No Magic Pill Will Provide All Erectile Dysfunction Treatment

Medications are not quite a magic pill to improve the sex lives of men with erectile dysfunction problems, a Deakin University study has found.
Hayley Matic conducted the study for her Doctor of Psychology (Health) with Deakin's School of Psychology under the supervision of Professor Marita McCabe. She found that while oral medications, known as PDE5 inhibitors, may restore a man's 'sexual function' they don't necessarily restore a man's 'sexual health'.
"As well as the obvious physiological aspects, men with erectile dysfunction (ED) suffer a range of problems such as significantly poorer self esteem, sense of masculinity, sexual satisfaction and relationship satisfaction," Dr Matic said.
"This study found that overall well being was not improved in the men who had used medical interventions for their erectile dysfunction."
Dr Matic's study explored the psychological and relationship impact of� � erectile dysfunction on the lives of Australian men and their partners. It also looked at men's help-seeking behaviour and experiences with oral medication as treatments for their ED. It involved 410 men with� � erectile dysfunction and 242 men without ED.
"Erectile dysfunction affects up to 50 per cent of men at some point in their lives and is generally treated with the use of oral medications," Dr Matic said.
"The focus on the medical and biological elements of� � erectile dysfunction has led to a relative dismissal of the role of psychological and relationship aspects of men's sexual experiences. As a result many men stop using the medications and continue to suffer ED as well as the associated problems with their masculinity, self-esteem and quality of life.
"Hopefully the results of this study will open up current mainstream treatments for this sexual dysfunction to include greater awareness of the psychological and relationship factors inherent in a man's sexual health."

Gene Therapy Reverses Erectile Dysfunction

Erectile Dysfunction Treatment

Rats with erectile dysfunction, or ED, that were injected with a gene therapy vector containing either of two nerve growth factors were able to regain normal function after four weeks, according to a study conducted by University of Pittsburgh School of Medicine researchers. These findings are being presented at the 10th annual meeting of the American Society of Gene Therapy, which is convening May 30 to June 3 at the Washington State Convention & Trade Center, Seattle.
Erectile Dysfunction is the repeated inability to achieve or maintain an erection necessary for sexual intercourse. Because of the variability of symptoms, estimates of the incidence of� � erectile dysfunction vary but range from 15 million to 30 million affected men in the United States.� � Erectile dysfunction is frequently associated with damage to the cavernous nerve that results from surgery for prostate cancer. Even if a patient receives a nerve-sparing procedure during surgery, recovery from ED after radical prostatectomy may take a long time.
In this study, which was led by Joseph C. Glorioso, III, Ph.D., chair of the department of biochemistry and molecular genetics, and Joel Nelson, M.D., chair of the department of urology, University of Pittsburgh School of Medicine, researchers inserted either the gene for the glial cell line derived neurotrophic factor (GDNF) or the GDNF family ligand (neurturin) into a genetically engineered herpes simplex virus (HSV). They then injected either of the recombinant viruses into the damaged cavernous nerve of rats. GDNF is an important nerve growth promoter and has been shown in other studies to contribute to survival and regeneration of penile nerves. Neurturin also is a nerve growth factor closely related to GDNF. Control mice received only the virus without the GDNF or neurterin genes inserted.
Four weeks after the treatment, rats administered HSV-GDNF exhibited significant recovery of intracavernous pressure (ICP) and systemic arterial pressure (AP) compared with rats treated with the control virus or untreated mice with erectile dysfunction. Rats treated with HSV-neurturin also exhibited significant recovery of ICP and AP compared with the control or untreated mice at four weeks after treatment. Fluorescent protein studies also showed that the delivered genes had been effectively incorporated into the target nerve cells.
According to Dr. Glorioso, HSV delivery of GDNF or neurturin presents a potentially important new approach for the treatment of ED. "Because the herpes virus persists in the nerve cell for as long as it is alive and nerve cells typically do not reproduce, this represents the first-ever demonstration of a long-term treatment for� � erectile dysfunction that does not rely on the chronic administration of drugs that can have potentially harmful side effects," he explained.

Treatment of Men with Erectile Dysfunction Improves Women's Sexual Function and Satisfaction

Treatment for Erectile Dysfunction

Couples Share Sexual Problems and Solutions
Couples share wine, movies, vacations and bedrooms.� � Do couples also share sexual problems and solutions?� � In the November issue of The Journal of Sexual Medicine, researchers have published the first-ever prospective, double-blind, placebo-controlled, multi-institutional treatment study with multi-dimensional psychometrically valid outcomes and concluded that an effective erectile dysfunction treatment in men also significantly improved sexual function and sexual satisfaction in untreated women partners.� � The research concluded that women partners' sexual function improvements related significantly and consistently to treatment-related improvements in men's erectile function.� � Furthermore, erectile dysfunction management should acknowledge that both members of the couple may be affected by erectile dysfunction and its treatment.
The research, in an article entitled: "Women's Sexual Function Improves When Partners Are Administered Vardenafil for Erectile Dysfunction: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial," published in The Journal of Sexual Medicine, involved 229 men with erectile dysfunction and their women partners for more than 6 months.� � The women completed baseline sexual function questionnaires including the Female Sexual Function Index, which has 19 questions concerning 6 domains: desire, arousal, lubrication, orgasm, satisfaction, and pain.� � Other outcome scales used included the Sexual Life Quality Questionnaire.
The couples were divided into two groups, those couples in which the men with erectile dysfunction received a safe and effective PDE5 inhibitor (vardenafil, Levitra) and those in which the men received placebo. There was no difference between the untreated women's sexual function scores in the two groups at baseline.� � After 12 weeks and approximately 20 intercourse experiences, the untreated women who were with men assigned to placebo were observed to have their sexual function scores fall in all domains.� � The untreated women who were with men assigned to effective erectile dysfunction treatment recorded significantly increased sexual function scores in all domains.� � The greatest increases in sexual function were noted in orgasm and satisfaction domains.
In this landmark research, the physiological changes in sexual function of one member of the couple (the untreated woman) were found to be significantly linked to the physiological changes in sexual function of the other member of the couple (the treated man with erectile dysfunction).� � There are limited studies in medical literature where a physiological function of one individual not receiving treatment is improved when another individual receives treatment to improve a physiological function.
Dr. William Fisher, co-author of the study and Professor of Psychology, and Obstetrics and Gynecology at the University of Western Ontario in London, Canada, noted that "Erectile dysfunction has never been only about a man, a pill, and a penis. It is often the case that a partner's sexual function suffers when a man experiences erectile dysfunction, and this research documents this fact and the welcome improvement of sexual function among women whose partners received effective treatment for their sexual problem."
"The most fascinating aspect of this study," said Dr. Irwin Goldstein, lead author of the research, "is that the women in the study were untreated and we observed that their physiology changed.� � Think of this for one minute.� � These are the first ever data that show physiologic changes in lubrication, orgasm and arousal in an individual who was NOT TREATED."

FDA Approves Cialis For Treatment Of Erectile Dysfunction

FDA has approved Eli Lilly and Company’s Cialis (tadalafil) for once daily use (2.5 mg and 5 mg), an oral medication taken once per day to treat erectile dysfunction (ED). When Cialis for once daily use is taken daily, men can attempt sexual activity at anytime between doses.
Currently available in parts of Europe, this low-dose daily treatment option of Cialis may be most appropriate for men with ED who anticipate more frequent sexual activity (e.g. twice weekly). For other men, Cialis taken as needed – the previously approved dosing regimen – may be most appropriate.
In clinical trials, when taken without restrictions on the timing of sexual activity, Cialis for once daily use improved erectile function over the course of therapy.
"ED can be a chronic condition like diabetes or high blood pressure," said Ridwan Shabsigh, M.D., Director of the Division of Urology at Maimonides Medical Center in New York. "As a urologist, I know couples like to have choices and will appreciate the availability of Cialis for once daily use."
Cialis for use as needed transformed the U.S. ED market when it was approved in 2003 as the first and only PDE5 inhibitor clinically proven to provide sustained efficacy for up to 36 hours. Cialis for once daily use provides a new option for men who may be looking for a dosing option that can be taken without regard to timing of sexual activity. In consultation with their physician, patients now have the freedom to choose the dosing regimen that is appropriate for them.
"We strive to provide patients with solutions that fit their needs and Cialis for once daily use delivers on this promise," said Shawn Heffern, Cialis U.S. Director of Brand Marketing at Lilly. "Now, patients have two options – some may prefer the up to 36 hours of efficacy provided by Cialis for use as needed while others may want the unique benefit provided by this daily dosing option."
Additionally, Lilly’s wholesale pricing for Cialis for once daily use will be comparable to Cialis for use as needed such that patients who currently use two or more pills per week of Cialis for use as needed should not experience higher treatment costs with Cialis for once daily use.
The FDA’s approval of Cialis for once daily use was based upon the evaluation of the comprehensive data package for the daily dosing option. The data include results from three phase III randomized, double-blind, placebo- controlled studies. Men with ED who participated in these clinical studies and who took tadalafil 2.5 mg and 5 mg once daily without regard to their timing of sexual activity experienced improved erectile function compared with those taking placebo. Cialis 5 mg, 10 mg and 20 mg have been approved in the United States for as-needed treatment of ED since November 2003.
The most commonly reported adverse events were headache, indigestion, back pain, muscle aches, nasal congestion, flushing and pain in limb. Most adverse events reported with tadalafil were transient and generally mild or moderate.

Treatment Options for Erectile Dysfunction

Erectile Dysfunction Treatment

What is Erectile Dysfunction?
Erectile dysfunction is defined as the inability to attain and/or maintain an erection suitable for intercourse.

What are the causes of erectile dysfunction?

Erectile dysfunction can be caused by a number of factors, including the following:

• Vascular disease--Blood supply to the penis can become blocked or reduced as a result of vascular diseases such as atherosclerosis (hardening of the arteries).
• Nerve disorders--Nerves that send impulse to the penis can become damaged from stroke, diabetes or other causes.
• Psychological states--Such as stress, depression, and performance anxiety.
• Trauma--Such as from injury.

Chronic illness, medications and Peyronie's Disease (scar tissue in the penis) can also cause erectile dysfunction.

How is erectile dysfunction treated?

The first step to treating erectile dysfunction is finding the underlying cause, then the appropriate treatment can be given. If the problem continues after treatment, there are a number of nonsurgical treatments that can help you gain and maintain erections.
Nonsurgical Treatments

Oral Corporeal Pharmacotherapy

Viagra (sildenafil) is the first oral medication for erectile dysfunction ever approved by the Food and Drug Administration. It was approved in March 1998 and should be available in pharmacies soon. The medication is taken about one hour before sexual activity. It will be available in three dose sizes: 25 milligrams (mg), 50 mg and 100 mg. Most men will start on 50 mg. Men who are on medications that contain nitrates such as nitroglycerine, should not take Viagra. The combination of Viagra and nitrates can cause low blood pressure (hypotension). The most common side effects of Viagra are dyspepsia (indigestion), nasal congestion, flushing, headaches and a transient visual disturbance. There have been no reports of priapism (prolonged, painful erection) with Viagra therapy.

Vacuum Constriction Device

The vacuum constriction device is a cylinder that is placed over the penis. The air is pumped out of the cylinder, which draws blood into the penis and causes an erection. The erection is maintained by slipping a band off the base of the cylinder and onto the base of the penis. The band can stay in place up to 20 minutes. The vacuum device can be safely used to treat most causes of erectile failure. Lack of spontaneity and cumbersomeness of the device seem to be the biggest concerns of patients.

Intracavernosal Injection Therapy

This type of treatment is more commonly known as penile self-injection. Using a tiny needle and syringe, you inject a small amount of medication into the side of the penis. The medication relaxes the blood vessels, allowing blood to flow into the penis. This treatment has been widely used and accepted since the early 1980s. The three most commonly used medications are prostaglandin E1 (alprostadil) and papaverine and phentolamine (Resitine).
Injection therapy is effective in treating a wide variety of erection problems caused by blood vessel, nerve, and psychological conditions. The most common adverse side effects are pain and penile scarring (fibrosis). Patients with cerebral vascular disease or severe cardiovascular disease may not be able to tolerate the dizziness and high blood pressure occasionally encountered with injection therapy. A painful erection that lasts longer than 2 to 3 hours (priapism) can occur but can be lessened with proper dosing and by following the treatment guidelines.

Transurethral Pharmacotherapy

For this treatment, which became available a little over a year ago, you place a suppository into the urinary tube (urethra) using a plastic applicator. The suppository contains the medication alprostadil (MUSE), which is absorbed into the blood stream. MUSE relaxes the blood vessels, allowing blood to flow into the penis. MUSE is available in four dose sizes: 125 micrograms (mcg), 250 mcg, 500 mcg, and 1000 mcg.
MUSE appears to be less effective than either injection or vacuum therapy. MUSE can be used to treat erectile dysfunction due to a wide variety of causes. Patients with urethral problems must use special care when using this treatment, since the suppository is placed directly into the urethra.