Archive for August, 2011

A New Pill That Will Put Power Into Your Potency

August 27, 2011

I am often asked if there is anything new for treating erectile dysfunction (ED) or impotence. Now there is a new pill that may be helpful for those suffering from ED. Staxyn is a new oral tablet that contains the same ingredients as Levitra but is used as a tablet that dissolves on the tongue.

Staxyn helps increase blood flow to the penis, so it may help men with ED get and keep an erection that lasts long enough for sexual activity. Once a man has stopped sexual activity, blood flow to his penis decreases, and his erection goes away.
It is suggested that you take Staxyn about an hour before sexual activity. The tablet is place on the tongue where it will dissolve rapidly. The tablet should be taken whole and not crushed or split. The tablet should not be taken with liquid. The tablet may be taken with or without food. It is not recommend to take more than one Staxyn a day.
Forget the Rumors
Staxyn will not give you an instant erection; you’ll need to be sexually stimulated for it to work.
The medication not leave you erect for hours. If an erection lasts more than 4 hours, get medical help right away to prevent lasting damage that may make future erections difficult or impossible.
No the drug will not make you have a stiff tongue. It’s mechanism of action is on the blood supply to the penis and not the tongue!
No, no, with nitrates
Do not take Staxyn if you take any medications called ”nitrates” (often used to control chest pain, also known as angina). Nitrates may cause abnormally low blood pressure and Staxyn may increase that risk.

Bottom Line: Erectile dysfunction is a common problem affecting millions of American men. Help is available. You don’t have to suffer the “tragedy of the bedroom”.

When You Gotta Go-Putting a Handle On Overactive Bladder

August 27, 2011

As many as one in four adult women experience episodes of urine leaking involuntarily, according to the National Association for Continence. And about 17% of women and 16% of men have continuing problems with overactive bladder (OAB).
If you have OAB, you know how difficult and embarrassing it can be to manage your overactive bladder at work. How can you keep things dry and professional? Many experts will advise you to try behavioral therapy, and if that fails, seek medical or surgical treatment. All that can take time. Here are some tips to help you manage OAB at the office, at the shop, and on the road.
1. Don’t dehydrate yourself at work.
You may think you should restrict beverages so you’ll urinate less, but fluid restriction can be counterproductive.
Cutting back on your fluid consumption results in a dark colored urine which is highly concentrated; this actually acts as a bladder irritant.
2. Keep on schedule.
Scheduled fluid intake and urination are the keys to managing OAB. If you know you’ll have a big presentation at noon, stop drinking fluids at about 11 a.m., and then take a bathroom break right before your big appearance.
3. Know where the restrooms are located.
Familiarize yourself with all the restrooms on your floor, especially when you’re on a visit to a different office or at a conference. This is often called “toilet mapping” and can increase your security when you know exactly where the restrooms are.
4. Give yourself an exit.
The power spot at most work meeting is at the front of the room. But if you have an overactive bladder, sit in the back of the room and at the end of the aisle for presentations.
5. Know your triggers.
Stay away from obvious OAB triggers in work situations — coffee and anything else with caffeine, acidic drinks like orange juice, chocolate, and spicy foods.
6. Plan your travels.
Choose airline seats ahead of time if at all possible so that you can have an aisle seat near the restroom.
7. Make friends when traveling.
Solicit help from flight attendants when traveling. For example, explain your situation, and ask if they can let you know ahead of time when the seat belt light is about to come on so you can go to the bathroom first.
8. Involve your boss.
Most supervisors will be reasonable about scheduling regular bathroom breaks.
I can assure that doctors who treat patients with OAB will write letters confirming the condition so that the boss doesn’t think it’s just an excuse to get another break.
9. Kegel-keep squeezing
The pelvic floor contractions called Kegels are a great way to keep your bladder muscles strong in general, and you can do them without people noticing.
Even if you haven’t been doing Kegels regularly, if the urge to urinate hits, a quick series of pelvic floor contractions can sometimes abate that sensation until you can get to the bathroom.
See my article on Kegels at
10. Don’t fear the pad.
If you know you’re going to be having a horribly hectic day, wear a pad or other protective undergarment that day. For men, there are “condom catheter” devices, that can collect urine until you can change. Condom catheters allows a little more control so that in the worst-case situation, you’re not going to have a visible accident.
11. Get help!
You don’t have to live with overactive bladder, at work or at home. People wait an average of seven years before seeking professional help for continence issues, but there’s no need to suffer in silence.
Bottom Line: The overactive bladder can be tamed. Start with your family physician. Your doctor may refer you to a urologist or urogynecologist, who can discuss your options for medication, behavioral therapies, or surgery.

This article was excerpted from 11 Ways to Manage OAB at Work

By Gina Shaw

Testosterone Is For Women, Too!

August 23, 2011

If you are a middle aged woman who is post menopause, you may find that your sex drive or libido has decreased to the point of no interest in sexual intimacy. It doesn’t have to be this way.

When we think of testosterone we usually think of this hormone as only existing in men. However, testosterone is also produced by the female reproductive organs.
A special menopause supplement in the March 1999 issue of the “American Journal of Obstetrics and Gynecology” recommends the addition of androgen (testosterone) to estrogen for all women undergoing surgical menopause. The use of androgen therapy may also be beneficial to women who experience loss of libido and other symptoms of testosterone deficiency during natural menopause.

Medical science now knows that testosterone is produced naturally by the ovaries and smaller amounts by the adrenal glands. Testosterone is an important factor in women’s health before and after menopause. Testosterone provides several benefits to women:
• improves relief of vasomotor symptoms of menopause 

• increases energy levels

• enhances of feelings of well-being

• decreases breast tenderness

• improves sexual desire

• increases sexual sensitivity

• increases the frequency of coitus

• enhances orgasm

Androgen therapy has been around since 1936, however the myths often associated with testosterone therapy in women have placed fear in many women and resulted in few women considering this therapy. Rare, but possible side effects of testosterone therapy include hoarseness or other voice changes, development of facial hair, acne, and over-sexuality. These side effects rarely occur at the low doses most often in use today; when side effects do occur relief is usually achieved by reducing the dose of testosterone.

The Symptoms of Testosterone Deficiency?
• diminished sexual pleasure

• decreased sensitivity of breast and genital tissues

• decreased orgasmic response

• decreased libido

• low energy

• depression
If you are experiencing any of these symptoms, talk with your doctor. Several forms of testosterone replacement are available including oral estrogen-androgen combinations such as Estratest, injections of testosterone, topical gels containing testosterone and, recently, there is an implantable forms of testosterone, Testopel.
Bottom Line: Testosterone is not just for men. If you are a woman and suffer from a significant decrease in your sex drive or libido, check with your doctor. You may be a candidate for testosterone replacement therapy.

This blog was excerpted from an article, Menopause and Testosterone, by Tracee Cornforth.

ED Not Responding to Viagra? Try Gelling Out!

August 22, 2011

For patients who have failed on Viagra®, Levitra® or Cialis® and who cannot or will not self inject medicine with a needle, TriMix-GEL® has been used as an alternative to restore your sexual health.
For a patient who failed on PDE5 inhibitors and cannot use a needle to self inject his penis, TriMix-gel® has been used as an alternative.
Many ED sufferers cannot take PDE5 inhibitors for a variety of reasons. Contraindications include patients on nitrates, certain beta blockers or patients with nonarteritic anterior ischemic optic neuropthy (NAION). Still other patients cannot tolerate the side effects, which increase when dosage is increased. At the point PDE5 inhibitors are eliminated as a viable option, of the remaining options, penile injections with vasodilators prevail as the most effective non surgical alternative. There are some patients who are not receptive to this alternative because they cannot self inject the penis.
TriMix-gel® is an easy to apply gel used before sexual intercourse. Each dose contains trimix in powder form which is energized into a gel at time of use. Trimix ingredients (alprostadil, phentolamine, and papaverine) have been tested and widely prescribed for many years for improvement of sexual health.
• There are no needles, pellets, or pills
• Can be carried by the patient at room temperature
• ED-gel® Easy Applicator (pat. pending)
Typically, the trimix for injection version of the compound would have to be refrigerated and then self injected with a needle at time of use. But the compound in gel form, called TriMix-gel®, allows the patient to carry the medicine at room temperature. More importantly, an erectile dysfunction patient wil not have to use a needle to self inject his penis before sexual intercourse.
• Tell your doctor and pharmacist if you are allergic to alprostadil/prostaglandin or any other drugs.
• Tell your doctor and pharmacist what prescription and nonprescription medications you are taking.
• Tell your doctor if you have or have ever had anemia, bleeding disorders, sickle cell disease, leukemia, cancer, kidney or liver disease.
The effects of TriMix-gel® should last no longer than one hour. We have found that this is satisfactory for most men who live in the Gulf Coast area!
Bottom Line: If you suffer from ED and the oral medications are not working, there are still options that help nearly every man so they don’t have to suffer the tragedy of the bedroom.

Libido In the Tank-Fill ‘Er Up With Maca

August 21, 2011

Maca, the Peruvian herb, has been generating lots of buzz about its reputed ability to boost libido.
It is revered in the ancient Incan culture for its many medicinal purposes. According to folk belief, it is a plant known for its legendary ability to deliver energy and mental clarity, and enhance sex drives in Peruvians for more than 2,000 years.
Maca is an herb that has plenty of anecdotal information passed down from generation to generation, but scientific evidence on its effectiveness is limited. Researchers continue to study how it may help men and women with low libido. Some studies suggest it may improve semen quality, relieve symptoms of menopause, and reduce enlarged prostates.
A review of maca in the journal Current Sexual Health Reports concluded “there is no strong medical evidence in support of its use for female sexual dysfunction.”
In Peru, maca has been a staple in the diet of men, women, children, infants, pregnant and lactating women, elderly, and the infirm — out of necessity. Only two crops grow in the higher elevations in Peru: potatoes and maca.
In the Andes, people typically eat about half a pound of maca daily. Maca (Ledpidium meyenil) is an Andean root, referred to as an herb. It’s a starchy tuber that resembles a radish or a turnip but tastes more like a potato.
Like other starches, maca contains carbohydrates, protein, fats, and dietary fiber. It is also rich in plant sterols and a good source of iron, magnesium, selenium, and calcium.
There have not been reports of adverse effects of eating maca, so it is probably safe.
Talk to your doctor before taking any supplements because even though maca is a natural product grown in the Peruvian highlands, there are always potential side effects, including those from processing.
A growing demand for maca has resulted in a wide variety of products online and in health food stores boasting sexual health and stamina-enhancing claims. Maca, like other dietary supplements, are not reviewed or approved by the FDA.
This article was excerpted from an article in WebMD by Kathleen Zelman, MPH, RD, director of nutrition for WebMD.

Mixing Politics and Medicine-A No-No

August 21, 2011

Recently a urologist, Dr. Jack Cassell in Florida, posted a sign on his office door reading, “If you voted for Obama … seek urologic care elsewhere. Changes to your health care begin right now, not in four years.”
Although physicians are not compelled to enter into a doctor patient relationship with every patient who walks through his\her door, denying a patient medical care because of their political persuasion or how they voted, is probably not going to bring a lot of sympathy towards the medical profession. I don’t think Hippocrates would look kindly on Dr. Cassell for this sign that he has posted in his reception area. The most famous Jewish physician of all time, Moses Maimonides, who was a physician to the royal court in Egypt in the Twelfth Century, advised doctors to “see every patient as a human being in pain and make every effort to help him.”
I know that I have taken care of neo-Nazis, skin heads, prisoners, compulsive gamblers, alcoholics and those convicted of child molestation even though I am not on their philosophical wavelength, but believe that they are human beings in pain and in need of my urologic care. I think that is good advice for all physicians including Dr. Cassell.

Want A Non-Medicinal Treatment For Hypertension? Try Soy Protein

August 21, 2011

A recent study finds that soy and milk protein supplements may be associated with lower blood pressure more than refined carbohydrate supplements.
The study, published online in Circulation: Journal of the American Heart Assn., put 352 adults who were at risk for high blood pressure or who had mild hypertension on various rounds of supplements. The participants were given 40 grams of powdered soy, milk or refined complex carb supplements daily for eight weeks, and had their blood pressure taken at various intervals during the trial. They were told to keep their calories the same, as well as their usual sodium consumption and amount they exercised.
Although none of the groups experienced a significant drop in diastolic blood pressure readings, there were differences in systolic readings. A systolic reading (the top number) measures the force put on the arteries when the heart contracts, pushing blood through the arteries. A diastolic reading (the bottom number) measures the force in the arteries between heart beats.
Those who took the milk protein supplement had an average 2.3-mmHg lower systolic blood pressure compared with when they had the carb supplement. And those who had the soy protein supplement saw an average 2-mmHg drop in systolic pressure compared with the carb supplement.
Bottom Line: In addition to salt restriction and exercise, consider adding soy protein to your diet if you have hypertension.

Are You As Smart As A Stanford Student?

August 20, 2011

Usually I blog on medical topics but I would like to deviate to a riddle and humor that will test your creativity and your insight. Good luck!

Only 5% of Stanford University graduates figured it out. How about you?

Can you answer all seven of the following questions with the same word?

1. The word has seven letters…

2. Preceded God

3. Greater than God

4. More Evil than the devil

5. All poor people have …

6. Wealthy people need …

7. If you eat it, you will die.

Did you figure it out?

Try hard before looking at the answers

Did you get it yet?

The Answer is:


NOTHING has 7 letters.

NOTHING preceded God.

NOTHING is greater than God.

NOTHING is more Evil than the devil.

All poor people have NOTHING.

Wealthy people need NOTHING.

If you eat NOTHING, you will die.

Okay, let me know how you did and I will share with you how I and my children did….one a Stanford graduate.

When Your Bladder Ruins a Good Night’s Sleep-Taming the Overactive Bladder

August 19, 2011

Nothing ruins a good night’s sleep more than getting up multiple times to empty your bladder. Often those millions of American men and women are exhausted in the morning because their sleep was interrupted to many times. Now there’s a few steps you can take to tame that overactive bladder.

For the approximately 16% of people over the age of 18 who have an overactive bladder (OAB), getting up two or more times a night can become a regular occurrence. Even if they make it to the bathroom in time, they wake up so often to urinate that they aren’t getting a good night’s sleep.
Generally, the amount of urine in our bodies decreases and becomes more concentrated at night, so we can sleep six or eight hours without having to get up to use the bathroom more than once. But many people with OAB have nocturia, the need to urinate several times a night, which interrupts their sleep cycles.
Even worse, there are some men and women who are particularly sound sleepers or can’t get out of bed fast enough can wind up with wet sheets.
Take these steps to prevent accidents from happening:
Limit your fluid intake before bedtime. Try not to drink any liquids after 5 p.m. or 6 p.m.
Avoid foods and beverages that can irritate your bladder. If you can’t cut them out entirely, skip them in the hours before bedtime to help prevent nocturia. That includes:
Caffeine, which is a diuretic, which increases urine output
Citrus juices
Cranberry juice — though it is touted as great for bladder health, it is actually an irritant if you have OAB
Spicy foods, like curries
Acidic foods, such as tomatoes and tomato sauces
Artificial sweeteners

Double-void before bed or urinate twice, right before bed. For example, you can go to the bathroom, then brush your teeth and go through the rest of your bedtime routine. Then, just before you’re about to lie down — even if you don’t feel like you have to go — try to urinate and see if you can squeeze out another tablespoon or so.

Do Kegel exercises. Done regularly, they help control an overactive bladder. They will trigger a reflex mechanism to relax the bladder. If you feel a tremendous urge to urinate, doing a Kegel before you run to the bathroom will help settle down the bladder spasm and help you hold it until you get there.
Kegels simply involve contracting and releasing the muscles around the opening of your urethra, just as you do when going to the bathroom. You can learn what a Kegel exercise feels like by starting, then stopping, your urine stream. Start with three sets of 8-12 contractions. Hold them for six to 10 seconds each and perform these three to four times per week.

OAB and Your Sex Life
OAB can interfere with sexual intimacy another important activity that takes place in the bed. There’s nothing that can shut down an intimate moment faster than realizing you’ve lost control of your bladder during sexual intimacy — something that happens for many people with OAB. About 15% of my patients report having incontinence during sex.

When you’re being intimate, you’re used to secretions and moistness, but the thought that it’s actually urine leakage is really upsetting and uncomfortable. Usually it’s the female patient who has the leakage, and it’s actually more bothersome for her than for her partner.

Tips for Getting Your Groove Back
There are some things you can do to ward off discomfort or embarrassment during sex.

Talk about it. First, know that your partner will probably be a lot more understanding than you expect. Then bring it up before you have intercourse. Plan and prepare for sex, just as you do for bedtime. Double-void, cut back on fluids, and avoid foods and beverages that are likely to irritate your bladder. This means passing up that romantic glass of wine to get you in the mood.

Keep up the Kegels. Doing these several times a day — and even during intercourse — will help prevent urine leakage during sex.
All of these approaches can help you manage your overactive bladder at night, letting you get a better night’s sleep and have a more active and satisfying sex life.
Bottom Line: An overactive bladder can wreck havoc with sleep, your sex life, and your entire life. I suggest you try these few self-help ideas. If they do not resolve the problem, then contact your doctor, urologist or gynecologist. Help is available. You don’t have to be embarrassed and tired because your overactive bladder is controlling your life.

This article has been modified from “Putting an Overactive Bladder to Bed-Insights for Good Sleep and Good Sex”
By Gina Shaw

When You Gotta Go-Putting a Brake On The Overactive Bladder

August 18, 2011

You’ve seen the ads on T.V. and if you have an overactive bladder you can relate to those women who an intense urge to go to the restroom immediately and if you aren’t able to make it in time you will pee on yourself. This is a great source of embarrassment and can even make women social reclusive.
Urge incontinence occurs when an overactive bladder spasms or contracts at the wrong times. You may leak urine when you sleep or feel the need to pee after drinking a little water, even though you know your bladder isn’t full. This sensation can be a result of nerve damage or abnormal signals from the nerves to the brain. Medical conditions and certain medications — such as diuretics – can aggravate it.
Whatever the source, you don’t have to feel that your OAB symptoms are beyond your control or that they are controlling your life. In fact, you may be able to take control over them just by making some changes in your everyday behavior. Try these practical tips to get started.
Start by eliminating bladder irritants such as caffeine, nicotine, and alcohol. All of these irritate the bladder. Caffeine also acts as a diuretic, meaning it causes you to urinate more. Cutting out the big three can be tough. Try these strategies:
Think about how much water you drink. This can be difficult in New Orleans where we lose so much water through sweating and we are thirsty and have to replenish the excess water loss. Drink plain water when you’re thirsty, from four to eight 8-ounce glasses a day. You’ll know you’re drinking enough if your urine is light yellow or almost colorless. Sip water throughout the day, instead of gulping down a lot at one time. If you take a diuretic, like Lasix or hydrochlorothiazide, try taking the diuretic in the morning. That way you should be able to empty your bladder by bedtime.

In addition to cutting down or eliminating alcohol and caffeine drinks, limiting other foods or beverages may help OAB. Try cutting back on:
Acidic foods and beverages, such as tomatoes, pineapple, and citrus fruits such as oranges, grapefruit, lemons, and limes
Salty foods, which can make you thirstier and make you drink more liquids
Spicy foods, such as chilies, which can irritate the bladder
Carbonated beverages, such as sodas or seltzer

It’s possible to retrain your bladder to hold more urine for longer periods of time. Better muscle control can also help. Ask your doctor for a specific plan and stick with it — it can take up to three months to see results. These strategies may be part of your plan:
Exercises that combat the overactive bladder. Kegels strengthen the pelvic floor muscles that hold up the bladder. They also help reconnect nerve impulse communication between the bladder and the brain. To do them, lie on your bed or the floor and squeeze the pelvic muscles as if you were trying to prevent passing gas from your rectum. Hold the contraction for a count of three; then relax for a count of three. Do Kegels three times a day for five minutes at a time.

Tension, diet, and being overweight can all contribute to urinary incontinence. The good news is that you can do something about all three:
Eat more vegetables and fiber. Fiber helps you avoid constipation, which may help reduce pressure on your bladder.
Reduce tension. Tense situations can make you to feel as if you need to pee Deep breathing exercises are one of the tools that can ease tension.
Exercise. If you’re overweight, losing weight will keep extra pounds from adding to the pressure on your bladder. Exercise may aggravate stress incontinence, though.
When you need to go, then go. Holding back too much can create other problems. For example, teachers and nurses may have bladder problems because they wait too long between bathroom breaks.

Bottom Line: Though urge incontinence is uncomfortable, it’s also very treatable. Changes in your lifestyle and habits can play a part in treating it.

This blog has been modified from: Urge Incontinence: Tips for Daily Life, By Louise Chang, MD