Archive for January, 2015

ED (Erectile Dysfunction) May Be Prevented With Vitamin D

January 28, 2015

Erectile dysfunction affects millions of American men and also has an impact on the man’s partner. Often times non-medical treatments are available. One consideration is the use of vitamin D.

A new research out of Italy is suggesting that low levels of vitamin D may increase a man’s risk of erectile dysfunction. Called the sunshine vitamin, vitamin D is the only vitamin that is formed in the body by the rays of the sun.

It has long been touted that an adequate supply of vitamin D is necessary for optimum health and to ward off diseases such as cancer, diabetes and heart disease. But now researchers are showing its importance in helping men to maintain their erection.
According to the study, the researchers tested 143 men with varying degrees of erectile dysfunction, and they found that nearly half of them were deficient in vitamin D, and only one in five had optimal levels of the nutrient.

Additionally, men with severe cases of erectile dysfunction had vitamin D levels that were about 24 per cent lower than those with mild forms of the condition.

Insufficient levels of vitamin D may encourage the production of free radicals called superoxide ions. These free radicals deplete a person’s nitric oxide, a molecule that helps blood vessels function properly. As a result, it makes it difficult for a man to get a firm erection.

Nitric oxide causes the blood vessels to relax, which increases blood flow and causes an erection under normal circumstances.
Without the necessary amounts of nitric acid, your blood vessels may not relax enough to allow for an erection.

How can men increase their vitamin D intake? There are two recommendations.

1) Get sun exposure at least 30 minutes per day. The best source of vitamin D is optimal sun exposure. You don’t have to be completely nude, but expose as much skin as possible for better absorption. Exposing the skin to sunlight’s UV-B for vitamin D3 production is best obtained between the hours of 10 a.m. and 2 p.m.

2) Men can also take vitamin D supplements. For those with low levels of vitamin D, the study recommends taking supplements to get back to the optimal level of 30 ng/mL or above.

As for men with normal erectile function, research is currently studying whether vitamin D supplementation may act as a preventive measure to delay erectile dysfunction.

Bottom Line: I always suggest that men lead a healthy life style including good nutrition, exercise, get adequate sleep and now I’d like to add get plenty of vitamin D.

Advance To Every Cancer Patient

January 24, 2015

Cancer and cardiovascular disease are the most common medical causes of death in America. Tremendous advances have been in the treatment of cancer and there is often more than one treatment option for any disease. This is certainly true for prostate cancer where there are multiple treatments such as surgery, radiation, chemotherapy, and even no treatment at all but watchful waiting.

Here are my suggestions for each patient who has cancer:

1. Get a second opinion. Each patient needs to be aware of all the treatment options and to feel confident and informed about the options available. For example, a urologist who performs surgery is not likely to recommend radiation therapy when radiation therapy may be the better option for the patient. A second opinion is a chance to gain ore knowledge and insight into the accuracy of the diagnosis. Also if a pathologist looking at a biopsy or surgical specimen makes the diagnosis, I suggest that another pathologist provide a second opinion to confirm the diagnosis.

2. Find the right doctors. Nearly 20% of patients who receive a diagnosis of cancer have the disease in an advanced stage where the cancer has spread to other organs or other areas of the body. These patients with cancer that has spread, as well as all newly diagnosed patients, should get advice from physicians experienced in treating the specific type of cancer. You want to be sure that you are in the right hands.

3. Know what questions to ask. There are 10 questions compiled by the Cancer Treatment Centers of America ( that would be helpful for newly diagnosed cancer patients to bring to their visit with the doctor. These are:

1 What types of diagnostic testing do you perform? An accurate diagnosis is critical because it is the basis upon which your treatment plan will be determined. For example, PET/CT scans help determine the precise location of cancer in the body to accurately plan treatment. Tumor molecular profiling identifies a tumor’s unique blueprint to choose targeted chemotherapy drugs. It’s important to have access to advanced diagnostic tests, as well as physicians who are experienced in performing them.
2 What does my diagnostic testing tell me? The information you should receive from diagnostic tests includes: where the cancer originated, the size of the tumor, the stage of cancer and whether or not it has spread to the lymph nodes or other parts of the body.
3 What treatment options are available? What do you recommend and why? Many types of cancer have a variety of treatment options available. Your doctor should be able to explain the potential benefits of each to help you understand your options, even if he or she doesn’t perform a specific treatment.
4 What happens if a treatment approach doesn’t work for me? At any point, you should feel comfortable asking your doctor about the status of your treatment. When choosing a care team, you may want to consider doctors willing to try new therapies, depending on your response. Look for professionals who will tailor treatments to your specific diagnosis, and who are willing to pursue other options if your treatment isn’t progressing as expected.
5 What are the side effects of treatment, and how often do your patients experience them? No two people will have the exact same response to cancer treatment, and side effects may vary depending on what type of treatment you choose. Ask your doctor what side effects you might experience, so that you can plan ahead and choose with all of the information you need.
6 How will you help me manage side effects? Integrative therapies can help prevent or manage side effects, so you stay strong and avoid treatment interruptions. Some therapies that can support your wellness during cancer treatment include: nutrition therapy, naturopathic medicine, mind-body medicine, acupuncture, oncology rehabilitation, spiritual support and pain management. Ask your doctor if any of these are available at your hospital, and how they can be incorporated into your treatment plan.
7 How many patients have you treated with my type and stage of cancer, and how successful have you been? Ask how much experience your doctor has treating your type and stage of cancer and whether he/she is a board-certified specialist. You may also want to ask about his/her facility’s treatment results so you can see how successful they have been in treating your cancer type.
8 Who will be involved in my care, how often will they meet and who is my main point of contact? An integrated care team including a surgical, medical, and/or radiation oncologist; dietitian; naturopathic oncology provider; clinical nurse and medical advocate (often a nurse care manager) can ensure you get support for your entire well-being during treatment. If you don’t already have a team like this in place, talk to your doctor about assembling a multidisciplinary team.
9 Where will all my treatments, appointments, tests, etc., take place? When looking for a treatment facility, consider the coordination and convenience of your treatment. Having appointments and procedures in one location can make treatment less stressful for you, and it may allow you to start treatment sooner.
10 How will you help me balance my cancer care with the demands of my normal life? Your cancer treatment should adapt to your individual needs, and family and professional obligations. Talk to your doctor about your personal needs, so that all aspects of your life are considered when choosing a treatment plan.

4. Stay strong. You will often experience significant side effects dealing with your treatment or the disease. I recommend that you consult with a nutritionist to be sure that you are receiving the right combination of calories, vitamins, and nourishment in order to be in the best physical shape to fight the disease. I also suggest a regular program of exercise that enhances your heart, lungs, and muscles to keep you in the best body-mind condition.

Bottom Line: The cancer diagnosis is often shocking and requires each patient to muster all of his\her energies to engage and fight cancer. These are a few suggestions that will help you prepared to carry the biggest fight of your life.

Saw Palmetto for the Enlarged Prostate Gland-What You Need to Know

January 23, 2015

Over 30 million Americans suffer from the enlarged prostate gland. The symptoms include getting up at night to urinate, frequency of urination, and dribbling after urination. Constantly rushing to the bathroom is a common complaint among the millions of men who develop an enlarged prostate gland, or benign prostatic hyperplasia (BPH). This blog will discuss the treatment with the herbal product, saw palmetto.

Saw palmetto has been used to treat urologic conditions since the days of the ancient Egyptians. It is a common non-medical approach to the enlarged prostate gland.

Here are five reasons you should skip saw palmetto and head to the doctor for advice instead.
1. It’s no better than a placebo.
Researchers have shown that saw palmetto is no better than a placebo at alleviating symptoms. Large studies have also shown the same effect in scientific studies comparing saw palmetto to placebo.

2. Its dosage may vary.
Even if you wanted to try taking a regular dose of saw palmetto, there’s currently no guarantee that the supplement you choose contains what it says it does. One study analyzed six different brands of the supplement and found that half of them contained less than 20 percent of the amount stated on the label.

3. It might not be safe.
Saw palmetto doesn’t seem to have any major side effects, but some users have reported headaches, nausea, and dizziness. However, we haven’t seen studies proving that saw palmetto is actually safe for the long term. In addition, supplements, including saw palmetto, are not well regulated by the FDA, and it’s not uncommon for wily manufacturers to distribute tainted products. You may think you’re taking a “natural” herbal remedy, but for all you know, you could be taking prescription, or even experimental, drugs.

4. It might mask another problem.
If you have symptoms of an enlarged prostate, including frequent urination, it doesn’t necessarily mean that you have an enlarged prostate. The same symptoms might pop up if you have prostatitis (an inflamed or infected prostate gland) or a bladder infection that can be treated with an antibiotic. Or the symptoms might even be a side effect of another medication. If supplements relieve your symptoms for some reason, you might neglect treating another ailment.

5. It’s a waste of money.
Instead of throwing your dollars away on saw palmetto supplements, see your doctor to get a proper diagnosis and find out about approved drugs that can help. Common treatments include alpha-blockers and 5-alpha-reductase inhibitors. Visit Consumer Reports’ Best Buy Drugs to find out more about drugs it recommends for treating enlarged prostate.

Bottom Line: The enlarged prostate is a common problem affecting millions of American men. Saw palmetto is an over the counter non-medical, herbal supplement that probably has minimal or even no benefit at all. All men with symptoms prostate enlargement should seek medical care as solutions are available.

New Help For the Enlarged Prostate Gland-The Uro-Lift

January 21, 2015

The enlarged prostate is a medical condition in which the prostate gland that surrounds the male urethra (tube in the penis that transports urine and semen located in the penis) becomes enlarged with advancing age and begins to obstruct the urinary system. The condition is common, affecting approximately 37 million men in the United States alone. BPH symptoms include sleepless nights as men are awakened to empty their bladder and urinary problems such as dribbling after urination, frequency of urination, and urgency of urination. This condition can cause loss of productivity, depression and decreased quality of life. About one in four men experience these urinary symptoms by age 55 and by age 70, over 80 percent of men suffer from BPH.

Treatment options
Medication is often the first-line therapy for enlarged prostate, but relief can be inadequate and temporary. Side effects of treatment can include sexual dysfunction, dizziness and headaches, prompting many patients to quit using the drugs. For these patients, the classic alternative is surgery that cuts or ablates prostate tissue to open the blocked urethra. While current surgical options, such as transurethral resection of the prostate (TURP or “roto rooter”), can be very effective in relieving symptoms, it can also leave patients with permanent side effects such as urinary incontinence, erectile dysfunction and retrograde ejaculation (dry orgasm).

A new study in published in Urology Practice, an official journal of the American Urological Association, concluded that the UroLift System preserves sexual function and provides rapid improvement in symptoms, flow and quality of life that are sustained to two years.

UroLift, which provides rapid relief of enlarged prostate symptoms with minimal side effects, are durable for at least two years after treatment, with less than one in ten patients requiring an additional procedure for symptom relief. At two years only 7.5% of patients required an additional procedure for lower urinary tract symptoms. Adverse events were typically early, mild and transient. There was no occurrence of de novo sustained ejaculatory or erectile dysfunction\impotence.

Bottom Line: Millions of American men suffer from the enlarged prostate gland. Help is available often starting with medication. Another option is Uro-Lift which can be done in the ambulatory treatment center and has immediate results.

Natural Remedies For Treating Erectile Dysfunction

January 14, 2015

Lots of men with erectile dysfunction (ED) have issues talking about their problem with their doctors. Because of this issue between patients and doctors, it is a strong curiosity in complementary, alternative medicine also known as CAM therapies for ED. Sadly, there is more than unhappy evidence to support the use of many CAM therapies for ED. Furthermore, some CAM therapies are really working or some may actually be harmful for men health.

Many male enhancement pills or treatments have been tested to see if they have a positive outcome. Nevertheless, the conclusion of these studies has been low. Evidence for these ED treatments is limited and many of these male enchantments pills have risks. These risks may not yet be fully known. CAM therapies and all ED drugs, like other treatment options, must always be used only approved by your healthcare provider.

Several studies have suggested that Panax Ginseng (Korean Red Ginseng) may be able to help men with ED. Panax Ginseng is dangerous to diabetics because this perennial plant is causing low blood sugar. Another herb used as naturally treatment for erectile dysfunction is ginko. Ginkgo is a great herb which was applied medicinally for hundreds of years to treat a variety of conditions. It has been reviewed as a possible ED treatment in many studies. This ED supplement is supposed to be able to increase penile blood flow. Ginko can increase bleeding risk potential and it is not suggested to be used by people using blood thinners.

There is some proof that the bark from the yohimbe tree might aid in ED. Yohimbe’s bark contains a substance known as yohimbine, and has been frequently used in Africa as a sexual enhancement. At this time, a medication form of yohimbine (known as yohimbine hydrochloride) is being studied to reduce erectile dysfunction in men. Nevertheless, it may trigger side effects, including tremors, anxiety or high blood pressure.

L-arginine is an amino acid that is found in certain foods. It is essential for nitrous oxide (NO) synthesis. Beneficial NO synthesis is essential for erectile function. Recent studies show that Larginine improves penis blood circulation simply by relaxing muscles and blood vessels. Viagra and equivalent pills work by modifying NO levels. There is different evidence that L-arginine pills may be qualified to aid with ED. These studies have discovered positive results, while other reports in the medical literature have reported negative results regarding impotence issues.

Bottom Line: Erectile dysfunction ED is a common problem that impacts the lives of so many men and has an impact on their partners as well. Many men received unsolicited E mails and regular mail promises of miraculous solutions for their ED. I suggest that you contact your physician before ordering such pie-in-the-sky cures for ED.

Erectile Dysfunction Is Not Always an Affliction of Old Age

January 14, 2015

When you think of erectile dysfunction (ED), there are two assumptions that often come to mind: first, that ED only happens to old men and, second, that your sex life or appearance is to blame. I want to put both of these myths to rest. This blog will help you identify the cause of ED and what treatment options are available.

Recent research published in The Journal of Sexual Medicine found that one in four men seeking help for erectile dysfunction is younger than 40 [2]. What’s more, 50 percent of men over 50 are struggling with some variation of ED.

Men and their significant others would like to believe it’s all in their head, and women often put the blame on their sex life. Some women even wonder “if it’s me” or “is he having an affair?”—but these excuses are often never the cause.”

The actual culprit: his health and usually the blood supply to the penis.
Vasculogenic erectile dysfunction—which means his lack of erection is due to a blood flow issue, as opposed to erectile issues caused by neurological, psychological, or endocrinological complications—is a huge predictor for major health concerns like heart disease, diabetes and high blood pressure or hypertension.

The arteries in the penis are just like the arteries all over the rest of the body such as to the heart, the brain, the kidneys, only those to the penis are significantly smaller. So if there is a blood flow issue happening at the level of the penis, perhaps to due to plaque buildup, then it’s only a matter of time before he starts noticing issues with his heart.

ED is really just the tip of the blood vessel iceberg when it comes to deteriorating health. So if man suffering from ED wants to treat the issue, some lifestyle changes will have to be made. Here’s are some suggestions:

See a men’s health specialist
Primary care doctors and urologists don’t always have familiarities with the penis and may not understand the physiology as much as they should. What’s more, a primary care doctor will likely just prescribe Viagra, Cialis, or Levitra—which ultimately does nothing for his overall health. The man using these drugs eventually builds a resistance to the pills and they do nothing to reverse the process affecting the decrease in blood supply to the penis and other vital organs.

Step up your physical activity
As couples get older and their schedules become more hectic, going for walks often become the primary source of exercise. And while walking may help relieve stress, it’s not going to improve ED. You really need to work up a sweat and get your heart pumping to improve your cardiovascular health. Transition some of your walks together into runs, and incorporate 2-3 strength-training sessions into your weekly routine. But remember walking is better than being a couch potato or no exercise at all.

Develop better eating habits
Abdomen fat is a big predictor of poor health. It’s a major red flag because it leads to ED, diabetes, high blood pressure, and issues with the heart, he adds. Simply put: if your partner’s diet consists of meat, potatoes, pretzels, chips and beer, this has to change. Spouses are often enablers of lifestyle changes, which is why the woman’s workout and eating habits matter to his ED improvement. So if you’re looking for a diet that promotes good heart health, it should be packed full with fish, fruits, and vegetables.

Bottom Line: ED is a common problem affecting over 30 million American men. Help is available. See a male health expert to find a solution and to treat other health-related problems affecting your heart and other vital organs.

Your Age And Your Vagina

January 4, 2015

Aging takes its toll on my organs and systems in the body. No one can ever entirely escape the affects of aging. No one can ever completely turn back the biologic clock. But we can conduct ourselves with good nutrition, exercise, and good lifestyle behaviors.

As we all get older, many things change and we often have to make allowances for them. Take our skin, for example. We use creams and moisturizers to combat aging and sagging of our skin as we enter middle age. And, just like our skin, it’s important to remember things internally like our joints, bones, and even vaginal tissue can also change with age.

As a woman enters menopause, vaginal changes may occur. The vagina can become shorter and narrower. And, as a woman’s estrogen levels start to naturally decline with age, the vaginal tissue can become less of a soft cushion for an erect penis to land. This allows more potential for increased friction, and intercourse can become quite painful for some women who have estrogen changes in the vagina.

In your fertile years, estrogen plays a key role in the development of your reproductive cycle and—among other things—helps keep your vagina healthy, i.e., soft, pliable, and accommodating to an erect penis. As a woman approaches menopause, her hormone levels start to plummet. Once menopause occurs, a woman’s estrogen production really starts to decline and can cause her vaginal tissue to change.

A new drug, Osphena® (ospemifene) works like estrogen in the lining of the uterus, but can work differently in other parts of the body.

Taking estrogen alone or Osphena® may increase your chance for getting cancer of the lining of the uterus, strokes, and blood clots. Vaginal bleeding after menopause may be a warning sign of cancer of the lining of the uterus. Your healthcare provider should check any unusual vaginal bleeding to find out the cause, so tell them right away if this happens while you are using Osphena®.
You and your healthcare provider should talk regularly about whether you still need treatment with Osphena®.

Possible Side Effects
Serious but less common side effects can include stroke, blood clots, and cancer of the lining of the uterus.
Common side effects can include hot flashes, vaginal discharge, muscle spasms and increased sweating.

Bottom Line: The side effects of menopause are vaginal dryness and often painful sexual intimacy. Help is available. Women who experience these problems can be helped with topical and oral medications.

Nighttime Erections-Are They Normal? What You Need To Know

January 4, 2015

Many of my patients ask about the purpose and significance of nighttime erections. This blog will explain those nighttime erections and how they can help differentiate physical from psychological erectile dysfunction.

Men’s early morning erections are a common occurrence and there is nothing to worry about. Most experts will tell you that an erection first thing in the morning is not always due to any kind of sexual stimulus.

So hear are the reasons that men have night time or nocturnal erections.
Reason #1: A man’s rapid eye movement or REM sleep cycle: In a study published in the Achieves of General Psychiatry [1] researchers found that men characteristically have about five erections every night that is linked to the REM (Rapid Eye Movement) cycle of sleep. It is believed that at this time the brain shuts down a particular pathway to prevent a person from acting out their dreams.
Reason #2: Release of Nitric Oxide: Also tied to the REM sleep cycle, it is believed that when a man is in this stage of sleep, it triggers a cascade of events, and one of those is the release of NO or Nitric Oxide. This compound, causes smooth muscles to relax and blood vessels to dilate which in turn increases the amount of blood that flows into a man’s penis — causing an erection.
Reason #3: Higher testosterone levels in the morning: The amount of testosterone in a man’s body in the morning is far greater than any other time in the day[2]. This normal morning increase of testosterone is also one of the leading reasons for a morning erection.
Reason #4: The repair and restore activity of the body: Scientists also believe that night time or morning erections are the body’s way of maintaining, repairing and restoring the health of the penis. When a man has an erection it causes the erectile tissue of his penis (also known as the corpora cavernosa) to swell, which helps in oxygenating the tissue.

Bottom Line: Night time erections are a good thing and a man should welcome these erections as his friend as it restores the oxygen level to his penis to keep it functioning when he needs those erections to engage in sexual intimacy.

[1] FISHER C, GROSS J, ZUCH J. Cycle of Penile Erection Synchronous With Dreaming (REM) Sleep: Preliminary Report. Arch Gen Psychiatry. 1965;12(1):29-45. doi:10.1001/archpsyc.1965.01720310031005.
[2] Diurnal Testosterone Levels in Peripheral Plasma of Human Male Subjects.The Journal of Clinical Endocrinology and Metabolism. JOHN A. RESKO1, and KRISTEN B. EIK-NES DOI: 10.1210/jcem-26-5-573.

Prescribed Pills – Don’t Take Two and Then Call in the Morning!

January 4, 2015

Millions of Americans take prescribed medications. Yet few patients ask about the medications, the purpose, if there are drug interactions with their existing medications, the cost, and most important of all, the side effects of the medications. This blog will discuss the questions you should ask your doctor when you are given a new prescription.

One study reported that doctors spent an average of 12 seconds talking about a new medication’s side effects, and in another report, fewer than 50% of physicians covered the topic of side effects at all.

Luckily, doctors love to answer questions. If you can guide the conversation with relevant questions, you’ll (1) get better information, (2) participate in the decision, and (3) leave with confidence instead of confusion about your new prescription.
Before you walk out the door with that new prescription I suggest that you do the following:
• Ask for the generic name as well as the trade name of the medication?
• What does it do? (conditions it treats, how it works)
• What are the benefits? For example:
Does it just lower your blood sugar or cholesterol, or has it actually been shown to prevent strokes, heart attacks, or other health events? There are some drugs that just change your lab results without altering your health risks and you may not want to treat your numbers on a lab report.
How many people taking the drug does it actually help? (Drugs have varying rates of response — for example, 50% for many anti depressant meds.)
What are the risks?
How many people taking the drug have side effects?
What side effects are common? Are they temporary?
Any severe side effects?
What side effects should you call your doctor about if you have them?
Are there alternatives?
◦ Other types of medications
◦ Drug-free alternatives. (Exercise is more effective than drugs at reducing your risk of death from certain causes.)
How do you take it?
Does it interact with any of your current health conditions, other medications, supplements, foods, or alcohol?
Timing: How long does it take to start working? Can you stop taking it if you feel better?
What if you miss a dose?
Is any monitoring required? (Some medications can affect kidney function, for example, so it’s checked periodically with a blood test.)
How much does it cost? Is there a generic version available?

Bottom Line: If you are armed with these questions and ask your doctor and get answers to these important questions, then you will be a better informed and a healthier patient.