Erectile Dysfunction - An Overview

Funny the things you will never forget. It was 1968, and we gathered in the hall of the Rotunda Hospital - the oldest maternity hospital in the world. Then acted liked the character of Dublin Obstetrical Brotherhood - Dr. Raymond Cross. It was then, by default, as it were, a leading expert in Ireland for impotence, as it was then known - more politically correct term is erectile dysfunction have not yet invented. His problem was really a thankless one for it, if you'll excuse the pun, there are no tools for their trade.

The lecture was fun and light relief from more serious topics placenta previa and persistent back neck. The fact that forty years ago there was no effective treatment for ED and the topic was seen as a joke. I well remember the teacher holds the wire form a tire, he had style, and in which the patient had to place his penis before intercourse. It was all the technological complexity of coat hanger wire, except that it was not so helpful.

When this yoke could not be effective for one suspected him from time to time, may have done, we were then quickly reduced to folk remedies. Chief among them, of course, there were oysters. Oysters, Dr. Raymond Cross told us, were, according to mythology, Dublin, the day can raise the elevation to archbishop dead! More fun.

Now fast forward ten years to the pioneering research of Masters and Johnson, with their classic work - the human sexual response. This was quickly establishing itself as the basis of sex therapy, as it remains to this day. Perhaps their greatest contribution was the recognition of performance anxiety as key factors in all of ED, but most particularly to the fact that affects young men. Sexual dysfunction, finally came of age and ceased to laugh.

Now fast forward ten years and we have a penile injection. Papaverine, injected directly into the corpus cavernosum, as an inducer of erection, was discovered by accident, but has quickly established itself as a very effective, if somewhat uncomfortable, the means of most ED of any etiology. In combination with phentolamine its effectiveness was further increased. Now, however, as papaverine and phentolamine largely fallen out of favor because of their tendency to cause priapism and penile fibrosis.

Today both of these chemicals have been replaced or alprostadil PGE1 represented mainly as Caverject 5 to 20mcg. Where higher doses of 50 or 100 micrograms PGE1 listed, you can have your local pharmacy compounding to make them for you. Suffice here to find out that today 95% of all ED any etiology can be successfully and safely manage this method of treatment.

Now fast-forward another decade, until 1998, with pomp and glory of the world, hardly escaped the attention of our neighbors in Jupiter, we get sildenafil or Viagra and answer to prayer girl in the end. Well, maybe not maiden prayer, but you know what I mean. Because now, finally, was the ultimate aphrodisiac, rhinoceros horns and monkey gland in one person little blue pill, an oral drug that can cause an erection in men. Utopia indeed arrived.

Today, his two cousins ​​joined Cialis and Levitra Viagra and together these three forms of oral medications mainstay drugs in the management or treatment of erectile dysfunction. Unfortunately, with their light and illegal access to the Internet, they are often abused as drugs or pressed into service for the treatment of ED when behavioral therapy may be more appropriate.

When it comes to identifying the causes and decide on a case by case treatment of ED, do not forget, the study of aging Longitudinal Massachusetts. Here they found that about a third of men with moderate to severe erectile dysfunction full recovery of sexual potency in a long time without any treatment. I also use this rule: at the age of 20 to 40 years 75% ED will have a psychogenic factor he said while the age of 50 years, 75% ED is physiological. In all cases, performance anxiety erectile dysfunction should be addressed and explained he even went so often the last thing a patient wants to know. Men often see performance anxiety as a weakness, and somehow their own fault, and therefore rejected.

A few words about my old friend testosterone therapy replacement or TRT. Recent peer-review published studies (Carruthers and others) showed that when older men are not able to adequately respond to PDE-5 inhibitors only of testosterone, given as a transdermal gel (Testogel) or deep intramuscular injection (Nebido), will significantly improve their reactions to these drugs. Do not give up on older men, they too disservice to be taken seriously.

The same researchers, Carruthers, Trinnick and Wheeler in an article published in Aging Male September 2007 showed androgen blood test to be a very poor marker of testosterone deficiency syndrome. And yet we are still adhering to the practitioners of this expensive and largely useless laboratory tests.

Another consideration when it comes to older men with BPH and ED is the use of tadalafil 20 mg taken daily. In an article published in the Journal of Urology October last year, it was clearly shown that Cialis 20 mg taken daily had the same efficiency with alpha-1 blocker to take daily. And since we know that the alpha-1 blockers have no effect on erectile dysfunction and Cialis has proven efficacy, the latter as a treatment for BPH in the presence of coexisting ED might make sense.

Other pharmaceutical erectile dysfunction are currently under development. As to whether these will progress on our repertoire of treatment remains to be seen. One thing is for certain though. In the space of just forty years, we came awfully long way from the bus wire of the penis, oysters and dead archbishops.Generic pills Online Store - buy cheap Glycomet without prescription
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