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Replacement androgens are available in oral, injectable, gels and transdermal preparations. Oral therapy is the least effective and the most likely to be associated with hepatotoxicity, even though this is a relatively small risk. Parenteral therapy is most likely to restore androgen levels to the reference range, but this therapy requires periodic injections, usually every 2 weeks, to sustain an effective level. Peak and trough levels are suggested when using injectable agents to avoid symptomatic troughs and supernormal peak levels. Weekly injections using lower doses can be used to minimize the wide swings in blood levels with less frequent dosing. Skin patches deliver a sustained dose and are generally accepted by patients. Androgen creams (AndroGel and Testim) are now available for daily topical use for male hypogonadism and have the advantage of minimizing the peaks and troughs of injectable agents. However, they require daily dosing and are relatively expensive.
The Pittsburgh team found that the genes for the "glial cell line derived neurotrophic factor" (GDNF) and the GDNF family ligand, called neurturin, were both effective in treating erectile dysfunction in the rats. The genes were placed in a genetically engineered herpes simplex virus, which was then injected into the rats' damaged cavernous nerve.
Erection begins with sexual stimulation. Sexual stimulation can be tactile (for example, by touching the penis), or mental (for example, by having sexual fantasies). Sexual stimulation generates electrical impulses along the nerves going to the penis and causes the nerves to release nitric oxide, which in turn increases the production of cyclic GMP (cGMP) in the smooth muscle cells of the corpora cavernosa. The cGMP causes the smooth muscles of the corpora cavernosa to relax, and allow rapid blood flow into the penis. The in-coming blood fills the corpora cavernosa, making the penis expand.
"It's an important message to get out," said Dr. Ira Sharlip, a spokesman for the American Urological Association. "There's an increasing body of knowledge that tells us that erectile dysfunction is a form of cardiovascular disease and often predates the onset of other forms of clinical cardiovascular disease, specifically coronary disease."
Conclusions: The study offers a quantitative estimate of the prevalence of ED and of its main risk factors in Italian men
Bob Dole is hawking Viagra. The ad, sponsored by the drugs manufacturer, Pfizer, seems to be everywhere in the print and broadcast media. Words like "courage" and "worthwhile" leap from the ad, as the former senator urges men to speak to their doctors about erectile dysfunction, the new term for impotence. In keeping with the current trend in prescription drug advertising, Viagra isnt mentioned in the ad. Instead, Pfizer is selling the illness of erectile dysfunction, or E.D., as it is referred to throughout the ad.
Oral erectile dysfunction (ED) drugs, which belong to a class of medications called phosphodiesterase 5 (PDE5) inhibitors, are widely used and highly effective but can cause such side effects as headache, upset stomach, nasal congestion, facial flushing and hearing and vision problems. Men who've recently had a heart attack or have severe heart disease have to use oral ED drugs with caution, if at all.
Health Tip: Why You May Have Erectile Dysfunction
Online supplemental material.
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.
K Sairam and T McNicholas are the principal authors. E Kulinskaya provided statistical support. D Hanbury and G Boustead edited and revised the manuscript
"At the present time, there is no consensus or standard of care for optimal management of the cardiac complications of dystrophinopathies, and further research in this area is clearly needed," Cwik said.
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