There have been reports of heart attacks and sudden death in men who took Viagra, Pfizer’s brand of the drug sildenafil. This drug is a usually effective remedy for impotence, or erectile dysfunction, but safety concerns have prevented some men from trying it. A new report in today’s New England Journal of Medicine may alleviate some of this fear, although there are still cautions that apply to Viagra’s use in some heart patients.

A group of investigators from the University of Pennsylvania, led by Howard Herrmann, M.D., studied the hemodynamic (blood flow and pressure) responses of 14 men who underwent coronary artery catheterization for severe vessel narrowing. Measurements were made before, and then one hour after the men took 100 milligrams of sildenafil citrate. The average age of the men studied was 61. They were in a stable condition at the time of the study; thus, those who were on nitrates were able to temporarily discontinue the use of such medication, which should not be used with sildenafil.

The variables measured included blood pressure, pressure within the coronary arteries, and flow rates in the diseased arteries, as well as in normal-appearing arteries in the same patients. Pressure studies and arterial blood flow measurements were also conducted within the heart chambers and in the great vessels leading from the heart to the lungs.

The 14 men studied had one severely narrowed vessel, with an average narrowing of 78 percent, or more than three-quarters occluded. The responses to sildenafil in the narrowed vessels were compared to the responses in the normal vessels, in those men who had an accessible normal vessel — 12 out of the 14.

The results were that there were no clinically significant differences in the pressure-flow measurements before and after sildenafil administration, although there was a slight decrease in total body and pulmonary (lung) arterial blood pressure after drug ingestion. And there was lower flow through the diseased (narrowed) vessels than there was through the normal ones, as was to be expected. However, the narrowed vessels did not respond any differently to sildenafil than did the normal coronary arteries.

Erectile dysfunction affects up to 30 million men in the United States, and is more common in those with heart disease. Thus, it is to be expected that some men taking Viagra, especially older men, would experience heart symptoms during sexual activity. There may also be some men who use the drug incorrectly, perhaps by taking it while using nitrates, which can cause serious interactions and even death.

Hormone Replacement (ERT or HRT):
Replenishing the body with estrogen is an important step in treating menopause. Your doctor can help relieve the menopausal symptoms your are currently experiencing… and help protect you from the long-term problem of osteoporosis by prescribing treatment in the form of estrogen replacements therapy (ERT) or hormone replacement therapy (HRT).

ERT contains estrogen alone. It is usually prescribed for a woman who does not have a uterus. HRT contains 2 hormones—estrogen and progestin. Estrogen therapy given alone can cause a buildup of the cells of the lining of the uterus (endometrium), increasing the risk of a condition called hyperpasia. If left untreated, this condition could sometime lead to cancer of the uterus. Adding a progestin to estrogen therapy helps to prevent overgrowth of the lining of the uterus, reducing but not eliminating this risk.

Is replacement therapy right for me?
After carefully reviewing all of your symptoms, medical and menstrual histories, and your risk factors for osteoporosis, you and your doctor can determine if replacement therapy is right for you.

What risks are associated with hormone replacement?
All estrogen-containing products raise the risk for blood clots and gallbladder disease. These effects are due in part to estrogen’s interaction with the liver. In addition, women who still have a uterus are at increased risk for uterine cancer if they are unopposed estrogen. The addition of progesterone to women’s estrogen replacement therapy essentially resolves this risk.

How does hormone replacement therapy (HRT) effect the risk if breast cancer?
Between the years 1975 and 1995 there have been 33 studies conducted to determine the effects if HRT on breast cancer. Twenty-five (25) of the studies found either no effect or decreased risk of breast cancer in women on hormones. Eight (8) studies found a slight elevation in risk fir breast cancer in patients who took hormones for over 5 years. Interestingly, in the patients who did get breast cancer, there was a 16% reduction in mortality for the estrogen users as compared to the women who were not on hormone therapy and developed breast cancer.

In summary, the preponderance of the evidence suggests HRT does not raise the risk of breast cancer with short-term use. It may however slightly raise the risk for breast cancer with long-term use. The Women’s Health Initiative Study, due to be completed in 2007-2008, should answer this question more definitely in the future.

Does 0.625 mg of Conjugated Equine Estrogen work?
In multiple scientific studies, 0.625 mg of CEE has been shown to relieve symptoms, to improve bladder and sexual function, lower the risk of cardiovascular disease (50% reduction) osteoporotic fracture (60% reduction), Alzheimer’s Disease (30% reduction) and colon cancer (50% reduction).

Are there alternatives to Conjugated Equine Estrogen (CEE) and/or medroxy progesterone (MP)?
While CEE/MP have been very effective for millions of patients, approximately 30% of women who take these medications eventually stop them due to side effects of fear of breast cancer. Over the last 5 years, several new hormone replacement therapies have become available. These include naturally derived estrogen/ progesterone/ testosterone pills, patches, and creams.

When you’re having impotency, erectile dysfunction, do not be disheartened anymore, as this days you can buy vardenafil jelly that help you maintain your erection.

Erectile Dysfunction affects the lives of many men, and they don’t like to make it known. To contradict what Issacs believes, for a lot of men there is nothing that is worse than NOT being able to obtain an erection. It guarantees laughs on your favorite TV comedies, it’s a punchline for jokes, it’s blamed for failed marriages, and (what many men truly fear) it’s the subject of hush-hush conversations between women in restrooms around the globe. There are not many other conditions that carry the stigma that erectile dysfunction does. Are you suffering from a form of depression or social anxiety? There are numerous support groups that defend your right for acceptance, making you feel welcome and understood by society. Do you think you are suffering from erectile dysfunction? You are basically on your own, and you sure feel like you are. And this question may not always be posed so delicately. Even in your own mind, you may perceive the condition as not being able to ‘get it up!’

Erectile dysfunction — like depression and anxiety (which you hear about more often) — is more prevalent than most people think, and it is not a lifelong problem. In today’s culture, no one talks about Erectile Dysfunction, so the prevalence of the condition is probably underestimated, but statistics show that perhaps as many as one out of every ten men has Erectile Dysfunction. That would mean there are at least 30 million men suffering from one form or another in the United States alone. For men who have diabetes, the numbers jump to over half.

How do you know if you are suffering from Erectile Dysfunction? The basic explanation of erectile dysfunction as ‘being unable to obtain or keep an erection for pleasurable sexual activity’ seems to be unclear and not helpful — nearly all men feel unsatisfied with their bedroom activity at some time in their lives, even though they are in good health. It can be safely said that if a man makes 4-6 unsuccessful attempts out out of every 10 tries, then they have full-blown erectile dysfunction. If your erectile success is only around 50%, consider it to be a problem and see your physician.

As already suggested, diabetes can be an all-too-common cause of erection difficulties. Diabetes is connected with the destruction of the inner lining of the blood vessels, which leads to restricted blood circulation to the limbs and penis, making it impossible to support an erection.

Other causes that work in the same way are vascular diseases, high blood pressure, smoking, and anything else that can affect your circulation.

There are also causes that are not vascular in nature, like: surgical procedures (particularly prostate removal), nerve damage, endocrine problems (low testosterone levels – there is a blood test for this), drugs (narcotics, sedatives and alcohol), and emotional and psychological problems.

Both males and females tend to overlook some of the major factors that cause an unhappy sex life. These are also among the most difficult to treat, usually needing plenty of time, determination, regular meetings with a therapist trained in this area, not to mention support from family and friends. Some prescriptions for psychological problems may seriously affect a man’s sexual performance, so remember to read every label and all pamphlets very carefully.

What kind of medication or treatment you need will hinge on what’s causing your trouble. In older men, a hormonal imbalance is often the cause of erectile dysfunction. If this is determined to be the cause, testosterone supplements may be your best solution. Women reaching menopause are often prescribed estrogen supplements for similar reasons.

If you have a more serious medical issue, then you may consider taking prescription medication. PDE5 inhibitors work the best, and a lot of men prefer them since they don’t create an instant erection (this differs from other treatments that are discussed later on). PDE5 inhibitors function by inhibiting a substance in the penis that makes an erection come to an end. When used on a regular basis, they will enhance a growing erection — and more importantly, they will only have this effect when it is appropriate. Some of the well known PDE5 inhibitors are Viagra, Cialis, and Levitra.

If you don’t like the notion of swallowing pills on a regular basis and want a short-term solution, you may think about using a Vacuum Pump (you place your penis inside a plastic tube and use a hand pump to increase the blood flow to your penis — Mike Myers popularized this when he starred as the sex maniac, Austin Powers), or you can consider an Intra-urethral Suppository. With this, a small applicator is placed inside the tip of the penis that puts out a a small dosage of medication, which opens up the blood vessels. Men who prefer this method affirm that this not actually as painful as you might think.

You can purchase these treatments without a prescription, but you should consult with a physician to determine the true cause of your problem.

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