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If you have a chronic illness such as diabetes or kidney disease, follow your doctor's guidelines to keep these conditions in control. Men with diabetes usually face erectile dysfunction. About 75% of diabetic men suffer from erectile dysfunction or impotence. The erectile dysfunction develops earlier in diabetic men than non diabetic men. What are the causes of erectile dysfunction? Treatment Options Are Many for Prostate Cancer The study involved 285 patients with coronary artery disease who were divided into four groups: those with acute coronary syndrome and disease in one vessel; those with acute coronary syndrome and disease in two or three vessels; those with chronic coronary syndrome; and a control group of patients with suspected coronary artery disease but who were found by angiography to have normal coronary arteries. The laboratory evaluation should be directed by the history and physical examination findings. The patient should be screened for any undiagnosed medical disease that may be the underlying cause of erectile dysfunction. A urinalysis, complete blood count and basic chemistry panel will help to rule out most metabolic and renal diseases.5,8 In elderly men, because thyroid disease can present subtly, the thyroid-stimulating hormone level should be measured to rule out thyroid dysfunction. In one study6 of men who underwent an endocrinologic evaluation for erectile dysfunction, 6 percent were found to have hypothyroidism, and their erectile function improved with treatment. Diabetes mellitus: Erectile dysfunction tends to develop 10-15 years earlier in diabetic men than among nondiabetic men. In a population study of men with type I diabetes for more than 10 years, erectile dysfunction was reported by 55% of men between the ages of 50 to 60 years. The increased risk of erectile dysfunction among men with diabetes mellitus may be due to the earlier onset and greater severity of atherosclerosis that narrows the arteries and thereby reduces the delivery of blood to the penis. When insufficient blood is delivered to the penis, it is not possible to achieve an erection. The findings are published in this weeks issue of the Proceedings of the National Academy of Sciences. propecia hair loss Day One ... We're here to help. DONALD W. SHENENBERGER, LT, MC, USNR One of the forms of phophodiesterase is termed PDE5. The prescription PDE5 inhibitors sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) are prescription drugs which are taken orally. They work by blocking the action of PDE5, which causes cGMP to degrade. CGMP specific phosphodiesterase type 5 causes the smooth muscle of the arteries in the penis to relax, allowing the corpus cavernosum to fill with blood. Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) are medicines prescribed for erection difficulties caused by either physical or psychological problems. The drugs work only when the man is sexually aroused. The effect is usually seen within 15 - 45 minutes. For example, surgical patients can opt for a "nerve-sparing" procedure less likely to interfere with sexual function. And radiation patients can choose between external beam treatment and brachytherapy, in which radioactive "seeds" are implanted in the tumor, according to the American Cancer Society. Possibly uncomfortable ejaculation Do you suspect that my or my partner's erectile dysfunction might be caused by an underlying medical condition or psychological disorder? Why or why not? "Smoking, because it causes blood vessel constriction, is a very big cause of erectile dysfunction," said Dr. Larry Lipshultz, chief of male reproductive medicine at Baylor College of Medicine in Houston. Results Two hundred fifty-two patients (94%) completed the study (131/136 in the sildenafil group, 121/132 in the placebo group). By intention-to-treat analysis, at 12 weeks, 74 (56%) of 131 patients in the sildenafil group reported improved erections compared with 13 (10%) of 127 patients in the placebo group (P<.001). The proportion of men with at least 1 successful attempt at sexual intercourse was 61% (71/117) for the sildenafil group vs 22% (25/114) for the placebo group (P<.001). Adverse events related to treatment were reported for 22 (16%) of 136 patients taking sildenafil and 1 (1%) of 132 patients receiving placebo. The most common adverse events were headache (11% sildenafil, 2% placebo), dyspepsia (9% sildenafil, 0% placebo), and respiratory tract disorder (6% sildenafil, 2% placebo), predominantly sinus congestion or drainage. The incidence of cardiovascular adverse events was comparable for both groups (3% sildenafil, 5% placebo). An erection problem is the inability to get or maintain an erection that is firm enough for a man to have satisfactory intercourse. You may be unable to get an erection at all, or you may lose the erection during intercourse before you are ready. If the condition persists, the medical term is erectile dysfunction.

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