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U.S. and Japanese researchers are investigating whether firing shock-waves towards the heart will help it sprout healthy new blood vessels. Yes. It's important to identify and treat any correctable problems. In some men, a doctor's exam may find an underlying medical problem that is causing the infertility. The use of exogenous androgens suppresses natural androgen production. Elevating serum androgen levels has the potential to stimulate prostate growth and may increase the risk of activating a latent cancer. Periodic prostate examinations, including digital rectal examinations, prostate-specific antigen determinations, and blood counts (ie, CBC counts), are recommended in all patients receiving supplemental androgens. Obtaining a testosterone level while on therapy is also suggested to optimize the dosage. Similarly, DTC antidepressant ads that depict depressed women as unable to fulfill their roles in the family have medicalized that issue, Metzl said. Q. What are the major differences between the two devices? Has not improved despite self-care. I like Here are some tips to help get the conversation started. Other adverse events associated with oral PDE-5 inhibitor therapy appear to be few (Table 4). In clinical trials the rates of discontinuation of the drug because of adverse events was low (< 5%) for all of 3 drugs, with few or no cases of priapism.37,53,55,56 Extra caution should be taken for patients who are expected to have reduced clearance of the drug. This group includes men who have severe hepatic or renal insufficiency, men over 65 years old and men taking drugs that inhibit the cytochrome P450 3A4 enzyme (e.g., cimetidine, erythromycin and ketoconazole).57 For these patients it is prudent to start with smaller doses of medication and build up gradually. For sildenafil, it is our experience that a starting dose of 50 mg is safe and effective for all men. 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. Inexpensive Condom use required 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. Pharmacy Reviewed by Louise Chang, MD Workers in the BPA factories were four times more likely to report erectile dysfunction, reduced sexual desire and overall dissatisfaction with their sex life. They were also seven times more likely to have ejaculation difficulties. Oral testosterone can reduce ED in some men with low levels of natural testosterone, but it is often ineffective and may cause liver damage. Patients also have claimed that other oral drugs—including yohimbine hydrochloride, dopamine and serotonin agonists, and trazodone—are effective, but the results of scientific studies to substantiate these claims have been inconsistent. Improvements observed following use of these drugs may be examples of the placebo effect, that is, a change that results simply from the patient's believing that an improvement will occur. A useful and simple way to distinguish between physiological and psychological impotence is to determine whether the patient ever has an erection. If never, the problem is likely to be physiological; if sometimes (however rarely), it could be physiological or psychological. The current diagnostic and statistical manual of mental diseases (DSM-IV) has included a listing for impotence. A vacuum constriction device (VCD) is an external pump with a band on it that a man with erectile dysfunction can use to get and maintain an erection. 2,306 men were involved in the study. Just over a quarter already had erectile dysfunction. None of the men had any obvious signs of heart disease, or stroke. restoring nNOS protein within the PVN of diabetic rats with viral gene transfer could alleviate the blunted NMDA induced erectile responses.