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    • Treatment Through Gymnastic Exercises

      The exercise is used for adjusting the front part of the brain. II exercise. This exercise is like the first one, but the left arm is raised up under an angle of 45° from the shoulder level and the right one is to be let down under the same angle, at which you squat six times. During that exercise, focus your mind on the heart. The exercise serves for regulation of the emotions. III exercise. Bring both arms back, palms facing each other, and row forward, at which squat 6 times. During that exercise, focus your mind on the spine. The exercise serves for regulation of the spine. IV exercise. Raise the left arm up and forward to the east,...

    • A Wife’s Important Role in Helping Her Husband Overcome

      Impotence In any relationship, a male sexual impotence can take place at some time or other in all relationships. When this happens it not only affects the man, but al­so the woman feels distress. Yes, impotence can deprive the wife of sexual plea- sure and cause personal and psychological distress as well. The good news is, there are steps couples can take to overcome male erectile dysfunction and improve their sexual intimacy. And, the woman can play a significant role to help his husband! There’s no need to try to ignore sexual dysfunctions or suffer in silence when there are ways of achieving satisfying sexual relations for the both of you. Here are some helpful tips a wife can do...

    • Blood Pressure – The Silent Killer

      What Are the Complications of Raised Blood Pressure? For many years raised blood pressure may cause no symptoms. Occasionally, raised blood pressure can be associated with headaches and nose bleeds, but usually only when the blood pressure is very high. However, high blood pressure makes the heart and arteries work harder, causing damage over the years. This can lead to a heart attack or stroke at an early age. Fortunately, treatment can reverse most of these effects. However, raised blood pressure can have devastating consequences by putting extra strain on the system over a long period of time. These complications can include blindness, kidney damage, heart attacks and mini-strokes, as well as full-blown strokes. These complications can come on suddenly...

    • Cardiovascular Side Effects: Theory or Clinically Relevant?

      Soon after the approval of sildenafil for treatment of ED, several reports of adverse events temporarily related to use of sildenafil raised concerns regarding the safety of PDE-5 inhibitors, particularly in patients with cardiovascular disease. However, detailed statistical analyses, considering that the patient population using these agents is characterized by a high prevalence of cardiovascular risk factors, did not confirm an increased cardiovascular risk of sildenafil use. Neither prospective clinical trials nor retrospective analyses revealed an increased risk for sildenafil alone or for vardenafil or tadalafil. Some theoretical concepts were initially suggested to explain the cardiac events in men taking PDE-5 inhibitors. Direct effects of PDE-5 inhibitors in altering myocardial contractility, altered response of the heart to adrenergic stimulation by...

    • Effects in the Cardiovascular System (part 2)

      There is another class of agents requiring special attention: α-blockers (e.g., doxazosin, terazosin, or tamsulosin) used as antihypertensive agents or in the treatment of benign prostate hyperplasia because of potential enhancement of blood pressure-lowering effects. For vardenafil, tadalfil, and sildenafil, the label precaution is used for a combination with α-blockers—especially with higher doses. No more than 25 mg of sildenafil should be taken within a 4-h window with an α-blocking agent. In summary, the three available inhibitors of PDE-5 are well-tolerated by most of the cardiovascular patients, and blood pressure-lowering effects are mild. Generally, a base-line blood pressure of more than 90/60 mmHg should be a prerequisite for PDE-5 inhib-itors (or any vasodilator) to be applied. Various antihypertensive agents can...

    • Effects in the Cardiovascular System

      Because smooth muscle cells of both the arterial and venous system contain significant amounts of PDE-5, blood pressure-lowering effects of the three agents are especially important. In a study by Zusman et al. oral administration of sildenafil resulted in a non-dose-dependent reduction of arterial systolic and diastolic blood pressure of 7 to 10 mmHg. These mild blood pressure-lowering effects were similar in patients with hypertension; small reductions in blood pressure were also observed with vardenafil and tadalafil. Most importantly, combination with a broad spectrum of antihypertensive agents was well-tolerated, as investigated in several studies in normotensive and hypertensive patients. However, there are two important exemptions: Nitrates or any drug serving as a nitric oxide donor must not be combined with...

    • Sildenafil, Vardenafil, Tadalafil: Basic Mechanism of Action

      For the physician interested in cardiovascular issues, PDE-5 inhibitors, now broadly used for the treatment of ED, are a highly interesting class of agents. Sildenafil, the first available agent for treatment of ED, was initially developed to find a novel anti-anginal concept. Although its anti-anginal potency was not promising in the first clinical studies, the “side effect” of enhancing penile erections soon became the main target of further clinical research. In several tissues, smooth muscle cells relax in response to nitric oxide (NO), which stimulates the enzyme guanylate cyclase, resulting in increased intracellular concentra-tions of cyclic guanosine monophosphate (cGMP). PDE-5, the major target of the PDE-5 inhibitors sildenafil, vardenafil, and tadalafil, catalyzes the breakdown of cGMP. There-fore, in tissues containing...

    • ED: First Warning Sign of Silent Cardiovascular Disease?

      A detailed medical history, including sexual and psychosocial history and an updated list of the medications, should be obtained from any patient seeking help for ED. As mentioned earlier, because of the close association between cardiovascular risk factors and ED, searching for potential cardiovascular disorders in these patients appears worth-while. In some cases, ED may be a warning sign of silent cardiac disease before symp-toms of heart disease are present. Among patients with type 2 diabetes mellitus, ED was identified as a highly efficient predictor of silent coronary artery disease apart from traditional risk factors such as smoking, micro-albuminuria, and lipid abnormalities. Furthermore, a strong association between endothelial dysfunction of peripheral arteries (measured as vasodilation of the brachial artery) and...

    • Erectile Dysfunction – Conclusion

      ED is highly prevalent among men, regardless of geography or ethnicity. Its prevalence and incidence are associated with aging, cardiovascular disease, diabetes, hyperlipid-emia, lifestyle issues (such as smoking, alcohol abuse, obesity, and sedentary lifestyle), depression, pelvic surgery, neurological disorders, trauma, symptoms of benign prosta-tic hyperplasia, side effects from medication, and psychological and interpersonal factors. The severity of ED is also a prognostic marker of important medical diseases. ED has a significant negative impact on the quality of life of patients and their partners. Treatment-seeking behavior is influenced negatively by certain barriers, including the belief that ED is a normal part of aging, denial, and embarrassment.

    • Treatment – Erectile Dysfunction

      In the Cross-National Survey on Male Health Issues, the aim was to describe the motivators and barriers influencing treatment-seeking behavior in men with ED. Screening included 32,644 men. Follow-up questionnaires were completed by 2831 men who suffered from ED. Men were recruited in waiting rooms in general practice offices. Treatment-seeking among men who suffered from ED was highest among Spanish men (48%) and lowest for German and Italian men (27 and 28%, respectively). Rate of cur-rent ED medication use among men suffering from ED was quite low across all countries, ranging from only 8% in France and Italy to 14% in the United States. The top three barriers to seeking ED treatment were the belief that ED was a normal...

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