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Erectile dysfunction (ED) affects the lives of many middle-aged men and their partners. The term erectile dysfunction covers a range of disorders, but usually refers to the inability to obtain an adequate erection for satisfactory sexual activity. Although erectile dysfunction, formerly called impotence, is more common in men older than 65, it can occur at any age. An occasional episode of erectile dysfunction happens to most men and is normal. As men age, it's also normal to experience changes in erectile function. Erections may take longer to develop, may not be as rigid or may require more direct stimulation to be achieved. Men may also notice that orgasms are less intense, the volume of ejaculate is reduced and recovery time increases between erections. Erectile dysfunction may also be a sign of a physical or emotional problem that requires treatment.

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Erectile dysfunction was once a taboo subject, but more men are seeking help. Doctors are gaining a better understanding of what causes erectile dysfunction and are finding new and better treatments.

This Website discusses all about erectile dysfunction, physiology of the normal erection and the pathophysiology, and treatment of ED.

What is Erectile Dysfunction?

Erectile dysfunction or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. There are various underlying causes, such as diabetes, many of which are medically reversible.

The causes may be physiological or psychological viagra price comparison. Psychological impotence can often be helped by almost anything that the patient believes in; there is a very strong placebo effect.

Due to its embarrassing nature and the shame felt by sufferers, the subject was taboo for a long time, and is the subject of many urban legends. Folk remedies have long been advocated, with some being advertised widely since the 1930s. The introduction of perhaps the first pharmacologically effective remedy for impotence, sildenafil (trade name Viagra), in the 1990s caused a wave of public attention, propelled in part by the news-worthiness of stories about it and heavy advertising.

The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina. It is now mostly replaced by more precise terms.

Signs and symptoms:

Erectile dysfunction is characterized by the inability to maintain erection. Normal erections during sleep and in the early morning suggest a psychogenic cause, while loss of these erections may signify underlying disease, often cardiovascular in origin. Other things leading to erectile dysfunction are diabetes mellitus (causing neuropathy) or hypogonadism (decreased testosterone levels due to disease affecting the testicles or the pituitary gland).

Here are some causes of Erectile Dysfunction:

* Arousal: The first step is sexual arousal, which men obtain from the senses of sight, touch, hearing and smell, and from thoughts about viagra price comparison.

* Nervous system response: The brain communicates the sexual excitation to the body's nervous system, which activates increased blood flow to the penis.

* Blood vessel response:. A relaxing action occurs in the blood vessels that supply the penis, allowing more blood to flow into the shafts that produce the erection.

Physiology of normal erections:

Penile erections involve an integration of complex physiologic processes involving the CNS, peripheral nervous system, and hormonal and vascular systems. Any abnormality involving these systems, whether from medication or disease, has a significant impact on the ability to develop and sustain an erection, ejaculate, and experience orgasm. Tumescence, the vascular filling of the cavernous bodies, relies on neural and hormonal mechanisms operating at various levels of the neural axis. This is unique among visceral functions because it requires central neurological input.

Andersson et al viagra price comparison summarized some of the information related to the pathways involved in erectile function. The degree of contraction of corpus cavernosal smooth muscle determines the functional state of the penis. The balance between contraction and relaxation is controlled by central and peripheral factors that involve many transmitters and transmitter systems. At the cellular level, smooth muscle relaxation occurs following the release of acetylcholine from the parasympathetic nerves.

Pathophysiology of erectile dysfunction:

Erectile Dysfunction is essentially a vascular disease. It is often associated with other vascular diseases and viagra price comparison conditions such as diabetes, hypertension, and coronary artery disease. Other conditions associated with Erectile Dysfunction include neurologic disorders, endocrinopathies, benign prostatic hyperplasia, viagra price comparison, and depression. Conditions associated with reduced nerve and endothelium function, such as aging, hypertension, smoking, hypercholesterolemia, and diabetes, alter the balance between contraction and relaxation factors. These conditions cause circulatory and structural changes in penile tissues, resulting in arterial insufficiency and defective smooth muscle relaxation. In some patients, sexual dysfunction may be the presenting symptom of these disorders.

Treatment:

Sildenafil Citrate is the way to treat Erectile Dysfunction. Generic Viagra contains sildenafil citrate and contains same ingredients like branded drug.

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Male Hormone Replacement Therapy: Andropause

Author: JP Saleeby, MD

Article source: http://www.prostateology.com/. Used with author's permission.

Testosterone is a major player in the complex mielu of hormones (cellular messengers) that direct our bodies to function. In men who are over the age of 40, there is a significant drop in this level of this hormone. Until recently it was considered taboo to replace this important hormone. But today forward thinking anti-aging speCialists realize what scientific studies over the past decade have taught us.

As with women who have gone through the change of life, replacement of their sexual hormones (estrogen, progesterone and testosterone) enact major health benefits such as osteoporosis prevention, heart disease prevention and increases in cognitive function. Likewise for older male subjects the benefits of the addition of testosterone under careful physician management is a crucial aspect of maintaining good health. I wish in this article to dispel some misconceptions about Testosterone Replacement Therapy and provide a list to readers of the benefits of this simple and safe treatment.

First of all there is overwhelming evidence in the scientific literature that testosterone does not cause prostate cancer. In actuality it is the unbalanced estrogen excess in man that is implicated in prostate cancer.

The caveat here is that once there is prostate cancer, testosterone which is an anabolic (building) hormone can promote cancer growth, but contrary to the popular belief, even within the medical field, it does not cause cancer. With advancing age Testosterone levels drop while estrogen levels rise and compete for binding sites on the prostate gland as well as other cells in the body causing a hormonal havoc.

Such problems as an increase in adipose tissue with midsection obesity, a decrease in muscle mass, generalized hormonal imbalances (growth hormone, estrogen, thyroid), depression, increased cholesterol and lipid dysfunction, glucose and insulin imbalance, decreased coronary artery elasticity, elevated blood pressure and loss of a feeling of well being result from low testosterone levels. Supplementing Testosterone in the appropriate candidates reverses these unwanted outcomes, but it is not as simple as taking a pill. There are enzymes in our body that can change exogenous testosterone into other undesirable hormones such as Estrodiol and DHT. Therefore, a physician that understands the balancing act and has the ability to monitor these other hormones is best to treat such a disorder.

Along with the correct replacement modality (cream, gel or patch) there are other considerations which halt the trend of testosterone conversion and these are usually supplemented along with testosterone. Such supplements are Saw palmetto, Zinc and Nettle extract to name a few. In a recent study of the Androderm patch after a 12-month period a depression score dropped by nearly one half with testosterone replacement alone. Again men with complaints of fatigue receiving testosterone in one study had symptoms of fatigue drop for 79% to 10%. A Medline medical literature search reveals many more positive outcomes of testosterone replacement. For those interested in finding out more about their bodies, there is a non-invasive home testing kit available at the Saleeby Longevity Institute which allows men to evaluate the levels of testosterone in circulation.

Andropause the male menopause
by J.P. Saleeby, MD

Dr. J.P. Saleeby, MD is assistant medical director of the Emergency Room at LRMC, Hinesville, GA. Dr. Saleeby also performs tele-medicine/online medicine for Natural HRT for men and women at http://www.saleeby.net. Dr. Saleeby can be reached for by email at jpsaleeby@aol.com


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