How I Healed my Erectile Dysfunction

Ancient ED Fix

Ancient E.D Fix is a 3000-year secret once lost to history that can treat the root cause of erectile dysfunction. This program will give you rock hard erections complete with marathon staying power, no matter your age or physical appearance. The Ancient E.D Fix program approaches the problem of erectile dysfunction from a very interesting angle. It claims that the ED that many men suffer may be a result of inflammation caused by gum disease. Apparently, if you have oral inflammation from gum disease, this can damage the cells that form the lining on all of your blood vessels in your body including those in your penis. This damage may be causing impaired blood flow to your manhood, causing you not to be able to get hard when you need to.The program cites a study which showed that men with ED were more likely to be diagnosed with gum disease. So, the program offers you some oral cleaning methods that will help you to keep your gums healthy, which will increase the overall health of your body.In addition to this, the program will also include tips on how you can use natural remedies to deal with your erectile dysfunction issues. The program will help you to regain control of your sex life so that you can have firm hard-ons again and please your partner in bed. Read more...

Ancient ED Fix Summary

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Ginseng and Erectile Function

Erectile dysfunction is commonly associated with diabetes, a condition that has well-characterized effects on peripheral tissue innervation and vascularization 21 . Penile intracavernous pressure after nerve stimulation was significantly lower in long-term diabetic rats relative to age-matched controls 22 . In diabetic rats treated with Korean red ginseng (30 mg kg-1) for one month, however, erectile function was not different from nondiabetic age-matched controls 22 . Ginseng use has also been shown to produce beneficial effects in clinical studies (Table 4.1) that evalu- ated the efficacy of ginseng use in men with erectile dysfunction 6, 10, 23-25 . In double-blind, placebo-controlled studies, men with diagnosed erectile dysfunction took 900 to 1000 mg of Korean red ginseng or placebo by mouth three times daily for either 8 or 12 weeks 23-25 . Using an International Index of Erectile Function (IIEF) self-assessment, ginseng treatment produced significant improvement in IIEF scores...

Herbal Treatments for Erectile Dysfunction

Preliminary research on a few drugs such as ginseng, PLC and DHEA is encouraging, but well-designed randomized controlled clinical trials are lacking. It is likely that the use of medicinal plants will increase in popularity as men seek subtle methods of treating themselves. However, whilst it is easy to purchase many 'natural Viagra'-like substances over the Internet, the safety and reliability of many of these drugs is poor, and patients should be cautious when acquiring these products. Information about how these herbal products interact with prescribed drugs is also limited. Keywords Erectile dysfunction Herbal therapies Impotence

Physiology of an Erection

Impotence, or erectile dysfunction, can be defined as the persistent inability to develop and or maintain an erection adequate for sexual intercourse. Vascular diseases, including atherosclerosis, hypertension, diabetes, and high cholesterol, can cause restricted blood flow to the penis and may account for approximately 70 of physically related causes of erectile dysfunction 11 . The arterial blood supply to the penis is mainly provided by the internal pudendal artery, which branches into several smaller arteries that contribute to vascularization of the erectile tissues. The erectile tissue of the human penis consists of two dorsal corpora cavernosa and a ventral corpus spongiosum. Reduced sympathetic input combined with stimulation The physiological regulation of erectile function has been well reviewed 12-15 . To understand how ginseng may affect the erection process, a brief overview of ginseng-relevant processes will be described. The dilation of penile vascular smooth muscle is...

Sildenafil

Myocardial infarction has been attributed to the combination of cannabis and sildenafil. A 41-year-old man developed chest tightness radiating down both arms (107). He had taken sildenafil and cannabis recreationally the night before. His vital signs were normal and he had no signs of heart failure. However, electrocardiography showed an inferior evolving non-Q-wave myocardial infarct and his creatine kinase activity was raised (431 U l). Cannabis inhibits CYP3A4, which is primarily responsible for the metabolism of sildenafil, increased concentrations of which may have caused this cardiac event.

Endocrine and Sexual Effects

All standard antipsychotic drugs elevate serum prolactin levels by blocking the tonic inhibitory actions of dopamine on lactotrophic cells in the pituitary. Among second-generation antipsychotics, risperidone and amisulpride can produce dose-dependent hyperprolactinemia to a greater extent than firstgeneration antipsychotics, whereas clozapine, olanzapine, ziprasidone, and quetiapine do not cause a sustained elevation of prolactin above normal levels. Aripiprazole, being a partial DA agonist, produces no elevation of prolactin and even suppresses prolactin levels slightly. Hyperprolactinemia in women can lead to menstrual disturbances, including anovu-latory cycles and infertility, menses with abnormal luteal phases, or frank amenorrhea and hypoestrogenemia. Women have also reported decreased libido and anorgasmia, and there are reports of increased long-term risk of osteoporosis although this is controversial. Antipsychotic-induced gyneco-mastia has been reported in 3 of women and 6...

Central Nervous System Actions of Ginseng

Ior 53, 54 , and treatment with dopaminergic drugs has long been shown to facilitate masculine sexual behavior 55, 56 . In the paraventricular nuclei (PVN) and medial preoptic area of the hypothalamus (MPOA), brain areas critical for male sexual behavior 57 , dopamine levels are increased before and during copulation 58, 59 . The microinjection of dopamine receptor antagonists directly into the MPOA decreases libido and impairs copulatory performance 60, 61 . NO may be an important mediator of hypothalamic dopamine release 62 . Treatment with NOS inhibitors decreased hypothalamic dopamine levels 63 and reduced male mounting activity 64, 65 , libido 64 , and penile erection 66, 67 . Although there is no direct evidence to show that ginseng ginsenosides modulate hypothalamic NO levels, the injection of ginsenoside Rc or Rg3 into the cerebral ventricles inhibits stress-induced hypothalamic activation in mice through a NO-mediated pathway 68 , suggesting that ginsenosides directly induce...

Treatment Options for Depression

Selective Serotonin Reuptake Inhibitors (SSRIs) Named for their action in the brain, SSRIs have proved to be enormously helpful for depression. They need to be taken every day and take some weeks to become effective. Their side effects are minimal in most people, although some people experience fatigue and a few become agitated. Most people notice decreased sexual drive and impaired sexual response, side effects that can cause considerable distress. Monamine Oxidase Inhibitors (MAOIs) Named for their action in the brain, MAOIs are also very effective. They too must be taken every day and take weeks to become effective. Common side effects include weight gain, dry mouth, insomnia, impaired sexual response, and low blood pressure. Their most troubling side effect is the potential to cause a stroke if you ingest adrenaline or adrenaline-like substances. MAOIs can be used only with a fairly strict diet that avoids foods or medicines that contain adrenaline or adrenaline-like substances....

W Hemp Chronicles

Meanwhile, to add further confusion, the 1980s brought forth the medicinal argument to the broader discussion of cannabis prohibition in North America. Not only were expert opinions about the health impacts of cannabis contradictory, but here we see also the emergence of a group with the belief that this much-maligned drug can actually be therapeutic. It's not really a new belief cannabis has been used by herbalists for millennia and has been proscribed for everything from failing eyesight to erectile dysfunction (Spicer 2002). In fact, cannabis even existed in the pharmacopoeia of the U.S. from 1850 until 1942. Statements by various government officials seem to back this up in 1988, U.S. Drug Enforcement Agency (DEA) administrative law judge Francis L. Young noted that in its natural form, cannabis is one of the safest therapeutically active substances known, and the 1972 Canadian Le Dain commission reached similar conclusions (Young 1988 LeDain 1972). Further, the 1978 creation of...

Its getting harder every day

When Viagra hit the market in 1998, a few women's health advocates mistakenly cried foul at the notion that drug companies were creating drugs to deal with male sexual dysfunction but not women's. Further, they reiterated the claims that our sexist culture still has not come up with a male birth control pill because men are not willing to take responsibility for contraception. In fact, Viagra was discovered by accident in a clinical trial for a drug intended to treat angina. Men in the trial were reporting a surprising and sometimes awkward side-effect that in some cases improved some aspects of their I don't know about you, but I don't know many men that wouldn't opt to take a pill to prevent unintentional fatherhood responsibilities. If we count on men being as shallow as we think they are (a safe bet), you would have men bragging about being on the pill. Also, the accusations of no effort going into male contraceptives miss the minor detail that there has actually been a lot of...

How to Monitor Your Progress

Changes in your condition will affect your relationship with your family, friends and, most especially, your partner. Ideally, these will be positive changes that will enhance your relationships. Sometimes however, these changes can require unforeseen adjustments. For example, if sildenafil (Viagra) improves your sexual functioning, the change may be disconcerting to someone who has grown accustomed to your previous level of sexual interest. If fluoxetine has improved your anxiety and depression to the point that you want to start working, your partner' s

Clinical Use Of Agents

Remains to be seen whether selective prostanoid receptor antagonists might provide better medicines for the treatment of pain and other therapeutic indications. A summary of the available agents and their indications is presented in Table 6.13. The therapeutic areas in which these agents are used are diverse and are a consequence of the widespread physiological actions of the natural prostaglandins. Prostaglandins used in the termination of pregnancy, cervical ripening, and labor induction include dinoprost (PGF2a) and carbaprost (15-methyl-PGF,,), dinoprostone (PGE2), sul-prostone,gemeprost, and misoprostol. Alpros-tadil (PGEi) is used to treat erectile dysfunction. Prostaglandins used in cardiovascular conditions include alprostadil and the PGE, analog, limaprost, as well as epoprostenol (prostacyclin) and its analog, iloprost. Miso-prostol is used clinically, with some success, as an inhibitor of gastric acid secretion. Prosta-glandins, particularly of the F series, are widely used...

Overall level of evidence for adverse effects B

Prevalence of erectile dysfunction as compared with men without cardiac diseases 7 reporting no erectile dysfunction, 17 reporting erectile dysfunction No 22208 Rosen RC, Fisher WA, Eardley I, Niederberger C, Nadel A, Sand M. Men's Attitudes to Life Events and Sexuality (MALES) Study. The multinational Men's Attitudes to Life Events and Sexuality (MALES) study I. Prevalence of erectile dysfunction and related health concerns in the general population. Curr Med Res Opin. 2004 May 20(5) 607-17. English Erectile dysfunction Sexual function questionnaire 2218 Blumentals WA, Gomez-Caminero A, Joo S, Vannappagari V. Should erectile dysfunction be considered as a marker for acute myocardial infarction Results from a retrospective cohort study. Int J Impot Res. 2004 Aug 16(4) 350-3. English Prevalence of erectile dysfunction as compared with men without cardiac diseases OR 3.13 (95 CI 2.35-4.16) No 22206 Grover SA, Lowensteyn I, Kaouache M, Marchand S, Coupal L, DeCarolis E, Zoccoli J, Defoy...

Overall level of evidence of adverse effects D

Erectile function 6 21381 Gupta S, Salimpour P, Saenz de Tejada I, Daley J, Gholami S, Daller M, Krane RJ, Traish AM, Goldstein I. A possible mechanism for alteration of human erectile function by digoxin inhibition of corpus cavernosum sodium potassium adenosine triphosphatase activity. J Urol. 1998 May 159(5) 1529-36. English Cardiac disease Erectile function Erectile function, impairment No influence on libido and testosterone Complete impotence Erectile dysfunction

General Information

Interferon gamma has been investigated in 27 patients with systemic sclerosis randomized to receive interferon gamma for 12 months. Most of them complained of symptoms consistent with a flu-like syndrome, namely headache (85 ), fever (81 ), and arthralgia and myalgia (70 ) (5). There were adverse events (one or more per patient) leading to treatment withdrawal in four cases, including arthral-gia, cardiac pain, atrioventricular block, reversible loss of hearing, and impotence however, a causal relation with interferon gamma was not documented.

Overall level of evidence of adverse effects B

Are men with erectile dysfunction more likely to have hypertension than men without erectile dysfunction A naturalistic national cohort study. J Urol. 2005 Jul 174(1 ) 244-8. English Prevalence of erectile dysfunction as compared with normotensive men 19 reporting no erectile dysfunction, 36 reporting erectile dysfunction No 22208 Rosen RC, Fisher WA, Eardley I, Niederberger C, Nadel A, Sand M. Men's Attitudes to Life Events and Sexuality (MALES) Study. The multinational Men's Attitudes to Life Events and Sexuality (MALES) study I. Prevalence of erectile dysfunction and related health concerns in the general population. Curr Med Res Opin. 2004 May 20(5) 607-17. English Erectile function, impairment Bedrofluazide propranolol placebo Reported incidence figures for suspected adverse reactions are probably lower than the true incidence, since not all reactions will have been mentioned by patients. Side effects such as, for example, impotence, lead less often to...

Male Sex Hormones and Anabolic Steroids

Androgenic steroids are used in medicine for replacement therapy in men with insufficient function of the male sex glands, for maturation arrest, impotency, climacteric, and other irregularities, and in women for breast and ovarian cancer and climacteric disorders. Like all steroid drugs, androgens are functionalized derivatives of cyclopentanophenan-threne.

Pregnancy Category X

Methyltestosterone is a synthetic drug manufactured from testosterone. Methyltestosterone's medical uses include supplementation of testosterone in males with low levels of that hormone and treatment of female breast cancer. Scientists report unsatisfactory results from a test of whether the compound might work as a male contraceptive and mixed results when the substance was used to treat male impotence. Impotence improvement was better when methyltestosterone was taken in combination with a yohimbe preparation. Methyltestosterone has provided pain relief and occasionally fertility enhancement to women suffering from a reproductive disorder called endo-metriosis externa. Therapeutic regimens to build up bone strength in older women may include methyltestosterone, as may therapies designed to compensate for hormonal changes caused by menopause. In research projects height increase occurred when the drug was administered to boys of short stature. Experimenters describe the drug as...

Treatment consequences Efficacy Side effects compromising effectiveness Randomization of patients Dose arms 13 Study

Erectile dysfunction Erectile function 1547 Waldhauser M, Schramek P. Efficiency and side effects of prostaglandin E1 in the treatment of erectile dysfunction. J Urol. 1988 Sep 140(3) 525-7. English Erectile dysfunction Erectile function Erectile function, improvement 1052 Becher E. Topical alprostadil cream for the treatment of erectile dysfunction. Expert Opin Pharmacother. 2004 Mar 5(3) 623-32. English Erectile dysfunction Erectile function 21514 Purvis K, Brekke I, Christiansen E. Determinants of satisfactory rigidity after intracavernosal injection with prostaglandin E1 in men with erectile failure. Int J Impot Res. 1996 Mar 8(1) 9-16. English

Physiology and Pharmacology

Erection occurs as a result of increased pressure in the corpora cavernosa, which translates into penile rigidity. The pressure increase is caused by three synergistic processes (2) relaxation of the smooth muscles of the corpora cavernosa (2)increase in arterial blood flow to the penis and (3) restriction of the venous blood flow out of the penis. Both central and peripheral mechanisms contribute to the process of penile erection. At the central level, the psychological component of penile erection is controlled by the hypotha-lamic and limbic systems (140). At the peripheral level, both sympathetic and parasympa-thetic pathways as well as several mediators are involved. Psychogenic and local stimulation results in the release of neurotransmit-ters from the cavernosal nerve terminals and smooth muscle endothelium. Factors that mediate the corpus cavernosum relaxation include nitric oxide (NO), vasoactive intestinal peptide (VIP), calcitonin gene-related peptide and prostaglandin....

Study quality Reference

Erectile dysfunction Erectile function 11489 Lammers PI, Rubio-Aurioles E, Castell R, Castaneda J, Ponce de Leon R, Hurley D, Lipezker M, Loehr LA, Lowrey F. Combination therapy for erectile dysfunction a randomized, double blind, unblinded active-controlled, cross-over study of the pharmacodynamics and safety of combined oral formulations of apomorphine hydrochloride, phentolamine mesylate and papaverine hydrochloride in men with moderate to severe erectile dysfunction. Int J Impot Res. 2002 Feb 14(1) 54-9. English Erectile dysfunction Erectile function Erectile function, improvement 1483 Shamloul R, Atteya A, Elnashaar A, Gadallah A, Zohdy W, Abdelsalam W. Intracavernous sodium nitroprusside (SNP) versus papaverine phentolamine in erectile dysfunction a comparative study of short-term efficacy and side-effects. J Sex Med. 2005 Jan 2(1) 117-20. Erectile dysfunction Erectile function

No of patients treated

Erectile dysfunction in spinal cord lesion Erectile function Papaverine nitrogylcerin 21509 Renganathan R, Suranjan B, Kurien T. Comparison of transdermal nitroglycerin and intracavernous injection of papaverine in the treatment of erectile dysfunction in patients with spinal cord lesions. Spinal Cord. 1997 Feb 35(2) 99-103. English

Organs and Systems Sexual function

Intracavernous administration of papaverine with phen-tolamine has been used in the diagnosis and treatment of erectile dysfunction. The major local adverse effect is prolonged erection, which usually occurs early during diagnostic testing and is reduced after dose adjustment furthermore, local hematomas have been reported in a number of patients. It may be that patients most susceptible to priapism can be identified in advance by testing their erectile abilities in response to erotic stimulation (1). Long-term therapy can also cause intracavernous fibrosis but it can also lead to development of tolerance to the desired effect.

The Endocannabinoid System and Female Reproductive Function

THC has been reported to account for the majority of the reproductive hazards of marijuana use, and in males it leads to impotence by suppressing spermato-genesis, reducing the weight of reproductive organs, and decreasing the plasma concentration of circulating hormones like testosterone (Kolodney et al. 1974). In

Side effects compromising effectiveness Randomization of patients Dose arms 13 Study quality

Erectile dysfunction in various conditions IIEF Erectile function, improvement Patients' abilities to achieve and maintain an erection in the sildenafil group was significantly improved compared with the placebo group. Mild to moderate in 27 of patients in sildenafil group, and in 8 of patients in placebo group Sildenafil placebo 1208 Meuleman E, Cuzin B, Opsomer RJ, Hartmann U, Bailey MJ, Maytom MC, Smith MD, Osterloh IH. A dose-escalation study to assess the efficacy and safety of sildenafil citrate in men with erectile dysfunction. BJU Int. 2001 Jan 87(1) 75-81. English Sildenafil (G04BE03) Erectile dysfunction IIEF Erectile function, improvement Compared with placebo, sildenafil significantly improved self-esteem, confidence, sexual relationship satisfaction and overall relationship satisfaction. Not mentioned Sildenafil placebo 1 + 1229 Althof SE, O'leary MP, Cappelleri JC, Hvidsten K, Stecher VJ, Glina S, King R, Siegel RL. International SEAR Study Group. Sildenafil citrate...

Prostaglandins in urology

A single dose of PGEi into the corpus cavernosum is highly effective in inducing artificial penile erection in cases of erectile dysfunction. The reported adverse effects include pain and a burning sensation, prolonged penile erection, and local fibrosis. The incidence of pain was high (75 ) in older studies (53), while later data improved to 13-44 (54-57). Pain is cited as a prominent factor in non-adherence to therapy and in the dropout rate of patients from self-injection programs, although the incidence may fall with time (57). An alprostadil sterile powder formulation had a lower incidence of pain after penile injection (6.6 ), attributed to lower doses and the lack of alcohol in the formulation (58). Burning and pain can be reduced by using a lower initial dose, with incremental increases until a satisfactory erection is produced (59).

Randomization of patients Dose arms 13 Study quality Reference

Erectile dysfunction IIEF Significantly better effect of tadalafil regardless of concomitant thiazide use Tadalafil headache 15 dyspepsia 8 back pain 5.3 . Placebo headache 4.0 , dyspepsia 0.7 and back pain 1.2 no statistically significant difference between thiazide users and non-users. Yes Tadalafil placebo 1 - (meta-analysis) 1559 Kloner RA, Sadovsky R, Johnson EG, Mo D, Ahuja S. Efficacy of tadalafil in the treatment of erectile dysfunction in hypertensive men on concomitant thiazide diuretic therapy. Int J Impot Res. 2005 Sep-Oct 17(5) 450-4. 2.4 Drugs Which Compromise Erectile Function 517 Tadalafil (G04BE08) Erectile dysfunction in diabetes mellitus Erectile function, improvement Diabetes group receiving tadalafil 20 mg a mean improvement of 7.4 in the IIEF score against baseline versus 0.9 for placebo 53 of the attempts at intercourse were successful, compared with 22 for placebo Tadalafil placebo 1216 Fonseca V, Seftel A, Denne J, Fredlund P. Impact of diabetes mellitus on...

Organs and Systems Cardiovascular

In several reviews, in which the same data have been analysed, sildenafil has been rated as being well tolerated One patient without a history of previous chest pain or risk factors for cardiovascular disease, developed a well-documented myocardial infarction 30 minutes after he took sildenafil 50 mg and before any attempt at sexual intercourse (8). The interpretation of these sporadic cases is controversial, although some have argued that the reported cardiovascular adverse effects occur more often with sildenafil than with other pharmacological treatments of erectile dysfunction. It is at present unclear whether there is an increased risk with sildenafil. For example, in placebo-controlled trials there have been no differences in the incidences of myocardial infarction, angina, or coronary artery disorders between sildenafil and placebo (9). Exclusion criteria in clinical trials may have prevented the inclusion of patients who are at increased risk of adverse events. On the other...

Long Term Effects Drug tolerance

Potential tachyphylaxis with long-term use of silde-nafil has been discussed following a survey in which 200 patients were questioned twice, 2 years apart, about the effects of sildenafil on the second occasion 20 of them reported needing an increased dose, and 17 had discontinued therapy because of lack of effect (36). However, others have commented that more likely reasons for the loss of effect over time included worsening of the disease (37-41), reducing testosterone concentrations with age (38,39), or lack of proper arousal (42). Although the mRNA for phosphodiesterase type 5 is down-regulated in the retina by long-term administration of sildenafil in rats (43), it is not known whether that happens in human corpus cavernosum, nor whether long-term sildenafil use is associated with tachyphylaxis.

Drug Drug Interactions Calcium channel blockers

Retrospective analysis of clinical trials has suggested that the concomitant use of antihypertensive drugs did not lead to an increase in adverse events in patients also taking sildenafil (45). Hypertensive patients taking amlodipine, in contrast to glyceryl trinitrate, had only a minor supplementary fall in blood pressure when challenged with a single dose of sildenafil, and a few had a mild to moderate headache (46).

Regulation of other receptors

It has an inhibitory effect on the cardiovascular system. Ergometrine also has a high affinity to uterine a2 receptors, and it therefore influences uterine muscle activity. Ergometrine is used in the treatment of postpartum or postbortal haemorrhaging. Yohimbine blocks presynaptic a2 adrenoreceptors and increases the release of noradrenaline at sympathetic nerve endings. It may be used to increase heart rate and blood pressure and even in the treatment of severe cases of male impotency.

Congestive Heart Failure

A number of adverse reactions can occur such as dehydration this is a common risk in the use of all diuretics especially in the elderly patients. Other effects include hypokalemia (usually mild), hyperuricemia gout, impaired glucose tolerance diabetes mellitus, insulin resistance (significance is uncertain), Hypercholesterolemia (usually in short-term therapy rather than in long-term therapy), impotence, and hypercalcemia. Contraindications are gout, diabetes mellitus, and renal disease.

Side effects compromising effectiveness Randomization of patients Dose arms 13 Study quality Reference

Erectile dysfunction IIEF Erectile function, improvement Mean erectile function domain scores of IIEF statistically greater than placebo, irrespective of aetiology, baseline severity or age. Vardenafil significantly improved the IIEF domain scores of erectile function, orgasmic function and intercourse satisfaction. Vardenafil placebo

Overall level of evidence of adverse effects C

Incidence of erectile dysfunction 22231 Ricci E, Parazzini F, Mirone V, Imbimbo C, Palmieri A, Bortolotti A, Cintio E di, Landoni M, Lavezzari M. Current drug use as risk factor for erectile dysfunction results from an Italian epidemiological study. Int J Impot Res. 2003 Jun 15(3) 221-4. English 2.4 Drugs Which Compromise Erectile Function 579 Incidence of erectile dysfunction drug use as risk factor for erectile dysfunction results from Erectile function Erectile function Quantification Erectile function Quantification Erectile function Psychosis Erectile function Erectile function, impairment Improved with sildenafil No 1605 Atmaca M, Kuloglu M, Tezcan E. Sildenafil use in patients with olanzapine-induced erectile dysfunction. Int J Impot Res. 2002 Dec 14(6) 547-9. English Psychosis Erectile function Erectile function, improvement 1626 Weizman A, Maoz B, Treves I, Asher I, Ben-David M. Sulpiride-induced hyperprolactinemia and impotence in male psychiatric outpatients. Prog...

Neuron For A Neuron

Until 1973, homosexuality was listed as a psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Up until June 2003, when the United States Supreme Court declared them unconstitutional,140 thirteen states had laws making it a criminal offense to engage in consensual homosexual sex. In some of these states, people who admitted that they were homosexual, or who were accused of being gay or lesbian, were subject to involuntary confinement under mental health laws, and subjected to reparative therapy designed to forcibly convert them into heterosexuals.141 Treatment, in addition to counseling, included penile plesthysmograph shocks (electronic shock triggered by penile erection), drugging, and hypnosis. Some state laws even permitted the forcible sterilization of homosexuals.142

Other Nervous System Drugs

Sexual side effects have been well proven by multiple studies. In particular, the erectile function is compromised. Among the patients who complain of erectile dysfunction, there are more smokers and heavy smokers (40 vs 27.7 , and 39.2 vs 4 , respectively) than in the general population. The prevalence of erectile dysfunction in 1162 never smokers was 2.2 , in 1292 former smokers 2.0 and in 2008 current smokers 3.7 (Mannino et al. 1994). The odds ratio (OR) for suffering from erectile dysfunction is significantly higher in smokers and in ex-smokers than in never smokers (OR 1.24-2.2, in all studies significantly enhanced). The association with pack-years suggested a dose-response pattern. Only one study published decribes no correlation of current cigarette smoking with erectile dysfunction, but the duration was positively correlated with erectile dysfunction (p< 0.01 Bai et al. 2004). In men who are abstaining from smoking erectile function improved. Cigarette smoking increased...

Sexual and reproductive function

Ironically, some of the drugs that increase a teen's risk of engaging in sexual activity can also impair his or her sexual and reproductive functioning. A large number of studies have shown a link between alcohol use and sexual dysfunction. According to Medications That May Contribute to Sexual Disorders, a 1997 article in the Journal of Family Practice, chronic alcohol abuse can suppress normal hormonal functions such as sexual arousal. It can also reduce the size of the testes. The 2003 Health Professionals Follow-up Study reported that impotence was more common among men who drank alcohol. Drugs other than alcohol can also have a negative effect on sexual function. The 1997 article reported that cocaine use may hinder the ability to attain an erection or achieve orgasm. Like cocaine, chronic use of amphetamines also affects orgasm and erection. Barbiturates can impact sexual function as well by reducing desire and making it difficult to achieve erection or orgasm. A 1996 article,...

Im Built Like a Bean Pole

Not long after we began training, one of my lifting buddies showed up with a pill that he says will help us get bigger and stronger faster. The pill is a steroid, and he told us it is harmless and said if we really want to get really big we can stack steroids. I wasn't totally sure about this, so I went to talk with Coach Smith. She told me that stacking is when two or more anabolic steroids are taken together. people who stack mix oral and injection steroids and sometimes add drugs like stimulants or painkillers. She said the idea behind stacking is an unproven belief that the different drugs interact to produce a greater effect on muscle size. She also said we needed to be careful because steroid use had some really nasty side effects. It can cause acne, reduce a guy's sperm count, shrink the testicles, lead to impotence, result in difficulty or pain in urinating, baldness, and even irreversible breast enlargement. She said that the long-term effects can include cancer and possibly...

Imino2 phnyl5 oxazolidinone4

Imperial Group Leading British manufacturer of tobacco products, including Player and Embassy cigarettes, Wilson's snuff, and several brands of cigars. Its other products included beer, prepared foods, and packaging. Corporate headquarters are in London. Impfen German colloquial term for adding opium to hashish. Import Colloquial term for crack. Impotence Inhibited sexual excitement in a man during sexual activity that, despite an unaffected desire for sex, results in inability to attain or maintain a penile erection. Impotence can result from psychological factors (performance anxiety or fear of abandonment or unwanted pregnancy), sociocultural factors (negative sexual attitudes or religious beliefs) or, less frequently, physical causes such as hormonal abnormalities, drug abuse and alcoholism. Treatment of impotence depends on the underlying cause. Many drugs are used as aphrodisiaca. Central stimulants lika amfeta-mine and cocaine initially acts as sexual stimulants but can have...

Effects And Risks Of Smoking

Besides the danger of nicotine addiction, cigarette use poses a wide range of threats to the user's health. The main health dangers include increased risk of heart attack, respiratory diseases such as emphysema and lung cancer, cancer of the mouth and throat, and pancreatic cancer. About one in six men who continue to smoke tobacco will develop lung cancer compared to one in 75 nonsmokers. Male smokers are also 85 percent more likely to suffer from impotence than nonsmokers are. Other diseases linked to smoking include various forms of cancer, stroke, cardiovascular disease, bronchitis, cataracts,

General adverse reactions

The adverse effects of disopyramide are mostly mediated by its effects on the cardiovascular system and by its anticholinergic effects. Disopyramide has a strong negative inotropic effect on the myocardium and can cause heart failure and hypotension. It prolongs the QT interval and can cause serious ventricular tachydysrhythmias. Anticholinergic effects can cause dry mouth, blurred vision, urinary retention, glaucoma, and erectile impotence. Hypoglycemia can also occur. Disopyramide can cause uterine contractions and should not be used during pregnancy. Angioedema has been reported rarely. Tumor-inducing effects have not been reported.

OTC Classification in Japan

Lifestyle drugs received much publicity (5456) since the launch of the little blue pill, Viagra. The publicity is fueled partly by the hype cf the media and partly by the debates about who is going to pay and what are their therapeutic benefits to the consumers (57-61). The scientific field is equally interested in this class of drugs, as reflected by a dedicated Scrip report (62), an article in the British Medical Journal (63), and a special series of articles in the International Journal ofClinical Pharmacology (64-68). Increase muscle mass or height Quality of life improvement Incontinence Impotence Influenza Lifestyle Postpone menstruation Smoking cessation Contraception Weight control Dyspepsia Sun protection Psychological Anti-depression Obsessive-compulsive disorder Social anxiety disorder The other controversy is what benefits do lifestyle drugs offer the consumers because they are primarily treating non-life-threatening diseases. Diseases such as incontinence and impotency...

Amfetamines Introduction One of a

A typical sign of amfetamine intoxication is wide pupils, fast talk and aggression. AMFETAMINES - Mental effects Moderate use of amfetamine can give euphoria, self-confidence, weight loss and sexual stimulation for many hours. These effects explains the popularities of the amfetamine-pills in the 1930s through the 1960s. After repeated long-term use a schizophrenialike psychosis can develop. The first amfeta-mine-psychosis occurred in 1938. Administration of amfetamine to volunteers with no history of psychosis have showed that a majority of the persons develop paranoid psychosis after already after one to five days of administration. The symptoms wear off after the drug is discontinued usually within a week. Of ethical reasons experiments with healthy persons has been limited, but the amfetamine psychosis represent a reasonably accurate model of schizophrenia , including symptoms of paranoia, persecution, hyperactivity, excitation, hallucinations (visual and auditory) as well as...

Problems In The Evaluation Of Clinical Results

Sexual experiences and behavior can be deeply influenced by the LSD pro-cess. The intensity, depth and completeness of the sexual orgasm and the ease with which it occurs seems to be closely related to the process of letting go of psycho-1 logical defenses. Many problems in this area can be traced back to unconscious confusion between the pattern of genital orgasm and that of the total physical release that characterizes the orgasm of birth. As LSD subjects learn to let go in the death-rebirth process, their orgasmic ability increases considerably this improvement of sexual experiences can be observed in both males and females. In those individuals who did not have any major psychopathological symptoms prior to the LSD session, the same effect can usually be observed after one or several high-dose psychedelic experiences. Sexual neuroses, such as frigidity, vaginal spasms (vaginism), genital pain during intercourse, impotence and premature ejaculation frequently respond well to LSD...

Medical And Behavioral Toxicity Overview

Cortisol is a hormone (chemical messenger) responsible for multiple effects on the body, including changes in the immune response, glucose regulation, fat breakdown, blood pressure, and mood. Alcohol-induced cortisol excess can mimic Cushing's disease (a condition associated with excess cortisol production, often caused by a tumor on the adrenals) and is known as pseudo-Cushing's disease. Alcohol affects the hypothalamus (an area of the brain), where it modifies chemical-releasing factors, which in turn control release of hormones from the pituitary (a gland in the brain linked to the hypothalamus by a special blood supply), which in turn affect endocrine organs throughout the body. Acutely, alcohol also inhibits the release of antidiuretic hormone (ADH) from the posterior pituitary, which results in increased urine production. The best documented chronic endocrine effect of alcohol is male hypogonadism, a condition resulting from low sex-hormone function. Signs of the condition are...

Adulteration and Contamination

Adulteration in Asian medicines mostly results from the misidentification of plants. This has resulted in a number of serious events, primarily due to poisoning with digitalis, belladonna, skullcap, etc. 8 . In 1998, the California Department of Health reported that 32 of Asian patent medicines sold in the US contained undeclared pharmaceuticals or heavy metals 60, 61 . The FDA and other investigators have also reported the presence of prescription drugs, including glyburide, sildenafil, colchicines, adrenal steroids, alprazolam, etc. in products claiming to contain only natural ingredients 62 .

Ape Drunk Colloquial term for being slightly

Central stimulants as amfetamines and cocaine has an aphrodisiac effect and is often connected with sexual activities. When central stimulants are abused for a longer time, the pleasure of the drug kick becomes more desirable than sexual stimulation and a paradoxal effect disinterest in sexual activity can appear. In rehabilitation of cocaine and amfetamine abusers the sexual aspects are important. Sexual activities is often strongly connected with drug-taking often with multiple partners or hours of masturbating with pornography. Drug-free sex can therefore be complicated and initially cause impotence. Despite long-standing literary and popular interest in internal aphrodisiacs, few scientific studies of them have been made. Scientific research is limited to occasional tests of drugs or hormones for the cure of male impotence. Most writings on the subject are little more than unscientific compilations of traditional or folkloric material. Of the various foods to which aphrodisiac...

Endocannabinoids and regulation of fertility

The adverse effects of cannabinoids, and in particular of A9-tetrahydro-cannabinol (A9-THC), on reproductive functions have been known for a long time 1,2 , and include retarded embryo development, fetal loss and pregnancy failure (recently reviewed in 3, 4 ). A9-THC has been reported to account for the majority of the reproductive hazards of marijuana use, in particular in males it leads to impotency by suppressing spermatogenesis, by reducing the weight of reproductive organs and by decreasing the plasma concentration of circulating hormones like testosterone. In females, A9-THC inhibits ovulation by prolonging the estrous cycle and decreasing the proestrous surge of luteiniz-ing hormone. In addition, exposure to natural cannabis extracts during pregnancy has been correlated with embryotoxicity and specific teratological malformations in rats, hamsters and rabbits. Also the major endocannabinoid anan-damide (N-arachidonoylethanolamine, AEA) has been shown to impair pregnancy and...

Chemistry and Structure Activity Relationships

Sildenafil (6) is a pyrazolopyrimidinonederiv-ative. The pyazolopyrimidinone ring is essential for PDE5 inhibitory activity. It seems that this ring structure mimics the guanosine base of cGMP (149). Another ring system that has been shown to produce potent and selective PDE5 inhibitory activity is imidazoquinazoli- (6) Sildenafil Citrate (6) Sildenafil Citrate none (150). In the sildenafil series, the n-pro-pyl substitution on position 3 of the pyazolopy-rimidinone ring gives a more potent compound compared with a 3-methyl analog. Intramolecular hydrogen bonding of sildenafil and its analogs is important for biological activity by maintaining co-planarity between the phenyl and purine ring (151). The 2'-alkoxy moiety on the phenyl group serves this purpose by providing the oxygen lone pair for hydrogen bonding with the pyrimidinone NH (149). The alkoxy moiety also provides the requirement for a small lipophilic substituent, which is important for activity. Replacement of the alkoxy...

Hair Growth Disorders

The clinical dose of finasteride is well tolerated. The main side effects reported in phase III clinical studies were sexual function disorders including decreased libido, ejaculation disorders, and erectile dysfunction. All these sexual disorders were mild-to-moderate and were reversed on discontinuation of the drug, and in some patients, they resolved even with continued therapy (86). A 5-mgdose in hirsute women was well tolerated with no significant side effects, although the risk of developing abnormalities in the external genitalia of male fetus, if the drug is taken or a crushed tablet is handled by a pregnant woman, causes a great

Ecstasy As A Date Rape Drug

Ecstasy is not as commonly used as a date rape drug as GHB or Rohypnol, primarily because it does not incapacitate the victim or make him or her unable to ward off sexual advances. In addition, Ecstasy is relatively insolu-able in many liquids. Also, Ecstasy actually tends to make male users impotent and unable to achieve an erection. This impotence is increasingly common in men who repeatedly use Ecstasy. This has spurred the popularity of a new drug combination, Viagra (a drug that helps men achieve erections) and Ecstasy, which male users take so they can remain sexually functional while high on Ecstasy. This combination is quite risky, however, with numerous side effects such as heart problems, high blood pressure, and even death, especially when taken with another drug called amyl nitrate (poppers).

Introduction to Ginseng

Ginseng most commonly refers to the plant Panax ginseng C.A. Meyer (Asian ginseng) or Panax quinquefolius L. (North American ginseng). Ginseng is widely used in Asian countries as a tonic to promote and maintain good health, and as a constituent in herbal medicines used to treat various diseases, including liver dysfunction, hypertension, cerebrovascular disease, atherosclerosis, cancer, postmenopausal symptoms, and impotence 1-8 . Elsewhere, ginseng supplements are marketed as a natural stimulant that will increase endurance and vitality and improve overall health. It is the root of the ginseng plant that is harvested for its reported medicinal effects. The root is typically dried (white ginseng) or steamed (red ginseng) and can also be extracted to concentrate its bioactive components, the ginsenosides. Ginsenosides are unique to ginseng and are saponin glycosides containing one or more sugar moieties that form side chains off the aglycone ginsenoside structure 9 . There are over 20...

Ginseng and Male Sexual Behavior

Abstract Ginseng is widely used in Asian countries as a tonic to promote and maintain good health and as a constituent in herbal medicines used to treat various diseases, including liver dysfunction, hypertension, cerebrovascular disease, atherosclerosis, cancer, postmenopausal symptoms, and impotence. Very few controlled clinical studies have been performed to validate the medicinal use of ginseng or its constituents in humans. However, laboratory studies, primarily using rodents, have elucidated potential medical uses for ginseng and ginsenosides in the treatment of a number of human disorders, including impotence and loss of libido. Panax ginseng and Panax quinquefolius have both been shown to enhance male cop-ulatory behavior in laboratory studies. Human studies have suggested that ginseng ingestion may be a safe and effective alternative method for treatment of erectile dysfunction. Ginsenosides have been shown to interact with steroid receptors and, through nongenomic pathways,...

Histamine H2 receptor antagonists

Changes in healthcare utilization resulting from a formulary switch from nizatidine to cimetidine have been studied in 704 patients (4). There was no evidence of increased healthcare utilization during the 6 months after the formulary switch, which led to considerable pharmaceutical savings. During this period only four (0.004 ) adverse drug reactions associated with cimetidine were reported urticaria, nausea and vomiting, leg cramps, and impotence.

Ginseng and Copulatory Behavior Animal Studies

Table 4.1 Ginseng preparations and their effects on copulatory behaviors in animals and on erectile dysfunction (ED) in humans Table 4.1 Ginseng preparations and their effects on copulatory behaviors in animals and on erectile dysfunction (ED) in humans Double-blind and 1 erectile function, Double-blind and 1 erectile function

Previous Chronic Cannabis Use Studies

In 1980, Cannabis in Costa Rica A Study of Chronic Marihuana Use was published (Carter 1980). Forty-one subjects smoking for 10 years or more were recruited. Although 10 or more cigarettes per day were smoked, the weight of material was only 2 g with an estimated THC range of 24-70 mg per day. Thirteen samples were assayed with a range of 1.27-3.72 , and average of 2.2 THC. Claims of benefit for cough, asthma, headache, hangovers, anorexia, impotence, depression and malaise were mentioned, but once more, the focus was on social use.

Other Peripheral Vasodilators

Sildenafil (SED-14, 636 SEDA-23, 215 SEDA-24, 231 SEDA-25, 238) The adverse effects of a single dose of silde-nafil 50 mg have been evaluated in a placebo-controlled study in 40 young healthy volunteers (5c). The most commonly reported adverse effects with sildenafil and placebo respectively were flushing (75 and 0 ), headache (50 and 5 ), and dyspepsia (15 and 5 ). This adverse effects profile was similar to that observed in clinical trials. Heart rate changed significantly, but blood pressure did not. Nervous system Clinical trials of sildenafil have not shown increased risks of stroke or myocardial infarction. However, postmarketing drug surveillance programs have mentioned strokes associated with sildenafil, and the first case reports have now been published. A 50-year-old man took sildenafil 50 mg, and 2 hours later developed a right-sided hemiparesis and altered hemibody sensation, a right facial paresis, and slurred speech (6A). The symptoms gradually disappeared 4 hours later,...

Adenanthera pavonina L

Uses In Burma, a paste made from the seeds of Adenanthera pavonina L. is applied externally. In Malaysia, the leaves are used to invigorate health. In India, a decoction of the leaves is used externally to treat chronic rheumatism, gout and impotence, and to treat bleeding. The seeds are used in necklaces.

A10Drugs Used in Diabetes

It has been well proven that there is a higher prevalence of erectile dysfunction in diabetic men than in non-diabetic men. The figures of the odds ratio vary between 1.04 and 6.97. In most studies the confidence interval does not include 1.0, i.e. there is a significant difference. Only one study has found no increase of the risk with medication of antidiabetics. The incidence of erectile dysfunction increases with the duration of the disease a 10 higher risk was calculated with each year of duration of diabetes, and it was even higher in combination with depression and cardiac disease. In a duration of diabetes > 5 years 56 of men had erectile dysfunction, and 72 of men with > 20 years of diabetes. On the other hand, the prevalence of diabetes mellitus in men with erectile dysfunction was significantly higher than in a control group of non-impotent men. Although there are a number of well-conducted case-control studies, it remains unanswered as to whether the disease itself or...

Allan Mazur

Adverse effects of drugs on sexual functions are often neglected in practical medicine, because they are usually mild or moderate and rarely prompt hospital admissions, denominated as severe ADEs. In addition, standard textbooks of pharmacology and those which discuss drug side effects consider these topics only marginally, and well-known sexual side effects are not mentioned. There are, of course, a number of review articles on the possible adverse effects of drugs on sexual dysfunction, in particular on erectile dysfunction. But delineations of the exact figures of the incidence of sexual adverse effects in a concrete drug are often lacking in these papers. Reviews also frequently do not describe the database of the reported adverse effects, thus leaving the quality of evidence uncertain. 2.4 Drugs Which Compromise Erectile Function 385 Erectile dysfunction International index of erectile function

How safe is cannabis

Enthusiasm for cannabis in the 1960s and early 1970s was rapidly followed by a wave of reaction in the Western world. Extravagant warnings were issued, suggesting that cannabis was a highly dangerous drug that could cause chromosomal damage, impotence, sterility, respiratory damage, depressed immune system responses, personality changes, psychosis, and permanent brain damage (1R, 2S). Most of these claims were later proved to be spurious, and balanced reviews (3R-5R) have shown how effectively many of them have been demolished.

Sexual function

Intracavernosal alprostadil was effective and well tolerated in the treatment of erectile dysfunction, according to the results of a 6-month study (funded by Pharmacia & Upjohn) in 848 men (mean age 52 years) with at least a 4-month history of erectile dysfunction (10). This is provided that the individual dose is established by titration and patients receive training in injection techniques and periodic supervision during treatment. An initial dose was established for each patient and the patients then administered the alprostadil themselves at home. Of 727 evaluable patients, 682 (94 ) had at least one erectile response after the injection of alpros-tadil, and 88 of injections lead to a satisfactory sexual response. The most commonly reported adverse event was penile pain, reported by 44 of patients, but only after 8 of injections. In just over half of the patients who had penile pain, the condition was reported as mild. There is a high dropout rate from self-injection therapy...

Advertisement

We fear that accepting the proven scientific facts and redefining our concept of reality will plunge us into subjectivism, hippie Zen, agnosticism, loss of all standards, moral impotence, confusion. Or, if we can conquer this fear (which basically exists in confronting every new discovery) we still can't see the need for re-programming our circuits to remember, moment-by-moment, what is actually happening as we receive, code, classify, integrate energy signals. Thus, we voluntarily retain the lazy, inaccurate, unscientific assumption that it is reasonable and safe to continue acting as if the world were no more than our private map of it.

Amphetamine Class

Amphetamines stimulate the central nervous system (the brain and associated anatomy). At one time evidence of damage to nerve cells was not clear enough to satisfy some credible researchers that such a hazard exists, despite any theoretical reasons for concern, but in the 1990s evidence was becoming persuasive. Among other things, researchers have found that persons who continually abuse amphetamines and persons with a certain type of organic brain injury (focal damage to orbitofrontal PFC prefrontal cortex ) have similar problems in making decisions.4 Severity correlates to length of amphetamine abuse. Nonprescription sales have long been banned in Sweden due to kidney system damage, and amphetamines are suspects in liver damage involving hepatitis. Amphetamines also excite the heart, increasing pulse rate and blood pressure. Normally cardiac effects are unharmful but can be risky at high doses. To a lesser extent, amphetamines help to open air pathways in the lungs while stimulating...

Option

While I fully support marijuana's use for medicinal purposes, why don't we regulate it like we do Lipitor or Viagra You can't buy those two without getting it through a legitimate pharmacy. If this drug is so important and so helpful, why is it not regulated like every other drug They pass a law, then they have no regulations as to how to enforce the darn thing and, as a result, we have hundreds of these locations selling drugs to every Tom, Dick and Harry.16

And Drugs

The descriptions of the effects of ADEs on male sexual function are generally scarce and restricted to few topics. Any intervention which influences the sexual hormone system obviously also influences male sexual functions, e.g. antian-drogenic compounds, which depress sexual libido and other sexual functions. In some circumstances, it may be questionable as to whether the effect of a drug on male sexual functions is a desired therapeutic effect, or whether it is an untoward effect. For example, the depression of pituitary hormone secretion by the gonadotropin-releasing hormone (GnRH) analogues in the treatment of prostate carcinoma is important in order to achieve androgen deprivation and prolong the remission of the disease. On the other hand, the depression of gonadotropin secretion in these men by GnRH leads to impotence and infertility, which is definitely an untoward effect. Some sexual ADEs which occur during treatment of other diseases are broadly recognized, e.g. erectile...

Conclusions

Human studies have suggested that ginseng ingestion may be a safe and effective alternative method for treatment of erectile dysfunction 10 . Animal studies indicate that ginseng ginsenosides mediate the release and or the modification of release of NO from endothelial cells and perivascular nerves, and the consequent vasodilatation of the penile corpus cavernosum may contribute to the copulatory performance-enhancing action of ginseng. Ginsenosides have been shown to interact with steroid receptors and, through nongenomic pathways, activate NO production. How ginseng and its ginsenosides may act centrally to modulate sexual desire and copulatory performance is not known, but it could potentially involve activation of NO pathways, perhaps in brain areas involved in sexual behavior.

Sarsaparilla

Effects Sarsaparilla is said to increase energy, regulate hormonal activity and protect against radiation. Herbalists have used it for catarrhal problems, colds, fever, flatulence, frigidity, gout, hives, impotence, infertility, nervous system disorders, PMS, rheumatism, and certain blood disorders.

LArginine

L-arginine is an essential amino acid found naturally in meat, dairy, poultry and fish, It is also available as an herbal supplement and is often marketed as a 'natural Viagra'. Other studies have shown positive results but have tended to use larger doses of L-arginine. One group conducted a double-blind trial in 50 men with ED 36 . Patients were given L-arginine (5 g per day) or a matching placebo for 6 weeks. The group consisted of 40 men with ED who were given three ampoules of Sargenor a day for the first month. This is a drinkable solution of the dipeptide arginyl aspartate (equivalent to 1.7 g of L-arginine per day). During the second month, patients were additionally supplemented with 40 mg of Pycnogenol twice a day, and during the third month the daily dosage was increased to three 40-mg Pycnogenol tablets. At the end of the first month with L-arginine alone, a statistically non-significant number of 2 patients (5 ) experienced a normal erection. At the end of the second month...

PropionlyLCarnitine

The testosterone and carnitine groups (1 and 2) showed significantly improved peak systolic velocity, end-diastolic velocity, resistive index, nocturnal penile tumescence and International Index of Erectile Function (IIEF) score. This effect was noted for as long as the drugs were administered, with a suspension resulting in a reversal to baseline parameters. Placebo was ineffective in improving any of the above parameters. The researchers concluded that testosterone and, especially, car-nitines proved to be active drugs for the therapy of symptoms associated with male ageing 43 . Another double-blind, fixed-dose study examined the efficacy and tolerability of oral propionyl-L-carnitine (PLC) plus sildenafil in men with ED and diabetes unresponsive to sildenafil monotherapy 44 . Patients with documented ED of organic or mixed aetiology and diabetes unresponsive to at least eight doses of Viagra alone were randomized to receive oral PLC (2 g d) plus sildenafil (50 mg twice weekly) (20...

Reishi

Reishi has many uses in traditional Chinese medicine, including ED. In a study in China of 60 men with ED, there was a significant benefit after drinking a decoction made using fruit bodies of a member of the Ganoderma family for 1 month 48 . Only 4 patients reported no improvement 17 patients reported slight improvement 25 men claimed marked improvement in their sexual function, and 14 men reported that they were cured. No other drugs were taken during the period of the study 48 .

Yohimbine

Men with psychogenic ED showed a 46 response to yohimbine compared with a placebo response of only 16 . However, only 50 of the men actually achieved an erection sufficient for penetration 56 . However, another study assessed the clinical response at baseline and after two different doses of yohimbine in 18 non-smoking men with organic erectile dysfunction 57 . Of the 18 men, 9 (50 ) were successful in completing intercourse in more than 75 of attempts, although the authors note that the yohimbine responders were men with less severe ED 57 . They claimed that yohimbine is an effective therapy for organic ED, contradicting earlier studies. Ernst and Pittler reviewed and meta-analysed all randomized, placebo-controlled trials of yohimbine monotherapy for erectile dysfunction to determine its therapeutic efficacy 58 . They identified seven trials that demonstrated that yohimbine is superior to placebo (odds ratio 3.85, 95 confidence interval 6.67 to 2.22) and suggested that yohimbine...

Makin babies

The government established the Center for the Evaluation of Risks to Human Reproduction which put out a draft report on some phthlates and their risk to human reproduction. It found a range of concerns over their effect on human reproduction, but did not recommend that they be removed from items like food packaging, even though they had concerns that they could damage sperm producing cells in the testicles and result in low sperm count and damaged sperm in humans. How is it that more Americans are not deeply concerned about demasculinizing birth defects in their male children and premature sexual development in girls Part of the problem is that there are not that many people studying the effects of environmental chemicals on gene expression and health in animal models. The truth is, nothing really happens on these issues when you have a government that will bend over backwards to protect the interests of industry over the health of the citizenry. The trends are alarming and certainly...

Sexual Dysfunction

Every class of antidepressants is associated with some degree of sexual dysfunction. Difficulties can include problems with libido, impotence, ejaculatory dysfunction, and anorgasmy. The incidence of sexual dysfunction is as high as 30 with SSRIs. As with other side effects, some of these may be symptoms of the depression itself, and they may predate the initiation of the antidepressant trial. Treatment can include dose

Insomnia

After the first cycle into Stage 4, there are periods characterized by rapid eye movements (REM), changes in pulse, blood pressure, and respiration, penile erections, and a general lack of muscle movements with occasional twitching. People awakened during this stage commonly report dreams. REM sleep occurs about every ninety minutes, lasts ten to twenty minutes, and constitutes about 20 percent of sleep time.

Glutamine

Effects Subjects have reported clearer thinking, improved alertness, and better moods. It manufactures GAB A, a neurotransmitter which soothes and calms the mind. It has also reportedly helped in the control of obesity (by reducing the craving for carbohydrates) and alcoholism, in reducing the healing time for ulcers, and for the relief of depression, fatigue, and impotence. It has been used to treat schizophrenia and senility, and research has shown that it can offset the adverse effects of immune system suppression caused by intense exercise. Laboratory tests have shown that glutamic acid retards the formation of or dissolves kidney stones.

Nadph

Papaverine (Figure 6.45) is a benzylisoquinoline alkaloid, and is structurally very different from the morphine, codeine, thebaine group of alkaloids (morphinans). It has little or no analgesic or hypnotic properties put possesses spasmolytic and vasodilator activity. It has been used in some expectorant preparations, and in the treatment of gastrointestinal spasms, but its efficacy was not substantiated. It is sometimes used as an effective treatment for male impotence, being administered by direct injection to achieve erection of the penis.

General

Sexual function Diuretics remain important in the pharmacotherapy of hypertension. Highdose diuretic therapy was the therapeutic norm in the 1980s, but in the 1990s a low-dose stratagem was instituted. With this change the incidence of diuretic-related electrolyte and metabolic adverse effects has fallen. Now the adverse effect of diuretics that is a major obstacle to their use is sexual dysfunction. The exact incidence is poorly documented, perhaps because of the personal nature of the problem and the reluctance of patients and or physicians to discuss it. The adverse effects of thiazide and thiazide-like diuretics on male sexual function include reduced libido, erectile dysfunction, and difficulty in ejaculating. These abnormalities have been reported with incidence rates of 3-32 . The true incidence of sexual dysfunction probably lies closer to the lower end of this range (1R). In a meta-analysis of 13 randomized placebo-controlled trials conducted over a mean of 4 years the NNH...

C01Cardiac Therapy

Men with cardiac diseases have a higher prevalence of erectile dysfunction than men without these diseases (significant OR 1.05-3.15). This holds true also for men with poorer health in general, which includes insufficient cardiac capacity. On the other hand, the prevalence of cardiac diseases in men with erectile dysfunction was found to be higher than in men with normal erectile function. In addition, erectile dysfunction preceded cardiac diseases such as myocardial infarction it may thus be taken as a bio-marker of other cardiovascular diseases. Comparable to the impairment of erectile function in men with diabetes mellitus, in some studies it remained unclear as to whether the erectile dysfunction was associated with the disease itself or with the treatment procedures applied.

Estrogen Therapy

However, toxicities with this treatment are common, with dose-related adverse reactions including arterial and venous thrombosis, nausea, and fluid retention. Furthermore, impotence and gynecomastia always occur in men, and withdrawal bleeding can be a problem in women. Estrogen may also cause bone pain and hypercalcemia when used to treat breast cancer. Ethinylestradiol, also used to treat breast cancer, is the most potent estrogen available for this purpose.

Review

1195 Mikhailidis DP, Khan MA, Milionis HJ, Morgan RJ. The treatment of hypertension in patients with erectile dysfunction. Curr Med Res Opin. 2000 16 Suppl 1 s31 -6. English Erectile function assessed by rigiscan Erectile function, impairment Dependent on medication Effect of antihypertensive drugs on sleep-related erectile function remains unclear. 4 (review) Erectile function, unaltered Prevalence of erectile dysfunction as compared with Prevalence of erectile dysfunction as compared with 2215 Martin-Morales A, Sanchez-Cruz JJ, Saenz de Tejada I, Rodriguez-Vela L, Jimenez-Cruz JF, Burgos-Rodriguez RJ. Prevalence and independent risk factors for erectile dysfunction in Spain results of the Epidemiologia de la Disfuncion Erectil Masculina Study. Urol. 2001 Aug 166(2) 569-74. Prevalence of erectile dysfunction as compared with 2213 Moreira ED Jr, Lobo CF, Diament A, Nicolosi A, Glasser DB. Incidence of erectile dysfunction in men 40 to 69 years old results from a population-based...

Age group

Erectile dysfunction in hypogonadism, not responding to sildenafil Erectile function, improvement In 11 patients with T alone, in 12 patients with T+sildenafil None 1203 Hwang TI, Chen HE, Tsai TF, Lin YC. Combined use of androgen and sildenafil for hypogonadal patients unresponsive to sildenafil alone. Int J Impot Res. 2006 Jul-Aug 18(4) 400-4. Epub 2006 Jan 5. English

Urologicals

Drugs Used in Erectile Dysfunction In the past 20 years a number of drugs have been introduced which are able to induce or improve penile erection. There are two main groups of these drugs the vasoactive drugs applied intracavernously, which cause relaxation of the cavernous smooth muscle and are highly effective in inducing erection, and the 5-phosphodiesterase inhibitors, which may be applied orally. These drugs are designated to treat the disease erectile dysfunction and improve sexual health, which is not a severe or life-threatening condition, and treated patients are often otherwise healthy persons thus, the absence of severe ADEs is essential. All epidemiological and therapeutic studies agree that the most significant risk factor for the development of erectile dysfunction is age, but also multimorbidity increases the risk.

Treatment period

Erectile dysfunction IIEF Prevalence of erectile dysfunction 2221 Lyngdorf P, Hemmingsen L. Epidemiology of erectile dysfunction and its risk factors a practice-based study in Denmark. Int J Impot Res. 2004 Apr 16(2) 105-11. English Drugs used in erectile dysfunction (G04BE)

Pharmacokinetics

Sildenafil is rapidly absorbed after oral administration. The peak plasma concentration is reached after 30-120 min of dosing, but the absorption rate is delayed if taken after high fat meals. The absolute oral bioavailability is approximately 40 . The mean steady-state volume of distribution is 105 L, which indicates distribution into tissues. Sildenafil and its major metabolite are approximately 96 bound to plasma proteins. Sildenafil is eliminated mainly by hepatic metabolism. The main metabolizing enzyme is cytochrome P450 3A4. The major circulating metabolite is N-desmethyl sildenafil, which is further metabolized. N-desmethyl sildenafil retains sildenafil's selectivity profile and approximately 50 of its activity. Both sildenafil and its major metabolite have terminal half-lives of 4 h. The elimination half-life of sildenafil is 3-5 h. Most of the administered dose is excreted in the feces as metabolites with only 13 excreted in the urine.

Future Trends

New oral agents that target central and peripheral pathways of erection are expected t be introduced in the next few years. Some of the older off-label agents are also in late phases of clinical development or under FDA review. An injectable formulation of phentol-amine is being developed by Novartis, and Senetek is developing a combination of vasoactive intestinal peptide (VIP) and phen-in an autoinjector. Trazodone is another older drug marketed as an antidepres-sant and is in clinical development for erectile dysfunction. Trazodone (12) is a centrally acting serotoninergic agonist with peripheral sympatholytic activity. Studies indicate that it praoptic nuclei in the brain, but has low oral bioavailability. TAP Pharmaceuticals is developing a sublingual formulation of apomorphine for the treatment of erectile dysfunction. Recently, TAP withdrew its NDA application of the sublingual preparation after the FDA advisory panel rejected the use of 4 mg of apomorphine in ED treatment...

Ch2ch2nh

The latest entrant in the neurotransmitter lineup is NO, nitric oxide, the first neurotransmitter discovered in the gas phase. For decades physicians and pharmacologists have been aware of the ability of nitrates to dilate blood vessels. Compounds like nitroglycerin are key tools in the control of angina pectoris, constriction of the coronary arteries. Yet no one knew exactly how the nitrates performed their feat until recently. The notariety of Viagra attests to the interest in products which affect NO systems. More about the synthesis and actions of NO will be described shortly.

Remarks

Erectile dysfunction Genotype polymorphism Erectile function, improvement GNB3 825C allele carriers 50 , in genotype TT 90 positive response to sildenafil Not mentioned GNB3 825C allele carriers genotype TT Genetic profile may be of relevance for cardiovascular side effects of sildenafil 21087 Eisenhardt A, Siffert W. Genetic risk factors for erectile dysfunction and genetic determinants of drug response on the way to improve drug safety Herz. 2003 Jun 28(4) 304-13.

Finasteride

Finasteride is likely to be used less intensively in benign prostatic hyperplasia than in malignancies. In one study in 3040 men with benign prostatic hyperplasia the effects of fi-nasteride 5 mg day for 4 years were compared in men over and under 65 years (110C). In both groups the drug was effective and there were no significant differences in cardiovascular adverse events between placebo- and finasteride-treated patients. There were significant differences between placebo and finasteride in the incidence of typical drug-related adverse events, but there were no specific differences associated with age. The principal events were impotence (8.8 ), reduced libido (6.8 ), reduced volume of ejaculate (3.5 ), other ejaculation disorders (1.5 ), rash (0.6 ), breast enlargement (0.5 ), and breast tenderness (0.2 ). There were no drug interactions of clinical importance with finasteride.

Indinavir

A drug interaction between sildenafil and HIV antiretro-viral drugs is suspected, since both are metabolized by and act as inhibitors of the same cytochrome P450 iso-forms (48). A pharmacokinetic study of sildenafil in HIVpositive patients taking indinavir has shown that the AUC of sildenafil was 4.4 times higher than data from historical controls (49). The magnitude of the interaction suggested that a lower starting dose of sildenafil may be more appropriate in patients taking indinavir.

Metal metabolism

Thiazide diuretics promote zinc loss in the urine and can reduce the zinc content of hair in the long term (13). It has sometimes been suggested that changes in zinc balance could be responsible for the effects of thiazides on sexual potency. There is evidence that diuretics deplete body zinc, which in turn interferes with testosterone production and causes erectile impotence (14).

N06Psychoanaleptics

Antidepressants hold a high risk of induction of sexual dysfunction. Large case-control studies report an OR of up to 2.0, but not in all studies does the 95 CI exclude 1. In particular, the selective serotonin reuptake inhibitors (SSRI) exert sexual side effects due to overlapping neu-roregulatory mechanims. Up to half of patients complain of various dysfunctions. In comparison studies (RCTs are not available) the rate in treated patients was significantly higher than in the placebo groups however, there are also studies which describe no alteration of sexual functions. Erectile dysfunction in the patients treated with psychoa-naleptics may be treated with drugs which improve erection. The association of various symptoms with definite drugs is questionable. Priapism has been recorded to be a consequence of therapy with tradozone.

DesogestrelG03AC09

Sildenafil Tadalafil The drugs of Table 2.6.2 were used for Medline and Scopus searches. The Medline and Scopus searches were performed using a drug as MESH terms and combining it with the MESH terms sperm, testosterone, impotence and ejaculation. By these searches, more than 2000 articles were identified in which the effects of drugs on male sexual health are mentioned. Not all drugs listed in Table 2.6.2 produced hits in the literature databases. In addition, secondary literature was used.

Trompillo Virola

German colloquial term for causing a good feeling. 2. German colloquial term for smoking hashish. 3. German colloquial term for taking drugs. Turnera Humifusa Turnera diffusa. Turnera aphrodisiaca Turnera diffusa. Turnera diffusa Damina The leaves were originally used as medicine by the indigenous cultures of Central America, particularly Mexico. Today the plant is found in hot, humid, climates including parts of Texas. It is used today as herbal mecdicne agaoinst depression and impotence. Damiana has been hailed as an aphrodisiac since ancient times, particularly by the native peoples of Mexico. Other folk uses have included asthma, bronchitis, neurosis, and various sexual disorders. It has also been promoted as a euphoria-inducing substance at various times. Most research has been done on the essential oil of damiana, which includes numerous small, fragrant substances called terpenes. As yet, it is unclear if the essential oil is truly the main active fraction of damiana....

Manganese

Precautions Overdose through diet is extremely unlikely, though miners in northern Chile exposed to manganese dust have commonly developed a disorder known as locura manganica, or manganese madness. The first sign is a manic stage characterized by inexplicable laughter, heightened libido, impulsiveness, insomnia, delusions, and hallucinations, followed by a depressive stage of extreme drowsiness, impotence, and slowed speech. The third and final stage is distinguished by symptoms much like those of Parkinson's disease and, like Parkinson's, can be treated by levodopa.

Apama Tomentosa

Times Drugs The Future

Uses In India, the rhizome of Aristolochia indica L. is used to treat impotence, resolve inflammation, induce vomiting, treat malarial fever and to invigorate health. In Burma, the leaves are applied externally to treat skin diseases. In the Philippines, the rhizome is used to counteract insect-poison, combat fever, regulate menses, to invigorate the body, and to assuage intestinal discomfort. In Vietnam, the rhizome is used to treat malaria, dropsy and fever, and to stimulate appetite. A tincture of dried stems and rhizomes of Aristolochia indica L was used in Britain to promote digestion (British Pharmaceutical Codex, 1934).

Phentermine

Phentermine may interfere with sleep, cause dry mouth, make bowel movements looser or harder, produce impotence, make people edgy and ill-tempered, or (in contrast) create euphoria. The compound is suspected of involvement with stroke, but reported cases have confounding factors. In one instance the patient had a history of headaches before taking phentermine and a family history of migraine and stroke. In another case the person was also taking phendimetrazine, had used birth control pills for 14 years, had smoked cigarettes for two decades, and had a personal history of migraines and a family history of high cholesterol and high blood pressure. Phentermine has also been linked to narrowing of abdominal arteries with a possibility of ruptured aneurysms there. Uncommon accounts exist of phentermine users

Antihypertensives

Erectile dysfunction is claimed to be a frequent side effect of antihypertensive treatment. Also patients themselves are convinced that their impotence is caused by antihypertensive drugs they take, and many physicians support this opinion however, as early as 1978 Bauer et al. stated that the extent of sexual function impairment is age-related as compared with that observed in men not taking antihypertensives. Ten year later, Bansal (1988) quoted that the reported studies did not clearly indicate whether the impairment is due to the drugs, the influence of the disease, or both. Again 10 years later, other authors concluded Scientific evidence that links antihypertensive drugs to sexual dysfunction in placebo-controlled trials is limited (Grimm et al. 1997). Nevertheless, patients with hypertension are at greater risk to suffer from erectile dysfunction, irrespective of the treatment, than are healthy men. The OR was found to be significantly greater than 1 in large case-control...

Ginkgo biloba

Ginkgo is believed to increase blood flow to the penis, although the evidence is contradictory. In an early double-blind study published in 1991, 50 men with arterial ED were administered 240 mg of ginkgo leaf extract daily for a period of 9 months. The men were divided into two groups based on their earlier response to conventional drug therapy for ED. The first group consisted of 20 men who had previously experienced some success with earlier treatments. The second group of 30 men had not experienced an erection with these treatments 20 . Ginseng has been long alluded to in Chinese folk medicine as a sexual stimulant, and there appears to be some scientific truth to this. In animal studies, a concentration of 1 mg mL of ginseng extract relaxed corpus cavernosal tissue in rabbits. This action was mediated by an increase in the sequestration of intracellular calcium and in the corpus cavernosal sinusoids by an increase in the release of nitric oxide (NO) 26 . The increase in NO is a...

Androgens

Androgens are used for therapy of androgen-deficient conditions such as hypofunction-ing testicles, eunuchism and eunuchoidism, castration, impotence, climacteric conditions, and also for breast and ovarian cancer in women under 60 years. Testosterone (esters) are used medicinally for maturation arrest, functional problems in the reproductive system, hypertrophy of the prostate gland, climacteric disorders in men, a few forms of infertility caused by abnormal spermatogenesis, post-castration syndrome, and endocrine impotence. Testosterone is sometimes used to treat women with reproductive organ and breast tumors, climacteric disorders, and when estrogen drugs are counterproductive. When taken orally, testosterone itself is inactive, and therefore it is generally used in the form of carboxylic acid esters (propionate, enantate, cypionate, and a few forms of testosterone esters). Synonyms of this drug are histerone, malogen, menopax, testoral, and others, while synonyms of testosterone...

Lcms

LC MS is suitable for analysis of thermolabile and non-volatile compounds. The author et al. are using LC MS for benzodiazepines and sildenafil citrate (Viagra). Screening of benzodiazepines by Triage is a problem, because the cutoff level of the drug group is as high as 300 ng mL the lower levels of the drugs are overlooked. The urinary levels of a benzodiazepine are low in a short time after its intake, resulting in a negative result is the Triage test.

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