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Tobacco, alcohol or drug use: All three of these substances can damage a person's blood vessels and/or restrict blood flow to the penis, causing ED. Smoking in particular plays a large role in causing ED in people with arteriosclerosis. The most significant improvements over placebo are at dosages of 4mg to 6mg. However it was clear in this same trial and others (9, 15, 16, 18), that increased dosages also increase the likelihood of the most common side effect of nausea. These side effects are reported to diminish with continued dosing. (15) Sildenafil (Viagra), whose labeling was approved by the U.S. Food and Drug Administration (FDA) in March 1998, is the first oral medication to be marketed for the treatment of erectile dysfunction. Sildenafil inhibits the conversion of cGMP to guanosine monophosphate in the corpus cavernosum, thereby increasing the available concentration of cGMP. This reaction is largely catalyzed by the enzyme phosphodiesterase type 5. Sildenafil inhibits this enzyme, resulting in relaxation of the cavernosal smooth muscle.17 Sildenafil is absorbed rapidly, with peak plasma levels achieved within an hour. It undergoes hepatic metabolism and has a half-life of about four hours. Whether the cause of impotence is physiological or psychological, both the patient and his partner often experience a range of intense feelings and emotions. Any of these feelings can lead to a sense of hopelessness and lower self-esteem. Is erectile dysfunction just a part of old age? ED can in many cases be treated by drugs taken orally, injected, or as penile suppositories. These drugs increase the efficacy of NO, which dilates the blood vessels of corpora cavernosa. When oral drugs or suppositories fail, injections (e.g. of apomorphine) into the erectile tissue of the penile shaft may work. One of the very frequent disorders that have affected additional than 90% of the sexually active men a lowest possible of once is the impotence. Call your doctor immediately or go to an emergency room if medication for erection problems give you an unwanted erection that lasts more than 4 hours. Permanent impotence or other lasting damage to your penis may result from this condition. Seek care immediately if your erection lasts longer than 3 hours. After accounting for differences due to age, smoking and heart disease all risk factors for ED Chew and colleagues found that drinkers experienced rates of impotence 25% to 30% below those of teetotallers. Of these men, 118 had erectile problems when the study began, and over the next four years, they were twice as likely to suffer from some sort of cardiac problem such as a heart attack or stroke. The investigators found that the erectile dysfunction rate was 93 cases per 1000 persons per year among NSAID users compared with just 35 cases among nonusers. Damiana (Turnera diffusa) Traditionally used as an aphrodisiac and for various sexual disorders; however, there are no current studies to confirm its effectiveness. By Steven Reinberg One theory holds that ED and heart disease are both manifestations of the same disease. Indeed, Chew found that men who suffer from ED are more likely to go onto develop heart disease. Here

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