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Tobacco, alcohol or drug use: All three of these substances can damage a person's blood vessels and/or restrict blood flow to the penis, causing ED. Smoking in particular plays a large role in causing ED in people with arteriosclerosis.
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Methods and Resultsó We evaluated the prevalence of ED in 133 uncomplicated diabetic men with angiographically verified silent CAD and in 127 diabetic men without myocardial ischemia at exercise ECG, 48-hour ambulatory ECG, and stress echocardiography. The groups were comparable for age and diabetes duration. Patients were screened for ED using the validated International Index of Erectile Function (IIEF-5) questionnaire. The prevalence of ED was significantly higher in patients with than in those without silent CAD (33.8% versus 4.7%; P=0.000). Multiple logistic regression analysis showed that ED, apolipoprotein(a) polymorphism, smoking, microalbuminuria, HDL, and LDL were significantly associated with silent CAD; among these risk factors, ED appeared to be the most efficient predictor of silent CAD (OR, 14.8; 95% CI, 3.8 to 56.9).
But the potential impact on humans isn't clear, and Golombek said people shouldn't rush out to prevent jet lag with doses of Viagra. For one thing, Viagra can cause side effects such as low blood pressure.
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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.
The bottom line: Whatever it takes, experts say don't shut down the line of emotional communication, even if you have to put your physical relationship on hold. And most importantly, listen to your heart.
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Making life style improvements (for example; quitting smoking, and exercising more),
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Overall success rate of 40-50%
Talk to a sex counselor: If ED is straining your relationship, consider seeking care from a professional therapist.
Address correspondence to Anthony J. Viera, LT, MC, USNR, Family Practice Department, PSC 490, Box 9097, U.S. Naval Hospital, Guam, FPO AP 96538-1600. Reprints are not available from the authors.
Following completion of this phase, the physician should be able to determine the medical status of the patient, to identify and characterize the type of dysfunction, and to determine the need for additional testing such as penile or pelvic blood flow studies, nocturnal penile tumescence testing, or other blood tests. The patient's needs, expectations, and priorities should be discussed in order to decide about further management or referral.
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