erectile function, based on a standard scoring system, was significantly better in the pelvic exercise group than in comparison subjects. The men who crossed over to the intervention displayed a significant improvement in erectile dysfunction three months later.

Eat Less for Better Sex? Have you heard of the Metabolic Syndrome or Syndrome X? - Symptoms of metabolic syndrome include a large waistline, high blood pressure, raised insulin levels, excess body weight and abnormal cholesterol levels. If someone has three or more symptoms they have the syndrome and a higher risk of suffering from life-threatening illnesses.  In a new study, 100 men with metabolic syndrome were compared with matched male controls who did not have the syndrome (they are called the controls). Patients with metabolic syndrome had an increased prevalence of erectile dysfunction at 26% versus 13% for the control group. The syndrome X group also had a higher level of C-reactive protein, an marker of inflammation. Erectile dysfunction, which occurs in up to 30 million men in the United States and approximately 100 million men worldwide, affects up to 50% of males between 40 and 70 years of age. This study showed a linear increment in the prevalence of erectile dysfunction that is associated with a linear increase in C-reactive protein level. As the C reactive protein level rises, it starts affecting the endothelium, the lining in blood vessels responsible for maintaining healthy dilation of blood vessels. Many patients with erectile dysfunction seem to have a vascular mechanism that is similar to that seen in atherosclerosis, which includes endothelial dysfunction. “High Proportions of Erectile Dysfunction in Men With Metabolic Syndrome,” Esposito K, Giugliano F, et al, Diabetes Care, May 2005;28(5):1201-1203.

Smoking may raise the risk of erectile dysfunction, particularly in younger men. Researchers found that among the more than 1,300 men they followed, those who smoked were at greater risk of erectile dysfunction than either former smokers or non-smokers. Smokers in their 40s, the youngest group in the study, showed the highest smoking-related risk. Compared with other men their age, they were nearly three times more likely to have erectile dysfunction. Smoking was also linked, to a lesser extent, to erectile dysfunction among men in their 50s and 60s, but not among those in their 70s. This age difference is not surprising, according to Drs. Naomi M. Gades and Steven J. Jacobsen of the Mayo Clinic College of Medicine in Rochester, Minnesota, two of the authors of the study. Older men often have a number of risk factors for erectile dysfunction, including diabetes, heart disease and high blood pressure. In younger men, the association between smoking and erectile dysfunction is less likely to be "masked" by these other medical conditions.

Tadalafil may increase the blood pressure-lowering effects of doxazosin, which is commonly prescribed for the treatment of enlarged prostate, or benign prostatic hyperplasia (BPH), researchers report in the Journal of Neurology. Patients and physicians and patients should be aware that there might be interactions between alpha blocker drugs, which are often used to treat BPH and high blood pressure, and drugs used to treat erectile dysfunction, phosphodiesterase 5 inhibitors, which include drugs such as tadalafil.

Erectile dysfunction is sometimes more than just an issue that negatively impacts a man's quality of life -- it can also be an early sign of heart or blood vessel problems. Consequently, men need to tell their doctors as soon as they develop erectile dysfunction, so their doctors can order additional tests to make sure their heart and blood vessels are healthy. Erectile dysfunction is a barometer of a man's overall cardiovascular health. Erectile dysfunction is often caused by problems in the body's blood vessels, Billups explained. If blood vessel problems are causing high blood pressure or cholesterol -- so-called "silent" conditions -- men may not know it. But if those impaired blood vessels also impact erections, men will know.

The Food and Drug Administration on 11/04 warned consumers not to buy or use Actra-Rx or Yilishen for erectile dysfunction treatment because the supplements contain an ingredient that could lower blood pressure to unsafe levels. The FDA also instructed employees to block imports of the supplements, calling them “dangerous ... and even life-threatening.” Actra-Rx and Yilishen are promoted for erectile dysfunction treatment that enhance men’s sexual performance. Despite an all-natural label, Actra-Rx capsules contain prescription strength levels of sildenafil, the active drug ingredient in Viagra. Viagra, produced by Pfizer, was approved by the FDA to treat erectile dysfunction.

Preliminary observations on the use of propionyl-L-carnitine in combination with sildenafil in patients with erectile dysfunction and diabetes.
Curr Med Res Opin. 2004 Sep;20(9):1377-84.
To investigate the efficacy and tolerability of oral propionyl-L-carnitine plus sildenafil in men with erectile dysfunction and diabetes unresponsive to sildenafil monotherapy. Patients with medically documented erectile dysfunction of organic or mixed aetiology and diabetes (type 1 and 2) were randomised to receive oral propionyl-L-carnitine (2 g/day) plus sildenafil (50 mg twice weekly) (20 patients, Group 1) or sildenafil alone (20 patients, Group 2), in a double-blind, fixed-dose study. All patients had been previously treated unsuccessfully with a minimum of eight administrations of sildenafil. CONCLUSIONS: Salvage therapy with propionyl-L-carnitine plus sildenafil was more effective in erectile dysfunction than sildenafil in the treatment of erectile dysfunction in patients with diabetes refractory to sildenafil monotherapy.

Erectile dysfunction: a significant health need in patients with coronary heart disease.
Scott Med J. 2004 Aug;49(3):97-8.
Erectile dysfunction is a common condition, which negatively affects quality of life, and shares similar risk factors with Coronary Heart Disease (CHD). Studies from the pre - sildenafil era confirm a higher risk of Erectile dysfunction in patients with cardiovascular disease. The high profile and success of sildenafil therapy has made it easier for some men to discuss erectile difficulties with healthcare professionals. Our aim therefore was to estimate the prevalence of Erectile dysfunction in our cardiac rehabilitation patients . We surveyed 150 random male cardiac rehabilitation patients using the International Index of Erectile Function questionnaire. 61% of all respondents had erectile difficulties, rising to 75% in the over 55 age group. 48% of respondents indicated their wish to discuss erectile problems with the healthcare team. CONCLUSION: Erectile dysfunction and CHD commonly co-exist. A large proportion of our respondents wished further discussion of erectile insufficiency. We recommend that cardiac rehabilitation programs should adopt a proactive approach to detection and treatment of erectile dysfunction.

Erectile dysfunction rates and requests for treatment in patients attending outpatient urology clinics and those accompanying them.
Int Urol Nephrol. 2004;36(2):223-6.
Erectile dysfunction is a common sexual function disorder in men. The aim of the present study was to determine the rates of erectile dysfunction and requests for treatment in male patients referred to our outpatient urology clinics and those accompanying them who were older than 20 years. The study comprised 2 groups: group 1 included male patients older than 20 years whom attend to the outpatient urology clinics, and group 2 included their companies whom were older than 20 years. Subjects were asked whether they had erectile dysfunction or not, if so whether they had been treated or not, if not then why, and whether they desired treatment or not at present. RESULTS: Erectile dysfunction was determined in 224 subjects (13%) in group 1, and 57 (8%) in group 2. It was found that approximately one half of patients with erectile dysfunction did not complain about this. The main reasons for this were failure to perceive sexual dysfunction as a problem, and shame. Of 281 men who determined to have erectile dysfunction, 71 indicated that they desired treatment. In those who did not desire treatment, the main reasons were failure to perceive it as a problem, and shame. CONCLUSIONS: These findings show that the doctor has a great responsibility in determining erectile dysfunction. Therefore discussions of sexual health should be made a routine part of doctor-patient discussions, and patients, especially those over 50, should be asked whether they have a complaint of erectile dysfunction.

Morphologic findings and blood flow parameters of penile vasculature in patients with erectile dysfunction.
World J Urol. 2004 Sep 9
The objective was to study the risk factors in patients with erectile dysfunction in correlation with ultrasound findings of penile vasculature. Patients with erectile dysfunction were classified in four groups according to their risk factors. Group A (37 pts) who were heavy smokers, group B (40 pts) who suffered from diabetes mellitus, group C (30 pts) who suffered from hyperlipidemia and group D (40 pts) with no risk factors. The peak systolic velocity (PSV) was measured after the intracavernous injection of 10 mg alprostadile. Normal values were PSV>35 cm/s and endiastolic venous velocity<4 cm/s. It was found that the mean PSV in group A was 22 cm/s without venous leakage, in group B the mean PSV was 24 cm/s but there was a significant venous leakage (mean end-diastolic velocity 6 cm/s). Patients with hyperlipidemia (group C) had a mean PSV of 26 cm/s and insignificant venous leakage and patients in group D had a normal vascular profile. Patients with erectile dysfunction who are heavy smokers are predisposed to have penile arterial insufficiency, while diabetics have both arterial insufficiency and venous leakage.

Saddle pressure can cause temporary erectile dysfunction for men who take part in long distance cycling events, but bike adjustments may decrease the risk. However, bicycle seats with "cutouts" designed to relieve the pressure that may contribute to erectile dysfunction could actually put certain men at greater risk for the problem. Researchers found that among 463 men who'd taken part in long-distance cycling events, just over four percent developed short-lived erectile dysfunction within the following week. And while many of those who reported using a cutout saddle were at lower risk of temporary erectile dysfunction, others -- namely, those who felt numbness in the groin during the ride -- were more likely to develop erectile dysfunction if they used a cutout seat. The researchers also found a greater erectile dysfunction risk among men who used a mountain bike for the road race, and those with handlebars higher than the saddle. The findings are published in The Journal of Urology. cause of erectile dysfunction erectile dysfunction drug.

Is routine hormonal measurement necessary in initial evaluation of men with erectile dysfunction?
Arch Androl. 2004 Jul-Aug;50(4):247-53.
To prospectively compare serum hormone levels and the incidence of hormonal pathologies between men with and without erectile dysfunction, and investigate risk factors that might predict hormonal pathologies in men complaining of erectile dysfunction. The study included 262 men with erectile dysfunction and 53 healthy men with no erectile dysfunction as a control group. All men enrolled in the study were evaluated with a detailed history, physical examination, international index of erectile function, and serum hormone measurement. Hypotestosteronemia was considered as serum total testosterone value of <3 ng/mL, and hyperprolactinemia was considered as serum prolactin level of >18 ng/mL. Serum hormone levels and the incidence of hormonal abnormalities were compared between the controls and those with erectile dysfunction. In addition, risk factors for hormonal abnormalities were investigated. There were no significant differences in the mean serum FSH, LH, testosterone and prolactin values between the men with and without erectile dysfunction. Hypotestosteronemia was detected in 29 (11%) of the erectile dysfunction group and in 2 (3.7%) of the control group, revealing no significant difference (p = 0.104). Hyperprolactinemia was detected in 25 (9%) of the erectile dysfunction group and in 2 (3.7%) of the control group, revealing no significant difference. To investigate risk factors that might predict hormonal pathologies, there were no significant differences in the patient age, duration of the erectile dysfunction, smoking history and duration, the presence of chronic disease and the type of erectile dysfunction. Our findings suggest that hormonal measurement should not be routinely performed in the initial evaluation of men presenting with erectile dysfunction, and may be necessary based only on the findings obtained with a careful history and physical examination.

Erectile Dysfunction and diabetes.
Int J Clin Pract. 2004 Apr;58(4):358-62.
Erectile Dysfunction is common in men with diabetes. Diabetic men are three times as likely to develop Erectile Dysfunction as non-diabetic men. The cause is multifactorial, but most commonly reflects endothelial dysfunction and autonomic neuropathy. Diabetes and vascular disease often coexist and Erectile Dysfunction may be a marker for silent occlusive arterial disease, for which the patient should be screened. Many men still do not volunteer their problem, hence, routine questioning by health care professionals is an important part of the overall management because of the deleterious effect of Erectile Dysfunction on relationships, self-esteem and quality of life. Treatment is effective in the majority and all options should be considered, beginning with the much preferred oral phosphodiesterase type 5 inhibitors (sildenafil, tadalafil, vardenafil). Female Sexual Dysfunction or Disorder (FSD) is more difficult to define and specific studies in diabetics are limited. Problems with arousal, lubrication and orgasmic dysfunction occur, but the fatigue of diabetes may be influencing these complaints, and in general, psychological issues appear to predominate.

Prevention and treatment of erectile dysfunction using lifestyle changes and dietary supplements: what works and what is worthless, part II.
Moyad MA, et al. Sexual Medicine Society Nutraceutical Committee. University of Michigan Medical Center, Ann Arbor, MI  Urol Clin North Am. 2004 May;31(2):259-73.
It seems naive to believe that some plants or herbs do not contain specific compounds that could benefit patients with erectile dysfunction. Many supplements have not been investigated in a laboratory or clinical research setting before commercial sale, however, which creates a complex situation. If efficacy is or is not demonstrated through adequate research, then the benefit or lack thereof cannot be mentioned on the label. Furthermore, clinicians and the public cannot be made aware of which compounds or supplements are effective because no general standards for sale exist under the current guidelines. Dietary supplements have received a tremendous amount of publicity. The large and growing market for erectile dysfunction treatment seems to have contributed partly to the promotion of numerous supplements and their apparent benefits. Whether these dietary supplements have merit is questionable. Some supplements may produce results opposite to those advertised. Other supplements may be enjoying the benefits of the placebo effect. Because a placebo response of 25% to 50% has been recorded in clinical trials with effective agents, it is understandable that some supplements enjoy financial success despite the limited research espousing their use. If one to two of four individuals or one of three individuals who try a dietary supplement gain some benefit for their erectile dysfunction, the market for these supplements will remain extraordinary. On a larger scale, of 100,000 men who try a supplement, approximately 25,000 to 50,000 will claim some success. The challenge for clinicians is to discuss the placebo response properly and the need for good research before any intervention, especially supplements, can be advocated for general use. Table 2 summarizes some popular erectile dysfunction supplements and general conclusions that can be drawn from clinical investigations. Some dietary supplements may have an active ingredient that benefits patients with certain types of erectile dysfunction. An exciting area of future dietary supplement research is the ability of certain agents to have a synergistic effect with prescription agents for erectile dysfunction, thereby improving response rates in men that have failed approved erectile dysfunction therapy initially, especially with oral agents. Randomized clinical trials are the best method of determining which dietary supplements will become a part of conventional medicine. Therefore, more randomized trials for dietary supplements are needed so that they may have the opportunity to become a part of the mainstream milieu, which means that more funding needs to be made available for erectile dysfunction research.  male erectile dysfunction.

Erectile dysfunction: symptom or disease?
University of Padua, Italy. J Endocrinol Invest. 2004 Jan;27(1):80-95.
Erectile dysfunction has been defined by the National Institute of Health (NIH) as the inability to achieve and/or to maintain an erection for a sufficiently long period of time so as to permit satisfactory sexual intercourse. Erectile dysfunction affects millions of men throughout the world and could have a negative influence on the individual's well-being as well as on the quality of life of affected subjects. Discordant data have been reported on Erectile dysfunction epidemiology with prevalence ranging from 12% to 52%, probably depending on the different criteria utilized in the different studies for patient selection. Erectile dysfunction is a symptom, sometimes the first, of different pathological conditions. In 15.7% of 45-yr-old patients with vascular Erectile dysfunction a dynamic ergometric test has shown electrocardiographic alterations in the absence of any cardiac symptom. In 15% of the patients with Erectile dysfunction, high fasting glucose plasma levels are discovered for the first time and in patients with ED and normal fasting glucose plasma levels the prevalence of undiagnosed diabetes mellitus is 12% after an oral glucose tolerance test. The different risk factors are often additive in the possible development of systemic vasculopathy, neuropathy and Erectile dysfunction. Erectile dysfunction, underestimated in clinical practice due to archaic prejudice which hinders the patient in spontaneously revealing the problem and the physicians in investigating it, can mark the point where evaluation and prevention of important diseases (such as diabetes, arterial hypertension, atherosclerosis) hitherto unknown by the patients, can begin. The physicians' cultural baggage must include the ability to identify the pathology that can determine Erectile dysfunction and the ability to program a specific diagnostic workup. In this paper the different specialists involved in Erectile dysfunction diagnosis agreed that a clinical approach which allows the identification of systemic pathologies contributing to the development of Erectile dysfunction constitutes an improvement in disease prognosis and may either induce a spontaneous reduction of Erectile dysfunction or facilitate its specific treatment. dysfunction erectile meds.

A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report.
Hong B. niversity of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. J Urol. 2002 Nov;168(5):2070-3.
We investigated the efficacy of Korean red ginseng for erectile dysfunction. A total of 45 patients with clinically diagnosed erectile dysfunction were enrolled in a double-blind, placebo controlled, crossover study (8 weeks on treatment, 2 weeks of washout and 8 weeks on treatment) in which the effects of Korean red ginseng and a vehicle placebo were compared using multiple variables. The ginseng dose was 900 mg. 3 times daily. RESULTS: Mean International Index of Erectile Function scores were significantly higher in patients treated with Korean red ginseng than in those who received placebo. Scores on penetration and maintenance were significantly higher in the ginseng than in the placebo group. In response to the global efficacy question 60% of the patients answered that Korean red ginseng improved erection. Among other variables penile tip rigidity on RigiScan showed significant improvement for ginseng versus placebo. Our data show that Korean red ginseng can be an effective alternative for treating male erectile dysfunction.

Cessation of smoking rapidly decreases erectile dysfunction.
Section of Endocrinology, Lahey Hitchcock Medical Center, Burlington, Massachusetts. Endocr Pract. 1998;4(1):23-6.
Objective: To assess the relationship between cessation of smoking and rapid improvement in erectile dysfunction as well as the effect of nicotine patches on nocturnal penile tumescence and rigidity. Nocturnal penile erections were studied in 10 smokers with use of the RigiScan portable home monitor. Two nights were monitored: for the first night, the patients had not stopped smoking; for the second night, the patients had stopped smoking for 24 hours. In addition, four men were monitored after cessation of smoking and wearing nicotine patches for 1 month. Results: Multiple variables studied showed a statistically significant improvement in nocturnal penile tumescence and rigidity in the men who had stopped smoking for 24 hours. Continued improvement in erectile dysfunction was noted in the four men who were monitored while not smoking and wearing nicotine patches for 1 month. Conclusion: Stopping cigarette smoking is a factor that rapidly improves penile tumescence and rigidity. Because the improvement continues while the patient is receiving nicotine from transdermal patches, some factor or factors other than the nicotine are responsible for the erectile dysfunction.

The etiology of erectile dysfunction and contributing factors in different age groups in Turkey.
Caskurlu T.Sisli Etfal Training and Research Hospital, Istanbul, Turkey. Int J Urol. 2004 Jul;11(7):525-529.
Abstract Background: The aim of the present study was to determine the pathophysiological factors which cause erectile dysfunction, as well as the risk factors in different age groups in Turkey. Methods: A total of 948 patients with erectile dysfunction who were admitted to three andrology clinics were evaluated in terms of etiological factors. They underwent a multidisciplinary diagnostic evaluation. Erectile dysfunction was classified as primarily organic, primarily psychogenic, mixed or unknown in etiology. Results: Psychogenic erectile dysfunction was diagnosed in 65.4% of the patients and organic erectile dysfunction was diagnosed in 34.6% of patients overall. In patients under 40 years, the rate of psychogenic erectile dysfunction was 83% and the rate of organic erectile dysfunction was 17%, but in the patients over 40 years, the rate of psychogenic erectile dysfunction was 40.7% and the rate of organic erectile dysfunction was 59.3%. The causes of organic erectile dysfunction were identified as arteriogenic erectile dysfunction, 40.5%; cavernosal factor (venogenic) erectile dysfunction, 10%; neurogenic erectile dysfunction, 12.5%; endocrinologic erectile dysfunction, 1.8%; mixed type erectile dysfunction, 11.8%; and drug induced erectile dysfunction, 4.5%. Conclusion: Our data represent a higher ratio of erectile dysfunction in patients under 40, which are mostly psychogenic, This finding potentially results from local social and cultural differences.

Improvement in erectile function in men with organic erectile dysfunction by correction of elevated cholesterol levels: a clinical observation.
Saltzman EA. Lahey Clinic Northshore, Peabody, Massachusetts 01960, USA. J Urol. 2004 Jul;172(1):255-8.
We determined that use of a statin drug to lower cholesterol would improve erectile function in men who have hypercholesterolemia as the only risk factor for erectile dysfunction. A total of 18 men were determined to have increased cholesterol as the only risk factor for erectile dysfunction by history, system review, physical examination and laboratory analysis. Nine of these men agreed to participate in the study. Organic erectile dysfunction was verified by abnormal nocturnal penile tumescence and rigidity testing. Subjects were given atorvastatin with a goal decrease of total cholesterol to less than 200 mg/dl and low-density lipoprotein cholesterol to less than 120 mg/dl. RigiScan measurements were compared before and after treatment with atrovastatin. RESULTS: Mean age +/- SD was 49.7 +/- 7.4 years. Mean length of treatment with atrorvastatin was 3.7 +/- 2.1 months. Clinically 8 of the 9 men had improved erection adequate for penetration during sexual intercourse. Mean questionnaire scores improved from 14.2 to 20.7. Mean total and low-density lipoprotein cholesterol decreased significantly after treatment. RigiScan measurements showed an increased average penile rigidity at the base and tip after treatment with atorvastatin. CONCLUSIONS: Erectile dysfunction improves in men with hypercholesterolemia as the only risk factor for erectile dysfunction when treated with atorvastatin. Treating hypercholesterolemia may improve erectile dysfunction, while promoting primary cardiac prevention. dysfunction erectile pump

Cardiovascular disease and erectile dysfunction are closely interrelated disease processes. Erectile dysfunction reportedly affects 10 million to 20 million men in the United States and more than 100 million men worldwide. Each year, about 500,000 persons in the United States survive a myocardial infarction, and an estimated 11 million have existing cardiovascular disease, making the issue of erectile dysfunction and cardiac disease relevant to many patients. cure dysfunction erectile

Aging and pathogenesis of erectile dysfunction.
1Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy.
Int J Impot Res. 2004 May 6
The prevalence and the severity of erectile dysfunction increase with advancing age; different pathogenetic factors could contribute to age-related erectile dysfunction. We studied organic, relational and intrapsychic components of erectile dysfunction as a function of patients' age in a consecutive series of 977 patients with erectile dysfunction, using the specifically designed structured interview. A complete physical examination and a series of biochemical, hormonal, psychometric and penile vascular tests were also performed. Relational factors seems to be more relevant in patients aged over 60 y, while intrapsychic disturbances play a major role in younger subjects. Organic factors are the most important determinant of erectile dysfunction in all age groups, but their contribution is more important in older patients. In fact, basal and dynamic peak cavernosal velocity at Doppler ultrasound penile examination was reduced in older patients. Among hormonal factors, the body mass index-dependent reduction of testosterone in older patients does not seem to play a crucial role in the pathogenesis of erectile dysfunction. No significant correlation was observed between testosterone level and the severity of erectile dysfunction, although patients reporting hypoactive sexual desire showed significantly lower testosterone levels when compared with the rest of the sample.  drug dysfunction erectile dysfunction erectile medication.

Exercise and weight loss may improve sexual function in obese men, researchers in Italy report. In a new study of more than 100 obese men with erectile dysfunction, nearly a third regained normal sexual function after participating in an intensive weight loss program.

If a man with type 2 diabetes also suffers from erectile dysfunction, it strongly suggests that he could well have coronary artery disease that's not causing any symptoms.

U.S. health regulators have accused Vivus Inc. of misleading consumers by downplaying risks associated with its little-used erectile dysfunction treatment called Muse. Vivus failed to include risk information and made false claims about the drug's effectiveness both on its Web site and in television advertisements that ran in 2003. dysfunction erectile help dysfunction erectile vitamin.

Prostate cancer patients underwent an operation called a bilateral nerve-sparing retropubic radical prostatectomy. More than 90 percent of these men who had the operation suffered from erectile dysfunction afterwards. dysfunction erectile male dysfunction erectile impotence.

A third of older men have erectile dysfunction and the problem only gets more common with age. The good news is that there are many things men can do to reduce their risk of erectile dysfunction. The figures come from a survey of nearly 32,000 men, 53 to 90 years of age, who participated in the Health Professionals Follow-up Study. The results are reported in the Annals of Internal Medicine. Dr. Constance G. Bacon, from Harvard School of Public Health, and associates found that 33 percent of the men reported erection problems in the previous 3 months. Moreover, for each decade beyond 50 years of age, overall sexual function, desire, and orgasm frequency decreased sharply. Physical inactivity and obesity had a lot to do with erectile dysfunction. Men who ran for at least 3 hours per week or engaged in a similar amount of exercise were 30 percent less likely to have erectile dysfunction than men who barely exercised at all. Similarly, non-obese men were 30 percent less likely to develop these problems than obese men, the researchers note. Other "risk factors" for erectile dysfunction included smoking, drinking alcohol, and watching television. SOURCE: Annals of Internal Medicine August 5, 2003.
Dr. Sahelian adds: Diet also plays an important role in reducing the risk of erectile dysfunction. I recommend eating lots of healthy, organic vegetables and adding fish to the diet.

Effects of icariin on cGMP-specific PDE5 and cAMP-specific PDE4 activities.
Xin ZC, Kim EK, Lin CS, Liu WJ, Tian L, Yuan YM, Fu J.
Department of Urology, the 1st Hospital, Peking University, 8 Xishiku Street, Xicheng District, Beijing 100034, China.
AIM: To clarify the mechanism of the therapeutic action of icariin on erectile dysfunction. METHODS: PDE5 was isolated from the human platelet and PDE4 from the rat liver tissue. RESULTS: Icariin and papaverine showed dose-dependent inhibitory effects on PDE5 and PDE4 activities. The potencies of selectivity of icariin and papaverine on PDE5 (PDE4/PDE5 of IC(50)) were 167.67 times and 4.54 times, respectively. CONCLUSION: Icariin is a cGMP-specific PDE5 inhibitor that may be developed into an oral effective agent for the treatment of erectile dysfunction.

The endocrinologist as the focus in a multidisciplinary approach to management of erectile dysfunction.
Section of Endocrinology, Lahey Hitchcock Medical Center, Burlington, Massachusetts. Endocr Pract. 1997;3(1):1-8.
Objective: To present an approach to the complete but cost-effective office evaluation and treatment of erectile dysfunction. Methods: The numerous medical, hormonal, and psychologic causes of erectile dysfunction are reviewed, and the various treatment strategies are outlined. Results: Erectile dysfunction, which might also include libido and ejaculatory disturbances, is the most frequently encountered type of sexual dysfunction seen in office practice. Before 1960, the assessment of erectile dysfunction was dominated by psychiatrists; later, urologists assumed a role. More recently, physicians in internal medicine have become involved in the management of erectile dysfunction. Diabetes mellitus, hypertension, and tobacco abuse are the three most common causes of erectile dysfunction in men older than 50 years of age. In addition to optimizing the management of diabetes, the endocrinologist can treat other endocrine problems associated with erectile dysfunction. Conclusion: A multidisciplinary approach to the evaluation and treatment of erectile dysfunction is logical, and the endocrinologist--because of an extensive background in internal medicine and expertise in hormonal diagnosis and treatment--should be the focal point of this diagnostic and therapeutic team. dysfunction erectile medicine diabetes dysfunction erectile.

New oral drugs for erectile dysfunction.
Drug Ther Bull. 2004 Jul;42(7):49-52.
In 1998, we concluded that sildenafil (Viagra--pfizer Ltd), a selective phosphodiesterase type 5 inhibitor, appeared to offer advantages over other medical approaches for erectile dysfunction in terms of ease of administration and cost. Oral drug treatment is now widely advocated as first-line therapy for erectile dysfunction, except where the cause is clearly psychological. In the past 4 years, three more oral preparations have been licensed in the UK for the treatment of men with erectile dysfunction. A sublingual preparation of the dopaminergic agonist apomorphine (Uprima--Abbott Laboratories Ltd) is the first centrally acting drug to be licensed. Tadalafil (Cialis--Eli-Lilly) and vardenafil (Levitra--Bayer PLC) are phosphodiesterase type 5 inhibitors. Here we review the place of these preparations for men with erectile dysfunction. dysfunction erectile product dysfunction erectile pill.

Erectile Dysfunction emails
Q. Can you tell me if you have ever heard of any link between periodontal disease and erectile dysfunction?
   A. Not at this time, however most conditions that have a negative influence on the body are likely to influence blood vessels, hormone balance or other aspects of health and hence may have a direct or indirect influence on erectile dysfunction.