You may be wondering why alprostadil can’t just be applied directly to the penis as a topical agent instead of directly injecting/inserting it. A study conducted in 2006 in 1732 patients using a topical formulation did demonstrate some efficacy (though less than Caverject or Muse). Common side effects were burning sensation (for both men and women) though this was relatively low, with only 2.7% of subjects stopping its use. Currently, drug manufacturer Apricus Biosciences is looking to bring this formulation, named Vitaros, to market in the US (it is available in Europe at this time) but progress with regulatory approval has been slow. When and if this formulation makes it to the US market, it may be preferred by men who cannot take PDE-5 inhibitors.
Because the study included only subjects with dyslipidemia, the results may not be applicable to those with ED who have a normal serum lipid profile. Furthermore, patients using aspirin or NSAIDs were excluded to avoid the effect of these drugs in inhibiting prostaglandin D production, which may be one of the potential mechanisms for the effects of niacin on ED. It should be noted that it is quite common for ED patients to have coexisting cardiovascular disease that requires the use of aspirin. Therefore, further study on the interaction of aspirin and niacin in ED patients may be needed to establish the role of niacin in clinical usage.
You've probably heard of the old saying "use it or lose it". Your sex muscles are just like any other muscles. If you're not using them regularly (masturbation doesn't count) they will lose size and strength. This commonly happens as you age. Considering most people judge a healthy sex life to be 3-5 times per week, that's not a lot of use for these important muscle groups. Therefore, it's best to exercise the muscles which support a healthy sex life so you can enjoy sex well into your 80's.
A variety of personal habits and lifestyle choices have been linked to ED. In some ways, this is a good thing, since habits can be broken and choices reconsidered. What's more, many of the lifestyle factors that contribute to sexual problems are ones that affect overall health and well-being, both physical and mental. Addressing these factors, therefore, can have benefits beyond improving erectile dysfunction.
Sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis) and avanafil (Stendra) are oral medications that reverse erectile dysfunction by enhancing the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation.
Geraerts, I., van Poppel, H., Devoogdt, N., de Groef, A., Fieuws, S., & van Kampen, M. (2016, January–February). Pelvic floor muscle training for erectile dysfunction and climacturia 1 year after nerve sparing radical prostatectomy: A randomized controlled trial [Abstract]. International Journal of Impotence Research, 28(1), 9–13. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26538105
Many studies have been conducted on this topic; their results have been challenged by lack of controlled groups and non-randomization. Randomized controlled trials (RCTs) are generally accepted as the most valid method for determining the efficacy of a therapeutic intervention, because the biases associated with other experimental designs can be avoided.Non-randomized controlled trials, can detect associations between an intervention and an outcome. But they cannot rule out the possibility that the association was caused by a third factor linked to both intervention and outcome. Random allocation ensures no systematic differences between intervention groups in factors, known and unknown, that may affect outcome. Randomized controlled trials are the most rigorous way of determining whether a cause-effect relation exists between treatment and outcome and for assessing the cost effectiveness of a treatment (45, 22).
Yes, niacin is good for erectile dysfunction. Vitamin B3 or Niacin acts as a powerful agent to improve the condition of erectile dysfunction and a research study conducted in a medical center of Hong Kong confirmed that Niacin supplementation has resulted in the increase of blood flow across the pelvic region in men. In addition, researchers have further confirmed that the Vitamin comes with the ability to unclog various harmful fats collected in the artery region.
Returning to pellagra, Dr. Casal was the first to offer a clinical description of the disease. He called it mal de la rose due to the red rash seen on the hands and feet of sufferers. In fact, his account is now recognized as the first modern pathological description of a syndrome. This was the beginning of a progression of discoveries that led to the isolation of niacin in 1911, and its direct implication as the dietary deficiency factor in pellagra in 1937.
This study was designed to test the hypothesis that hydrochlorothiazide a diuretic used to treat hypertension depletes body zinc and thereby cause sexual dysfunction. Serum zinc and sexual dysfunction were measured in 39 middle aged hypertensive men who had been taking hydrochlorothiazide in average daily doses of between 25 and 50 mg daily for at least six months, and a control group of 27 unmedicated middle aged normotensive men. The medicated group had a higher incidence of sexual dysfunction (56 pc) as compared to 11 pc in the control group. The use of hydrochlorothiazide did affect serum zinc levels significantly in 20 patients. Sexual dysfunction occurred more often in older and overweight patients (p < 0.004). Three of the normotensive men experienced sexual dysfunction probably related to old age. Twenty two of the 39 on hydrochlorothiazide and experiencing sexual dysfunction were divided into two groups of 11 patients. Bloods were taken from the 27 normotensive and 22 hypertensive men receiving hydrochlorothiazide for the analyses of zinc. Subsequently one group of the patients were supplemented with zinc 500 mg daily for 30 days while the other group was supplemented with magnesium chloride 1 g daily for 30 days. The normotensive men were not treated. After 30 days, bloods were again taken from the three groups of analyses for zinc and magnesium. Serum zinc was significantly decreased (p < 0.05) by hydrochlorothiazide and a non significant decrease in serum magnesium (p = ns) was observed. After supplementation with zinc, the serum zinc levels returned to normal only in eight patients. There was improvement in the symptoms of sexual dysfunction in five patients. Two patients gained weight. Hydrochlorothiazide decreased serum zinc levels (p < 0.05) and was unchanged with magnesium supplementation but the serum magnesium returned to normal values. Improvement of symptoms of sexual dysfunction was positive in one patient. This study shows that low serum zinc levels may be associated with sexual dysfunction but the definitive role of zinc in the pathogenesis of sexual dysfunction will remain controversial.
In male rats, main olfactory epithelium (MOE) exerts an important role in regulating sexual behavior. Intranasal irrigation with zinc sulphate has been reported to destroy the MOE and completely abolish the sex behavior. In this study supplementation of zinc was done using a feeding tube and precautions were taken to avoid contacting nasal area. Hence the possibility of reducing sexual performance due to MOE disturbance is ruled out. Some humans experience gastrointestinal irritation with supplementation of zinc. If the same is applicable to animals it may be another possible explanation for the reduction of libido index with elevated doses of zinc. One drawback of our study is that we did not compare the weight of animals before and after treatment.
For many men, stopping smoking is an erectile dysfunction remedy, particularly when ED is the result of vascular disease, which occurs when blood supply to the penis becomes restricted because of blockage or narrowing of the arteries. Smoking and even smokeless tobacco can also cause the narrowing of important blood vessels and have the same negative impact.