The Causes of Erectile Dysfunction and How Viagra Can Help

Believe it or not, there are millions of men in the United States alone that are dealing with problems with erectile dysfunction. This is a very common that affects many men for a variety of different reasons and it can definitely cause apprehension, fear, anxiety, and even feeling of low self worth in men. However, today there are a variety of great treatments, such as Viagra that can provide some help. There are many different causes of erectile dysfunction, and it is important that you understand those causes and which one could be affecting your life. So, let’s take a closer look at some of the causes of erectile dysfunction and how Viagra can help you out.

Psychological Causes

There are actually psychological factors that can lead to erectile dysfunction; in fact, between 10-20% of erectile dysfunction cases actually are due to psychological factors, which sometimes work together with physical causes. Some of the main psychological causes of erectile dysfunction include stress, depression, low self esteem, and even anxiety. All of these things can contribute to the problem, and once erectile dysfunction occurs once, often it worsens these problems, making it occur again. However, Viagra can help some men who are dealing with ED due to these problems.

Physical Causes

Of course there are definitely some physical causes that can lead to erectile dysfunction as well. There are several physical problems that can cause problems getting an erection. These causes usually are related to damage or breakdown of the events that happen to cause an erection. This can include nerve impulses throughout the body, muscle responses, veins and arteries, and problems with the corpora cavernosa. There are a variety of different diseases that may cause these problems, leading to erectile dysfunction. Diabetes, Kidney disease, neurological disease, vascular disease, prostate cancer, surgery, injuries, drug use, alcohol and tobacco use, or even hormonal imbalances can all cause erectile dysfunction. However, even if you are suffering from any of these physical problems, usually you will find that drug therapies, such as Viagra, can actually help you to overcome the problems so that you can still experience a satisfactory erection in spite of these problems.

Medications

There are many medications out there that can cause erectile dysfunction too. So, if you are experiencing problems with impotence, consider taking a look at the medications you are taking. There are both over the counter medications and prescription medications that can cause problems with erectile dysfunction. Some of them can affect your circulation, hormones, or even your nerves, which can lead to erectile dysfunction. There are many drugs that can cause these problems, including antihypertensives, diuretics, antihistamines, antidepressants, antiepileptics, anti-anxiety drugs, antiarrythmics, NSAIDS, muscle relaxants, medications for Parkinson’s disease, chemotherapy medications, and even medications that are taken for prostate cancer. So, if you are dealing with erectile dysfunction that you think is a result of taking medications, consider speaking with your doctor about Viagra. Viagra can often be used safely with many of these medications and can help you deal with the problem.

How Viagra can Help

Viagra is a medication that is taken orally to help treat erectile dysfunction, and most men dealing with erectile dysfunction find that Viagra can really help to improve the erections that they have. Both getting an erection and maintaining an erection can be helped with Viagra and it can help you make sure that you have a sexual experience that is satisfying for you as well as your partner. Whether you are dealing with erectile dysfunction due to psychological issues, physical causes, or even medications, you will find that Viagra offers a safe way of help.

For more than 9 years now, Viagra has been helping men deal with ED safely. It works well for men of all different ages, for men who have various health issues, and even for men who only have difficulties some of the time. If you are wondering if Viagra may be right for helping you, then you may want to speak with your doctor. Your doctor can help you determine if you really have erectile dysfunction and can also help you figure out whether or not Viagra is a great choice for you. More than likely your doctor will recommend Viagra and you’ll be on your way to getting rid of those problems with erectile dysfunction.

Posted in Erectile Dysfunction | Leave a comment

Cheap Viagra: Buying Online in Canada

Viagra is one of the biggest achievements as far as male health is concerned. Thanks to Viagra life became brighter and feelings of desperation and hopelessness that tend to worry older men can be easily removed. Modern men know that there is solution to problems of male health and Canadian Viagra can solve them easily.

In the effort to buy Viagra online, Canadian pharmacy (hqcanadianpharmacy.com) comes out as a great alternative, where men can acquire required medicines at a reasonable price. Canadian Viagra is worth choosing for many reasons, but reasonably priced offer beats all other advantages. The amazing thing is that the price can differ ten times though the quality that is provided here is similar. Branded Viagra is still expensive though its original manufacturer Pfizer started lowering the prices to compete with generic medications that appear on the market. As Viagra patents expire in different countries, better and cheaper solutions become available and we urge to take advantage of this opportunity.

When patients apply to Canadian pharmacy, Viagra is delivered right to the doorstep. The package is fully sealed and packed into non-transparent paper. Customer will not feel embarrassed when he gets the parcel. The privacy of every client is preserved.d3894adb42749959ecf5347a0d06

The choice of medications is wide in online store. You can acquire Canadian Viagra  and choose the dosage that is necessary for you.

Being on prescription medication you can choose the place where to buy the drug. But if you just begin your treatment you should first visit your doctor because it is important to determine the right dosage. Let your health care provider help you to find the best option for your particular case. Don’t forget about individual intolerance that can reveal unexpectedly. Therefore it is better to try the medication first and only then fill in the prescription.

Buying online in Canada you do not have to pay taxes and cover expenditures of expensive store in the middle of the city. The expenses of this kind are included into the price of medications therefore pills are very expensive. They seem to be made of gold! With Canadian Viagra you get reasonably priced PDE5 inhibitor that is able to relax penis muscles to enhance blood circulation in it. That makes erection firm and durable while you get amazing experience of closeness with your partner.

When you buy online you do not need multiple trips to the drugstore. Besides, you can forget about embarrassment in a crowded store when you buy the medication. Viagra is an iconic drug that is known to all and all people around will be aware about your intimate problem as soon as you ask the pharmacist for it. Isn’t it better to order it in Canadian pharmacy? Viagra Online can be easily ordered online so there is no need to create unnecessary problems.

If you need to solve the problem of erectile dysfunction, then online pharmacy is a worthwhile solution. It is not only beneficial to buy Viagra online, it is convenient as well.

Posted in Generic Viagra | Tagged , | Leave a comment

Viagra Can Make Fantasies into Realities

Men who suffer from erectile dysfunction often think that a normal sex life is something that is beyond their reach. The idea of having a satisfying intimate relationship with their spouse or partner has become a fantasy. However, there is hope for turning that fantasy back into a reality with Viagra. Viagra can bring back the fun in the bedroom of many men who thought that their sex life was over permanently. If you have found that your sex life has turned into nothing but a fantasy since you began having problems with erectile dysfunction, Viagra may be right for you.

Why Do You Need Viagra?

While in an ideal world, erectile dysfunction would be a temporary problem that would clear up on its own within a few weeks, or months, at the most, the majority of men need Viagra or some other medical assistance to overcome the symptoms. Many times erectile dysfunction cannot be cured, only treated with Viagra whenever sexual activity is desired. If you are suffering from erectile dysfunction, you can get back your sex life by using Viagra.

What Does Viagra Do?

Many people believe that Viagra Professional Canada is a sexual stimulant or causes an erection, just from taking the pill itself. This common belief is actually a myth. Viagra works by helping to reestablish blood flow to the penis. This will allow you to achieve and maintain an erection, just as you naturally would. Viagra does not cause an erection by itself; it just allows you to react as you normally do to sexual stimulation. With Viagra, the process that it takes to get an erection does not change; it is just aided and enhanced by taking the medication.

What Are The Benefits?

Of course, the main benefit of Viagra is the reason you would choose to try it in the first place. Viagra works within the body to allow users to achieve an erection and to keep it throughout the act of sex. You and your partner can get greater satisfaction when you are intimate, allowing for a more enjoyable experience for you both. Outside the newfound enjoyment of your intimate, physical relationship, other aspects of your relationship will improve greatly, as well. You will likely have a closer relationship emotionally, too, as a result of Viagra. If your self-image or self-esteem was affected by your inability to perform in the bedroom, that will also quickly correct itself. So many aspects of your life can be positively affected by trying Viagra, it can really turn your world into the existence of your dreams.

What Are The Cautions?

While Viagra is very safe for most men to take, there are a few red flags that everyone considering Viagra should be aware of. Those with serious heart conditions and other medical situations that keep them from safely participating in sex should not take Viagra. This includes those who have been recently treated for stroke and heart attacks. If you are on medications such as alpha-blockers to control your blood pressure, you may not be able to take Viagra Online in New Zealand. The most dangerous drug interaction that has been shown in studies is that of nitrates and Viagra. Anyone who uses nitrates in any form should not take Viagra. Failure to heed this warning could prove to be fatal. Even with these extreme warnings about interactions, if care is taken when obtaining Viagra, it is an effective and safe treatment for erectile dysfunction.

How Can You Get Viagra?

Obtaining a prescription for Viagra is as simple as making an appointment with your doctor. As long as you are healthy enough for sex and are not taking any conflicting medications, you should be able to try Viagra without any problems or difficulties. Your doctor will evaluate your physical health and look at your current medications to decide if taking Viagra is a safe choice for you. Once you have been given the green light and a prescription, simply fill it at the pharmacy of your choice and you are good to go. The fantasy of getting back your intimate relationship with your partner can again become a reality once you get your prescription for Viagra.

Posted in Generic Viagra | Leave a comment

Generic Viagra Is The Best Ed Medication?

Viagra is a remedy for erectile dysfunction which is a health disorder suffered from by a great number of men of all ages. in order to understand if this medicine is safe for you, consult with the medical adviser.

Viagra Canada is the most commonly recommended impotence medicine in all parts of the world.

The most significants information about Viagra are:

- it is effective for majority of men experiencing loss of sexual power
– this remedy has been approved as a safe and effective medicament that has been used for more than 10 years
– this medicament is safe for the use in men with a number of medical problems.

Now you can learn more about the way Viagra deals with loss of sexual power

Viagra Drug is also called sildenafil citrate, which is the key ingredient of the medicine. The long use of this remedy showed that it works effectively for the most people, furthermore, it is safe and trusted remedy that can be used by patients having certain other medical disorders.

The question is, how can Viagra Canada help a man to deal with erectile disorder?

Viagra Med helps to gain an erection hard enough for sexual intercourse and keep it for a longer time.

Millions of males have already experienced the advanatges from taking this medicine. Don’t forget that Viagra Medication is a prescription medicine, so you should visit a medical provider before starting the treatment with this medication. Only a health provider can make a decision if this treatment will be right for your medical state.

In order to understand the problem of erectile dysfunction, you should know the mode of occurring of an erection.

Basically, the degree of erection stands on the blood flow in the penis. The penile area has veins that transfer the blood. When a person is sexually stimulated, this blood flows to the genital tissue which makes a penis to get hard and erected.

If the blood circulation is not enough because of some medical conditions it affects the usual process and the problem of erectile dysfunction occur.

Viagra improves the adequate supply of blood to the penis enabling the penis to become strong enough for longer which makes it possible to have a sexual intercourse easily.

Remember that this drug. acts only if an individual is sexually stimulated, in other way it won’t show its effectiveness. After completing a sexual intercourse, an erection goes away. In very rare cases an erection may last for more than 4 hours. This is quite an unfavourable condition, so obtain medical help immediately.

Viagra stays effective in your body for nearly 4 hours which enables to have a spontaneous sexual intercourse within this period of time.

What precautional steps should be followed while using Viagra Medication?

Viagra Pill must not be taken together with nitrate medicaments that are taken to cure chest pain, in other way it can cause an abrupt reduction in blood pressure that may be a life-threatening state.

Before using this medicine, make sure that sexual activities are not unfavourable for you because of certain medical disordrs you may suffer from. In case chest pain, nausea, or other unfavourable conditions are observed while sexual activity, get medical attention as soon as possible.

Senior persons or those patients having acute liver or kidney problems may be advises to begin taking the lowest dosage of this medication, (25 mg). Such a dose is typically prescribed for patients that are being treated with protease inhibitor medications. Individuals that experience prostate disorders or experience hypertension and use alpha blockers to treat such disorders might also be prescribed the lowest dosage of Viagra.

Viagra Drug must not be used in along with other erectile dysfunction medications

Also, be aware of the fact that Generic Viagra doesn’t protect against STDs, so use necessary methods of protection against STDs.

Adverse reactions

Viagra Medication is a safe medication nevertheless certain adverse effects can happen in some patients.

Among the generally observed side effects of Viagra Med are headache, flushing of the face, indigestion. Among rarely occurred side reactions are hazy vision and light sensitivity.

In rare cases, Viagra Pill might cause certain vision problems such as an unexpected reduction or loss of vision. Hearing impairments can also be seen in some cases. Basically, there are no adequate data regarding the direct influence of Viagra Drug on provoking such disorders. If abrupt reduction or loss of vision or any hearing disordersare observed, stop using Viagra Med and speak to your medical provider as soon as possible.
Sometimes a condition known as priapism may be observed. This medical condition is characterized by lenghthy erection which continues more than 4 hours. If this condition is observed, get medical assistance without a delay.

Additional information about Viagra Pill

Viagra Medication Australia usually is effective for most of men experiencing erectile dysfunction. Nevertheless it is not effective for everyone. The effects of any medicine, including Generic Viagra varies from person to person and you mustknow about that.

Besides, a number of health problems or medicines, you are currently taking might keep you from taking Viagra Med. Speak to your medical adviser regarding the treatment with Viagra. It’s important to discuss your presented health conditions with your doctor to know exactly if your general condition of your health doesn’t prevent you to be involved in sexual intercourses.

Posted in Generic Viagra | Tagged , , , , | Leave a comment

Natural Erectile Dysfunction Remedy – Why Increasing Circulation is Better than Viagra!

Millions of men will get on the internet today and search for an E.D. pill to cure their impotence. And only thousands of men will search for a natural erectile dysfunction remedy. Though both men could ultimately cure their erectile dysfunction problem, the latter will also increase circulation levels, lose weight and add up to ten years to his life.

It has been shown that naturally treating erectile dysfunctions is the best way to treat male impotence. Men who choose to incorporate natural health remedies into their treatment plan will also reap the benefit of…

1. Enjoying better overall health.

2. Increased sexual health.

3. Losing weight.

4. Having no side-effects.

Why Circulation Cures Impotence

Over 90% of erectile dysfunction problems stem from poor circulation levels. E.D. pills solve the problem be synthetically making the arteries relax or boosting the heart rate to increase the problem. However, erectile dysfunction pills can sometime cause more harm than good if the sufferer is not in good health. And if you are suffering from E.D., there could be a greater problem than impotence you should worry about.

Thousands of deaths and cardiovascular complications have been reported after taking the drug Viagra and other E.D. pills. Though it is uncommon, there are better ways to boost circulation levels than E.D. pills.

In fact, there are well over 10 natural ways to boost circulation levels downstairs. Here is a list of 4 ways that some doctors are now using before the pill is prescribed.

Natural Erectile Dysfunction Remedy Tips

For every problem, there is usually a remedy when it comes to the body. In the case of poor circulation, you can use your diet, vitamins, supplements, breathing techniques, herbs and even hydration to cure your problem. Here are some tips that prescription companies do NOT want you to know about!

1. Your Diet – My Erectile Dysfunction Remedy Report goes into great detail of how your diet has an impact on your circulation levels. But here is a short summary about how you should modify your diet. You should stay away from high fat and high cholesterol foods. Eat simple meals that are not processed or fried. Eat a bigger breakfast, normal lunch and a small dinner. Your stomach is about the size of your fist and you should eat accordingly.

Remember that if you eat before sex, the circulation you need downstairs will be also working in your digestive tract to digest the food. It is important to eat smaller at night and before sex.

2. Zinc – Most people suffer from a zinc deficiency, and if so, you will most likely suffer from a sexual dysfunction like erectile dysfunctions. You should take a supplement of 15 to 30 mg of zinc daily. It would also be suggested that you take 1 to 2 mg of copper with zinc because the mineral interferes with copper absorption. You could notice a change in weeks.

3. Lifestyle Habits – How you live also affects your sex life. Here are some secrets to live by: stop smoking cigarettes and cigars (plaque in arteries), moderate caffeine, eat complex carbohydrates, exercise to generate a sweat, and laugh. Though you might think these are too simple; they will work wonders for increasing circulation levels.

4. Vitamin Therapy - The average diet is no longer getting us the right vitamins. For instance, most erectile dysfunction sufferers are Vitamin A deficient. Take a trip to your local store and find a quality Vitamin A supplement. Take the recommended daily dosage and you are on your way.

A Guaranteed Cure for Erectile Dysfunctions…Side Effect Free

If you are finally ready to make a commitment to your health and to your sex life (she will thank you), then it is time you cured your erectile dysfunction for good! Please take a moment and visit our Natural Erectile Dysfunction Remedy website today.

We offer a 100% guaranteed, step by step, Erectile Dysfunction Remedy Report that has helped thousands of men cure their problem with no side effects! It will teach you everything you need to know to cure your problem and prevent it from ever coming back. This 40+ page report is a fraction of the cost of one prescription of E.D. pills and can be sent to your computer in the next 3 minutes.

For the sake of your health, please visit us today!

Natural Erectile Dysfunction Remedy

Joe Barton and Barton Publishing offer you 22 years of natural health experience and a 100% guaranteed, research-driven, step by step Natural Erectile Dysfunction Remedy. Try it risk free today!

Posted in Erectile Dysfunction | Leave a comment

How Sildenafil Citrate Works

Sildenafil citrate facilitates erections in men with psychogenic diabetic, vasculogenic, traumatic, and surgical causes of erectile dysfunction. It is not an “orgasm pill/* does not increase desire, and does not facilitate erection in the absence of psychological or tactile stimulation. Nevertheless, all these factors are interrelated; indirect effects are probably observed. Simplistically, erection is the process of sequestering blood within the penis to increase its size and rigidity. Tactile or psychological stimuli, or both, can initiate or sustain the process.

The blood is predominantly sequestered in the corpora cavernosa, two connected spongelike bodies in the penile shaft. The corpora cavernosa comprise a network of arteries, veins, nerves, smooth muscles, and sinuoids (i.e., the spaces that actually fill with blood). The tunica albuginea is a thick, fibrous bilaycr sheath that surrounds the corpora cavernosa. As the corpora cavernosa fill with blood, the tunica albuginea stretches to its capacity. The veins that drain the corpora cavernosa are compressed against and between the layers of the tunica albuginea, preventing outflow. The bulbocavernous muscles at the base of the penis contract, which raises the pressure above systemic blood pressure and results in a rigid penis.

The lining of the corpora cavernosa and some penile nerves produce nitric oxide (NO). The NO induces the production of cyclic guanosine monophosphate (cGMP), which specifically causes penile smooth muscle relaxation. In a process that is still not completely understood, smooth muscle relaxation leads to the trapping of blood in the corpora cavernosa. The NO also causes the arterioles (small arteries) to dilate, increasing the blood flow into the corpora cavernosa. The cGMP is degraded by phosphodiesterase type 5 (PDE5), an enzyme predominantly found in the penis. When the cGMP is degraded, the smooth muscle returns to its resting (contracted) state, the outflow of blood increases, and the erection re¬solves.

Sildenafil inhibits the action of PDE5, allowing smaller amounts of cGMP to produce an erection and for that erection to last longer. Similarly, less NO is needed to produce an equivalent amount of cGMP.

Sildenafil has been approved only for use in men; research on its effects in women is ongoing. Preliminary results are conflicting. Initial investigations reported that Sildenafil increased lubrication, genital sensation, ability to achieve orgasm, and sexual satisfaction among women with complaints of sexual dysfunction. Application of topical Sildenafil was reported to improve arousal, genital sensation, and ability to reach orgasm in a small sample of women with sexual dysfunction. Others, however, have found little evidence thus far that sildenafil is useful in the treatment of sexual dysfunction in women. Kaplan, Reis, Kohn. Ikeguchi, Laor, Те, and Martins, for example, concluded, “Our data do not support the use of sildenafil in treat¬ing postmenopausal women with sexual dysfunction.” Its effects and uses for women remain to be fully elucidated. In addition, sildenafil for women carries the same risks of misuse as for males.

Posted in Sildenafil Citrate | Leave a comment

Feminist Sex Therapy in the Age of Viagra™

Pharmacological treatments of sexual dysfunction have opened a new and exciting area for clinical sexology and sex therapy. Used correctly they can help people to overcome fears of and actual sexual dysfunction. Used incorrectly, they can wreak havoc in the relationship or with the individual. The recent pharmaceutical debut of sildenafil citrate (Viagra™), and the ensuing stampede by male consumers to obtain it, is a significant historical moment in our collective sexual history. The advent of a medication that reduces the vulnerability of erections to some psychological and even medical causes of impairment provides many men with a “bionic” insurance policy against shame regarding their sexual performance.

Undoubtedly, many men and their partners are well-served by sildenafil citrate. Such couples are unequivocally delighted at the remission of erectile problems, enjoying their regained ability to lose themselves in the sexual encounter without worrying about erections. For other couples, sildenafil citrate uncovers relational dilemmas, revealing the inadequacy of the medicalized construction of sexuality. The impact of any new medical innovation that makes it easier for men to have erections and thus to have penetrative sex must be understood within the relational and social context.

Fueled by the media and the anonymity and accessibility of the Internet, millions of patients are requesting pharmacological solutions for erectile dysfunction. Clearly, not all individuals who would benefit from sildenafil citrate are availing themselves of it; conversely, many inappropriate prescriptions have been written. Our clients and the public in general will not be well-served if sildenafil citrate is used indiscriminately. Any intervention, including psychotherapy, can be misused or abused. Pharmacotherapy is no different. Sildenafil citrate is just the first in a series of drugs that will treat various sexual concerns. Sex therapists should familiarize themselves with the uses, abuses, and misuses of these drugs. Some patients will seek out a nonphysical to avoid confronting a physical defect or problem. The opposite is also true—patients who want to deny a psychogenic etiology of their dysfunction will present to a physician. The solution to this dilemma involves helping both sex therapists and physi­cians to incorporate these new medications in social and relational con­text.

Posted in Generic Viagra | Leave a comment

Feminist Sex Therapy

Feminist sex therapy has led the field in recognition of the costs of dismembering of sexuality from relational context. Tiefer identified the influences of the positivist approach and of biologically based explanations of human sexuality in the misdirection of sex therapy’s focus away from sex-role, relational, or psychological issues. Seidler-Feller ques-tioned the adequacy of sex therapy from a feminist perspective, citing the tendency to implicitly reinforce normative sex roles and the power differential between the sexes that underlies them. Tiefer also critiqued the DSM-III sexual dysfunction nomenclature as focusing exclusively on physical performance while omitting empirically based information on what women consider important in sexual life, including intimacy, negotiation, and communication. Tiefer adapted Reissman’s analysis regarding the negative consequences of medicalization for women’s sexuality, pointing out the processes of mystification, moral neutrality, and individualization of sexual problems inherent in the medicalized, traditional approach.

Mystification places definitions of “normal and healthy” sexual functioning in the hands of officially sanctioned experts rather than selfdefined enjoyment, more often reflecting these experts’ reality rather than women’s. When medical science alone defines the norms for sex, an objective reality is assumed, leading to a stance of moral neutrality in which “sex is no longer a human arena for negotiation, but an arena where there is an objective standard against which performance can be measured”. McCormick further identified the “nonconscious equation of sexual activity with reproductive potential” that influences clinicians to equate sexual dysfunction with “physical failures in the performance of intercourse”. In indhidualizniii sexuality and sexual problems, medicalization denies and obscures the effects of social contri-butions to people’s sexual complaints, including rigid sex roles, unrelenting standards of performance, relationships of unequal power, and histories of sexual victimization.

Tiefer recommended that feminist sex therapy include “corrective genital physiology education, assertiveness training, body image reclamation, and masturbation education.” McCormick also recommended that therapists treat individuals and couples for deficits in tenderness, poor communication, sexual selfishness, disinterest in oral sex, and unwillingness to cuddle, although she noted that deficits in these areas have not been assigned formal psychiatric diagnoses. A feminist approach to sex therapy uses existing scientific knowledge about biology, medical approaches, and empirically validated treatment techniques while adding the following ingredients:

  1. Recognition of social and cultural gender inequality;
  2. Recognition of the influence of this power differential in relationships, and a willingness to intervene at this level;
  3. Valuing equally the subjective and affective aspects of sexuality, relative to physical performance;
  4. Recognition of traditional sex roles as etiologic of many sexual problems, and a willingness to intervene at this level; and
  5. Recognition of the unique experiences of men and women regarding sexual socialization, experiences of sexual coercion, sexual decision making, and the influence of relational factors in sexual dysfunction.
Posted in Erectile Dysfunction | Leave a comment

Endocrine Causes Part 2

Evaluation for low testosterone involves a simple blood test. If low testosterone is diagnosed in a man with some of the aforementioned symptoms, consideration for testosterone replacement therapy is in order. The goal is to restore testosterone to normal levels and to treat the symptoms and signs of low testosterone with better libido and erectile function and improved energy, body composition (reduced fat, increased muscle) and increased bone mineral density. There are a variety of different means of testosterone replacement therapy (TRT). Oral replacement is not used because of erratic absorption and liver toxicity.

Injections are generally not the first-line means of TRT because of wide fluctuations in testosterone levels and injection site reactions. There are a number of gel formulations that are commonly prescribed including: Androgel; Testim; Axiron; Fortesta; additionally, many pharmacies will compound testosterone in gel or cream formulation at a fraction of the cost of the commercially available products. With the gels and creams, one needs to beware of skin-to-skin contact with the potential exposure of testosterone to others. There are scrotal patches: Testoderm and non-scrotal patches: Androderm, both of which can cause skin irritation. There is another formulation in the form of pellets that are injected into the fatty tissue of the buttocks: Testopel, advantageous in terms of its long-term efficacy (3-6 months) but disadvantageous in terms of the need for the minor procedure for implantation. There is a buccal formulation that is placed in the inner cheek or gum: Striant, a simple means of administration, but one that can cause gingivitis, interference with eating, drinking and dental hygiene.

Men on TRT need to be carefully followed to ensure that the testosterone is effective, adverse effects are minimal, and blood levels are in-range. Periodic digital rectal exams are important to check the prostate and in addition to testosterone levels, other blood tests are obtained including a complete blood count and PSA. Side effects of TRT may include the following:

  • Oily skin; acne
  • Sleep apnea
  • Breast growth
  • Increased red blood cell count
  • Lipid profile changes
  • Infertility—testosterone can be viewed as a male contraceptive
  • Testes atrophy
Posted in Erectile Dysfunction | Leave a comment

Endocrine Causes Part 1

Testosterone (T) is an important male sexual hormone that promotes the physical changes that commence at the time of puberty including pubic, axillary and facial hair, deepening voice, prominent Adam’s apple and increased bone and muscle mass. Throughout adulthood, testosterone helps maintain libido, masculinity, sexuality, and youthful vigor and vitality.

The lion’s share of testosterone is manufactured in the testicles, although a small percentage is made by the adrenal glands. Healthy men produce 6-8 mg testosterone/day in circadian pattern with a peak in early morning hours and lag in the late afternoon. There is a gradual decline in T that occurs with the aging process—approximately a 1% decrease each year after age 30. The decline will occur in most men, but will not always be symptomatic. Symptoms of low T may include one or more of the following: fatigue, irritability, depression, decreased libido, erectile dysfunction, ejaculatory dysfunction, decreased energy and sense of wellbeing, loss of muscle and bone mass, increased body fat, abnormal lipid profiles. Essentially, low T can accelerate the aging process.

There is a strong relationship between low T and Metabolic Syndrome. Metabolic Syndrome is defined as having three or more of the following: high blood glucose levels; abdominal obesity; high fats (triglycerides); low levels of the “good” cholesterol (HDL); and high blood pressure.

Obesity can have a pivotal role in the process leading to low T. Fat is not just fat—it is a metabolically active endocrine organ that does not just protrude from our abdomens in an inert state. Fat produces pro-inflammatory factors, hormones and immune cells—including cytokines—which function to inhibit T production in the testicles and the release of hypothalamus and pituitary hormones that govern the release of T. Low T is present in about half of obese men. Fat has an abundance of the hormone aromatase, which functions to convert T to the female hormone estrogen (E). The consequence of too much conversion of T to E is the potential for gynecomastia, aka breast enlargement.

Posted in Erectile Dysfunction | Leave a comment