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Health >
Health Conditions > Impotence
Impotence
I get some many emails on this that I put together a short
version. See the side bar.
Popular Supplements:
Popular Formulas:
Popular Medications:
General Information:
-
Erectile Dysfunction - American Academy of Family Physicians
- Erectile Dysfunction - emedicine.com
-
Erectile Dysfunction - familydoctor.org
- Impotence - Intelihealth
-
Erectile Dysfunction Diagnosis - urologychannel
-
Erectile Dysfunction
- eMedicine
-
Erectile
Dysfunction - NIH
-
Can blood pressure medicines cause impotence?
- drugstore.com
-
Hyperandrogenism - AACE
- Sexual Dysfunction In Men - Intelihealth
-
Evaluation
and Treatment of Male Sexual Dysfunction - American Association of
Clinical Endocrinologists and The American College of Endocrinology -
- "increased
prolactin levels may also cause erectile problems, even in the presence of a
normal testosterone level"
- "Most problems
revolve around dysfunction of the hypothalamic-pituitary-gonadal axis and
are associated with either excess prolactin
or decreased testosterone levels. Other
endocrine disorders that may cause libido or erectile difficulties include
hypothyroidism, hyperthyroidism, adrenal insufficiency, or excessive levels
of adrenal corticosteroids." - see
prolactin and cortisol
- "With any form of
testosterone treatment, the patient may have a slow and steady increase in
libido and erectile capacity during a course of months. If no improvement is
noted after 3 months, the hormone deficiency may not be the only cause of
the sexual dysfunction"
- Are there any prescription therapies for low sex drive?
- drugstore.com ask the pharmacist.
-
Medscape ED page
- Doppler
Evaluation of Erectile Dysfunction – Part 1 - Medscape, 1/9/07
- Doppler
Evaluation of Erectile Dysfunction – Part 2 - Medscape, 1/11/07
- Impotence
- DrMirkin.com, 6/28/99
- Treatments for impotence
- Medifocus.com
- Hypertension
can cause impotence. Angiotensin II receptor blockers (ARBs)
can treat hypertension without sexual side effects and of all the
hypertensives, have fewer side effects. See
Blood pressure drug reverses sexual dysfunction - Life Extension
Magazine, 7/01 - "the active
ingredient in Cozaar and Hyaar (losartan) can significantly improve sex
lives of men who suffer from sexual dysfunction" - also see
alternative ways to lower blood pressure
-
Sexual
Dysfunction Guidelines - aace.com -
"Other endocrine disorders that may cause libido or erectile difficulties
include hypothyroidism,
hyperthyroidism, adrenal insufficiency,
or excessive levels of adrenal corticosteroids."
-
Sexual
Dysfunction Guidelines - aace.com -
"With any form of testosterone treatment, the patient may have a slow and
steady increase in libido and erectile capacity during a course of months.
If no improvement is noted after 3 months, the hormone deficiency may not be
the only cause of the sexual dysfunction."
-
Patient's Fact Sheet: Prolactin Excess (.pdf format) - American Society
for Reproductive Medicine - "In men, hyperprolactinemia may be associated with impotence and can affect
fertility." - see prolactin
Alternative Therapies:
-
Propionyl-L-carnitine,
L-arginine and niacin in sexual medicine: a nutraceutical approach for erectile
dysfunction - Andrologia. 2011 Oct 4 - "In a group of 54 unselected men
(35-75 years), consecutively presenting to our ED clinic and naive to other ED
treatments, we carried out a single-blind, one-arm study to evaluate the effects
of a 3-month supplementation with propionyl-L-carnitine, L-arginine and niacin
on their sexual performance ... Analyses on GAQs revealed that treatment improved
erections in 40% of cases, with a partial response occurring in up to 77% of
enrolled subjects. These preliminary findings indicate that the favourable
cardiovascular effects of nutraceuticals might also reflect on male sexual
function with possible implication in the treatment and prevention of ED. This
study documents a considerable patients' interest toward nutritional
supplementation - as first-line or adjunctive treatment to PDE5 inhibitors -
that goes beyond the measurable increment in penile rigidity" - See
Ester Carnitine Propionyl at iHerb
,
Twinlab niacin 1000mg at iHerb
and
Jarrow Formulas, Arginine 1000, 1000 mg, 100 Easy-Solv Tablets
at iHerb.
-
Effect of
α-lipoic acid on sperm quality, reproductive tract measures in thinner exposed
rats - Andrologia. 2011 Sep 15 - "The aim of this study was to investigate
the effect of alpha lipoic acid (ALA, an universal antioxidant) on
thinner-induced testicular toxicity regarding spermatological features, body and
reproductive tract measures in rats. Adult male Sprague-Dawley rats were divided
into five treatment groups, eight rats in each. Control group was treated with
placebo. Group O was given only olive oil. The group L received only α-lipoic
acid. Thinner + Lipoic Acid group received thinner + α-lipoic acid and group T
received only thinner. Thinner alone administration caused significant decreases
in body and some reproductive organ weights, sperm count, motility and sperm
membrane integrity, and significant increases in seminal vesicle weight and
abnormal sperm rates compared with the values in the control group. However,
concomitant administration of thinner with α-lipoic acid provided significant
improvements in sperm parameters compared with values in alone group T. In
conclusion, the results of this study suggest that α-lipoic acid has a
protective effect against thinner-induced reproductive dysfunction in male rats"
- See
Alpha lipoic acid products at iHerb
.
I assume that the thinner is something like this:
-
ScienceDirect - Toxicology Letters : Melatonin protects the central nervous
system of rats against toluene-containing thinner intoxication by reducing
reactive gliosis - Toxicology Letters, Volume 137, Issue 3, 3 February
2003, Pages 169-174 - "Thinner containing 60–70%
toluene is a neurotoxic mixture which is widely used as an aromatic
industrial solventThinner containing 60–70% toluene is a neurotoxic mixture
which is widely used as an aromatic industrial solvent"
-
Antioxidants of growing interest to address infertility, erectile dysfunction
- Science Daily, 7/28/11 - "A growing body of evidence
suggests that antioxidants may have significant value in addressing infertility
issues in both women and men, including erectile dysfunction, and researchers
say that large, specific clinical studies are merited to determine how much they
could help ... Some commonly used antioxidants, such as vitamins C and E, could
help, Hagen said. But others, such as lipoic acid, are a little more
cutting-edge and set up a biological chain reaction that has a more sustained
impact on vasomotor function and health ... Polyphenols, the phytochemicals that
often give vegetables their intense color and are also found in chocolate and
tea, are also of considerable interest"
-
Unhealthy lifestyle is associated with sexual dysfunction - Science Daily,
7/6/11 - "A new study published in The Journal of Sexual
Medicine reveals that several unhealthy lifestyle factors, such as weight
problems, physical inactivity, high alcohol consumption, tobacco smoking, and
hard drugs are associated with sexual dysfunctions in men. Additionally, an
unhealthy lifestyle is more common in persons who are sexually inactive ...
Among those who had a sexual partner, risk of experiencing sexual dysfunction
was greater in men who lead unhealthy lives by 71% in those with substantially
increased waist circumference and more than 800% in men using hard drugs. Women
who used hashish had almost 3 times increased risk of anorgasmia (difficulties
or inability to reach climax during sexual activity with a partner) compared to
non-users"
-
Clinical
Assessment of a Supplement of Pycnogenol® and l-arginine in Japanese Patients
with Mild to Moderate Erectile Dysfunction - Phytother Res. 2011 May 27 -
"Subjects were instructed to take a supplement (Pycnogenol® 60 mg/day,
l-arginine 690 mg/day and aspartic acid 552 mg/day) or an identical placebo for
8 weeks, and the results were assessed using the five-item erectile domain
(IIEF-5) of the International Index of Erectile Function. Additionally, blood
biochemistry, urinalysis and salivary testosterone were measured. Eight weeks of
supplement intake improved the total score of the IIEF-5. In particular, a
marked improvement was observed in 'hardness of erection' and 'satisfaction with
sexual intercourse'. A decrease in blood pressure, aspartate transaminase and γ-glutamyl
transpeptidase (γ-GTP), and a slight increase in salivary testosterone were
observed in the supplement group. No adverse reactions were observed during the
study period. In conclusion, Pycnogenol® in combination with l-arginine as a
dietary supplement is effective and safe in Japanese patients with mild to
moderate erectile dysfunction" - See
Pycnogenol products at iHerb
,
l-arginine products at iHerb
and
l aspartic acid products at iHerb.
-
Erectile
dysfunction association with physical activity level and physical fitness in men
aged 40-75 years - Int J Impot Res. 2011 May 12 -
"This study showed that younger men with higher physical activity and better
physical fitness are less likely to suffer from erectile dysfunction.
Multivariable analysis through logistic regression showed that age (odds ratio
(OD)=1.15; 95% confidence interval (95% CI)=1.07-1.23), physical activity
(OD=10.38; 95% CI=3.94-27.39) and physical fitness (OD=4.62; 95% CI=1.75-12.25)
were independent variables associated with erectile dysfunction. This study
reinforces the concept that healthy habits have a direct effect on erectile
function"
-
Natural
aphrodisiacs: 'Spicing' up your love life possible, finds study of ginseng and
saffron - Science Daily, 3/28/11 - "Ours is the most
thorough scientific review to date. Nothing has been done on this level of
detail before now ... They found that panax ginseng, saffron and yohimbine, a
natural chemical from yohimbe trees in West Africa, improved human sexual
function ... People report increased sexual desire after eating muira puama"
-
Fenugreek extract shows male libido boost: Human RCT - Nutra USA, 2/16/11 -
"A formulation containing a standardized extract of Trigonella foenum-graecum
and minerals was associated with an improvement in libido for 81 percent of the
men in the study, and a 63 percent improvement in the ‘quality of sexual
performance’, compared with no such improvements in the placebo group" - See
Fenugeek products at iHerb
.
-
Physiological Aspects of Male Libido Enhanced by Standardized Trigonella
foenum-graecum Extract and Mineral Formulation - Phytother Res. 2011 Feb 10
- "The aim of the clinical study was to evaluate the
effect of Testofen, a standardized Trigonella foenum-graecum (Fenugreek) extract
and mineral formulation, on male libido (sexual drive, urge or desire) in a
double blind randomized placebo controlled study. The study recruited 60 healthy
males aged between 25 and 52, without erectile dysfunction and randomized to an
oral dose (two tablets per day) of the active treatment (600 mg Testofen per
day) or placebo for 6 weeks. The primary outcome measure was the DISF-SR (male)
self-administered QOL total score and the four domain scores. The secondary
outcome was specific quality of life parameters. Testofen had an overall
positive effect on physiological aspects of libido. In particular, there was a
significant increase in the subdomains of sexual arousal and orgasm. Testofen
had a positive effect on QOL in self-reported satisfaction with muscle strength,
energy and well-being but did not have an effect on mood or sleep. Serum
prolactin and testosterone levels remained within the reference range. It was
concluded that Testofen demonstrated a significant positive effect on
physiological aspects of libido and may assist to maintain normal healthy
testosterone levels" - See
Fenugeek products at iHerb
.
-
Oral
L-citrulline supplementation improves erection hardness in men with mild
erectile dysfunction - Urology. 2011 Jan;77(1):119-22 -
"L-arginine
supplementation improves nitric oxide-mediated vasodilation and endothelial
function; however, oral administration has been hampered by extensive
presystemic metabolism. In contrast, L-citrulline escapes presystemic metabolism
and is converted to L-arginine, thus setting the rationale for oral L-citrulline
supplementation as a donor for the L-arginine/nitric oxide pathway of penile
erection ... A total of 24 patients, mean age 56.5 ± 9.8 years, were entered and
concluded the study without adverse events. The improvement in the erection
hardness score from 3 (mild ED) to 4 (normal erectile function) occurred in 2
(8.3%) of the 24 men when taking placebo and 12 (50%) of the 24 men when taking
L-citrulline (P < .01). The mean number of intercourses per month increased from
1.37 ± 0.93 at baseline to 1.53 ± 1.00 at the end of the placebo phase (P = .57)
and 2.3 ± 1.37 at the end of the treatment phase (P < .01). All patients
reporting an erection hardness score improvement from 3 to 4 reported being very
satisfied" - See
L-citrulline products at iHerb.

-
Increasing BPA levels in urine associated with worsening male sexual function,
study finds - Science Daily, 5/26/10 - "Increasing urine BPA level is
associated with decreased sexual desire, more difficulty having an erection,
lower ejaculation strength and lower level of overall satisfaction with sex
life" - See stainless steel water bottles at Amazon.com.
-
Lack of
omega-3 fatty acid linked to male infertility, study suggests - Science
Daily, 4/12/10 - "In our experiment, we used 'knockout' mice that lacked the
gene responsible for an enzyme important in making docosahexaenoic acid (DHA).
In the absence of DHA, male mice are basically infertile, producing few if any
misshaped sperm that can't get where they need to go ... But, when DHA was
introduced into the diet, fertility was completely restored. "It was very
striking. When we fed the mice DHA, all these abnormalities were prevented,"" -
See
Jarrow Max DHA at iHerb.

-
A new
herbal combination, Etana, for enhancing erectile function: an efficacy and
safety study in animals - Int J Impot Res. 2009 Jun 4 -
"a new herbal combination called Etana that is
composed of five herbal extracts including Panax quinquelotius (Ginseng),
Eurycoma longifolia (Tongkat Ali), Epimedium grandiflorum (Horny goat weed),
Centella asiatica (Gotu Kola) and flower pollen extracts. Most of the
above-mentioned extracts have a long historical and traditional use for
erectile dysfunction (ED) ... penile erection index (PEI) ... At a 7.5 mg
kg(-1) single dose, the percentage of responding rats was 53+/-7 with a PEI
of 337+/-72 compared with 17+/-6 with a PEI of 30+/-10 for control animals.
This PEI was significantly (P<0.001) higher than each single component and
than the sum of any two herbal components of Etana. When compared with
sildenafil citrate, Etana induced more pronounced PEI than 0.36 mg kg(-1),
but similar to 0.71 mg kg(-1) of sildenafil. Furthermore, full acute and
sub-acute toxicity studies showed no toxic effects of Etana. In conclusion,
this study describes a new and safe combination of herbal components that
enhance erectile function in male rats"
-
Talking And Treating Erectile Dysfunction - Science Daily, 2/4/09 -
"Stop smoking ... Control cholesterol ... Cut back
on fat"
-
Ingredient in Chinese Herb Acts as a Natural Viagra - WebMD, 9/26/08 -
"the main compound in horny goat weed, called
icariin, acted the same way that Viagra does" - See
horny goat weed products at iHerb
.
-
Antioxidant treatment
with alpha-tocopherol improves erectile function in hypertensive rats -
Hypertens Res. 2008 May;31(5):1007-13 - "Treatment
with 24 mg alpha-tocopherol decreased TBARS levels and increased SOD
activity in the serum and corpus cavernosum. Relaxation in response to
acetylcholine chloride in the corpus cavernosum was improved with
alpha-tocopherol treatment at each dose. These results suggest that
alpha-tocopherol treatment increases the diminished relaxation in the corpus
cavernosum of SHRs by improving neuronal or endothelial function related to
nitric oxide and carbon monoxide. This, in turn, indicates that antioxidant
therapy may play a role in treatment for ED in hypertensive patients"
-
Berries and pomegranate - the ultimate Valentine's combo? - Nutra USA,
2/14/08 - "The results of this study demonstrated,
for the first time, that daily consumption of PJ for seven weeks caused
increased spermatogenic cell density, epididymal sperm concentration, sperm
motility and decreased abnormal sperm rate related with decreased lipid
peroxidation in male rats ... Forty-seven per cent of subjects reported
erections improvements as a result of pomegranate juice, compared to only 32
per cent in the placebo group" - See
pomegranate Juice Extracts at iHerb
.
-
Exposure to the phytoestrogen daidzein attenuates apomorphine-induced penile
erection concomitant with plasma testosterone level reduction in dose and
time-related manner in adult rats - Urology. 2007 Sep;70(3):613-7 -
"The phytoestrogen daidzein has the potential to
adversely affect erectile function in a dose and time-related manner that is
at least partly attributable to androgen deficiency. These findings
implicate that phytoestrogens, especially isoflavones, if overconsumed for a
long period, might be a novel risk factor for erectile dysfunction"
-
Erectile Dysfunction In Diabetes Is Due To Selective Defect In The Brain
- Science Daily, 3/15/07
-
Erectile Function in Subjects With the Metabolic Syndrome - Medscape,
7/19/06 - "consumption of a
Mediterranean-style diet in men with the metabolic syndrome and ED at
baseline produced significant improvement of erectile and endothelial
functions, together with a significant reduction of systemic vascular
inflammation, as indicated by the reduced levels of CRP"
-
Restoring Sexual Potency? - Dr. Weil, 5/4/06 -
"Arginine ... Ginkgo biloba ...
Ashwaganda"
-
Sexual Enhancement Supplements (L-Arginine, Yohimbe, Horny Goat Weed) -
ConsumerLab.com, 1/13/06
-
What about
erectile dysfunction? - Dr. Murray Natural Facts, 8/24/05 -
"by far the most common cause of
impotence by far is atherosclerosis of the penile artery. Atherosclerosis
refers to a process of hardening the artery walls due to a build up of
plaque containing cholesterol, fatty material, and cellular debris"
-
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 - "Salvage therapy
with PLC plus sildenafil was more effective than sildenafil in the treatment
of ED in patients with diabetes refractory to sildenafil monotherapy"
- See
Ester Carnitine Propionyl at iHerb
.
-
Erection Supplements Under Fire - WebMD, 9/23/04
- Diet and Exercise Programs Have Benefits for Obese Men With Erectile
Dysfunction - Doctor's Guide, 6/24/04
- Daily 2-Mile Walk May Prevent Impotence - WebMD,
6/22/04
- Carnitine Improves Symptoms of Male Aging -
Medscape, 4/14/04 -
"Carnitine
is more active than testosterone for improving symptoms of male aging such
as sexual dysfunction, depressed mood, and fatigue ... In this trial, 120
patients were randomized to receive testosterone undecanoate 160 mg/day,
propionyl-L-carnitine 2 g/day plus acetyl-L-carnitine 2 g/day, or placebo
for six months" [Abstract]
- See
iHerb
or
Vitacost
acetyl-l-carnitine products and
iHerb
propionyl-l-carnitine.
- Policosonal: Nature's Cholesterol Balancer -
Vitamin Research News, 2/04 -
"Statin drugs are also known to cause male impotence" - See
iHerb
or
Vitacost
policosanol products.
- Regular Exercise Can Help Prevent Impotence -
WebMD, 8/22/03 -
"men over age 50 who kept physically active had a 30% lower risk of
impotence than men who were inactive ... The fitter the man, the better the
erection. Frequent, vigorous exercise, the equivalent of running at least
three hours a week or playing singles tennis five hours per week, produced
the most benefit -- with a 30% lower risk of impotence"
- Korean
Red Ginseng Benefits Men with Impotence - New Hope
Natural Media, 1/2/03 - "Men
experiencing sexual difficulties due to inability to achieve erection may be
helped by Korean red ginseng (Panax
ginseng), according to a study published in the Journal of Urology ... It is
a problem that affects nearly half of men over age forty worldwide ... Some
60% of participants reported improved erections while receiving ginseng.
Improved sexual desire was also reported during ginseng treatment.
Testosterone levels did not change with treatment, leading the
researchers to conclude that improvements observed with ginseng are not due
to hormonal effects"
- See
iHerb
or
Vitacost
Korean (Panax) ginseng.
-
Ginkgo Supplements Useful for SSRI-Related Sexual Dysfunction - Clinical
Psychiatry News, 9/02 - "Ginkgo
has multiple systemic effects. It acts as a free-radical scavenger, inhibits
platelet aggregation, causes vasodilation, and allows more efficient
cellular uptake of oxygen and glucose. The effects of ginkgo on sexual
arousal are thought to result from increased blood circulation to the
genital area ... The proprietary multi-ingredient ginkgo preparation
ArginMax (Daily Wellness Co.) is “one of the best things I've ever seen
for SSRI sexual dysfunction,”" - See ArginMax at drugstore.com
- Natural
Remedy for Erectile Dysfunction - New Hope Natural
Media, 9/5/02 - "received three
separate treatments for two weeks each, in random order: (1) 3.25 grams of
arginine plus 6 mg of
yohimbine, (2) yohimbine alone and (3) placebo ... Combination treatment
was considered successful by 40% of the participants, compared with 28.9%
with yohimbine alone and 17.8% with placebo ... Arginine is available in
health food stores without a prescription, but yohimbine can be obtained
only with a doctor's prescription. Although the herb yohimbe is sold in
health food stores, it contains much less yohimbine than the amount used in
the new study" - See
iHerb
and
Vitacost
arginine products.
- Yohimbine Plus L-Arginine Potential Therapy For Mild To Moderate Erectile
Dysfunction - Doctor's Guide, 7/31/02 -
"randomly assigned 45 men with erectile dysfunction to treatment with 6 mg
of L-arginine glutamate combined with 6 mg of
yohimbine hydrochloride, to 6 mg of
yohimbine hydrochloride
alone, or to placebo ... They took the drugs orally one to two hours before
intended sexual intercourse ... Changes in this score [Index of Erectile
Function (IIEF)]
were significantly greater among patients taking yohimbine
plus L-arginine compared to those taking placebo" - Note: That "6 mg
of L-arginine glutamate" has to be a misprint. It probably should have
been 6 grams as in a
U. of Texas study on
postmenopausal women.
-
Low testosterone levels can mean high health risks - Life Extension
Magazine, 11/00
-
Study: Supplement Can Help Take the 'Dys' Out of Female Sexual Dysfunction,
Researchers Promote Idea of 'Sexual Wellness' - WebMD, 6/5/01 -
"ArginMax -- a dietary cocktail consisting of
ginseng, ginkgo, B vitamins, calcium, folic acid, and other vitamins and
minerals -- is being heralded as one component of a lifestyle that improves
sexual performance and helps prevent problems associated with intimacy"
-
Want a love potion? What to know before you try - CNN, 6/15/00 -
"a study of 21 men with "mild to moderate" impotence taking a supplement
called
ArginMax (3,000 milligrams per day) found big
improvements in erection and sexual satisfaction."
-
When It Comes to Love, the Nose Knows - WebMD, 2/14/01-
"Another spirit in the heady cocktail making us intoxicated with romantic
love is phenylethylamine (PEA) ... I believe that
PEA may be the hormone of libido ...
high PEA levels help explain increased sex drive and activity in the manic
phase of manic-depressive illness, while low PEA levels reflect loss of
libido in depression. PEA is effective when given by mouth, but like Viagra,
could be dangerous in patients with heart disease" -
- Note:
Amino Acids anyone? at DrBob.org says
"L-phenylalanine can also be
converted (through a separate pathway) to phenylethylamine, a substance
that occurs naturally in the brain and appears to elevate mood."
-
Study: Oversexed Monkeys Immune - Intelihealth, 11/11/00 -
"Promiscuous species of monkeys appear to have stronger
immune systems than less-active ones, researchers say."
- Herbal Viagra Alternative Works -- at Least on Rats
- WebMD, 10/23/00 - "All the rats
fed the high-cholesterol diet indeed ended up with high cholesterol levels
-- and all became impotent. But those who drank the herbal mixture
[BetterMAN]
were later able to achieve erections, while the other eight rats remained
impotent"
-
Study finds exercise reduces the risk of impotence - CNN, 10/2/00
-
Exercise May Reduce Impotence Risk - Intelihealth, 10/2/00
-
With Regular Exercise, You May Never Need Viagra - WebMD, 8/30/00
-
Laboratory Investigations of Erectile Dysfunction - WebMD -
"men with erectile dysfunction frequently have low levels of high-density
lipoproteins, the good form of cholesterol." - see
HDL
-
Saving Yourself from AGE - Life Enhancement Magazine, 8/00 - with
American Ginseng, "The researchers
found a reduction in plasma prolactin, a hormone connected with passive
"nesting" behavior, suggesting that this may play a role in the ability of
American ginseng to stimulate sexual activity in the male rat."
-
Want a love potion? What to know before you try - CNN, 6/15/00 -
"a study of 21 men with "mild to moderate" impotence taking a supplement
called
ArginMax (3,000 milligrams per day) found big
improvements in erection and sexual satisfaction."
-
Natural Alternatives to Viagra with Ellen Kamhi - WebMD, 5/26/00
-
Replenish Testosterone Naturally - Life Extension Magazine, 1/00
-
Study finds new therapy for impotence [l-arginine] - CNN, 10/27/99
-
Be All That You Can Be - Life Enhancement Magazine, 7/99
-
Dehydroepiandrosterone in the treatment of erectile dysfunction: a
prospective, double-blind, randomized, placebo-controlled study -
Urology. 1999 Mar;53(3):590-4; discussion 594-5
- Long
Term Safety and Efficacy of Ginkgo Biloba in the Treatment of
Anti-Depressant-Induced Sexual Dysfunction - Alan Jay Cohen, M.D., UCSF
Faculty
-
Ginkgo biloba for antidepressant-induced sexual dysfunction - J Sex
Marital Ther. 1998 Apr-Jun;24(2):139-43
CME:
Other Information:
-
Association
of metabolic syndrome, atherosclerosis risk factors, sex hormones in ED in
aboriginal Taiwanese - Int J Impot Res. 2012 Apr 12 -
"International Index of Erectile Function (IIEF)
questionnaire ... Using age-adjusted multivariate logistic regressive analysis,
this study showed that aboriginal males with ED had a significantly higher
prevalence of MS (OR=12.02, 95% confidence intervals (CI): 6.33-22.83, P<0.001).
Among the MS components, abnormal fasting blood sugar was the most significantly
independent factor for ED in aboriginal males (OR=8.94, 95% CI: 4.71-16.97,
P<0.001). The presence of MS had a significant correlation with lower IIEF-5
scores, lower sexual desire scores, lower testosterone serum level (P<0.01) and
abnormal interleukin-6 (IL-6) and high sensitivity C-reactive protein (HsCRP).
The results of this study support the idea that MS, low serum testosterone and
HsCRP may predict ED in aboriginal Taiwanese males" - See
metformin at IAS.
-
Serum
testosterone levels in diabetic men with and without erectile dysfunction -
Andrologia. 2012 Apr 4 - "TT was lower in diabetic men
with ED as compared to those with normal erectile function (EF), 392.4 ± 314.9
versus 524.3 ± 140.2 ng dl(-1) , respectively ...
Receiver operating characteristic (ROC) curve of TT in men without associated
co-morbidities showed that EF was compromised at TT = 403.5 ng dl(-1) or less.
Sensitivity of 63.3% and a specificity of 94.0% were detected. At this level, ED
was found in 33/38 (86.8%) men with TT 403.5 ng dl(-1) , whereas ED was observed
in 57/147 (38.8%) men with TT ≥ 403.5 ng dl(-1) (P < 0.0001). We propose a
cut-off value of 403.5 ng dl(-1) of TT blood levels as an indicator for
initiation of testosterone replacement therapy in diabetic men with ED. Further
prospective controlled trials are recommended"
-
Do Glaucoma, Erectile
Dysfunction Have a Common Cause? - Medscape, 2/7/12 -
"Men with erectile
dysfunction (ED) have a nearly 3-fold greater risk for also having open-angle
glaucoma (OAG) than men with normal erectile function ... The study suggests
that OAG and ED appear to have a common mechanism of endothelial dysfunction
related to nitric oxide"
-
A jolt to
the penis may cure impotence - MSNBC, 10/28/11
-
The
Relationships between Sex Hormones and Sexual Function in Middle-Aged and Older
European Men - J Clin Endocrinol Metab. 2011 Aug 17 -
"The aim of the study was to investigate the
relationships between serum testosterone (T), estradiol (E2), and
dihydrotestosterone (DHT) and sexual function in a multicenter population-based
study of aging in men ... Total and free T, but not E2 or DHT, was associated
with overall sexual function in middle-aged and older men. E2 was the only
hormone associated with sexual function-related distress such that higher levels
were related to greater distress. Free T levels were associated with
masturbation frequency and erectile dysfunction in the fully adjusted models,
such that higher T was associated with less dysfunction and greater frequency.
Moreover, there was a T threshold for the relationship between total T, sexual
function, and erectile dysfunction. At T concentrations of 8 nmol/liter or less,
T was associated with worse sexual functioning, whereas at T levels over 8 nmol/liter,
the relationship came to a plateau. Conclusions: These findings suggest that
different hormonal mechanisms may regulate sexual functioning (T) vs. the
psychological aspects (E2) of male sexual behavior. Moreover, there was a T
threshold for overall sexual function such that at levels greater than 8 nmol/liter
the relationship between T and sexual function did not become stronger"
-
Weight
Loss Improves Erections in Obese Men With Diabetes - Medscape, 8/10/11 -
"For the study, researchers recruited obese men who had
body mass indexes (BMIs), a number calculated from weight and height, of greater
than 30 and waist sizes over 40 inches ... The average age of men in the study
was 60 ... men were randomly assigned to either a low-calorie diet, where two
daily meals were replaced by weight loss shakes, or to a higher-protein,
lower-carbohydrate eating plan ... In the healthy eating plan, which focused on
three meals of lean protein, five daily servings of vegetables, and two daily
servings of whole grain carbohydrates and fruit, was designed to shave about 600
daily calories off what the men would normally eat ... After eight weeks, the
men on the low-calorie meal replacement diets were switched to the healthy
eating plan, and all continued to be followed for a year ... After eight weeks
on the diets, the men on the low-calorie plan had lost about twice as much
weight as the men on the healthy eating plan, 20 pounds vs. 11 pounds ... But
they had similar improvements in erectile function, sexual desire, and urinary
symptoms ... Of the 17 men with severe erectile dysfunction, Wittert says that
after eight weeks, seven had improvements in their symptoms, with some achieving
normal function. After a year, 25% had normal erectile function"
-
Sexual
health of men with chronic heart failure significantly improves with CRT, study
finds - Science Daily, 6/3/11
-
Non-Steroidal Anti-Inflammatory Drugs Linked to Increased Risk of Erectile
Dysfunction - Science Daily, 3/2/11 - "After
controlling for age, race, ethnicity, smoking status, diabetes, hypertension,
heart disease, high cholesterol and body mass index, the researchers found that
ED was 1.4 times more likely -- a modest risk -- among regular NSAID users
compared to men who did not take the drugs regularly. This association was
consistent across all age groups"
-
Does a
replacement or revision of an inflatable penile prosthesis lead to decreased
patient satisfaction? - Int J Impot Res. 2011 Feb 10 -
"Approximately 58.3% were satisfied with their
prosthesis, 75% would have the surgery performed again and 91.7% would still
recommend prosthesis surgery. Device malfunction was the primary reason for
replacement/removal at our institution. Despite the complications of prosthesis
reoperation, the majority of patients were still satisfied with their
prosthesis, would have the surgery performed again and would recommend
prosthesis surgery to a friend"
-
Drugs
for hair loss and benign prostatic hyperplasia may result in loss of libido,
erectile dysfunction in men - Science Daily, 1/11/11 -
"5a-reductase inhibitors (5a-RIs), while improving
urinary symptoms in patients with benign prostatic hyperplasia (BPH) and
possible hair loss prevention, produces significant adverse effects in some
individuals including loss of libido, erectile dysfunction (ED), ejaculatory
dysfunction and potential depression" - Note: That goes back and
forth. One study claimed that finasteride improved sex after after six
months of taking it. Regarding gynaecomastia, if you're taking low dose
letrozole to increase testosterone and to prevent aromatization it many also
help prevent gynaecomastia.
-
Prostate Drug May Not Dim Sex - WebMD, 6/26/07 - "Six months after the men started taking their assigned drugs, the survey
scores were about three points higher for the men taking Proscar. By the end
of the study, that gap narrowed to about two points"
-
Prostate Drug Doesn't Limit Sexual Function In Most Men - Science Daily,
7/19/07 - "The study suggests that finasteride will
cause little or no sexual dysfunction for most men who decide to take it"
-
Ask a Medical Question - Can letrozole cure gynecomastia - JustAnswer -
"Letrozole may be effective in preventing and
reversing the gynaecomastia provided it is used early enough in steroid
induced gynaecomastia" - See letrozole at
OffshoreRX.com.
I believe the recommended dose is something like a quarter tablet every
three days but don't quote me on it. That's what I take.
-
Patients' preference in
the treatment of erectile dysfunction: a critical review of the literature -
Int J Impot Res. 2010 Dec 30 - "the majority of the patients preferred tadalafil
versus either vardenafil or sildenafil" - See tadalafil at
OffshoreRX.com.
-
Effects
of sildenafil and vardenafil treatments on sleep quality and depression in
hemodialysis patients with erectile dysfunction - Int J Impot Res. 2011
Jan 6 - "Sleep quality and depression were evaluated
via post-sleep inventory (PSI) and Beck's depression inventory (BDI),
respectively, at baseline and at the end of the treatment. Sildenafil and
vardenafil both improved PSI and BDI scores significantly compared with
pretreatment values. However, there was no difference between sildenafil and
vardenafil with respect to these parameters"
-
Obesity may harm your sexual health, study suggests - Science Daily,
6/15/10 - "obese women were 30% less likely to have
had a sexual partner in the last 12 months. Obese men were 70% less likely
to have had more than one sexual partner in the same period and were two and
half times more likely to experience erectile dysfunction"
-
Link
established between erectile dysfunction and calcified coronary arteries
- Science Daily, 6/1/10 - "men with ED had a 54
percent greater likelihood of having a high-risk CACS than men without ED.
The increased risk was similar to that of patients with a history of
hypertension and smoking"
-
Erectile dysfunction and increased dangers of cardiovascular disease -
Science Daily, 4/25/10 - "men with erectile
dysfunction and low testosterone have a higher than normal risk of dying
from cardiovascular disease. Further work from the same research group shows
that obesity is also associated with an impairment of blood flow to the
penis, which in turn is also associated with cardiovascular disease in men
with erectile dysfunction ... Low testosterone itself was not associated
with major cardiac events, but those patients with the lowest testosterone
who had a major cardiac event were significantly more likely to die than
those with higher levels of testosterone (P<0.001; the risk is increased by
a factor of seven ... In a second study (but using the same group of
patients as above), the group showed that the degree of obesity, along with
erectile dysfunction, were significantly and independently associated with
cardiac events"
-
Efficacy of
testosterone gel in the treatment of erectile dysfunction in hypogonadal
hemodialysis patients: a pilot study - Int J Impot Res. 2009 Nov 19 -
"T administration significantly increased serum T levels
to the normal range, and was associated with statistically significant
improvements of the scores of the IIEF domains (erectile function from 7.6+/-8.0
to 12.8+/-7.8; intercourse satisfaction from 3.4+/-4.5 to 4.8+/-3.1; orgasmic
function from 4.8+/-3.1 to 3.4+/-2.9; sexual desire from 3.4+/-2.9 to 4.4+/-0.6;
overall sexual satisfaction from 2.6+/-1.3 to 3.8+/-1.0). But scores of the IIEF
did not normalize. Frequency of weekly sexual intercourse increased from
0.4+/-0.4 to 1.1+/-0.8 (P<0.05) after 6 months. There were no adverse effects"
- Note: One problem with testosterone administration is that it increased
estradiol by about the same percentage. I'm 60 years old and my
testosterone was above the limits just by taking a half tablet of
letrozole per day.
I've cut it to a quarter tablet but haven't had it rechecked. Letrozole
has been shown to double or triple testosterone and lower estrogen at the same
time. Some studies indicate that you might want to keep estrogen around 25
for men. See letrozole at
OffshoreRX.com.
See:
-
Androgel prescribing information - androgel.com -
"Serum estradiol (E2) concentrations increased
significantly within 30 days of starting treatment with AndroGel 5 or 10
g/day and remained elevated throughout the treatment period but remained
within the normal range for eugonadal men"
- High, Low Estradiol Levels and Mortality in Men With Systolic HF - Medscape,
5/19/09 - "Both low and high serum levels of estradiol,
compared with mid-range levels, are significantly and independently associated
with increased all-cause mortality in men with chronic systolic heart failure"
-
Short-term
aromatase inhibition: effects on glucose metabolism and serum leptin levels in
young and elderly men - Eur J Endocrinol. 2008 Dec 2 -
"Ten elderly and nine young healthy men were randomized
to receive letrozole 2.5 mg daily or placebo for 28 days in a crossover design.
Results: Both in young and elderly men, active treatment significantly increased
serum testosterone (+128 and +99%, resp.) and decreased estradiol levels (-41
and -62%, resp.). Fasting glucose and insulin levels decreased in young men
after active intervention (-7 and -37%, resp.) compared to placebo. Leptin
levels fell markedly in both age groups (-24 and -25%, resp.), while adiponectin
levels were not affected by the intervention. Lipid profile was slightly
impaired in both groups, with increasing LDL-cholesterol levels (+14%) in the
younger age group and 10% lower levels of ApoA1 in the elderly. A decline in
IGF-1 levels (-15%) was observed in the younger age group. No changes in weight
or BMI were observed in either young or old men"
-
Letrozole once a week normalizes serum testosterone in obesity-related male
hypogonadism - Eur J Endocrinol. 2008 May;158(5):741-7 -
"Isolated hypogonadotropic hypogonadism (IHH) is
frequently observed in severely obese men, probably as a result of increased
estradiol (E(2)) production and E(2)-mediated negative feedback on pituitary
LH secretion. Aromatase inhibitors can reverse this process ... treated with
2.5 mg letrozole once a week for 6 months ... Six weeks of treatment reduced
total E(2) from 123+/-11 to 58+/-7 pmol/l (P<0.001, mean+/-s.e.m.), and
increased serum LH from 4.4+/-0.6 to 11.1+/-1.5 U/l (P<0.001). Total
testosterone rose from 5.9+/-0.5 to 19.6+/-1.4 nmol/l (P<0.001), and free
testosterone from 163+/-13 to 604+/-50 pmol/l (P<0.001). Total testosterone
rose to within the normal range in all subjects, whereas free testosterone
rose to supraphysiological levels in 7 out of 12 men ... Letrozole 2.5 mg
once a week produced a sustained normalization of serum total testosterone
in obese men with IHH. However, free testosterone frequently rose to
supraphysiological levels. Therefore, a starting dose <2.5 mg once a week is
recommended"
-
Comparative assessment in young and elderly men of the gonadotropin response
to aromatase inhibition - J Clin Endocrinol Metab. 2005
Oct;90(10):5717-22 - "As assessed after 28 d of
treatment, letrozole lowered E2 by 46% in the young men (P = 0.002) and 62%
in the elderly men (P < 0.001). In both age groups, letrozole, but not
placebo, significantly increased LH levels (339 and 323% in the young and
the elderly, respectively) and T (146 and 99%, respectively) (P value of
young vs. elderly was not significant). Under letrozole, peak LH response to GnRH was 152 and 52% increase from baseline in young and older men,
respectively"
-
Letrozole normalizes serum testosterone in severely obese men with
hypogonadotropic hypogonadism - Diabetes Obes Metab. 2005 May;7(3):211-5
- "Six weeks of treatment decreased
serum estradiol from 120 +/- 20 to 70 +/- 9 pmol/l (p = 0.006). None of the
subjects developed an estradiol level of less than 40 pmol/l. LH increased
from 4.5 +/- 0.8 to 14.8 +/- 2.3 U/l (p < 0.001). Total testosterone rose
from 7.5 +/- 1.0 to 23.8 +/- 3.0 nmol/l (p < 0.001) without a concomitant
change in sex hormone-binding globulin level. Those treated with Letrozole
17.5 mg per week had an excessive LH response"
The
effect of chronic antipsychotic drug administration on nitric oxide synthase
activity and gene expression in rat penile tissues - Eur
Neuropsychopharmacol. 2009 Nov 13 - "Antipsychotic
drug treatment may be associated with common and problematic sexual
dysfunction, especially impotence, which can diminish quality of life and
lead to treatment noncompliance. Nitric oxide synthase (NOS) is an important
cellular modulator of erectile function. We have therefore investigated the
effect of antipsychotic drug on activity and gene expression of NOS in rat
penile tissues. The activity of constitutive NOS was significantly
suppressed below control by a 21days administration of 1mg/kg haloperidol,
which also significantly decreased expression of endothelial NOS (eNOS) and
neural NOS mRNA. Risperidone at 0.5mg/kg also reduced eNOS mRNA expression.
Haloperidol or risperidone did not change gene expression and activity of
inducible NOS (iNOS). Quetiapine significantly increased activity and mRNA
expression of iNOS with 20 and 40mg/kg doses"
Study: High Bisphenol A ( BPA) Linked to Sex Problems in Men - Science
Daily, 11/11/09 - "Compared to the unexposed factory
workers in the study, BPA-exposed workers were four times more likely to
report erectile dysfunction, low sexual desire, and less than optimal
satisfaction with their sex lives. They were seven times more likely to
report problems with ejaculation ... BPA has been used for more than three
decades to make plastic bottles and other products shatter resistant and
clear. It is also used in the lining of many canned foods and a wide range
of other commercial goods"
Erectile
function in men with diabetes type 2: correlation with glycemic control
- Int J Impot Res. 2009 Sep 17 - "the level of
HbA(1c) is significantly higher with declining degrees of potency
(P-value=0.003). Also, there is an association between potency degree and
glycemic control (P=0.002). We conclude that glycemic control is
independently and inversely associated with ED in men with diabetes type 2"
Link
Between Erectile Dysfunction And Obesity Explored In Obesity And Weight
Management - Science Daily, 8/25/09 - "Obese men
are at increased risk for erectile dysfunction (ED), likely caused by
atherosclerosis-related hypertension and cardiovascular disease, as well as
hormonal changes associated with obesity"
alpha-Blocker Use Is Associated With Decreased Risk of Sexual Dysfunction
- Urology. 2009 May 8 - "Lower urinary tract
symptoms (LUTS) ... alpha-Blocker use was associated with a decreased risk
of sexual dysfunction across all domains for men >/=50 years old
(age-adjusted hazard ratio 0.53-0.69). A decreased risk of erectile
dysfunction and low libido remained significant only among those using
alpha-blockers who also experienced an improvement in LUTS (P = .01)"
The
relationship of serum and salivary cortisol levels to male sexual
dysfunction as measured by the International Index of Erectile Function
- Int J Impot Res. 2009 May 7 - "testosterone (T)
and cortisol (F) ... (Total-T, Free-T, Bioavailable-T, Total-F and
Bioavailable-F) and salivary hormones (Saliva-T and Saliva-F) ...
International Index of Erectile Function (IIEF) ... Free-T and
Bioavailable-T showed significant inverse correlations with age (P<0.01). In
the group not taking antidepressants, the levels of Bioavailable-F and
Saliva-F showed significant inverse correlations with a portion of the IIEF
score (P<0.05). However, reductions in Bioavailable-T and Saliva-T showed no
association with the IIEF score. In the group taking antidepressants, these
hormone levels showed no correlation with IIEF"
Major Statin Study Reveals Several Important Findings For Reducing Prostate
Cancer And Disease - Science Daily, 4/26/09 -
"non-statin users were three times more likely to develop prostate cancer,
suggesting statin use may prevent development of prostate cancer ...
Overall, statin use was not significantly associated with a decreased risk
of developing ED. However, statins were associated with a decreased risk of
ED among older men (>60 years). Men in this age category who used statins
were less likely to develop ED, compared to older men who did not use
statins. Additionally, men who took statins for a longer time were more
protected against developing ED. For example, men who took statins for
nearly nine years or more were 64 percent less likely to develop ED, while
men who took statins for less than three years had about the same risk of
developing ED. compared to men who did not take statins" - See
atorvastatin at
OffshoreRX.com .
Tadalafil Response in Patients With Erectile Dysfunction Is Androgen
Dependent - Doctor's Guide, 3/23/09 -
"Testosterone gel therapy significantly improves the response to tadalafil
in nonresponding patients with erectile dysfunction (ED) -- but only if they
have total testosterone levels of less than 3 ng/mL or bioavailable
testosterone levels of less than 0.6 ng/mL"
Statin study: Lower cholesterol, diminished joy of sex linked - USA
Today, 3/5/09 - "In the study, sexual pleasure sank
along with LDL levels ... Some studies have found that statins improve
sexual function, probably because the pills can improve blood flow to the
genital area, Golomb says. But she says the drugs also may reduce Coenzyme
Q10, a nutrient that helps cells convert oxygen, blood and glucose into
energy. "Orgasm is a high-energy activity," so losing the nutrient could
weaken sexual pleasure, she says" - See
Jarrow Ubiquinol at iHerb .
Obesity Linked To Hormone Imbalance That Impacts Sexual Quality Of Life
- Science Daily, 3/3/09 - "In our study population,
we found that lower testosterone levels and diminished ratings for sexual
quality of life were correlated with increased BMI ... Subjects who lost
weight through bariatric surgery experienced a reduction in estradiol
levels, an increase in testosterone levels and an increase in ratings of
sexual quality of life" - See my
aromatization page. Another way to increase testosterone and
decrease estradiol is with
letrozole. I
take a quarter tablet every other day.
-
Letrozole once a week normalizes serum testosterone in obesity-related male
hypogonadism - Eur J Endocrinol. 2008 May;158(5):741-7 -
"Isolated hypogonadotropic hypogonadism (IHH) is
frequently observed in severely obese men, probably as a result of increased
estradiol (E(2)) production and E(2)-mediated negative feedback on pituitary
LH secretion. Aromatase inhibitors can reverse this process ... treated with
2.5 mg letrozole once a week for 6 months ... Six weeks of treatment reduced
total E(2) from 123+/-11 to 58+/-7 pmol/l (P<0.001, mean+/-s.e.m.), and
increased serum LH from 4.4+/-0.6 to 11.1+/-1.5 U/l (P<0.001). Total
testosterone rose from 5.9+/-0.5 to 19.6+/-1.4 nmol/l (P<0.001), and free
testosterone from 163+/-13 to 604+/-50 pmol/l (P<0.001). Total testosterone
rose to within the normal range in all subjects, whereas free testosterone
rose to supraphysiological levels in 7 out of 12 men ... Letrozole 2.5 mg
once a week produced a sustained normalization of serum total testosterone
in obese men with IHH. However, free testosterone frequently rose to
supraphysiological levels. Therefore, a starting dose <2.5 mg once a week is
recommended" - See
Femara (letrozole) at OffshoreRX
.
Sex
Is In The Brain, Whether It Be Lack Of Sexual Interest Or Hypoactive Sexual
Desire Disorder - Science Daily, 3/2/09
Younger Men With Erectile Dysfunction At Double Risk Of Heart Disease -
Science Daily, 2/2/09
Association of Sexual Dysfunction With Lower Urinary Tract Symptoms of BPH
and BPH Medical Therapies: Results From the BPH Registry - Urology. 2009
Jan 21 - "The severity of lower urinary tract
symptoms (LUTS) has correlated with erectile dysfunction (ED) and
ejaculatory dysfunction (EjD) ... The alpha(1A)-subtype nonsuperselective
quinazoline alpha(1)-blockers alfuzosin, doxazosin, and terazosin appeared
to be associated with better ejaculatory function than were the
alpha(1A)-subtype superselective sulfonamide alpha(1)-blocker tamsulosin,
5alpha-reductase inhibitors, and alpha(1)-blocker plus 5alpha-reductase
inhibitor combination therapy"
Testosterone Gel Monotherapy Improves Sexual Function of Hypogonadal Men
Mainly Through Restoring Erection: Evaluation by IIEF Score - Urology.
2008 Dec 30 - "After 3 months of testosterone gel
therapy for the hypogonadal men, the most beneficial effect on sexual
function was erectile function, with sexual desire and orgasmic satisfaction
insignificantly affected. CONCLUSIONS: The results of our study have shown
that transdermal testosterone gel treatment for hypogonadal patients can
improve their sexual dysfunction mainly through restoring erectile function"
Sexuality and the management of BPH with alfuzosin (SAMBA) trial - Int J
Impot Res. 2008 Dec 11 - "Alfuzosin for the
treatment of patients with BPH is effective in improving sexual function, as
well as lower urinary tract symptoms (LUTSs) and quality of life, and is
well tolerated"
Testosterone Gel Addition Benefits Men With Erectile Dysfunction Who Do Not
Respond to PDE5s Alone if Testosterone Levels Are Low - Doctor's Guide,
12/10/08 - "Addition of testosterone gel to improve
efficacy of the phosphodiesterase-5 (PDE5) inhibitor tadalafil in men with
erectile dysfunction (ED) shows significant improvements for those with a
serum testosterone level <=3 ng/mL at baseline"
Erectile
Dysfunction in Men With Congenital Heart Disease - Am J Cardiol. 2008
Dec 15;102(12):1728-1730 - "beta blockers ... Men on
BB were 3.13 times more likely to report ED"
Early
endothelial dysfunction as a marker of vasculogenic erectile dysfunction in
young habitual cannabis users - Int J Impot Res. 2008
Nov-Dec;20(6):566-73 - "We conclude that early
endothelial damage may be induced by chronic cannabis use (and
endocannabinoid system activation); insulin resistance may be the hallmark
of early endothelial dysfunction and may concur to determine vascular ED in
the absence of obesity"
Obesity Linked to Erectile Dysfunction - WebMD, 10/31/08 -
"conditions related to obesity, particularly
hypertension (or high blood pressure), are the most significant causes of
obesity-related erectile dysfunction. Abnormal penile blood flow was found
to be linked to high blood pressure"
Erectile Dysfunction Lower In Men Who Have Intercourse More Often -
Science Daily, 7/2/08
Effect
of irbesartan on erectile function in patients with hypertension and metabolic
syndrome - Int J Impot Res. 2008 Jul 3 - "Erectile function increased
significantly (P<0.0001) after 6 months of treatment with irbesartan,
irrespective of dosage and independent of additional treatment with
hydrochlorothiazide. Prevalence of ED declined to 63.7% from 78.5% at baseline,
along with a significant increase in orgasmic function (P<0.001) and intercourse
satisfaction (P<0.001). Treatment with irbesartan alone, as well as in
combination with hydrochlorothiazide is associated with an improvement of sexual
desire, frequency of sexual contacts and erectile function in hypertensive
patients with the metabolic syndrome. These results suggest a beneficial role of
angiotensin receptor antagonists in the treatment of metabolic syndrome, and ED"
- Note: I've been suggesting telmisartan (an ARB) for some time as the
first line treatment for hypertension. See telmisartan at
OffshoreRX.
Testosterone Gel Improves Insulin Sensitivity, Sexual Function in
Hypogonadal Men With Diabetes and Metabolic Syndrome - Doctor's Guide,
6/20/08 - "Among patients with type 2 diabetes with
or without metabolic syndrome, insulin resistance as measured by HOMA-IR
improved from baseline in the testosterone-treated group compared with
placebo at 6 months (testosterone: -0.62, placebo: +0.16; P = .049) and at
12 months (testosterone: -.58 ... Patients receiving testosterone also
achieved more than a 5-point improvement over placebo-treated patients on
the International Index of Erectile Function (IIEF) at 6 months (P < .05)
and more than 6 points over placebo-treated patients at 12 months"
Low
Testosterone May Cause Health Problems That Lead To Erectile Dysfunction
- Science Daily, 6/16/08 - "It is becoming clear
that obesity, diabetes, high blood pressure, cholesterol problems and
erectile difficulties are intertwined, and a common denominator is
testosterone deficiency"
Erectile Dysfunction May Signal A Broken Heart - Science Daily, 5/20/08
Hyperhomocysteinemia is a risk factor for erectile dysfunction in men with
adult-onset diabetes mellitus - Urology. 2008 May;71(5):897-900 -
"Hyperhomocysteinemia (HHcy) ... those with HHcy had
5.2 times the odds of vasculogenic ED compared with men without HHcy"
Erectile
Dysfunction in Patients with Hyper- and Hypothyroidism: how Common and
Should We Treat? - J Clin Endocrinol Metab. 2008 Feb 12 -
"ED was more prevalent in patients with
hyperthyroidism and hypothyroidism compared to controls ... ED is extremely
common in males with dysthyroidism. Treatment of the latter restores
erectile function"
Erectile Dysfunction Epidemic - Dr. Weil, 1/18/08
Erectile dysfunction is associated with low bioactive testosterone levels
and visceral adiposity in men with type 2 diabetes - Int J Androl. 2007
Nov;30(6):500-7 - "ED is associated with low
bioavailable and free testosterone levels, age, visceral adiposity and
hypertension in type 2 diabetic men"
Epilepsy Drugs May Cause Sexual Disorders - Science Daily, 10/29/07
Erectile Dysfunction Linked To Smoking - Science Daily, 7/27/07 -
"An estimated 22.7 percent of erectile dysfunction
cases among Chinese men might be attributable to cigarette smoking"
Inflammation, Metabolic Syndrome, Erectile Dysfunction, and Coronary Artery
Disease: Common Links - Eur Urol. 2007 Aug 13 -
"Increased circulating levels of inflammatory and endothelial-prothrombotic
compounds are related to the presence and severity of ED"
The prevalence of newly diagnosed hyperlipidaemia in men with erectile
dysfunction - BJU Int. 2007 Jun 6 -
"This study shows the high
prevalence of undiagnosed hypercholesterolaemia and hypertriglyceridaemia in
men presenting with ED"
Erectile Dysfunction and Hypertension - Medscape, 5/24/07
ED Drugs May Treat Urinary Problems - WebMD, 5/23/07 -
"Sexual performance in men seems to
decline as their prostate enlargement becomes more severe, experts have
begun to notice ... A once-a-day dose of Cialis helped men with erectile
dysfunction and moderate to severe urinary tract symptoms due to an enlarged
prostate improve sexual functioning" - See tadalafil at
OffshoreRx.com .
The role of nitric oxide in erectile dysfunction: implications for medical
therapy - J Clin Hypertens (Greenwich). 2006 Dec;8(12 Suppl 4):53-62 -
"Impaired NO bioactivity is a major
pathogenic mechanism of erectile dysfunction" - See my
nitric oxide page for ways to increase it.
Testosterone use in men with sexual dysfunction: a systematic review and
meta-analysis of randomized placebo-controlled trials - Mayo Clin Proc. 2007
Jan;82(1):20-8 - "Testosterone
use in men is associated with small improvements in satisfaction with erectile
function and moderate improvements in libido"
The effects of quinapril and atorvastatin on the responsiveness to sildenafil in
men with erectile dysfunction - Vasc Med. 2006 Nov;11(4):251-7 -
"International Index of Erectile
Function (IIEF) questionnaire ... Compared to placebo,
quinapril (p < 0.01)
significantly improved symptoms of ED as measured
by the IIEF-5 questionnaire. There was a trend toward a significant improvement
in IIEF-5 with atorvastatin"
- See atorvastatin at
OffshoreRx.com .
Getting to The Heart Of ED - washingtonpost.com. 3/13/07
Prevalence of Metabolic Syndrome and Its Association with Erectile Dysfunction
Among Urologic Patients: Metabolic Backgrounds of Erectile Dysfunction -
Urology. 2007 Jan 30 - "waist
circumference (WC) and triglyceride (TG) ... MS was strongly associated with ED.
Fasting blood glucose levels, hypertension, and WC are the most significant risk
factors predicting the risk of ED. A more pronounced increase in ED risk in the
presence of abdominal obesity, together with altered TG and HDL cholesterol
levels, may indicate a special metabolic background of ED regarding lipid
metabolism"
Erectile Dysfunction Hits 18 Million - WebMD, 2/1/07
Doppler Evaluation of Erectile Dysfunction – Part 2 - Medscape, 1/11/07
Doppler Evaluation of Erectile Dysfunction – Part 1 - Medscape, 1/9/07
Metabolic syndrome and erectile dysfunction : Epidemiologic associations and
pathogenetic links - Urologe A. 2006 Dec 12 -
"There is abundant evidence for the
association between erectile dysfunction (ED) and the traditional
atherosclerotic risk factors, such as dyslipidemia, hypertension, glucose
intolerance, and obesity, that make up the metabolic syndrome. Recent findings
have demonstrated a linear relationship between the number of these risk factors
and the prevalence of ED"
Hyperhomocysteinemia: a novel risk factor for erectile dysfunction -
Metabolism. 2006 Dec;55(12):1564-1568 -
"Hyperhomocysteinemia, known to be an important risk factor in endothelial
dysfunction, seems to be an important determinant in ED. These data suggest that
slightly elevated Hcys levels are significantly related with arterial and
probably endothelial dysfunction in patients with ED"
The
Evolving Role Of Testosterone In The Treatment Of Erectile Dysfunction -
Medscape, 10/30/06 - "testosterone
replacement therapy has evolved from a monotherapy for ED in cases of low
testosterone, to a combination therapy with PDE5 inhibitors. There is increasing
evidence that combination therapy is effective in treating the symptoms of ED in
patients for whom treatment failed with testosterone or PDE5 inhibitors alone.
Screening for hypogonadism and combination therapy of ED may be particularly
useful in men with type 2 diabetes or the metabolic syndrome"
Comparison of phosphodiesterase type 5 (PDE5) inhibitors - Int J Clin Pract.
2006 Jun 16 - "With regard to the onset
of action, achievement of an erection that leads to successful intercourse has
been reported for 35% of patients treated with sildenafil within 14 min, 21% of
patients treated with vardenafil within 10 min and 16% of patients treated with
tadalafil within 16 min. Sildenafil and vardenafil both have half-lives of
approximately 4 h but the half-life of tadalafil is 17.5 h. Another difference
between the PDE5 inhibitors is that food, especially fatty food, affects the
pharmacokinetic profiles of sildenafil and vardenafil, but not that of
tadalafil"
Clomiphene Citrate Restores Fertility in Men With Prolactinoma and Decreased
Sexual Function - Doctor's Guide, 6/30/06
Erectile Dysfunction Drugs Affect Other Systems, Mostly for the Better -
Doctor's Guide, 6/16/06 - "PDE-5
inhibitors actually improve blood flow even in areas where there is a blockage
of an artery, thereby having a protective effect on the heart muscle"
Erectile Dysfunction Goes Into Remission On its Own - Doctor's Guide,
5/29/06
New
ED Drugs on Horizon - WebMD, 5/24/06
Switching to Tiagabine Alleviates Antidepressant-Induced Sexual
Dysfunction in Patients With Generalized Anxiety Disorder
- Doctor's Guide, 3/29/06 - "After 14
weeks of tiagabine treatment, patients had maintained improvement of GAD
symptoms, as indicated by HAM-A and HADS scores, while having significant
improvement in sexual function scores" - See
OffshoreRx.com.
Smokers: More Erectile Dysfunction? - WebMD, 3/22/06
Erectile Dysfunction and Statin Treatment - Medscape, 3/21/06 -
"Simvastatin was found to cause
impotency in five men with coronary artery disease, and within 1 week of
discontinuing simvastatin, sexual function was restored. The Australian
Adverse Drug Reactions Committee reported 42 cases of ED associated with
simvastatin.[13] In contrast, in one study in men aged 49.7 years and
isolated hypercholesterolaemia [low-density lipoprotein (LDL)-C 4.3 mmol/l]
as a risk factor which used penile Doppler ultrasound in a per protocol
analysis of 50% of the cohort of 18 patients (n = 9), atorvastatin therapy
was associated with improvement in erectile function"
Erectile Dysfunction Common, Linked with Severity of Heart Disease -
Doctor's Guide, 1/24/06 - "Erectile
dysfunction (ED) affects approximately one in five American men, appears to
be associated with cardiovascular and other chronic diseases and may predict
severity and a poor prognosis among those with heart disease"
Erectile Dysfunction-Heart Risk Link - WebMD, 12/20/05 -
"Our data suggest that older men in
this group have about a twofold greater risk of cardiovascular disease than
men without erectile dysfunction ... any sign of erectile dysfunction should
prompt them to make an appointment for a complete cardiovascular
examination"
Erectile Dysfunction, Artery Problems Linked? - WebMD, 10/11/05 -
"Erectile dysfunction often stems
from blood vessel problems tied to atherosclerosis, the hardening of the
arteries"
Serious Riders, Your Bicycle Seat May Affect Your Love Life - New
York Times, 10/4/05
Studies Link Bike Seats, Erectile Dysfunction - WebMD, 8/25/05 -
"three new studies in The Journal of
Sexual Medicine ... when erectile dysfunction is related to bicycling, it's
linked to pressure on the perineum (the area between the anus and scrotum
where nerves and arteries pass). The pressure, which comes from sitting on a
bicycle seat with a nose extension, restricts blood flow to the penis"
Cause Of Diabetes-related Erectile Dysfunction Is Clarified By Johns Hopkins
Researchers - Science Daily, 8/11/05 -
"one particular simple sugar,
present in increased levels in diabetics, interferes with the chain of
events needed to achieve and maintain erection and can lead to permanent
penile impairment over time"
Vascular Disease Most Common Cause of Male Erectile Dysfunction -
Doctor's Guide, 6/28/05
AUA Releases Guidelines for Erectile Dysfunction - Doctor's Guide,
5/30/05
Pills Best for Erectile Dysfunction - WebMD, 5/24/05
Erectile Dysfunction Seen in Men With Prehypertension - Doctor's Guide,
5/19/05
Blood Pressure
Linked to Erectile Dysfunction - WebMD, 5/16/05 -
"if a man's blood pressure is
anything but normal, he may have a higher risk of erectile dysfunction ...
Thirty-five percent had some degree of erectile dysfunction, compared with
14% of men without high blood pressure ...
In men with high blood pressure, 20% of those taking no medication had
erectile dysfunction, while 36% on one medication and 47% on more than one
reported erectile dysfunction ... Men on older high blood pressure
medications (diuretics, beta-blockers) had higher rates and more severe
erectile dysfunction than men on newer medications (calcium antagonists, ACE
inhibitors, angiotensin II receptor blockers)"
Glycosylated haemoglobin levels and the severity of erectile
function in diabetic men - BJU Int. 2005
Mar;95(4):615-7 - "This study suggests
that the severity of ED is associated with increasing HbA(1c) levels in
diabetic men"
Problems In The Bedroom Can Indicate Heart Problems
- Science Daily, 2/2/05 -
"ED is now being considered an important barometer of a man's overall
cardiovascular health and an early symptom of a more generalized vascular
problem"
Treating Sexual Dysfunction - Clinical Psychiatry News. 12/04
Sexual Problems Common Among Obese People - WebMD,
11/15/04
More Guidelines, CCBs, ACEs, and ARBs, and Novel Predictors
- Medscape, 9/14/04 - "spontaneously
hypertensive rats (SHR)
demonstrate detectable erectile dysfunction (ED) before the onset of
hypertension This may be due to earlier manifestation of the effects of
endothelial dysfunction and tissue remodeling in erectile tissue compared
with vascular tissue"
Erectile Dysfunction in Diabetic Men May Predict Silent Heart Disease
- Doctor's Guide, 6/22/04
Erectile Dysfunction May Be Warning Sign - WebMD,
1/20/04 -
"erectile dysfunction affects about 52% of men between ages 40 and 70 years,
and the majority of cases are caused by conditions that affect blood flow to
the penis, such as atherosclerosis and diabetes"
Love Potions - Time Magazine, 1/19/04
1 in 3 Older Men Have Erection Difficulty -
Physician's Weekly, 9/1/03
Erectile Dysfunction Common With Age - WebMD,
8/4/03
Relationship between obesity-related metabolic abnormalities and sexual
function - J Endocrinol Invest. 2003;26(3
Suppl):62-4 -
"it will be reported about the 3
possible mechanisms through which obese people may suffer from sexual
dysfunction: a) insulin resistance and associated hormonal changes, b)
dyslipidemia
and related drugs, and c) psychological problems"
Pathophysiology of diabetic sexual dysfunction - J
Endocrinol Invest. 2003;26(3 Suppl):65-9
Men with Borderline Low and Low Baseline Testosterone Benefit Equally from
Testosterone Gel (Androgel) - Doctor's Guide,
6/23/03 - "Transdermal
testosterone replacement gel (Androgel)
improves sexual function, body composition and bone mineral density in men
with borderline low testosterone levels almost equal as in men with
pretreatment testosterone levels below the normal"
Sexual Dysfunction Common But Conservatively Treated In Depressed Patients
- Doctor's Guide, 5/26/03 - "Sexual
dysfunction was observed in 35% of those spontaneously reporting
problems and in 69% of those with problems identified by physician
questioning. Of patients treated with antidepressants, 71% reported sexual
dysfunction compared to 65% in untreated patients. The researchers also
found that treatment with
tianeptine was associated with a lower
incidence of sexual dysfunction than was treatment with
tricyclic antidepressant or serotonin reuptake inhibitors" -
Interesting because depression is associated with high
cortisol and tianeptine has been shown
to counter the effects of cortisol. That supports the theory of
cortisol being the cause. - Ben
Improving Erectile Function: Detection, Prevention, and Treatment of ED
- PowerPak.com, exp. 4/1/05 - "ED
was 82% more likely in men with depression ... Low serum
testosterone levels are noted in up to 36% of patients with ED. However,
the correction of sexual dysfunction with testosterone replacement therapy
alone is poor, with treatment response at approximately 35%" - That
may be because testosterone does two things that hinder sexual function.
It decreases HDL cholesterol and it
increases estrogen. - Ben
Valsartan Appears to Improve Sexual Function in Men and Women with
Hypertension - Doctor's Guide, 5/18/03 -
"Men and women being treated with the
angiotensin II receptor blocker valsartan for mild-to-moderate
hypertension appear to show improvements in sexual function and desire"
Smoking Can Lead to Erectile Dysfunction - WebMD,
3/6/03
Focus on Risk Factors in Erectile Dysfunction - Clinical Psychiatry
News, 1/03 - "I generally tell patients that what's good for your heart is
generally good for your sex life—and so maintaining good
cholesterol levels, exercising, losing
excess weight—all these things could make a difference to the severity
of a patient's ED [erectile dysfunction]—partly by improving vascular flow"
Check Erectile Dysfunction Patients For Vascular and Cardiac Disease -
Clinical Psychiatry News, 1/03
Sex and the Serious Cyclist - Time Magazine,
10/28/02 -
"Goldstein has been warning cyclists that hours of sitting on a bike saddle
can create enough pressure on the perineum, the area between the anus and
the pubic bone, to permanently damage the artery that supplies blood to the
penis"
Intrathecal Opioids Linked to Sexual Dysfunction -
Doctor's Guide, 6/28/02
Impotent Patients on Valsartan Find Increased Interest in Sex; Use
Sildenafil More Often - Doctor's Guide, 5/19/02 -
"Because the use of
sildenafil significantly
increased with the use of valsartan, it suggests that angiotensin II
antagonism induces an increase in sexual desire in
impotent hypertensive men ... It could be related to the reactive
stimulation of angiotensin cascade due to AT1 receptors blockade"
Why is this man smiling? It's not Viagra - USA
Today, 4/18/02
High Blood Pressure Kills Sex - WebMD, 3/21/02 -
"the problem may not be with blood flow alone. New research suggests
plummeting levels of the male hormone
testosterone could partly be to blame"
1/3 of Diabetic Men Have Impotence - WebMD, 2/1/02
Physical and Psychological Effects of Stress -
MedicineNet.com, 2/02 -
"Under excessive stress, we tend to produce cortisol, the classic
anti-stress hormone produced by our body, perhaps to conserve energy.
However the side-effect here is sexual dysfunction and infertility as
cortisol also inhibits production of the hormones essential for sexual"
Smoking
Increases Likelihood Of Impotency - Doctor's
Guide, 12/4/01
Blood pressure drug reverses sexual dysfunction - Life Extension
Magazine, 7/01 - "the active
ingredient in Cozaar
and Hyaar
(losartan)
can significantly improve sex lives of men who suffer from sexual
dysfunction"
Antidepressants and Sex: What to Watch For, Common Problem Manageable With
Doctor's Help - WebMD, 5/11/01 -
"The antidepressants that caused the least sexual dysfunction were Serzone
(28%) the slow-release Wellbutrin SR (24%), and the immediate-release
Wellbutrin (22%) -- all of which are non-SSRIs"
Newest
Hypertension Drug, Losartan, May Improve Sexual Function
- Doctor's Guide, 5/1/01
Carvedilol Reduces But Valsartan May Increase Sexual Activity In
Hypertensive Men - Doctor's Guide, 2/1/01 -
"carvedilol induces a chronic reduction of sexual activity whereas
valsartan, an angiotensin II antagonist, not only does not significantly
reduce sexual activity but may even increase it."
Newest
Hypertension Drugs May Improve Sexual Function -
Doctor's Guide, 11/13/01
Submissive Men More Likely to Suffer Erectile Dysfunction - WebMD,
11/2/00
Is
a Male 'Change of Life' Fact or Fiction? - WebMD, 10/20/00 -
"A very small drop in testosterone -- 10% or so -- might cause symptoms like
depression, mood swings, decreased muscle strength and energy, reduced sex
drive, problems with erections."
Impotence Risk High for Both Prostate Cancer Treatments - WebMD, 9/22/00
Antidepressant [Wellbutrin SR] Can Boost Sex Drive - Intelihealth,
5/18/00
Lifestyle may play role in potential for impotence - CNN, 5/3/00
Impotence Drugs in the Spotlight -- for Different Reasons
- WebMD, 5/3/00
Viagra sometimes fails, but there are alternatives - CNN, 4/5/00
FDA
Approves Prescription AndroGel For Low Testosterone - Doctor's Guide,
2/29/00
Impotence
May Be Early Warning Of Heart Disease - Doctor's
Guide, 11/10/99
Tanning drug may find new life as Viagra alternative - CNN, 6/14/99
Muse Offers
Second Chance For Patients Unsuccessful With Viagra - Doctor's Guide,
5/6/99
Uprima Shows
Promise In Patients With Erectile Dysfunction - Doctor's Guide, 5/5/99
Invicorp
Conditionally Approved In The U.K. For Impotence -
Doctor's Guide, 3/29/99
Viagra anniversary sees herbal competitors by the dozens - CNN, 3/26/99
Antidepressant-Induced Sexual Dysfunction Associated with Low Serum Free
Testosterone - Psychiatry Online
Erectile
Dysfunction Associated With Depression - Doctor's Guide, 7/23/98
Doctor says bike-riding can hurt a man's sex life - CNN, 6/1/98
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