Myths and Misinformation On Prostate Cancer

Prostate cancer is the second most common cancer in men, following lung cancer, with 250,000 new cases discovered each year. There are many areas of confusion about prostate cancer. Let me debunk a few of these myths.

Myth 1: Prostate cancer surgery will end your sex life and cause urine leakage.
Fact: Your surgeon may be able to spare the nerves that help trigger erections. Then you will probably be able to have an erection strong enough for sex again. But it may be a while. Recovery can take from 4 to 24 months, maybe longer. Younger men usually recover sooner.
If you still have trouble, ask your doctor about treatments for erectile dysfunction. Cialis, Levitra, and Viagra are common medications that can help. Your doctor will tell you if these are right for you.

Other prostate cancer treatments, such as radiation and hormone therapy, also can affect your sex life. Urine leakage may occur after surgery, but it’s usually temporary. Within a year, about 95% of men have as much bladder control as they did before surgery.

Myth 2: Only elderly men are at risk of prostate cancer.
Fact: Prostate cancer is rare for men under 40. If you are concerned, ask your doctor if you need to get tested earlier. Age isn’t the only factor. Others risk factors include:
Family history. If your father or brother had prostate cancer, your own risk doubles or triples. The more relatives you have with the disease, the greater your chances of getting it.
Race. If you are African-American, your risk of prostate cancer is higher than men of other races. Scientists do not yet know why.
You may want to discuss your risks with your doctor so you can decide together when you should be tested for prostate cancer with a screening PSA test and a digital rectal examination.

Myth 3: All prostate cancers must be treated.
Fact: You and your doctor may decide not to treat your prostate cancer. Reasons include:
Your cancer is at an early stage and is growing very slowly.
You are elderly or have other illnesses. Treatment for prostate cancer may not prolong your life and may complicate care for other health problems.
In such cases “active surveillance” may be an option to consider. This means that your doctor will regularly check you and order tests to make sure your cancer does not worsen. If your situation changes, you may decide to start treatment.

Myth 4: A high PSA score means you have prostate cancer.

Fact: Not necessarily. Your PSA could be high due to an enlarged prostate or inflammation in your prostate. The PSA score helps the doctor decide if you need more tests to check for prostate cancer. Also, your doctor is interested in your PSA score over time. Is it increasing, which could be a sign of a problem? Or, did it decrease after cancer treatment, which is great.

Myth 5: If you get prostate cancer, you will die of the disease.
Fact: You’re likely live to an old age or die of some other cause. That doesn’t mean checking for prostate cancer is not important. Most men with prostate cancer die with the cancer and not from it.

Bottom Line: I hope this article puts the perspective of prostate cancer back in its proper perspective. The diagnosis is common and help is available for most men with prostate cancer.

Stendra-Viagra’s New Cousin For the Treatment of Erectile Dysfunciton

For the past decade Viagra, Levitra, and Cialis have been the mainstay of oral medications for the treatment of erectile dysfunction or impotence. There’s a new drug on the block, Stendra, whose main claim to fame will be the faster onset of action compared to the three previous drugs.

In published studies in the medical literature, Stendra has an onset of action as early as 15 minutes. The drug can be taken with food or fluids but a high fat meal reduces the rate of absorption and delays the onset of action. Duration of Stendra is the same as Viagra and Levitra at 4-6 hours. Viagra and Levitra report onset at 30 minutes to 1 hour. Cialis is about the same or a little longer, but duration of Cialis is 24-36 hours.
The response or efficacy appears to be similar as the other oral medications, i.e., Cialis, Viagra and Levitra.

The same safety precautions exist: 1) Contraindicated with the use of any nitrates such as nitroglycerin as the use of Stendra with nitroglycerin may drop the blood supply to the hear and risk a serious heart problem; 2) Caution in combination with certain prostate drugs such as Flomax or Rapaflo; 3) Seek help for erection lasting more than 4 hours although I have never seen a man with an erection lasting more than 1-2 hours with the use of any oral medication for the treatment of erectile dysfunction.

The side effects include headaches, facial flushing, nasal congestion, and back pain.

Bottom Line: If a man is looking for a faster onset of action of oral medication for the treatment of erectile dysfunction, then Stendra may be his Holy Grail!

Sex After a Heart Attack: What You Need To Know

Your Average Middle Age Couple Who Are In Love And Wish To Be Sexually Active

Every man or woman who has had a heart attack has concerns when they can begin having sexual intimacy after recovering from a heart attack. Certainly the movie, Something’s Gotta Give with Jack Nicholson and Diane Keaton, offers the protagonist advice about engaging in sexual intimacy after a heart attack until the man can climb two flights of stairs without shortness of breadth or chest pain. Every woman is concerned whether resuming sexual activity may trigger another heart attack in her partner. We know depression is extremely common after a heart attack, especially for women. This blog will attempt to answer some of those questions that men and women have after a heart attack.

First, most cardiologist believe it is helpful for men to be in a supervised exercise program. These cardiac rehab programs teach men and women that it’s OK for them to exercise after a heart attack.

However, if you begin to feel symptoms such as chest pain, abnormal shortness of breath, fatigue, dizziness, or palpitations, it definitely makes sense to slow down what you’re doing, whether you’re a man or a woman. If you’re pretty certain it’s angina, which is temporary pain or pressure in the chest when the heart doesn’t get enough oxygen, it might help to take your nitroglycerin tablet under your tongue.

Now the warning: Just like the movie, Something’s Gotta Give, men who use medication for erectile dysfunction, such as Viagra, Levitra, or Cialis, — they should not take nitroglycerin. Your blood pressure can fall to dangerously low levels, and there’s an increased risk of heart attack and even death. If you’re on an erectile dysfunction drug and have heart-related symptoms during sex, call your doctor.

Yes, and sexual intimacy is often related to the emotions that follow a diagnosis of heart disease. It influences people’s lives in many different ways, and sexual activity is one of them. A new diagnosis of heart disease — or even a surgical scar — can make people feel less attractive. Some drugs have side effects that diminish sexual interest and performance. When patients feel angry and frustrated, it affects not only their sex lives but also their “couple” relationships.

Sexual intimacy is like a stress test. Engaging in sex shows that you’re capable of doing physical activity in which your heart rate and blood pressure go up. In a sense, you’re doing a stress test on your heart. If you tolerate that well and you feel good doing it, it suggests good things about your overall level of fitness and therefore your risk of heart disease.
Sex can also be a sign of healthy relationships and social supports. It shows you have the opportunities, frankly, and that you’re interested and engaged. Sex is a barometer for overall health.

Bottom Line: Sex is a good thing and sex is okay after a heart attack if your doctor gives you permission to exercise and engage in sexual intimacy. This is a discussion every man and woman needs to have with their doctor after having a heart attack and before leaving the hospital.

Time For A Tune Up-Men’s Health Routine Check Ups

Men need to treat their bodies like their cars and visit to the doctor to check what’s under
the hood Men do not usually talk about going to the doctor. Most of the time, it takes serious pain or a major concern to get them to schedule a visit. You may be surprised to know that the urinary tract is most commonly responsible for men’s complaints, as it can bring on problems with obstructive or irritative symptoms. “ ‘Obstructive’ means things like slow urinary stream, difficulty getting the stream to start, difficulty emptying the bladder completely and ‘irritative’ means things like urgency or feeling a strong desire to urinate that you may have trouble inhibiting, having leakage of urine with urge incontinence or nocturia or going to the bathroom at nighttime,” says Dr. Sean Collins, an urologist at East Jefferson General Hospital.

Kidneys can bring on troubles of their own. “Kidney stones can develop with back pain or cause blood in the urine, and the biggest risk factor is not drinking enough fluids when it gets hot outside,” says Dr. Benjamin Lee, a urologist at Tulane Medical Center. The majority of stones are made of calcium but can also be due to recurrent urinary tract infections. “We know that lemonade has a chemical called citrate, which helps dissolve calcium to help prevent stones from forming,” says Lee. It is important to be proactive because if you develop a kidney stone, there is a 50 percent chance you will have a second one in the next five years.

Prostate screenings are vital but keep some men far from the doctor’s office. “Men are intimidated by the rectal examination, but it is not a big deal and takes 30 seconds while the doctor puts a gloved finger in the rectum and feels the prostate,” says Collins. The doctor checks the size of the prostate and whether there is a mass, nodule or hard area that would be concerning and warrant a biopsy. The exam is not anything to be scared of. “Most men leave and say it was not that bad and was worth it if we could find something that could save their life,” says Collins.

Lifestyle choices affect the prostate. “The diet that is best for the health of the prostate is the diet we should be on for cardiovascular health: a low-fat diet, rich in fruits and vegetables,” says Collins. There is evidence that lycopene, a substance found in tomatoes, is good for the prostate. Cruciferous vegetables like broccoli and cauliflower are also helpful.

Sexual issues are not often talked about by men but are more common than you may think. “We find that erectile dysfunction is a barometer for a man’s overall health,” says Collins. The risk factors for erectile dysfunction are the same for cardiovascular disease. “The reason is the blood supply to the penis is a very tiny artery about two millimeters in diameter, whereas the blood supply to the heart is four to five millimeters in diameter, so it does not take much blockage of the blood supply to the penis to result in impotence,” says Dr. Neil Baum, a urologist at Touro Infirmary.
Thankfully, a lot of progress has been made in this area. “Viagra, Levitra and Cialis are the big advances that totally changed the way the field is approached and who you can help with it,” says Dr. Robert McLaren, a urologist at Ochsner Health System.

Infertility is a common issue with men being responsible half of the time. “If you have borderline problems with your semen, you can avoid hot baths and jockey underwear and should wear boxer shorts because of the excessive heat of bringing the testicles close to the body,” says Baum. A semen analysis can be done at a urologist or reproductive endocrinologist’s office.
Young men may think they are invincible when it comes to health issues but they aren’t. “In young men, the most common thing we see is prostititis, which is an infection or inflammation of the prostate, and some men who are active or do bicycle riding can have numbness of the bicycle area, which can resolve if they cut back on riding or use specialized seats,” says Collins.

Every man responds differently. “Prostate enlargement is a normal part of aging but not everybody develops problems from it,” says McLaren. Know what to expect. “The prostate is a gland that sits outside the bladder and is normally about the size of a walnut,” says Lee.
Robotic surgery has revolutionized the way prostate cancer is treated and gives men hope as recovery is quicker and less painful. “The da Vinci robot has made the greatest impact and there are medications that can shrink your prostate that were not around 20 years ago,” says McLaren.

It is a good idea to get a blood test to check your testosterone level as well. “It indicates a decrease in production of testosterone by the testicles, which can be treated with hormone replacement therapy,” says Baum. You can do a self-exam of the testicles to screen for testicular cancer, which is common in men between 20 and 45. “They look for a little bump or lump on the scrotum on the testicle. I tell men that if they make a fist and feel the knuckle, that is what the testicle tumor feels like and they can get an ultrasound exam and blood test to help diagnose testicular cancer,” says Baum.

Making wise choices is helpful for all ages. “If you want to make yourself healthier, exercise, eat right and do not smoke,” says McLaren. To prevent heart disease, you should stay away from red meat, salt and other high cholesterol-containing foods. Your health may be partly determined by what you eat. “Men who have diets that are low in fiber and do not have regular bowel movements or have firm, hard bowel movements are at risk for colon disease such as diverticulitis and diverticulosis, which is inflammation around the colon that results in cramping, abdominal pain and difficulty with the stool,” says Baum. Foods with omega-3 fatty acids like cold water oily fish, salmon, herring, mackerel, anchovies and sardines are helpful.

Self-care is important for men of all ages. “It is interesting that in the top seven cancers in the United States, number one is prostate, number four is bladder and number seven is kidney,” says Lee. Thanks to screenings, lives are being saved. “The message we are trying to get out is that many of these issues are very treatable at an early stage,” says Lee. The health-care community has adapted guidelines with this in mind. “The American Urological Association and the American Cancer Society are really trying to get the word out,” says Lee.

This month is the time to take charge of your health. “The most common problems men run into are cardiovascular disease, prostate cancer and colon and rectal cancer, all of which can be prevented by visiting the doctor on a regular basis,” says Baum. A few tests can also be useful. “A stress test checks the heart and blood supply to the heart, a prostate-specific antigen and digital rectal exam rule out prostate cancer and a colonoscopy every five years checks for colon and rectal cancer,” says Baum.

Even if you feel fine, it is important to see your doctor. “Early hypertension has no symptoms whatsoever unless you go to the doctor and have your blood pressure taken,” says Baum. It can lead to a stroke, kidney disease or heart disease if it is not adequately treated. If you do experience any new or unusual symptoms, it is important to report them. “Heart disease can manifest itself as chest pain, indigestion, lightheadedness or headaches, which are signs of high blood pressure and decrease of blood supply to the coronary arteries and to the heart,” says Baum.

Self-awareness is an asset when it comes to protecting your health. Men are often consumed with taking care of their loved ones, however, and end up neglecting themselves. “The main point is that men need to take an active role in their medical care and need to treat their bodies as something very special that needs fine tuning just like their car,” says Baum.

Watch Out Viagra, There’s A New Kid, Stendra, on the Erectile Dysfunction Block

It was nearly 15 years ago that Viagra was introduced to medical community and men havne’t looked back as this medication turned the sex revolution over on its head. There have been millions of Viagra, Levitra, and Cialis written world wide making it one of the most popular drugs of all time.

Now new erectile dysfunction drug, Stendra, that reportedly works in less than 15 minutes has just received approval from the U.S. Food and Drug Administration.

More than 30 million men in the U.S. are affected by erectile dysfunction (ED). The new drug Stendra, the brand name for avanafil, is the first new erectile dysfunction drug in a decade for this class of drugs known as phosphodiesterase type 5 (PDE5) inhibitors.
Similar to its counterparts, the drug works by helping increase blood flow to the penis. This is potentially the fastest acting of the four of the drugs used to treat ED. Patients taking Stendra are recommended to take the drug 30 minutes before sexual activity but clinical trials have shown the drug works as fast as 15 minutes. Viagra may take an hour to start working.
In clinical trials, 77 percent of men with general ED were able to get erections after taking Stendra, compared with 54 percent of men taking a placebo pill. Stendra resulted in successful intercourse for 57 percent of men with general ED, compared with 27 percent of men on placebo.
According to the FDA, the most common side effects for men taking Stendra were headache, face redness, nasal congestion, cold-like symptoms, and back pain. In rare cases men may get an erection that does not go away after four hours – a condition known as priapism. If that happens, patients should seek immediate medical care.
As with other PDE5 inhibitors, Stendra should not be used by men who also take nitrates commonly used to treat chest pain, because the combination can cause a sudden drop in blood pressure.

Bottom Line: Erectile dysfunction is a common problem affecting millions of American men. Viagra, Cialis, and Levitra are effective but a new drug, Stendra, may have an advantage of faster onset of action.

Libido Letting You Down? Solutions to That Problem

For men, Libido is your sex drive and it is different from ability to get an erection or be able to achieve a successful pregnancy. Women’s libido is also different from orgasm or her ability to have an egg unite with a man’s sperm. In women, gynecologic conditions may make engaging in sexual intimacy difficult or painful and ultimately impact her libido.

Libido is the name Freud gave to our sex drive. Libido is a multifactorial situation which is influenced by hormones, psychological and physical factors, romance, and the opportunity for fulfillment. It is normal for libido to decline with age going much faster for women after menopause than for men in middle age, which has about a 1% decline each year. But nearly all couples in their 60s and 80% of couples in their 70s continue to find enjoyment with engaging in sexual intimacy.

Hormonal deficiency is a common cause of deteriorating sex drive in both men and women. The solution is very simple and consists of replenishing the deficiency with testosterone in men and estrogens in women. However, hormones won’t solve the problem if there is some other underlying reason for the sex drive going into the tank.
So what is a man and a women with a loss of severe decrease in their sex drive to do? If you are suffering from fatigue, your sex drive deficiency may be a result of anemia, thyroid deficiency, or kidney disease. A few blood tests will make the diagnosis and help your doctor put your libido back on track.

Next talk to your doctor about all of your medications including, over the counter medicines, herbal medications and supplements. If the problem is related to medications, you can usually note the onset of libido problems that occurred shortly after staring a medication that can plummet your sex drive.

If you have heart disease or have suffered a heart attack and you or your partner is fearful that sex will worsen your cardiac problem or cause another heart attack, speak to your physician. A good rule of thumb is that if you can climb two flights of stairs without chest pain or severe shortness of breadth, then it is probably safe for you to engage in sexual intimacy with your regular partner.

If you are a woman and are going through the menopause, that doesn’t mean that you have bury your sex life forever. As a matter of fact, menopause for many women enhances their sex life as they are no longer worried about conception and fear of pregnancy. Some women do lose their sex drive after menopause and this may be a result of estrogen deficiency. Talk to your doctor about hormone replacement therapy.

I suggest that if you are a woman, try estrogen first. That works for most women as it reduces their hot flashes and pumps up their libido. However, testosterone may also be effective for women in small doses as it is for men who require larger amounts of testosterone in order to restore their libido. Testosterone is available for men and women in a topical gel or a small rice-sized pellet inserted under the skin and replaced every four to six months.

Women may lose interest in sex after menopause because of vaginal dryness (VD). This VD isn’t treated with antibiotics but with topical estrogen creams or vaginal rings impregnated with estrogen or vaginal pellets of estrogen. If a woman can’t take estrogens, then there is always lubricating creams and jellies such as the old standby, K-Y Jelly that alleviates VD and the discomfort associated with the loss of lubrication.

If you are a man and are suffering from erectile dysfunction (ED), this may also impact your sex drive as well. Certainly check your hormones because if low testosterone is the problem, then replacement therapy with gels, injections, or pellets will restore your sex drive 85% of the time.

For both men and women: get lots of exercise. Regular exercise promotes good health. It not only makes you feel good all over, but restores the blood supply to the pelvic area in both men and women.

How about aphrodisiacs?
You will probably receive unsolicited E mails and mail from companies offering an improvement in sex drive and creams and lotions to make a man’s penis bigger. Absolutely none of these studies have withstood scrutiny by medical professionals and probably are a waste of your time and hard earned money. I am an amateur magician and what they have to offer would be real magic if they worked the way the marketing materials described. A loss of sex drive has a problem since the beginning of recorded history and every society and culture have been looking for the magic elixir or potion that can restore the fountain of youth. The ancients have ground up dried beetles (Spanish fly) and rhinoceros horns but to no avail, except that Spanish fly can make you sick. Included in the myths of aphrodisiacs include oysters. They, too, will not restore a man’s libido or potency. According to the FDS, there is no scientific proof that any over the counter aphrodisiacs work to treat decreased libido problems. According to Dr. Ruth Westheimer, “The largest sex organ is not between our legs but between our ears.”

A few words about Viagra, Levitra, and Cialis. These are prescribed medications for the treatment of ED and will not resolve problems with libido or sex drive. The drugs are very effective for ED but will not cure loss of sex desire.

Bottom Line: Problems with a man or woman’s libido is common to many middle aged men or women. Many of the problems are related to hormone deficiency and can be effectively treated.

Men, Start Your Engines…Take The Road To Good Health

Unfortunately, men, including myself, often have the attitude that if ain’t broke, don’t fix it.  As a result men don’t take as good care of their health as they should.  There are some men who will spend more time, energy, and money taking care of their cars than they do of the wonderful machine called their body.  Men seldom see a doctor after they leave their pediatrician’s office at age 20 and never get medical, and especially preventive health care until they over 50 years.  That’s 30 years or a third of your life without any fine-tuning or maintenance.  Is it any wonder that our bodies breakdown in middle age?  It doesn’t have to be that way.  In this blog I will summarize an article, 6 Questions to Ask Your Doctor, by Dr. Matt McMillin that appeared in WebMD the Magazine on July 8, 2012

Your Diet

But eating right most of the time is an essential part of taking care of yourself. No matter how much you work out you can’t maintain a healthy weight unless you stick to a healthy diet. So be sure to satisfy your appetite with good-for-you foods, and make an effort to keep an eye on calories.

Men are often surprised that even though they are exercising four days a week, they are not losing weight. It’s all about portion control.  For example many men drink beer. To burn off the 150 calories in one can of beer, the typical man needs to jog a mile in less than 10 minutes or do 15 minutes of stair climbing.

Exercise

It’s simple: To get or stay fit, you have to get and stay active. According to the latest federal guidelines, that means a cardio workout of at least 30 sweat-inducing minutes five days a week, plus two days of dumbbell workouts or other weight-training activity to build and maintain muscles. Crunched for time? Kick up the intensity to vigorous exercise, such as jogging, riding a bike fast, or playing singles tennis, and you can get your cardio workout in just 25 minutes three days a week.

Exercise protects against so many conditions — from heart disease to colon cancer to depression — that the best choice is to start exercising now, no matter how healthy you are or think you are. If you haven’t been exercising regularly, see your doctor first and get medical clearance before engaging in a good exercise program.  I also suggest that you read the book, Younger Next Year by Chris Crowley and Henry S. Ledge, M.D.  This book will give you the motivation and the schedule for a real get-in-shape program consisting of diet and exercise. 

 

Stress Reduction

Stress is harmful. It can wreak havoc on your sex drive, increase your blood pressure, and overwork your heart. Here’s the facts: middle-aged and older men who reported years of moderate to high levels of stress were more than 40% more likely to die than men with low stress.

One of the best stress busters is exercise.  You might also try yoga or meditation in addition to exercise.

The D word-Depression

At least 6 million men in the United States suffer from depression each year, according to the National Institute of Mental Health. However, many guys don’t like to talk about their feelings or ask for help. Identifying those problems is a crucial part of any man’s checkup. Depression is more than simply feeling sad, unmotivated, and without energy. Depression is a real illness, and it can be life-threatening. That’s especially true for men, because it increases the risk of serious health problems, such as high blood pressure, heart disease, and stroke. Depression is also the leading cause of suicide — and men are four times more likely than women to take their own lives.

A lot of men are reluctant to discuss their feelings with friends, spouses, their clergyman\woman, or their doctor. Identifying those problems is a crucial part of any man’s checkup. Depression is more than simply feeling sad, unmotivated, and without energy. Depression is a real illness, and it can be life-threatening. That’s especially true for men, because it increases the risk of serious health problems, such as high blood pressure, heart disease, and stroke.

Depression is also the leading cause of suicide — and men are four times more likely than women to take their own lives. “I discuss how common it is so they see they are not isolated,” says White, who screens men for depression during their annual checkups. “Too often, it takes until they reach the end of their rope before they come to see you about it.” Depression is also the leading cause of suicide — and men are four times more likely than women to take their own lives. Medication, exercise, and therapy are all treatment options.

Get your zzzz’s-sleep

It’s hard to overestimate sleep’s importance. Diabetes, high blood pressure, and heart disease are all linked to insufficient sleep, as are excess weight and mood disorders. A recent study showed that young men who skimp on shut-eye have lower levels of testosterone than men who are well-rested. Lower testosterone translates to a decrease in sex drive and sexual performance including impotence or erectile dysfunction.  Meanwhile, older men risk high blood pressure if they don’t get enough deep sleep.

Sleep disorders can also have physical causes. Obstructive sleep apnea (OSA), for example, disrupts breathing and forces you to wake up to draw a deep breath. It affects an estimated 4% to 9% of middle-aged men (twice the rate in women), yet as many as 90% of cases go undiagnosed. OSA raises the risk of heart disease, stroke, and high blood pressure as well as car crashes, which are more common among the sleep-deprived.

You can vastly improve your sleep by practicing good sleep hygeine: Go to bed and wake up at the same time each day, exercise regularly and early in the day, avoid caffeine in the afternoon and evening, don’t eat large meals at night, skip the alcohol right before bedtime, and use the bedroom for sleep and sex only. If these measures don’t help, see your doctor.

Good Health Equals Good Sex

 Erectile dysfunction (ED) is a concern that goes beyond the bedroom.  Years ago, ED was thought to be just a psychological problem or do to testosterone deficiency.  Now we know that ED is most a problem of disease in the blood supply to the penis and now we have learned that ED is a risk factor for heart disease.  Men with ED are twice as likely to have a heart attack and nearly twice as likely to die of heart disease than other men. Men who have trouble with erections tend to be overweight or obese, and to have high blood pressure and high cholesterol.

The younger you are, the more likely your erectile dysfunction is a sign that you are at risk of heart disease.

Many of the men White sees for ED ask for quick fixes such as erection-enhancing drugs like Viagra, Levitra, or Cialis. For a long-term solution, you need to make some lifestyle changes. Sexual health depends on getting and staying fit, physically and mentally.  Yes, Viagra, Levitra, or Cialis will help but the real solution is to get fit and open up those blood vessels to the heart and also to penis.  Your heart and your sexual partner will thank you.

Bottom Line:  Men, you can’t buy good health.  It doesn’t come in a bottle or with one visit to the doctor’s office.  It comes with discipline, hard work, and the commitment to leading a healthy lifestyle.  Good health is within reach of every man.  Get off of the couch and into the pool, on to the jogging track, or into the gym.  You can thank me latter!

Dr. Neil Baum is a physician in New Orleans and the co-author of ECNETOPMI-Impotence It’s Reversible.

High Blood Pressure Can Lower Your Sex Life

Robert is a 53 year old man with high blood pressure. He has a job associated with stress. He is 25 pounds overweight. He rarely exercises and admits to being a little heavy handed with the saltshaker. He takes a diuretic, hydrochlorthiazide, and an anti-hypertensive medication and since beginning these two medications, he has noted that his sexual performance has gone into very low gear.

High blood pressure can get worse over time and cause problems with getting an erection. A major study showed that 26% of men with high blood pressure said they had erectile dysfunction (ED). That was twice the rate of ED in men with normal blood pressure. Some medicines for high blood pressure, such as diuretics, can also cause ED. But if you’re able to keep your blood pressure under control — even with medicines — you can help prevent your ED from getting worse. 


An estimated 15 million to 30 million men in the U.S. have ED. Some changes in sexual function are normal as a man ages. Erections may be less firm, or it may take you longer to get erect. ED is sometimes temporary, too. Stress, relationship issues, illness, and drug side effects may cause it. But if your erection difficulty is ongoing and it keeps you from having the sex life you want, it may be time to seek treatment.


Many men have problems getting or maintaining an erection at some point in their lives. If it happens occasionally, it is probably not a medical problem. But if you repeatedly have trouble — if it happens about a quarter of the time or more — you may want to talk to your doctor about treatment. .


Some drugs for high blood pressure may cause ED. These include diuretics (water pills) and beta-blockers. ACE inhibitors and calcium channel blockers are less likely to cause ED. If you started having erection problems after you began taking medicine, talk to your doctor. You may be able to switch to a drug that can lower your blood pressure without increasing your risk for ED.


Even with high blood pressure and ED, you can still have a good sex life. If your blood pressure is under control you may be able to take an ED pill. Cialis, Levitra, and Viagra are safe to take with most blood-pressure medicines. If ED pills aren’t for you, other proven treatments include implants, pumps, and injectable drugs.
 You also need to check your testosterone level if your sexual performance is not what you would like it to be or if your sex drive has gone into the tank.

Heart disease — a common complication of high blood pressure — and ED are commonly seen together. A blockage in a heart artery is a good indication that the same thing may be happening in arteries that supply blood to the penis, making it difficult to get an erection. Many men with heart disease can’t take ED pills due to an interaction with heart disease drugs called nitrates. But new research suggests some men with stable heart disease may be able to slowly stop taking nitrates if their doctor thinks they would benefit from an ED pill. Stopping nitrates can be dangerous, so talk to your doctor first. If ED pills aren’t for you, there are other ED treatments that are safe for men with heart disease.

Robert spoke to his doctor and got the message about the connection of ED and high blood pressure. He began an exercise program, lost the 25 pounds over a six-month period, and cut out salt in his diet. His blood pressure normalized and he was able to stop using the medication and he had a noticeable improvement in his sexual performance.

Bottom Line: High blood pressure can lower your sexual performance. Treating the high blood pressure and healthy life style changes can also significantly improve ED.

This article was excerpted from an article by Brunilda Nazario, MD appearing in WebMD

When Viagra, Levitra and Cialis Do Not Work In Diabetic Men-Other Treatment Options For Erectile Dysfunction

Diabetes is a risk factor for developing erectile dysfunction (ED).  However, the drugs that are commonly used to treat ED, Viagra, Levitra, and Cialis, are less likely to be effective in men with diabetes.  That doesn’t mean that your sex life is over.  Many of these men will find improvement in second line treatments such as injection therapy, where a drug, prostaglandin, is injected directly into the penis to increase the blood supply to the tissues that are responsible for an erection.  Also, there are vacuum devices that create a negative pressure around the penis and allows more blood to enter the penis which is then trapped with a special rubber band placed at the base of the penis.  Finally, if second line treatments do not work, there are surgical procedures where a prosthesis is placed in the penis.  This consists of two cylinders that are filled with a salt solution, a reservoir to hold the solution that is inserted behind the muscles of the lower abdomen and a pump that is placed beside the testicle in the scrotum.  By squeezing the pump in the scrotum, fluid transferred from the reservoir to the cylinders in the penis creating a natural erection.  When the man wishes the erection to subside, the pump is squeezed and the fluid returns from the cylinders back to the reservoir and the penis becomes naturally soft.  The procedure for the insertion of the prosthesis takes about 20 minutes and is done on a one-day stay basis not requiring hospitalization.  Most men can begin having intercourse 4 weeks after the insertion of the prosthesis. 

For more information please go to my website, www.neilbaum.com, or refer to the article on the “Dangling Stress Test” at http://www.neilbaum.com/erectile-dysfunction—the-dangling-stress-test.html

 

When Viagra, Cialis, Levitra, Don’t Work

Erectile dysfunction (ED) is a serious disorder that affects millions of men – as many as 30 million Americans.  With the aging of the US population, ED will become even more prevalent.  Erectile dysfunction can profoundly impact quality of life and, with the aging trends of the United States population, will become an increasingly important public health problem The likelihood of developing ED increases significantly with age, but this is not an old man’s disease as it also affects younger and middle aged men as well.

And, among those who do seek treatment and receive Viagra, one in three men do not have a satisfactory response. These are cases of drug-resistant erectile dysfunction, or DRED.  Some men find using the drug every time they want to have sexual relations inconvenient, or they don’t like the occasional headaches and other side effects.  What’s worse is when a man tries the drug, it doesn’t work, and he becomes depressed and it affects his marriage and other relationships.  That’s the bad news.  The good news is that there is a cure for ED, including drug-resistant ED, which works for nearly all men who suffer from the tragedy of the bedroom.

Success of the various treatments varies widely. Although the manufacturer of Viagra claims that it is effective in 82% of cases, studies have documented a high percentage of men who do not respond to the drug. Response seems to be somewhat linked to the underlying cause of ED. For example, men with diabetes are less likely to have a positive response than those with high blood pressure.

This leaves a significant population who require other more invasive options for the treatment of ED.  Another group for whom alternative therapies should be considered are those men who are taking nitrates for their angina. For these 6 million men, Viagra, Levitra, and Cialis are strictly contraindicated, since the nitroglycerin and the ED drugs can cause a severe drop in blood pressure.

Other treatment options include pellets of prostaglandin inserted into the urethra, injections of prostaglandin through a tiny needle into the penis, the use of an external vacuum device, and the surgical insertion of a penile prosthesis.

Bottom Line:  ED is a common condition and nearly everyone can be helped.  No one needs to suffer the tragedy of the bedroom.