Posts Tagged ‘erectile dysfunction’

Treatment Options for Men With Prostate Cancer-Side Effects You Need to Know

January 22, 2017

Prostate Cancer is the most common cancer in middle aged and older men.  It is the second most common cause following lung cancer of death from cancer in men.

This article will discuss the most common treatment options for prostate cancer and what are the side effects of these treatments.

For younger men with localized disease, surgical removal of the prostate gland either with an open 6-8-inch incision or through a robotic prostatectomy-5 small pencil-sized holes in the lower abdomen that removes the entire prostate gland.

Temporary or even permanent erectile dysfunction (impotence) occurs in many of the men who undergo surgery.  Urinary incontinence, inability to control the flow of urine, occurs in 3-30% of men who have their prostate gland surgically removed.

For older men or for men who have prostate cancer beyond the prostate gland, radiation therapy is treatment option.   The side effects include temporary fatigue, diarrhea or other bowel problems, urgency of urination, and impotence (ED).

For men with spread of prostate cancer beyond the prostate into the bones or lymph nodes, then hormonal therapy is often recommended.  Hormone therapy is used in men with advanced, high-grade prostate cancer. Hormone therapy is also used in men who cancer has recurred after being treated with radiation therapy or surgery.  This is usually determined with an elevation of the PSA level.  Prostate cancer is very sensitive to testosterone, the male hormone produced in the testicles, and removal of testosterone reduces the cancer and helps control the disease but does not cure the problem.

The side effects of hormonal therapy include reduced libido, hot flashes, softening of bones or osteoporosis which leads to bone fractures, impotence, loss of muscle mass, fatigue, weight gain, and increased risk of heart disease and diabetes.

Chemotherapy is indicated for men who do not respond to removing the testosterone produced by the testicles.  Chemotherapy leads to hair loss, nausea\vomiting, diarrhea, fatigue, muscle pain, and weight loss.

Proton therapy is a similar to external radiation that targets difficult to reach tumors and is designed to allow higher doses of radiation to be delivered to the prostate with fewer side effects.

Bottom Line:  Over the past few years there have been numerous options available for the management of localized prostate cancer and even prostate cancer that has spread beyond the prostate gland.  New Orleans has several doctors who are national and even global experts in managing prostate cancer.  For more information, contact your doctor.

Smoking Is Also Hazardous to Your Urologic Health.

November 26, 2016

It is given that smoking is deleterious to your lungs and heart causing lung cancer, chronic obstructive pulmonary disease and heart disease, just to name a few of the common medical conditions causes by smoking.  There are also urologic conditions that are affected by smoking.

Bladder cancer is 4th most common cancer in men with nearly 80,000 new cases each year in the united States.  Smoking causes harmful chemicals and drugs to collect in the urine.  These toxic chemical affect the lining of the bladder and increase your risk of bladder cancer.

Nearly 30 million American men have erectile dysfunction or impotence  This is usually due to a reduction of poor blood flow to the penis.  Smoking can harm blood vessels, when decrease the blood flow to the penis.  As a result, men will have difficulty obtaining and keeping an erection adequate for sexual intimacy.

Kidney cancer is in the top ten most common cancers in both men and women with nearly 60,000 new cases every year.  Smoking puts noxious chemicals from the lungs into the blood stream where it is filtered into the kidneys and can cause kidney cancer.

Kidney stones affect 1 million Americans and smoking is a known cause of having kidney stones and also for having recurrent kidney stones.

Painful bladder syndrome affects 12% of women.  The condition is irritated by smoking and produces more symptoms of pain and discomfort in the pelvis.

Overactive bladder (OAB) affects more than 30 million American men and women.  Smoking irritates the bladder and increase the frequency of urination.  Smoking also is associated with coughing that can increase urinary leakage.

Infertility caused by male factors affects 50% of all problems related to difficulty with achieving a pregnancy.  Smoking can harm the genetic make-up in eggs and sperm.  The infertility rate for smokers in nearly twice that for those men who do not smoke cigarettes.

Bottom Line:  Most people are looking for reasons to stop smoking.  There are so many medical conditions that are caused by or are made worse by smoking.  Talk to your doctor about some of the effective ways to achieve smoking cessation.

Erectile Dysfunction and the Other “Bones” That Are Important

September 4, 2016

I would like men to think of erectile dysfunction as a harbinger of other chronic diseases like heart disease, diabetes, kidney failure, high blood pressure, elevated cholesterol levels and also bone disease or osteoporosis.

A recent study from Taiwan 4,460 men aged 40 years and older diagnosed with erectile dysfunction from 1996 to 2010 with 17,480 randomly selected age-matched patients without ED.  The research found that osteoporosis developed in nearly 6% with ED and 3.65% in men without ED.  Men who had ED had a 3 times more likelihood of developing osteoporosis when compared with men who did not have ED.

Osteoporosis is a metabolic bone disease in which the bones become brittle and porous escalating the rate of bone loss and increasing the chance of a fracture of the hips and spine.

The researchers think that the men with ED had a lower level of testosterone which is necessary for bone strength and development.  Another explanation offered by the authors is that chronic, low grade inflammation can damage the lining of the blood vessels and perhaps lead to a decrease in the blood supply to the penis which is necessary for an erection to occur.  The same inflammation can also cause the bones to fail in calcium rebuilding of bone and thus lead to osteoporosis.

Finally, there is the theory that there is alternation of the vitamin D with decreased levels in men with ED.  With less vitamin D there is a risk of alternations in the lining of the blood vessels especially those that supply the penis and lead to ED.  Decrease in vitamin D also alters bone metabolism and may result in osteoporosis.

Bottom Line: Men with ED should be check for the co-morbid conditions such as heart disease, diabetes, high blood pressure, hormone deficiency and also have tests to be certain that men do not have osteoporosis.

Statins, Cholesterol and Erectile Dysfunction

September 4, 2016

Statins are a group of medicines that can help lower the level of cholesterol in the blood.  Having a high level of cholesterol is potentially dangerous, as it can lead to a hardening and narrowing of the arteries (atherosclerosis) and cardiovascular disease (CVD) such as coronary heart disease, chest pain, heart attacks,  strokes, and even erectile dysfunction\impotence.  Cholesterol that narrows the blood vessels can decrease the blood flow to the penis thus making it difficult to achieve and maintain an erection adequate for sexual intimacy.

Before taking statins, every man or woman should give strong consideration to lifestyle changes such as losing weight, exercising regularly, limiting alcohol consumption, and consider smoking cessation.  All of these actions can decrease the cholesterol levels.  All of these lifestyle changes can also improve sexual function.

Bottom Line:  Elevated cholesterol levels are deleterious to your health.  Consider lifestyle changes before starting statins.  Your erections and your partner will thank you!

Good News About Red Wine and Prevention of Erectile Dysfunction (ED)

February 19, 2016

 

ED affects millions of American men.  Most of the men have ED from vascular causes such as heart disease, high blood pressure, diabetes, or side effects of medications.

Men who consume red wine and blueberries and take regular exercise can cut their risk of developing erectile dysfunction by over a fifth.  My cardiologist, Dr. Frank Wilkow, informed me that two glasses of red wine a day was good for my heart and my erections.  (He also told my wife that one glass of red wine was good for her heart as well!)

Scientists have identified that foods rich in certain flavonoids cut the risk of men experiencing the sexual problem which affects up to half of all middle-aged and older men.

The foods with the greatest benefits include blueberries, cherries, blackberries, radishes and blackcurrant, which contain anthocyanins; as well as citrus fruits, which are packed with flavanones and flavones.

The study from The American Journal of Clinical Nutrition showed that men who regularly consumed food high in flavonoids were 10% less likely to suffer from ED.

Bottom Line: Men who consume a diet rich in flavonoids plus participate in regular exercise and maintain their body weight are the best way to preserve sexual health as well as a reduction in cardiovascular risk factors.  And another benefit is that men who consume the healthy diet also have a reduction in risk of diabetes.

Latest News on Testosterone-NBC Nightly News on 2\17\16

February 17, 2016

Testosterone gel can help some men get back a little of their loving feelings, and helps them feel better in general, according to a new study published today by the National Institute of Health.

It’s the first study in years to show any benefit for testosterone therapy. This was the first time that a trial demonstrated that testosterone treatment of men over 65 who have low testosterone would benefit them in any way.  The trial showed that testosterone treatment of these men improved their sexual function, their mood, and reduced depressive symptoms—and perhaps also improved walking.

The FDA does not approve the use of testosterone to treat the effects of aging. But it’s already a $2 billion industry, with millions of men buying gel, pills or getting injections.

Experts stress that the results, published in the New England Journal of Medicine, only apply to men over 65 who have medically diagnosed low testosterone. The trial consisted of 800 men.

A few men had heart attacks or were diagnosed with prostate cancer during the study, but the rate were the same in men who got real hormone and in those who got placebo cream.

Men in the testosterone group were more likely than those in the placebo group to report that their sexual desire had improved since the beginning of the trial. Men who received testosterone reported better sexual function, including activity, desire, and erectile function, than those who received placebo. Although the effect sizes were low to moderate, men in the testosterone group were more likely than those in the placebo group to report that their sexual desire had improved.

Testosterone was also associated with small but significant benefits with respect to mood and depressive symptoms. Men in the testosterone group were also more likely than those in the placebo group to report that their energy was better.

As men age, their bodies make less testosterone. It’s not as sudden as when women lose estrogen, but the effects can be similar – loss of energy, sexual desire, depression and bone loss.

Bottom Line: Testosterone is the male hormone responsible for sex drive, erections, bone strength, muscle mass, and even mood.  The hormone decreases starting in men in their 20’s and usually become symptomatic in the late 40s and 50s.  The diagnosis is easily made with a simple blood test and treatment is easily accomplished with injections, topical gels, or pellets inserted underneath the skin.  For more information speak to your doctor.

Sex and the Senior or Senior Sex

January 4, 2016

It is not a myth that seniors engage in sexual intimacy or wish to enjoy intimacy perhaps just as much as younger men and women. However, intimacy like many other physical and social interactions that occur as men and women get older. This blog will discuss simple suggestions for seniors to have enjoyable and more fulfilling sex life.

Start your intimacy by engaging your mouth or your communication skills before engaging in sex. You should be able to communicate your thoughts, fears, and desires with your partner. Be frank with your partner and encourage them too to be open with you. Holding back or hiding certain things will only dampen your spirits and diminish your performance.

Be open to new ideas and experiment

Just because you are growing old, doesn’t mean you can’t expand your horizons. Be open to new ideas and discuss them freely with your partner. Don’t hesitate and put your creative mind to use. If erectile dysfunction is an issue for you, try sex with the woman on top, as hardness is less important. If you are used to having sex in the evening, try the morning and visa versa.

Eat right and exercise

High blood pressure and cholesterol can cause the vascular problems that lead to trouble with your erections. It is important to maintain a healthy lifestyle by exercising and keeping your weight and cholesterol in check.

Avoid large quantities of alcohol and smoking

It’s no news that both alcohol and smoking can hinder a man’s ability to achieve an erection. If you are having sexual difficulties, consider abstaining from smoking and alcohol.

Sex does not always mean intercourse

You need to broaden your definition of sex. Holding each other, gentle touching, cuddling, kissing, and sensual massage are also ways which will fulfill you. Try oral sex or masturbation as substitutes to intercourse.

Know when to visit a doctor

Your doctor can help you manage chronic conditions and medications that affect your sex life. If you have trouble maintaining an erection, ask your doctor about treatments. If you have vaginal dryness, see your doctor as help is available.

Be optimistic

You need to maintain a positive approach when it comes to these sensitive issues. Having said that, you need to be realistic too to accept the changes that your body is going through. But nevertheless, accept these natural changes with confidence.

Bottom Line: Sex is enjoyable at any age. Seniors enjoy sexual intimacy just as younger men and women do. You need to know that you can be successful as a senior both in and out of the bedroom.

2016 Update of Peyronie’s Disease (PD)

January 3, 2016

PD is a health issue in which a scar or plaque forms under the skin of the penis. Most of this plaque builds up leading to a curved erection, which can make intercourse difficult or painful for a man and his partner. PD is thought to impact about 6% of men between the ages of 40 and 70 years of age. This may be an underestimate as many men are too embarrassed to seek help or report the problem to their physician.

Doctors do not know what causes PD or how to prevent the disease before it starts. We do know that PD runs in the family. We also know that forceful sexual activity causes minor injuries to the penis that may initiate the process of scar formation. The disease is not related to a sexually transmitted disease or is a source of cancer.

The symptoms of PD include a curvature of the penis. A man may also be able to feel one or more hard lumps on the penis. Men may also experience painful erections and the man’s partner may also complain of vaginal pain or discomfort.

The treatment options for PD include watchful waiting, non-surgical treatments, and surgery. Watchful waiting is appropriate for a man with a minimal curvature that does not cause pain or impede sexual intimacy. Injection therapy includes the use of interferon\verapamil\collagenase drugs directly into the plaque, which may dissolve the plaque. Surgical options include straightening surgery or plication. The plaque can also be removed the defect repaired with a graft of human tissue or synthetic disuse. Finally the plaque can be removed and a penile prosthesis inserted. (See my website, http://www.neilbaum.com, for more information on Peyronie’s Disease and the use of a penile prosthesis)

Bottom Line: Peyronie’s disease is a common urologic disorder. It is a source of potential pain and discomfort. Help is available and most men can achieve relief from the disabling curvature.

 

December 25, 2015

ED SOLUTION AU NATRIEL

Erectile dysfunction affects over 30 million American men.  Most of the men are looking for a solution, perhaps a pill to solve their problem.  Viagra, Levitra, and Cialis do work.  However, they are very expensive and not available in the generic format at this time.  So let’s look at other options, even natural supplements that may be effective.

 Ginseng

While a study published in the Journal of Urology found that men taking Korean red ginseng saw significantly improved erections compared to their placebo-popping counterparts, the American Urological Association Clinical Guidelines Panel feels this trial group of 45 men is too small to validate its clinical efficacy. In addition, Korean red ginseng can cause added health issues for men who have heart disease, mood disorders, or immune system disorders.

L-arginine

Taking a supplement of this amino acid can help increase blood flow both to the penis and the heart, While there’s no medical guarantee it will work like Viagra, Levitra, or Cialis, L-arginine is known to increase levels of nitric oxide, a gas that relaxes muscles and increases blood flow, and is involved in maintaining an erection.

Zinc Supplements

Zinc supplements are not shown to help, but a healthy lifestyle with an excellent diet — anything good for the heart — will be good for the penis. Perhaps the best advice is to lose weight, to exercise, and to stop smoking.

Acupuncture, Hypnosis, and Yoga

Anything that helps reduce stress and improves awareness of your body or calms you down is worth trying.  For some people, acupuncture can help in situations where stress, anxiety, or injury is the cause of ED.

Horny Goat Weed

Pills, powders, and teas are made from an extract of this plant, also called Epimedium, which has long been used in traditional Chinese medicine. Some animal-based studies show that it may increase nitric oxide, which is involved in maintaining an erection, but there is no conclusive scientific evidence that it has benefits in humans.

Pomegranate juice

Antioxidants in berries help nitric oxide last longer in the bloodstream, which is where the pomegranate myth began. However, there is no scientific proof that drinking this antioxidant-rich juice can actually help with erections.

Bottom Line:  I wish I could report that these supplements are the Holy Grail and can help men restore their erections so that they will be able to successfully engage in in sexual intimacy with their partners.  However, the jury is out; and although these options are not likely to be harmful they probably won’t solve most men’s erectile dysfunction.

FAQs on Erectile Dysfunction

December 5, 2015

It often is a mystery about men are able to achieve and hold an erection.  Even more mysterious is what are the causes of failure of erections and to fix the problem.  It is not uncommon for me to feel uncomfortable broaching the topic with their physician.  Fortunately, after the introduction of oral medication to treat impotence or erectile dysfunction in 1999, men are talking about their problems in the bedroom with their physicians.

In this blog I will discuss some of the most frequently asked questions about ED and the treatment for this common condition that impacts over 14 million American men.

  1. Why does Viagra fix the problem?

An erection requires an increase in the blood supply to the penis and more blood has to rush into the chambers of the penis than comes out of the penis.  When this happens, an erection will occur. Viagra helps blood vessels relax and increases the blood supply to the penis.

  1. Does the male hormone, testosterone, have a role in the erection process?

Testosterone acts on a series of different areas of the body to enhance bone development, muscle growth, sexual interest and function. Testosterone is primarily responsible for the libido or sex drive.  The testosterone level slowly decreases at a rate of about 1% a year starting around 25.  By middle age, most men start experiencing signs and symptoms of testosterone deficiency and men often need hormone replacement therapy.  This can be accomplished with injections, topical gels, or pellets of testosterone inserted under the skin.

  1. Why does sex feel good?

There is a high concentration of nerve endings in the penis and vagina, which triggers stimulation and orgasm. Dopamine is triggered and there is a pleasant feeling in the brain during ejaculation. It could also be an evolutionary thing. When we were cavemen with only animal instincts, the fact that sex feels good encouraged us to reproduce to keep the species going.

  1. Do sexually transmitted disease cause erectile dysfunction?

Gonorrhea and chlamydia are both sexually transmitted diseases that are caused by direct and unprotected sexual contact. Both STDs live in reproductive genital tracts of men and women and can be cured with antibiotics. If both STDs go untreated, it can lead to infection that will lead to infertility in men but usually does not cause erectile dysfunction.

5 Why does sex hurt?

The obvious reason is if the man’s penis is much larger than a woman’s vagina opening. The other possibility is that women have a decrease in lubrication of the vagina and the friction is a source of pain and discomfort usually for the men but also for the male partner as well.

Bottom Line:  Impotence is a common condition especially in middle age or older men.  Treatment is available and most men can be helped.  Talk to your doctor.