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In a second study based in Italy, researchers from four medical centers recruited 291 men who had both type-2 diabetes and silent CHD discovered by stress testing and confirmed by x-ray angiography. Of these subjects, 118 had erectile dysfunction at the beginning of the study. The study subjects were followed for four years with all instances of major adverse coronary events (MACE) documented. Results of the study indicated that those who had erectile dysfunction at the beginning of the study were twice as likely to experience a major adverse coronary event. This particular study also happened to conclude that taking a cholesterol-lowering statin drug reduced the risk for an adverse major coronary event by one third.
If this impotence treatment is not successful, what other options might you recommend?
These drugs should not be used with certain other medications, including nitroglycerin. When taken with nitroglycerin, a man's blood pressure can become dangerously low. Some men have died after taking these drugs with nitroglycerin.
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PDE-5 selective inhibitor. Inhibition of PDE-5 increases cGMP activity, which increases vasodilatory effects of NO. Effective in men with mild-to-moderate ED. Take on empty stomach approximately 1 h before sexual activity. Sexual stimulation is necessary to activate response. Increased sensitivity for erections may last 24 h. Available as 2.5-, 5-, 10-, and 20-mg tablets. Acts within 15-30 min and can be taken with food, although a high-fat meal can inhibit absorption. Half-life is 4.8-6 h.
A psychosocial examination using an interview and questionnaire may reveal psychological factors contributing to erectile dysfunction. The sexual partner also may be interviewed to determine expectations and perceptions encountered during sexual intercourse.
The men handling BPA were four times as likely to suffer from erectile dysfunction and seven times as likely to have difficulty with ejaculation, said De-Kun Li, a scientist at the Kaiser Foundation Research Institute, which conducted the study with funds from the National Institute for Occupational Safety and Health.
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"We as physicians should be asking about, and men should be reporting to their physicians, symptoms of ED, so it can be considered as we work to modify their risk -- treat blood pressure, cholesterol more aggressively, advise healthy lifestyle changes like exercise and healthy diet," he said.
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