<h3>Sex Education -Erectile Dysfunction Treatment</h3>

Erectile dysfunction

In this condition, male is unable to maintain “ Erectile function “ for a longer time & may lose erection before penetration in vagina.
. pomegranate juice improves erection. It contains antioxidants & improves blood supply to penis
. Detail sexual history & discussion with couple is very important & helps in solving the problems.
. Any prior bad sexual experience can affect one's performance in bed
. Mental, financial, physical stress can affect sex desire ( libido) & cause erection problems

. Fear, shyness will hamper one's performance in bed.
. Remember that couples who have better sex relations generally have better over all relations & understanding

Viagra - What is Viagra?

Viagra ( manufactured by Pfizer) is a drug used in male impotence. Males who have erectile dysfunction may get benefited with Viagra.
The Food and Drug Administration's approval of Viagra -- on March 27, 1998 -- was a landmark day in the history of sex.

This is a drug which has brought a lot of hope in lives of males with erectile dysfunction and is widely marketed in Western countries.

Sildenafil - adverse events

Investigators have suspected relationship between central serous chorioretinopathy (CSR / CSCR) and sildenafil ( Viagra) therapy.
This is important as sildenafil is used in young patients and CSR is also seen in young patients. So physician should be able to distinguish whether CSR is due to sildenafil (Viagra) therapy or some other cause.
If Ophthalmologists, physicians see patients with refractory CSC, they should consider recommending cessation of sildenafil therapy.

Read more about CSR at ---
Central-Serous-Retinopathy

In which conditions, Sildenafil generally should not be used?

A. Increased cardiac risk-
Investigators are studying the effects of Viagra on heart and cardiovascular system. In patients with cardiac diseases, there is an increased risk of getting heart attack associated with sexual activity. So any treatment for erectile dysfunction like Viagra, LEVITRA, generally should not be used. Some cardiac diseases like -
1. Left Ventricular Outflow Obstruction
2. Unstable angina .
3. Myocardial infarction (within the last 6 months). This is commonly known as “ heart attack” in layman’s language.
4. Cardiac arrhythmias


B. Recent history of stroke

Caution

1. Caution is advised when PDE5 inhibitors are prescribed with alpha-blockers.
Phosphodiesterase Type 5 (PDE5) inhibitors, including LEVITRA, and alpha-adrenergic blocking agents are both vasodilators with blood-pressure lowering effects. When vasodilators are used in combination, an additive effect on blood pressure may be anticipated.

2. Treatment for erectile dysfunction should generally be used with caution by patients with anatomical deformation of the penis (such as angulation, cavernosal fibrosis, or Peyronie’s disease) or by patients who have conditions that may predispose them to priapism (such as sickle cell anemia, multiple myeloma, or leukemia).

What is priapism?

Priapism means painful penile erections greater than 6 hours in duration .

What one should do if one gets priapism?

The patient should seek immediate medical assistance. If priapism is not treated immediately, penile tissue damage and permanent loss of potency may result.

Controversies related to Viagra

1. Pfizer even got warnings from FDA on “Viagra videos”. Read more in my next resource.

Success rate

93% of patients with mild to moderate erectile dysfunction (ED) had successful intercourses with completion in the 50-mg dose.

Drug-related adverse effects are mild to moderate

1. Headache in up to 23% of patients
2. Dyspepsia in up to 11%
3. Back pain in up to 4.7 %
4. Myalgia in up to 4 % mostly.

What is Vardenafil?

Vardenafil, a new selective phosphodiesterase type 5 inhibitor.

How is it available?

Vardenafil is available as Levitra ( brand name) 2.5 mg, 5 mg, 10 mg, and 20 mg tablet . It is an oral therapy for the treatment of erectile dysfunction.

Safety profile of Vardenafil?

No drug-related serious cardiovascular adverse events or color vision disturbances were encountered.

What are the advantages of Vardenafil?

1. Long half-life (>17 h),
2. Long duration of action, releases couples from the need to plan sexual activities and stress associated. It provides the highest amount of spontaneity for sexual activities.

When to take Vardenafil?

LEVITRA should be taken approximately 60 minutes before sexual activity. Patients should be counseled to report sudden loss of vision in one or both eyes. This may be due to non-arteritic anterior ischemic optic neuropathy (NAION) which is reported as a rare side effect. This is a condition which affects optic nerve blood supply..

Vardenafil adverse events

1. Headache (7-15%),
2. Flushing (10%)
3. Dyspepsia - 7%
4. Rhinitis 7%.
5. Single oral doses of phosphodiesterase inhibitors have demonstrated transient
6. Dose related impairment of color discrimination (blue/green).

Summary

Vardenafil treatment results in a high efficacy and low adverse-event profile

What precautions one should take?

Patients with Renal and Hepatic Insufficiency should take lower doses and inform their physician, sexologist.

Lower starting dose of LEVITRA (5 mg) in patients =65 years of age should be considered.

Which company produces LEVITRA?

“BAYER” pharma

Read more at -

Erectile dysfunction

Common causes of impotence are

. Diabetes ( as it affects nerves),

. Arteriosclerosis ( as it affects arteries and affects blood supply to genital organs)
Depression.

Some natural herbal sexual stimulants

. Ginseng-
Its used in Chinese medicines since long
. Tongkat ali-
It leads to increase testosterone production in body
. Amino acid arginine-
This is antioxidant & helps in erection due to increased blood flow in penis