Viagra Questions

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Urinalysis–Urine is analyzed for protein (albumin), sugar (glucose), and hormone (testosterone) levels that may indicate diabetes mellitus, kidney dysfunction, and testosterone deficiency. o Erectile Function Tests – Tests that assess erectile function examine the blood vessels, nerves, muscles, and other tissues of the penis and pelvic region. o Imaging Studies – Duplex ultrasound is used to evaluate blood flow, venous leak, signs of artherosclerosis, and scarring or calcification of erectile tissue. Erection is induced by injecting prostaglandin, a hormone- like stimulator produced in the body. Ultrasound is then used to see vascular dilation and measure penile blood pressure (which may also be measured with a special cuff). Measurements are compared to those taken when the penis is flaccid. o Prostate examination – An enlarged prostate, which can be detected with a digital rectal examination (DRE), can interfere with blood flow and nerve impulses in the penis. o Penile nerve function – Tests such as the bulbocavernosus reflex test are used to determine if there is sufficient nerve sensation in the penis. The physician squeezes the glans (head) of the penis, which immediately causes the anus to contract if nerve function is normal. A physician measures the latency between squeeze and contraction by observing the anal sphincter or by feeling it with a gloved finger inserted past the anus. Specific nerve tests are used in patients with suspected nerve damage as a result of diabetes or nerve disease. o Nocturnal penile tumescence (NPT) – A normal man will have five to six erections during sleep, especially during rapid eye movement (REM) sleep. These erections occur about every 90 minutes and last for about 30 minutes. Their absence may indicate a problem with nerve function or blood supply in the penis. Two methods are used to measure changes in penile rigidity and circumference during nocturnal erection: snap gauge and strain gauge. • Snap gauge – involves wrapping three plastic bands of varying strength around the penis. Erectile function is assessed according to which bands break.

Strain gauge – involves placing special elastic bands at the base and tip of the penis. These bands stretch during erection and register changes in circumference. o Penile biothesiometry – a test utilizing electromagnetic vibration to evaluate sensitivity and nerve function in the glands and shaft of the penis. A decreased perception of vibration may indicate nerve damage in the pelvic area, which can lead to impotence. o Vasoactive injection – The injection of certain solutions into the penis cause erection by dilating blood vessels in erectile tissue. Normally, these injections produce an erection lasting about 20 minutes. During this procedure, penile pressure is measured and x-rays may be taken of the penile blood vessels using a special dye (contrast agent).

Questions to Ask Your Doctor

What is the cause of my ED. Can it be treated. What treatments are available. Would lifestyle changes help. Could any medications that I’m taking be causing this problem. Do I need medication. If so, what are the possible side-effects. Will the problem ever go away so that I can stop using the treatment. Would you be willing to see my partner and explain the situation to her/him. Are there specific exercises that can help. Is hypnosis a viable option.

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admin — Fri, 14 Nov 2008 13:25:54 +0000

For example, within two months of Viagra’s approval in the United States, The Lancet published a news feature entitled ‘Is the honeymoon over for Viagra?’, in which the author paints a frightening image of Viagra as having already been confirmed by the FDA as being linked to the deaths of six men in the United States, leaving three men in Egypt in need of intensive care after its use, and causing the Israeli health ministry to prohibit its physicians from prescribing the drug. The same journal published an editorial in September of 1998 in which the relatively easy availability of the drug is criticized. The editorial states that “the speed of transfer of this agent from an FDA license to a drug of misuse has been remarkable but that is no reason to give up on attempts to control distribution”. It continues to state that the manufacturer will want to cooperate with drug regulators in bringing illicit sources and distribution networks under control, however difficult this might be, and concerns about the impact on health services indicate that restriction, for the time being, to hospital prescription only would be sensible for Europe. Two months later, The Lancet published another article cautioning physicians of potential issues with the drug. The article states that “sildenafil is no panacea” and that not all patients with erectile dysfunction will benefit from it (Chan-Tack, 1998). It continues that there is substantial risk that many patients will receive little or no evaluation before treatment, the potential for ill-informed and inappropriate prescribing is high, that sildenafil is not an aphrodisiac, does not increase sexual desire or libido and has a high potential for abuse by thrill-seekers. The article also notes that the known side-effects may not be transient, “as current data suggest” (Chan-Tack, 1998). It continues that, “sildenafil may also have other, as-yet-unknown, adverse effects that will become evident only over time” (Chan-Tack, 1998). The Journal of the American Medical Association, although not as unenthusiastic of sildenafil therapy as The Lancet, in its commentaries, editorials and news features also tends to advise physicians to prescribe sildenafil cautiously. In various issues, physicians are advised to exercise extreme caution when prescribing sildenafil to men with diabetes, or those with coronary artery disease. Physicians are also made aware of the possibility of hypotensive reactions in patients taking antihypertensive drugs and sildenafil and are instructed to alert their patients about this potential adverse effect. So, if the core medical journals were not publishing articles on sildenafil, then who was? In our database, The International Journal of Impotence Research is the most common journal title, having published 53, or 7.1% of the 745 articles. These findings are also supported by those from the Science Citation Index. The International Journal of Impotence Research was established eighteen years ago as an offshoot of the Nature publishing group, and lists no official sponsors on its website. However, the editor-in-chief, as well as the remainder of the editorial board have overwhelming financial relationships with Pfizer. Of the nine members, seven serve as speakers, consultants, scholars, researchers or recipients of research funding from Pfizer, all in multiple categories. A qualitative exploration of the articles published by the journal reveals a decidedly positive view of the drug, with minimal mention of side effects or unfavorable research results. This may stem from the fact that investigators and consultants for Pfizer must generally sign nondisclosure agreements that prevent them from divulging data that might conflict with the company’s reports (Loe, 2004). An examination of the top 100 most common authors publishing on sildenafil indicates a similar level of sponsorship. Of the top ten authors, eight openly receive research support from Pfizer, including all of those in the top six. The most common author within these 500 articles is Dr. R. Kloner, a urologist who serves on the International Journal of Impotence Research editorial board, as a speaker and consultant for Pfizer, and who also co-authored the book entitled Viagra: How the Miracle Drug Happened and What it Can Do for You! (1998). The second most common author is Dr. I Goldstein. As a Boston University urologist who also serves as consultant and spokesperson for Pfizer, Dr. Goldstein was “solely entrusted with the ‘branding’ of ED and teaching doctors and the public at large about ED” from the 1990s onwards, largely constructing and revealing the necessity for an impotence drug such as oral sildenafil (Loe, 2004).

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