Thursday, April 12, 2007

Depression And Erectile Dysfunction

Depression And Erectile Dysfunction
Canadian Health&Care Mall

Erectile dysfunction and depression are highly prevalent among men and the conditions coexist and interact in several ways that remain unclear. Erectile dysfunction is the inability to attain or maintain an adequate penile erection to penetrate the vagina during sexual intercourse. The relationship between erectile dysfunction and depression is complex. Some experts feel that the onset of erectile dysfunction causes some men to become depressed while others seem to think that the depression is the primary cause of erectile dysfunction.

Compare to men who do not have depression, men with major depression are about twice as likely as other men to have erectile dysfunction. Diminished libido and reduced sexual activity have been associated with depression as well. Men with major depressive disorder may experience the loss of nocturnal erections. Men with erectile dysfunction often feel inadequate and have diminished self esteem and tend to withdraw from their partners.

A hot area of erectile dysfunction research encompasses the possibility that successful treatment of erectile dysfunction may lead to improvements in depressive symptoms. The problem with treating the depression with SSRI anti-depressants such as Zoloft, Paxil, and Prozac, is that these particular types of medications often cause further sexual dysfunction by themselves and further diminish libido and worsen erectile dysfunction and sexual performance.

Another problem that should be ruled out when erectile dysfunction and depression are present is andropause (low testosterone levels). This alone can be the primary cause of both conditions.

If the testosterone levels are normal, a trial of one of the PDE-5 inhibitor medications (ie Viagra, Cialis, or Levitra) may be the most prudent thing to try initially. Even in a study conducted with men who had developed erectile dysfunction while on an SSRI (anti depressant medication), the results were rather clear. When compared with men in the placebo (fake pill) group, those assigned to the Viagra reported improvements in erectile dysfunction, arousal, ejaculation, orgasm, and overall satisfaction. Members of both the Viagra group and placebo group remained in remission from depression during the study, and the authors speculated that the use of Viagra might prevent men from discontinuing depression medication because of the sexual side effects.

The important thing to take from this is to seek help and determine what the cause is. The best news about it is that it can be treated successfully and there is no reason why any man cannot feel happy and have a healthy sex life as well.

Definition of Erectile dysfunction

Canadian Health&Care Mall
By Dr.Savitha Suri

Definition of Erectile dysfunction

Erectile dysfunction (ED) is the inability of a man to achieve or maintain an erection sufficient for his sexual needs or the needs of his partner. Erectile dysfunction is sometimes called as “impotence”.

The term "erectile dysfunction" can mean the inability to achieve erection, an inconsistent ability to do so, or the ability to achieve only brief erections.

Ayurveda defines Erectile dysfunction or ED as follows.

Sankalpapravano nityam priyaam vashyaamapi sthreeyam ||
na yaathi lingashaithilyaath kadaachidyaathi vaa yadi |
Shwaasaarthaha swinnagaatrshcha moghasankalpacheshtitaha ||
mlaanashishnashcha nirbeejaha syodetat klaibyalaxanam |

This means even though a man has a strong desire to perform sexual act with a cooperative partner , he can not perform sexual act because of looseness (absence of erection ) of his phallus ( penis). Even if he performs sexual act with his determined efforts he does not get erection and gets afflicted with tiredness, perspiration and frustration to perform sex

Physiology of erection

The two chambers of penis (corpora cavernosa,) which run throught the organ are filled with spongy tissue. The corpora cavernosa are surrounded by a membrane, called the tunica albuginea. The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The urethra, which is the channel for urine and semen runs along underside of the corpora cavernosa..

Due to sensory or mental stimulation, or both, the erection begins. Due to impulses from brain and local nerves the muscles of corpora cavernosa relax and allow blood to flow in and fill the spaces of spongy tissue.

The flow of blood creates pressure in the corpora cavernosa, making the penis expand. The tunica albuginea helps trap the blood in the chambers, thereby sustaining erection. When muscles in the penis contract to stop the inflow of blood and open outflow channels, erection recedes.

In ayurveda physiology of erection and ejaculation is described as follows

Vrishunow basthimedram cha naabhyuuru vankshnow gudam|
Apaanasthaanamantrasthaha shukra mootra shakrunti cha||

The “apaanavayu” one of the five types of vayu is located in the testicles, urinary bladder, phallus, umbilicus, thighs, groin, anus and colon. Its functions are ejaculation of semen, voiding of urine and stools”.

Shushruta explains the process of erection and ejaculation as “ When a man has desire (iccha) to have sex, his response to touch increases ( Vayu located in skin causes flow of signals from skin to brain, thus causing sensation of touch). This causes arousal or “harsha” . Arousal or Harsha intensifies actions of vayu and at this moment highly active vayu liberates the “teja “or heat of pitta. Thus tejas and vayu increase body temperature , heart beat and blood flow causing erection. “

Causes of ED

Erection requires a sequence of events. Erectile dysfunction can occur when any of the events is disturbed. Nerve impulses in the brain, spinal column, around the penis and response in muscles, fibrous tissues, veins, and arteries in and around the corpora cavernosa constitute this sequence of events. Injury to any of these parts which are part of this sequence ( nerves, arteries, smooth muscles, fibrous tissue ) can cause ED.

Lowered level of testosterone hormone: The primary male hormone is testosterone. After age 40, a man's testosterone level gradually declines. About 5% of men that doctors see for erectile dysfunction have low testosterone levels. In many of these cases, low testosterone causes lower sexual interest, not erectile dysfunction.

The whole male body responds to testosterone.
Even sushruta has illustrated about this response of body to the element “Shukra” . He has said

"yatha payasi sarpistu goodashchekshow raso yatha shareereshu tatha shukram nrinaam vidyaadhbishagwara"

This means " The shukra ( the element which helps in reproduction) is present all over the body .

This can be explained with the following examples.

1. The ghee is present in milk in an invisible form. This is extracted from milk using many processes.
2. The sugar is present all over the sugarcane. It is extracted by subjecting the sugarcane to number of processes.

Same way shukra is present all over the body. But the cream of shukra (semen) comes out of the body only during the process of ejaculation. But this process of ejaculation needs a joyful union of mind and body.
Decrease in production of “Shukra” causes erectile dysfunction.

Over exertion - physically and mentally : Working for long hours in office, mental stress at office and home, short temperedness ,insufficient sleep cause erectile dysfunction.

These causes are explained in ayurveda as "shoka chintaa, bhaya, traasaat .... " which means that erectile dysfunction or Impotence occurs due to grief, fear, anxiety and terror.

Strained relationship with sexual partner: Erectile dysfunction also occurs when there is a disliking towards sexual partner.

Ayurveda describes this as "naarinaamarasamjnatwaat..." means disliking for women.

Diseases that cause Erectile dysfunction: Neurological disorders, hypothyroidism, Parkinson's disease, anemia, depression, arthritis, endocrine disorders,diabetes, diseases related to cardiovascular system also become reasons for erectile dysfunction..

According to ayurveda the diseases which cause erectile dysfunction are "Hritpaandurogatamakakaamalashrama..." - Heart diseases , anemia , asthma , liver disorders , tiredness .Apart from these the imbalance in tridoshas also cause impotence or erectile dysfunction.

Consumption of medicines, drugs and tobacco: Using antidepressants, tranquilizers and antihypertensive medicines for a long time, addiction to tobacco especially smoking, excessive consumption of alcohol, addiction to cocaine, heroin and marijuana cause erectile dysfunction.

In ayurveda texts these causes have been said in brief as "rukshamannapaanam tathoushadham" - "dry food , drinks and medicines" cause impotence or erectile dysfunction.

Trauma to pelvic region: accidental injury to pelvic region and surgeries for the conditions of prostate, bladder, colon, or rectal area may lead to erectile dysfunction.

These causes are mentioned as abhighata (trauma), shastradantanakhakshataha (injury from weapons, teeth and nail.) in ayurveda.

Other reasons: Obesity, prolonged bicycle riding, past history of sexual abuse and old age also cause Erectile dysfunction.

Ayurveda describes the cause of impotence or erectile dysfunction due to old age as follows. " diminution of - tissue elements, strength, energy, span of life, inability to take nourishing food, physical and mental fatigue lead to impotence"

Remedies for ED

ED is treatable at any age. The total treatment in for impotence is called as “ Vajikarana therapy” in ayurveda. As this therapy increases the strength of a man to perform sexual act, like a horse, it is called 'Vaajikarana'. ( ' Vaaji'=Horse.)

Vaajikarana therapy leads to

• Happiness.
• Good strength.
• Potency to produce healthy offspring.
• Increased span of erection.

Eligibility for vajikarana therapy.

1. The vajikarana therapy should be administered to persons who are between 18 to 70 years of age.

2. These therapies should be administered only to a self controlled person. If this therapy is administered to a person who does not have self control, he becomes nuisance to society through his illegitimate sex acts.

Psychotherapy

Decreasing anxiety associated with intercourse, with psychologically based treatment helps to cure ED. The patient's partner can help with the techniques, which include gradual development of intimacy and stimulation. Such techniques also can help relieve anxiety when ED from physical causes is being treated.

Same treatment is illustrated in ayurveda. It has been said “A woman who understands a man and is liked by him, along with erotic environment act as best aphrodisiac. “

Drug Therapy

Numerous herbal preparations are mentioned in Ayurveda to treat ED or impotence. It has been said that people who have strong sexual urge, who want to enjoy sex regularly have to consume these preparations regularly to replenish the energy, vigor, stamina and strength. These preparations also supply the nutrients which are necessary for production of semen.

Ayurveda tips to overcome ED

1. Consuming herbal preparations to rejuvenate the reproductive organs.
2. Massaging the body with a herbal oil which gives a relief from physical exertion and also acts as aphrodisiac.
3. Practicing Yoga and Meditation to overcome mental exertion and to cope up with stress.
4. Sleep at least for 8 hours a day.
5. Avoiding the consumption of alcohol, tobacco, heroin etc.
6. Exercise regularly.
7. Avoid hot, spicy and bitter foods.
8. Favor sweets, milk products, nuts and urad dal.
9. Add little ghee in your diet.
10. Give a gap of four days between two consecutive intercourses

3 Ways To Fight Erectile Dysfunction

Canadian Health&Care Mall
3 Ways To Fight Erectile Dysfunction

1. Viagra (Sildenafil)

The most popular method amongst erectile dysfunction cases (around 90%). It is widely known that 70% of patients achieve success. Viagra takes effect in around 20-40 minutes, but sometimes takes 1-2 hours to take effect for some people. Sometimes it doesn’t even work at all.

However, Viagra is notorious for its common side effects. These include headaches, flushing, Dyspepsia (upset stomach), Nasal blockage, Urinary Tract infection, Abnormal Vision (sometimes blindness!), Diarrhea, Dizziness and Rashes. Basically you are vulnerable to these side effects while achieving better sexual function! This is generally not recommended because the negative effects outweigh the positive ones.

2. Horny Goat Weed

Also known as Epimedium, Horny Goat Weed is an odorless Chinese herb that has been used by practitioners for over 2,000 years, and is gaining popularity daily. The funny name came from hundreds of years ago when a farmer noticed his goats sexual behavior became more noticeable when they consumed this unknown weed – Epimedium, which was later named Horny Goat Weed. Amazingly Horny Goat Weed has no side effects.

Horny Goat Weed is basically a sexual enhancement pill like Viagra without the side effects. Users have also reported an increase in semen volume, and an overcome in sexual disorders. Horny Goat Weed is gaining popularity amongst erectile dysfunction patients, even now.

3. Herbal Alternative Viagra

These new pills are gaining popularity faster than any other pill. Called ‘Herbal Viagra’ or ‘Herbal Alternative Viagra’ these act more faster (15 minutes) and longer (up to 4 hours) than normal Viagra and work better without the side effects, since they are made from herbal ingredients. Most contain effective ingredients such as L-Arginine, an amino acid considered one of the most effective sexual enhancement nutrients ever. Some also contain Horny Goat Weed or Epimedium in their formula, which makes these products a better boost in sexual drive than any other product.

Erectile Dysfunction Or Impotence - What Is It About?

Canadian Health&Care Mall

Erectile Dysfunction is often referred to as Impotence. It means to the loss of a man's ability to maintain an erection during sex. It can include a reduced sense of sexual excitement, which in turn leads to a loss of an erection.

Love-Making and Getting An Erection

A man must be excited by one or more types of stimuli to succeed in achieving an erection. The stimulus may be psychological or physical both together.

Most often the stimulus can be what he sees or senses or even hears from his partner. On the other hand it can be his imagination producing thoughts and images that are of a sexual nature. Generally it is a combination of the both fantasy and reality.

Erections That Are Involuntary

All men will get what might be called an involuntary erection. This is when a man will achieve an erection that he has not chosen to have at that time. Most often a man will notice an involuntary erection when waking in the morning and before emptying his bladder. While asleep the bladder will fill with urine and this presses prostate gland. Stimulating the prostate gland brings sexual arousal and the result is an erection.

Similarly, there will be other times whether awake or asleep that a man will get an erection that is involuntary. Occasionally a man will be aroused by another person he has contact with. He will not seek to have an erection but because he is sexually stimulated he will experience an erection.

How Does the Body Achieve An Erection?

There are three chambers in the penis. These chambers expand with blood making the penis stiff and rise during an erection. The width and the length of the penis will get larger too.

When sexual stimulation (physical or imagined) or involuntary stimulation is present, the brain sends a message to increase the blood pressure in the body and to send blood to enlarge the penis. The three chambers in the penis fill with blood and the penis becomes hard and erect.

During sexual arousal, the penis stays enlarged and all the blood is prevented from escaping by muscles.

The body contains two specific action or relaxation systems; the parasympathetic and the sympathetic nervous system. Normally one or other of these systems are in ascendancy in the body at any one moment in time. For a successful erection the two systems are in balance.

This may give clues as to how psychological forms of impotence or erectile dysfunction can arise. During sex if a man thinks of an anxiety such as the possibility of losing his erection, it can tip the delicate balance between the parasympathetic and the sympathetic nervous system and the result may be a loss of erection.

Therefore impotence or erectile dysfunction is the loss of an erection through to ejaculation or desired completion of satisfaction for both partners.

There Are Three Good Choices For Treating Erectile Dysfunction

By Michael Connelly
www.savealotonpharmacy.com
There Are Three Good Choices For Treating Erectile Dysfunction

So you have decided that you are going to buy a PDE-5 inhibitor to treat your erectile dysfunction problem, but you are not sure which one would be right for you. The three that you have to choose from are Viagra (sildenafil, Pfizer), Cialis (tadalafil, Lilly/ICOS) and Levitra (vardinafil, Bayer). These three drugs are the only drugs approved by the FDA to treat erectile dysfunction. All three work in the same way to preserve high levels of the substance cGMP (cyclic guanosine monophosphate) that is produced when a man is sexually aroused. As long as there are high levels of cGMP an ample amount of blood flows to the penis and an erection can be sustained. PDE-5 (phosphodiesterase-5) is the enzyme that is responsible for breaking down cGMP, so the idea is to inhibit the introduction of this enzyme when an erection is desired. This can be accomplished with all three of the aforementioned products. However, there are some differences that exist between them that should be considered before you make your purchase.

There has never been a head-to-head clinical comparison of these three drugs, and this is due mainly to the fact that Cialis and Levitra are still relative newcomers to the world of PDE-5 inhibitors. Viagra on the other hand has been on the market for many years, and there have been over 30 million men treated with this drug and thousands of peer-reviewed articles written. Although there has never been an officially recognized comparison with these three drugs together, all three have been studied separately, and the results of these studies have yielded almost identical findings.

First, let’s talk about the similarities in these three drugs. The efficacy is approximately 70% with all three. Most men have successful results. Most importantly, they all appear to be safe as long as they are taken while following the proper instructions and guidelines. There are certain similar precautions that should be taken before using any of these drugs.

1. Tell your Doctor:

• About any allergies to medications.

• About any prescription or non-prescription drugs that you are currently taking, as well as any dietary or herbal supplements.

• About any surgeries you are planning to have in the future.

• About any nitroglycerin or long-acting nitrate you are taking for chest pains (may cause dangerously low blood pressure when taken with a PDE-5 inhibitor).

• About any alpha-blockers you are taking for prostate or blood pressure problems (may cause dangerously low blood pressure when taken with a PDE-5 inhibitor).

2. Read the instructions on the label carefully and follow them exactly as instructed.

3. Do not take any of these drugs more than once a day.

4. Ask your doctor or pharmacist to explain anything you do not understand. The side effects that are associated with Viagra, Cialis and Levitra are pretty much the same. The following side-effects can occur with some men, but they are not common:

• Headache

• Upset stomach

• Flushing (a warm feeling)

• Nasal congestion

• Changes in vision

• Back pain (mostly with Cialis)

Most of the time these side effects are mild, but if severe forms occur it is recommended that you contact your doctor.

If any of the following symptoms occur after taking one of these PDE-5 inhibitor drugs it is recommended that you seek emergency treatment at a hospital:

• Severe rash

• An erection that is painful

• A prolonged erection that lasts more than 4 hours.

• A fainting incident

• Any kind of chest pain

• Burning or itching while urinating

While the differences between these three drugs are subtle, there is one major difference that sets Cialis apart from Viagra and Levitra. The effects of Viagra last about four hours. Levitra lasts about five hours. However, the effects of Cialis on the other hand can last anywhere from 17-36 hours, which is the reason why it is often called “super Viagra” or the “weekender” erection drug. A man can take one 10mg pill on Friday and still be experiencing the effects on Sunday. This however does not mean that he will have an erection for the entire weekend. Cialis requires a man to be sexually stimulated to take effect, so an erection will only be obtained when he is thinking about sex. This is also the case with Viagra and Levitra.

There is one other difference that sets Cialis apart from Viagra and Levitra, and it is in the absorption rate. Viagra and Levitra absorb fairly rapidly in the blood stream. It takes between 30-120 minutes for these drugs to take effect. The absorption rate of Cialis is much faster, at about 15-30 minutes. While the absorption rate of Cialis is faster than the other two drugs, they are all highly protein bound drugs (96%). In plain terms this means that they will absorb faster when taken with a high protein meal. If you take them with a meal that has a high fat content, the absorption rate will be reduced.

One side effect that has been reported to occur with Viagra users that does not occur with the other two drugs is a tendency to experience a slight change in vision that causes the user to see things with a slightly bluish tint or hue. This effect goes away once the drug is out of the system.

Viagra, Cialis and Levitra are the best thing that ever happened to any man who is experiencing erectile dysfunction. They are safe, and they are the only PDE-5 inhibitors that are approved by the FDA. The benefits far outweigh the detrimental effects of using one of these drugs. The side effects are usually minimal and mild with most men. As long as these drugs are taken as prescribed following all of the instructions and guidelines closely, there are very minimal negative effects.