Archive for September, 2014

To Your Good Health. Give Me a High Fi-Ber!

September 30, 2014

We are trying to lead a healthy lifestyle. Doctors advise us to avoid processed food, take vitamins, and to exercise on a regular basis. Part of leading a healthy life style includes including plenty of fiber in our diets. Most men and women consume only 15gms of fiber a day. The daily recommendation for men is 35gms daily of fiber and for women the recommendation is 25gms. You can increase your fiber by 7gms a day by increasing vegetable and fruit consumption by two portions a day.

Good sources of fiber include what, rice, oats, barley and beans. Also fiber can be found in nuts and seeds, carrots, cauliflower, citrus fruits, strawberries and apples.

There’s no shortage of research showing how fiber may boost your health. Some of its top potential benefits include:

  • Blood sugar control: Soluble fiber may help to slow your body’s breakdown of carbohydrates and the absorption of sugar, helping with blood sugar control.
  • Heart health: An inverse association has been found between fiber intake and heart attack, and research shows that those eating a high-fiber diet have a 40 percent lower risk of heart disease.
  • Stroke: Researchers have found that for every seven-grams more fiber you consume on a daily basis, your stroke risk is decreased by 7 percent.
  • Weight loss and management: Fiber supplements have been shown to enhance weight loss among obese people,3 likely because fiber increases feelings of fullness.
  • Skin health: Fiber, particularly psyllium husk, may help move yeast and fungus out of your body, preventing them from being excreted through your skin where they could trigger acne or rashes.
  • Diverticulitis: Dietary fiber (especially insoluble) may reduce your risk of diverticulitis – an inflammation of polyps in your intestine – by 40 percent.
  • Hemorrhoids: A high-fiber diet may lower your risk of hemorrhoids.
  • Irritable bowel syndrome (IBS): Fiber may provide some relief from IBS.
  • Gallstones and kidney stones: A high-fiber diet may reduce the risk of gallstones and kidney stones, likely because of its ability to help regulate blood sugar.

Bottom Line: High-fiber foods are good for your health. But adding too much fiber too quickly can promote intestinal gas, abdominal bloating and cramping. Increase fiber in your diet gradually over a period of a few weeks. This allows the natural bacteria in your digestive system to adjust to the change. Finally, drink plenty of water. Fiber works best when it absorbs water, making your stool soft and bulky.

Modified from article by Dr. Maureen Hecker-Rodriguez from Touro Infirmary

Caffeine and Menopause-Say Adieu to the Brew

September 28, 2014

Menopause can cause uncomfortable and often incapacitating hot flashes. In most instances these are temporary and will subside without any treatment.

I suggest that if you are suffering from hot flashes, then limit your caffeine consumption. Higher caffeine intake could lead to more severe hot flashes and night sweats during the menopause.

A survey of more than 2,500 women who presented with menopause-related issues at the Mayo Clinic’s Women’s Health Clinic. Researchers then compared the data from those who used caffeine with those who did not.

The study shows that those who used caffeine were more likely to report more severe hot flashes and night sweats.

However, caffeine intake was also linked to experiencing fewer problems with mood, memory and concentration, indicating that it also has its benefits. Mayo Clinic said this could be because caffeine is known to enhance arousal, attention and mood.

Bottom line: While these findings are preliminary, our study suggests that limiting caffeine intake may be useful for those postmenopausal women who have bothersome hot flashes and night sweats.

Drug Treatment For Prostate Cancer

September 28, 2014

Many man will require drug treatment for prostate cancer.  Some of the drugs lose their effectiveness and need to have additional therapy.  This blog will discuss drugs that are used to stop the effect or the production of testosterone which is a necessary hormone for prostate cancer growth.

Drugs that stop androgens from working

Anti-androgens

Androgens have to bind to a protein in the cell called an androgen receptor in order to work. Anti-androgens stop androgens from working by binding to the receptors so the androgens can’t.

Drugs of this type, such as flutamide (Eulexin®), bicalutamide (Casodex®), and nilutamide (Nilandron®), are taken daily as pills.

Anti-androgens are not often used by themselves in this country. An anti-androgen may be added to treatment if orchiectomy, an LHRH analog, or LHRH antagonist is no longer working by itself. An anti-androgen is sometimes given for a few weeks when an LHRH analog is first started to prevent a tumor flare.

Anti-androgen treatment may be combined with orchiectomy or LHRH analogs as first-line hormone therapy. This is called combined androgen blockade (CAB). There is still some debate as to whether CAB is more effective in this setting than using orchiectomy or an LHRH analog alone. If there is a benefit, it appears to be small.

Some doctors are testing the use of anti-androgens instead of orchiectomy or LHRH analogs. Several recent studies have compared the effectiveness of anti-androgens alone with that of LHRH agonists. Most found no difference in survival rates, but a few found anti-androgens to be slightly less effective.

In some men, if hormone therapy including an anti-androgen stops working, the cancer will stop growing for a short time from simply stopping the anti-androgen. Doctors call this the anti-androgen withdrawal effect, although they are not sure why it happens.

Enzalutamide (Xtandi®)

This drug is a newer type of anti-androgen. When androgens bind to the androgen receptor, the receptor sends a signal for the cells to grow and divide. Enzalutamide (also known as MDV3100) blocks this signal from the androgen receptor to the cell.

In men with castrate-resistant prostate cancer, enzalutamide can lower PSA levels, shrink or slow the growth of tumors, and help the men live longer.

Enzalutamide is a pill, with the most common dose being 4 pills each day. In studies of this drug, men stayed on LHRH agonist treatment, so it isn’t clear how helpful this drug would be in men with non-castrate levels of testosterone.

Other androgen-suppressing drugs

Estrogens (female hormones) were once the main alternative to orchiectomy for men with advanced prostate cancer. Because of their possible side effects (including blood clots and breast enlargement), estrogens have been largely replaced by LHRH analogs and anti-androgens. Still, estrogens may be tried if androgen deprivation is no longer working.

Ketoconazole (Nizoral®), first used for treating fungal infections, blocks production of certain hormones, including androgens, similarly to abiraterone. It is most often used to treat men just diagnosed with advanced prostate cancer who have a lot of cancer in the body, as it offers a quick way to lower testosterone levels. It can also be tried if other forms of hormone therapy are no longer effective.

Ketoconazole can block the production of cortisol, an important steroid hormone in the body. People treated with ketoconazole often need to take a corticosteroid (like hydrocortisone) to prevent the side effects caused by low cortisol levels.

Possible side effects of hormone therapy

Orchiectomy, LHRH analogs, and LHRH antagonists can all cause similar side effects due to changes in the levels of hormones such as testosterone and estrogen. These side effects can include:

  • Reduced or absent libido (sexual desire)
  • Impotence (erectile dysfunction)
  • Shrinking of testicles and penis
  • Hot flashes, which may get better or even go away with time
  • Breast tenderness and growth of breast tissue
  • Osteoporosis (bone thinning), which can lead to broken bones
  • Anemia (low red blood cell counts)
  • Decreased mental sharpness
  • Loss of muscle mass
  • Weight gain
  • Fatigue
  • Increased cholesterol
  • Depression

Anti-androgens have similar side effects. The major difference from LHRH agonists and orchiectomy is that anti-androgens may have fewer sexual side effects. When these drugs are used alone, libido and potency can often be maintained. When these drugs are given to men already being treated with LHRH agonists, diarrhea is the major side effect. Nausea, liver problems, and tiredness can also occur.

Abiraterone does not usually cause major side effects, although it can cause joint or muscle pain, high blood pressure, fluid buildup in the body, hot flashes, upset stomach, and diarrhea.

Enzalutamide can cause diarrhea, fatigue, and worsening of hot flashes. This drug can also cause some neurologic side effects, including dizziness and, rarely, seizures. Men taking this drug are more likely to have problems with falls, which may lead to injuries.

Many side effects of hormone therapy can be prevented or treated. For example:

  • Hot flashes can often be helped by treatment with certain antidepressants or other drugs.
  • Brief radiation treatment to the breasts can help prevent their enlargement, but it is not effective once breast enlargement has occurred.
  • Several different drugs are available to help prevent and treat osteoporosis.
  • Depression can be treated by antidepressants and/or counseling.
  • Exercise can help reduce many side effects, including fatigue, weight gain, and the loss of bone and muscle mass.

There is growing concern that hormone therapy for prostate cancer may lead to problems with thinking, concentration, and/or memory. But this has not been studied well in men getting hormone therapy for prostate cancer. Studying the possible effects of hormone therapy on brain function is hard, because other factors may also change the way the brain works. A study has to take all of these factors into account. For example, both prostate cancer and memory problems become more common as men get older. Hormone therapy can also lead to anemia, fatigue, and depression – all of which can affect brain function. Still, hormone therapy does seem to lead to memory problems in some men. These problems are rarely severe, and most often affect only some types of memory. More studies are being done to look at this issue.

Bottom line: Many man experience recurrence of their prostate cancer after treatment. Hormone therapy is the most common treatment option for men in this situation.

Treating Prostate Cancer With Hormone Therapy

September 28, 2014

For men with advanced prostate cancer, hormone therapy is a treatment option. The goal is to reduce levels of male hormones, called androgens or testosterone, in the body, or to prevent them from reaching prostate cancer cells. Using drugs to decrease the testosterone is one of the most common methods of treating advanced prostate cancer.

The main androgens are testosterone and dihydrotestosterone (DHT). Most of the body’s androgens come from the testicles, but the adrenal glands also make a small amount. Androgens stimulate prostate cancer cells to grow. Lowering androgen levels or stopping them from getting into prostate cancer cells often makes prostate cancers shrink or grow more slowly for a time. However, hormone therapy alone does not cure prostate cancer and eventually, it stops helping.

Hormone therapy may be used:

  • If you are not able to have surgery or radiation or can’t be cured by these treatments because the cancer has already spread beyond the prostate gland
  • If your cancer remains or comes back after treatment with surgery or radiation therapy
  • Along with radiation therapy as initial treatment if you are at higher risk of the cancer coming back after treatment (based on a high Gleason score, high PSA level, and/or growth of the cancer outside the prostate)
  • Before radiation to try to shrink the cancer to make treatment more effective

Several types of hormone therapy can be used to treat prostate cancer. Some lower the levels of testosterone or other androgens (male hormones). Others block the action of those hormones.

Treatments to lower androgen levels

Orchiectomy (surgical castration)

Even though this is a type of surgery, its main effect is as a form of hormone therapy. In this operation, the surgeon removes the testicles, where most of the androgens (testosterone and DHT) are made. With this source removed, most prostate cancers stop growing or shrink for a time.

This is done as a simple outpatient procedure. It is probably the least expensive and simplest way to reduce androgen levels in the body. But unlike some of the other methods of lowering androgen levels, it is permanent, and many men have trouble accepting the removal of their testicles.

Some men having the procedure are concerned about how it will look afterward. If wanted, artificial silicone sacs can be inserted into the scrotum. These look much like testicles.

Luteinizing hormone-releasing hormone (LHRH) drugs

These drugs lower the amount of testosterone made by the testicles. Treatment with these drugs is sometimes called chemical castration because they lower androgen levels just as well as orchiectomy.

Even though LHRH analogs (also called LHRH agonists) cost more than orchiectomy and require more frequent doctor visits, most men choose this method. These drugs allow the testicles to remain in place, but the testicles will shrink over time, and they may even become too small to feel.

LHRH analogs are injected or placed as small implants under the skin. Depending on the drug used, they are given anywhere from once a month up to once a year. The LHRH analogs available in the United States include leuprolide (Lupron®, Eligard®), goserelin (Zoladex®), triptorelin (Trelstar®), and histrelin (Vantas®).

When LHRH analogs are first given, testosterone levels go up briefly before falling to very low levels. This effect is called flare and results from the complex way in which LHRH analogs work. Men whose cancer has spread to the bones may have bone pain. If the cancer has spread to the spine, even a short-term increase in tumor growth as a result of the flare could compress the spinal cord and cause pain or paralysis. Flare can be avoided by giving drugs called anti-androgens for a few weeks when starting treatment with LHRH analogs. (Anti-androgens are discussed further on.)

Degarelix (Firmagon®)

Degarelix is an LHRH antagonist. LHRH antagonists work like LHRH agonists, but they reduce testosterone levels more quickly and do not cause tumor flare like the LHRH agonists do.

This drug is used to treat advanced prostate cancer. It is given as a monthly injection under the skin and quickly reduces testosterone levels. With degarelix no anti-androgens are necessary. The most common side effects are problems at the injection site (minimal pain, redness, and swelling) and increased levels of liver enzymes on lab tests. Other side effects are discussed in detail below.

Abiraterone (Zytiga®)

Drugs such as LHRH agonists can stop the testicles from making androgens, but other cells in the body, including prostate cancer cells themselves, can still make small amounts, which may fuel cancer growth. Abiraterone blocks an enzyme called CYP17, which helps stop these cells from making certain hormones, including androgens.

Abiraterone can be used in men with advanced castrate-resistant prostate cancer (cancer that is still growing despite low testosterone levels from LHRH agonists, LHRH antagonists, or orchiectomy). Abiraterone has been shown to shrink or slow the growth of some of these tumors and help some of these men live longer.

This drug is a pill and the most common dose is 4 pills every day. Since this drug doesn’t stop the testicles from making testosterone, men who haven’t had an orchiectomy need to continue with treatment to stop the testicles from making testosterone (LHRH agonist or antagonist therapy). Because abiraterone lowers the level of other hormones in the body, prednisone (a cortisone-like drug) needs to be taken during treatment as well to avoid the side effects caused by lower levels of these other hormones.

Bottom Line:  Nearly 250,000 cases of prostate cancer are identified each year.  Nearly 40,000 men die from prostate cancer, second most common cause of death due to dancer after lung cancer.  For men who have elevated PSA levels after treatment, hormonal therapy is a consideration.

Cialis For Erectile Dysfunction AND Prostate Gland Enlargement

September 28, 2014

Many middle aged men have both erectile dysfunction (ED) and benign enlargement of the prostate gland. Now there’s one pill that can resolve both problems.

Studies have demonstrated the satisfactory quality of low dose Cialis, 5mg\day, for treating both medical conditions.

Millions of men have both ED and the enlarged prostate gland. The symptoms of the enlarged prostate gland include getting up at night to urinate, poor stream, frequency of urination, and dribbling after urination. It is believed that Cialis relaxes the muscles in both the penis and the prostate gland alleviating both conditions.

The side effects of daily Cialis include mild backache, flushing, and nasal congestion. Cialis is absolutely contraindicated in men using nitrates or nitroglycerin. Other treatment options for men who can’t use Cialis include a vacuum erection device (VED), self injections of drugs that create an erection prior to sexual intimacy, or a surgical insertion of a penile prosthesis.

Bottom Line:  If you have symptoms of an enlarged prostate gland and ED, speak to your physician about the possible use of daily low dose Cialis.

Alzheimer’s and Statins-What’s the Situation?

September 27, 2014

We have all heard of suggestions for preventing or delaying Alzheimer’s disease (AD) including physical exercise and crossword puzzles. Now we know that statins, which are used for treating high cholesterol levels, may prevent AD.

Multiple studies have showed that statin use was associated with a slightly lower risk of developing Alzheimer’s or any type of dementia than not using statins.

Bottom Line:  Currently, there’s not enough solid evidence to recommend taking statins to prevent dementia. In the meantime, however, if your doctor has prescribed a statin to lower your cholesterol, know that when you take your daily pill you may be protecting your brain as well as your heart.

Treating urinary incontinence-Don’t Be Pampered by Pampers

September 24, 2014

Many women experience incontinence after childbirth. Fortunately, most women have a temporary problem that usually subsides with time. However, there some women that have a persistent problem that lasts for a longer period of time.

After nine months of pregnancy and a rollercoaster of experiences with a changing body, it’s easy to chalk up bladder leaks after delivery to one more outcome of childbirth. While that’s true for many women, other conditions could be responsible for urinary incontinence —the inability to control the release of urine from one’s bladder —if a woman is having difficulties controlling urination two months post pregnancy or more.

The problem is common and nothing to be embarrassed about since many new moms experience urinary incontinence after baby’s arrival.

The condition is caused by the stretching and tearing of supporting structures including ligaments, tendons, nerves and muscles, resulting in a weakened pelvic floor. The extent of the stretching or tearing varies in each person. Incontinence often resolves itself within a couple months after delivering the baby when the structures have repaired themselves naturally.

According to the National Association for Continence, approximately 25 million adult Americans experience temporary or chronic urinary incontinence. UI can strike at any age, although women over age 50 are the most likely to develop the condition. In many cases, UI is often temporary—such as during or after pregnancy for a short while — or results from an underlying medical condition.

The most common form of incontinence in women post pregnancy is stress incontinence, which consists of losing urine when pressure is exerted on the bladder by coughing, sneezing, laughing, exercising or lifting something heavy. Another common form of urinary incontinence post pregnancy is known as urge incontinence —described as an intense urge to urinate, followed by an involuntary loss of urine. Many women will experience a mixture of both forms, which medical professionals refer to as mixed incontinence.

Urinary incontinence can affect a woman in many different ways. It’s more than just an awkward issue that makes it hard to not leak urine. The impact of incontinence on a woman’s personal life can be distressing. Women often avoid going out because they are embarrassed by their frequent bathroom usage. The problem can greatly affect a woman’s sex life, especially when suffering from stress incontinence. Many patients will talk to providers about the changes in relationships that take place in their intimate lives as a result of urinary incontinence.

Women with incontinence have to rearrange their lives. They have to buy pads, which can be expensive. It can irritate their skin. They are all emotionally challenging things to deal with especially after just having a baby. It has added to the stress of having a baby in general.

There are several different ways to treat urinary incontinence.

The most important thing is to allow the muscles to repair themselves. While some cases of urinary incontinence will disappear a few weeks after a woman gives birth, women should seek medical treatment if they are still experiencing leakage after two months.

Pelvic floor exercises, commonly known as Kegal exercises, can often improve urinary incontinence. The exercises strengthen the urinary sphincter and the muscles that help control urination. A physical therapist or professional recommended by a physician can provide insight on whether a patient is properly contracting muscles to help improve the condition.

I also recommend keeping a bladder diary for those dealing with urinary incontinence, which can help normalize fluid intake. Often times women, out of wanting to remain hydrated, can drink several liters more than is necessary causing their bladders to remain over filled. A bladder diary can help to realize this problem, she says.

Another option available to treat urinary incontinence is what’s known as a vaginal pessary. The device can be put in the vagina to support the structures that help prevent urinary continence. The device can serve as a bridge to allow activities like walks and hikes while a woman rehabilitates her muscles.

It takes only one baby for the problem to occur, and the subject of urinary incontinence should not be taboo. I suggest that women ask their physicians about the problem

Bottom line: Urinary incontinence is common after childbirth. Most women will have the problem resolve without any treatment. If the problem persists after several months, then medical attention is recommended.

Screening For Prostate Cancer-What You Need To Discuss With your Doctor

September 22, 2014

Prostate cancer remains the most common cancer in men and the second most common cause of death in men due to cancer in men. Because of advanced treatments, curing prostate cancer has become more common. There now are more than 2.5 million survivors in the United States. Still, many men suffer from side effects after treatment, which may be a deterrent to obtaining care or even discussing the matter with a doctor. But early diagnosis and appropriate treatment will provide the best outcomes. I suggest that men should discuss the pros and cons of screening with their doctors as they approach 50. This blog will provide you with the information you need to discuss with your doctor.

Treatment options for prostate cancer

The treatment options for prostate cancer have improved significantly over the years. There are three basic choices available to treat localized prostate cancer. These include surgical approaches, most importantly robotic prostatectomy (i.e., robot-assisted laparoscopic surgery); various types of radiation treatments including brachytherapy (placing radioactive seeds in the prostate gland); and active surveillance. Most common long-term side effects of any treatment for prostate cancer are related to urinary issues, including incontinence (difficulty controlling urination), urgency and frequency, as well as sexual problems (erectile dysfunction).

 

Side effects from treatment

Although these side effects are not necessarily harmful in terms of longevity, obviously if these problems occur they will have a significant effect on one’s quality of life. Fortunately, with the advent of robotic surgery and brachytherapy, these side effects are greatly reduced. The incidence of long-term urinary incontinence is less than 5 percent, and preservation of sexual function is as high as 70 percent to 80 percent. The patient’s pre-treatment health and age will certainly have an effect on the post-treatment outcomes.

Many of these side effects will improve with time. It may take as long as six months for urinary incontinence to resolve after surgery. It may take longer, usually six months to a year, for return of normal sexual function after surgery. After radiation treatment, these urinary issues (including frequency and urgency) usually will resolve in a shorter period of time, although the sexual problems tend to occur in a delayed fashion, usually presenting at six months to 1 year after radiation. Certainly if either of these problems persist, it is best to be treated by one’s urologist. There are several treatments for incontinence/ including medication, urethral injections and, if necessary, surgical correction. There is also a broad array of options to treat impotency. Again, the spectrum will range from medical intervention to ultimately surgical correction if necessary.

Follow-Up After Treatment For Prostate Cancer

Because of the advances in urology, cure rates for localized prostate cancer have become extremely high, approaching 90 percent. Continued follow-up is quite important. Usually, men should be seen every six months for the first five years after treatment and then yearly after that. The follow-up usually includes a physical exam as well as continuous monitoring of the patient’s PSA blood levels. Further testing may be necessary if the PSA levels do start to increase. Additional treatments may be necessary if there appears to be a recurrence. It is quite important that this be done at an early point in time for more successful outcomes.

Get Support From Support Groups

There are prostate cancer support groups available. It is often quite helpful to hear that other men have gone through similar issues during their recovery. Other patients with similar problems are a great resource for information. These support groups are generally found through various websites, including the Prostate Cancer Foundation and the American Urological Association. Also the Mercy website can be used as a link.

Bottom Line: Prostate cancer if detected when it is confined to the prostate gland is curable. The best screening device is an annual exam for men after age 50 and a PSA blood test. Before getting the blood test, talk to your doctor about the diagnosis and the treatment so that you know the consequences of prostate cancer screening.

Can’t Get It Up? May Be It’s Your Prescription Drugs Keeping Your Erection Down

September 22, 2014

Impotence or erectile dysfunction impacts nearly 30 million American men. Often times the problem is related to prescription medication. This blog will discuss five categories of medications that can cause you not to have an ejection or can make the erection less rigid and not adequate for sexual intimacy. This blog will discuss five medications that can impact your sex life and what you can do about it.

Most men who take prescription medications know that they’re going to come with a list of side effects, which usually include drowsiness, headaches, dry mouth, or upset stomach. Sometimes, they’re a bit more serious, encompassing everything from skin irritation to allergic reactions and anaphylactic shock. But most of these guys forget one of the more unwanted side effects: erectile dysfunction.

Around the country, erectile dysfunction, or simply ED, affects as many as 30 million men, according to the Department of Health and Human Services. Though this figure probably doesn’t include all those men taking prescription meds, they certainly experience the same effects, such as anxiety, depression, low self-esteem, and a decreased quality of life. Nevertheless, it’s important to know which medications may cause these side effects, and speak to a doctor about possible alternatives — or just prepare to have trouble keeping it up.

Benzodiazepines

It’s interesting that benzodiazepines, (Xanax, Ativan, Valium, and Librium,) which are commonly used for anxiety can cause ED, and thus further anxiety. In fact, you’ll find that it’s a running theme. Anxiety is well known to cause ED, as increased levels of stress harm the body and take away from a man’s libido or sex drive.

Antidepressants

Another condition that causes ED in itself, major depression affected an estimated 16 million adults. Antidepressants are also used to treat anxiety disorders, obsessive compulsive disorder, and even long-term pain. One of the major forms of antidepressants, called selective serotonin reuptake inhibitors (SSRIs), are comprised of the drugs Celexa, Prozac, Zoloft, and Lexapro.

Up to 60 percent of people taking SSRIs may experience ED.

Beta Blockers

High blood pressure damages blood vessels, including those in a man’s penis; causing ED. But beta blockers, one of the drugs most commonly prescribed to people who have blood pressure, may also cause them to experience ED. Drugs that fall into this category include Sectral, Lopressor, Cogard, and Tenormin.

Antihistamines

Millions of men suffer from allergies, but some of the most common drugs, such as Benadryl and Dramamine, may be causing them to have ED, too. The ED also seems to be temporary, with sensation coming back gradually after ending use.

H2 Blockers

Also called H2-receptor antagonists, this category of drugs include the popular heartburn drugs Zantac and Pepcid. They’re used to treat gastrointestinal disorders like gastric ulcers, erosive esophagitis, and gastroesophageal reflux disease.

For the most part, they cause ED when taken in high doses, and the drug Tagamet (cimetidine) is most likely to give men problems. Along with ED and a decreased libido, they can also lower a man’s sperm count.

Though life on these drugs may seem grim within the sexual arena, taking them is important for treating whatever disease a doctor has prescribed them for. Also, by talking with a doctor about alternative treatments, lowering doses, or taking supplements, anyone who takes these drugs may be able to get some of their sexual health back.

Bottom Line: There are dozens of medications that can affect a man’s sexual performance. Check with your doctor as he\she can usually alter the dosage or change to another medication that doesn’t have the side effect of ED.

When Viagra Doesn’t Work-Other Treatment Options For Erectile Dysfunction

September 22, 2014

Viagra-type drugs should be taken only with a doctor’s advice and are not suitable for men with serious heart conditions or who are taking nitrate medicine for angina (which, in combination with Viagra-type drugs, can lower blood pressure to dangerous levels).  This blog will discuss treatment options when Viagra or other oral medications for treating ED will not work.

Men with age-related ED or diabetes who have not responded to drugs.

It might sound like a painful solution, but injections into the penis of alprostadil, a synthetic chemical that helps produce an erection, can be effective for men who have not been helped by Viagra or similar drugs. The injection occurs through a tiny diabetic needle that causes minimal pain and discomfort.

An erection usually occurs within 15 minutes and usually lasts up to an hour. It works by relaxing the muscles and the blood vessels, improving blood flow to the penis.

Alprostadil also comes as a grain of rice sized pellet that’s pushed into the end of the urethra, where it dissolves, though this is less effective than the injection. Approximatley 10 per cent of users experience a burning pain upon insertion of the pellet.

Men with who have poor response to ED drugs, and who also suffer fatigue should have their testosterone level checked.

Men’s levels of testosterone can decline with age or as a result of diabetes, heart disease, obesity and stress.

If you have a distinct drop in libido or erectile dysfunction, your doctor may give you a blood test to check your levels and prescribe replacement of the testosterone deficiency.

Testosterone can be highly effective and safe, and potentially life-changing for men and their partners.

There are studies showing people with low testosterone have higher mortality rates, but there are also studies suggesting the reverse.

When all else fails, consider surgery

Most men can be helped with medication or injections. However, when these conservative options are ineffective, there are surgical procedures that ca restore a man’s potency and sexual performance.

Performed under a general or spinal anesthetic, this involves inserting semi-rigid or inflatable silicone implants into the shaft of the penis.

The inflatable devices have cylinders connected to a tiny pump implanted inside the scrotum. Squeezing the pump transfers fluid into the cylinders for erection, which afterwards go back to the pump and a reservoir underneath the muscles of the abdomen.

Erectile dysfunction can impact many men.  Although most men can be helped with oral medications, there are men who cannot take oral medications or the medications are ineffective.  There are additional options for men where Viagra does not work.  Men don’t need to suffer the tragedy of the bedroom.