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Doctors' Answers to "Frequently Asked Questions" - Impotence
Impotence [posted 1/7/99]
Answer: Could be the diabetes, the medications or a secondary cause. First, check your prolactin, TSH and testosterone levels. This will rule out secondary causes. Secondly, check with your doctor, but cut out or decrease the dosage of one of your meds one at a time a week or so. There is some risk here depending on whether you have angina and what your bp is. Lastly, consider viagra, which is very effective in diabetes and some medication induced impotence, but has some risk due to your previous coronary disease.
Impotence & Viagra [posted
Answer: Viagra should not be taken with nitroglycerin. Otherwise fairly safe if you don't over do it. When there is a soft erection, it usually works great. Have your thyroid function and testerone level checked. Both can cause this problem and are easily fixed with replacement meds which would not involve use of viagra.
Impotence Concerns [posted
Answer: First, diagnose the cause. This could be low testerone, high prolactin or low/high thyroid levels. If these are normal, I would check with an endocrinologist. Not usual for a young man and I would try to diagnose the cause.
Viagra or Caverjet Injections for
Erection Problems [posted 10/15/98]
Anser: Don't get an implant as long as the caverjet and/or viagra works. Try the viagra, sounds perfect for your problem.
Impotence & Carisoprodol
Answer: Probably the drug.
Impotence & Siunus Medications
Answer: No obvious connection-give it some time after your recovery.
Impotence Treatment with Oral
Phentalomil [posted 8/13/98]
Answer: Never heard of the drug or the organization. You might note that it cannot be prescription and I'm not aware of any non-prescription drug that works for impotence.
Impotence [posted 8/7/98]
Answer: Why did you stop the Procardia? It is a calcium channel blocker also, but works very differently from Norvasc. Try the procardia again unless there is a contraindication or take a holiday from the Norvasc for a day or two and see what happens to your sexual prowess.
Answer: There are three or four medications just about to be released for impotence. I suspect it will be available within the next six months.
Oral drugs for Impotence
Answer: I don't have enough experience with them as yet to tell you. At this point, I would check with a Urologist who specializes in erectile dysfunction.
Prescription Drugs and Impotence
Answer: Impotence with drugs is a very individual process. That is, what produces impotence in one will not in the other. Consequently, a selective approach by eliminating one at a time is a good place to start. Some classes like ACE inhibitors tend to be less, but no class is free of this problem. If you send me the names of the drugs, I can tell you what I'd start with. Certain drugs are more likely than others. Also, depending on the severity of the hypertension, etc... a drug holiday can work(that is, skipping the drugs once a week on those times that you'd like to have sex). Start by finding the drug that is causing the problem.
Answer: There are several reasons and they probably differ from individual to individual. Getting an erection is an incredibly complex undertaking. It takes just the right balance between the sympathetic and parasympathetic nervous system. It also requires sufficient blood pressure to extend the chambers of the penis necessary to obtain erection. Any blood pressure pill can interfere with either of the nervous systems or the blood supply. The only effective way to avoid the problem is to switch medications or take short drug holidays, depending on why you are on beta-blockers. This needs to be discussed with your physician.
Answer: Either of these can cause erectile dysfunction. Discuss this with his physician, but generally holding them for a day or two won't be a major problem. If this fixes the problem then add them back one at a time to see if either alone is causing the problem or if it is an additive effect. Many men will take 12-24 hour drug holidays to get an erection. However, this depends on why he is taking the drugs - is it for a serious problem? Also, switching to other drugs might eliminate the problem.
Answer: Trazadone would not be my first pick for impotence. The first step in evaluating impotence is to check the testosterone, prolactin, and TSH levels (for low thyroid). Each of these in the wrong levels (high or low) can cause erectile dysfunction. If these hormones are normal then evaluation of the vascular supply is next. There are several mechanical ways to attain an erection. You'll need to see a physician to utilize these. Antidepressants usually decrease sexual drive and the ability to have orgasm, but not erections per se. Often anxiety, depression, etc., will lead to erectile dysfunction. Treatment with Trazadone might help this type of dysfunction.
Impotency and Causes
Answer: Sounds good, but it is not true. However, not having sex for whatever reason can produce psychological blocks which will lead to impotency. I would focus on the reasons for not having sex rather than assess blame.
Answer: Accupril is an ACE inhibitor. Usually used for treatment of blood
pressure and other assorted problems. I'm not aware of any benefit from treating
allergies. However, it commonly causes erectile dysfunction.
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