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Erectile dysfunction or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. There are various underlying causes, such as diabetes, many of which are medically reversible.
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Hemoglobin A1c, serum chemistry studies, lipid profiles, and prostate-specific antigen levels should be obtained unless the patient has recently had these studies performed and the results are available.
If you use e-mail, you've probably also noticed that you get quite a bit of e-mail spam in your inbox that offers Viagra for sale. I haven't seen Pfizer do much of anything to try to halt Viagra spam, either. In fact, once again, it seems to be in the financial interest of Pfizer to allow the sales of Viagra through spam, because regardless of who buys the product or how it's sold, Pfizer generates profits from it anyway.
New nerve-sparing techniques aimed at lowering the incidence of impotence to 40% to 60% are now being developed and used in these surgeries. Temporary impotence is also associated with these procedures, even those in which nerve-sparing techniques were used. It can take as long as 6 to 18 months for full erections to return.
Sildenafil can cause hypotension (abnormally low blood pressure that can lead to fainting and even shock) when given to patients who are taking nitrates. Therefore, patients taking nitrates daily, even patients taking nitrates only once a day, should not take sildenafil. Nitrates are used most commonly to relieve angina (chest pain due to insufficient blood supply to the heart muscle because of narrowing of the coronary arteries); these include nitroglycerine tablets, patches, ointments, sprays, and pastes, as well as isosorbide dinitrate, and isosorbide mononitrate. Other nitrates such as amyl nitrate and butyl nitrate also are found in some recreational drugs called "poppers".
The trend has both its upside and downside, experts say.
Note: Clinical practice guidelines are “guides” only and may not apply to all patients and all clinical situations. Thus, they are not intended to override clinicians' judgment. All ACP clinical practice guidelines are considered automatically withdrawn or invalid 5 years after publication, or once an update has been issued.
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Erectile dysfunction seems to have become the proverbial canary in a coalmine, especially for older men. That's because it can be caused by any combination of various health problems that strike men later in life.
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Pfizer, which manufactures Viagra, analysed 2,383 suspected counterfeit samples forwarded to the company by law enforcement agencies between 2005 and 2009. It found that that a Hungarian sample contained amphetamine, a UK sample contained caffeine and bulk lactose and that printer ink had been used to colour some samples blue. Other samples contained metronidazole, which can have significant adverse effects when combined with alcohol."
During the session, the counselor will give the patient "assignments" to do at home, such as:
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