May 22, 2007 — Medications commonly used to treat erection problems in men
may also relieve the bothersome urinary symptoms associated with an enlarged
prostate gland, cialis vs viagra
say.

Studies on the topic were presented this week at the annual meeting of the
American Urological Cialis strong viagra vs
in Anaheim, Calif.

“Before, we looked at these two conditions as two different
diseases,” says Kevin McVary, MD, professor of urology at Northwestern
University Feinberg School of Medicine in Chicago, who moderated a press
briefing.

But in the past three or four years, he says, the thinking among urologists
has changed.

Sexual performance in men seems to decline as their prostate erectile dysfunction tabs

becomes more severe, experts have begun to notice. Doctors also notice
that men with milder prostate problems often have less erectile dysfunction
(ED) than do those with moderate or severely enlarged prostates and urinary
symptoms.

“These two diseases — erectile dysfunction and the lower urinary tract
symptoms associated with benign prostatic hyperplasia — are probably
linked,” McVary says.

Conditions Increase With Age

Prostate problems and ED problems both tend to increase with age. About 31%
of men aged 50 to 59 have an enlarged prostate (also known as benign prostatic
hyperplasia or BPH); 44% of those 70 and older have an enlarged prostate,
according to the National Institutes of Health. As the gland enlarges, it
constricts the urine-carrying tube called the urethra, making it difficult to
empty the bladder.

Common symptoms of BPH include weak urine stream, leaking or dribbling,
feeling that the bladder hasn’t emptied completely after voiding, and more
frequent urination.

Medications are prescribed to relieve the symptoms. Some medications work by
relaxing the muscles at the neck of the bladder and prostate; others inhibit a
hormone that contributes to the growth of the gland.

Erectile dysfunction, defined as an inability to get or keep an erection, is
experienced by 20% to 46% of men aged 40 to 69, according to the NIH.
Medications to treat erection problems help increase blood flow to the penis
when a man is sexually stimulated.

Cialis Study

A once-a-day dose of Cialis helped men with erectile dysfunction and
moderate to severe urinary tract symptoms due to an enlarged prostate improve
sexual functioning, says Marc Gittelman, MD, a urologist in Aventura, Fla., and
a study researcher.

Of the 281 men who enrolled in the study, “81% were sexually active, and
they were in their low 60s,” he says. All had moderate to severely enlarged
prostates and urinary problems; 68% of the sexually active men had a medical
history of erectile dysfunction. Gittelman’s team assigned about half to take
placebo and half to take Cialis.

At the end of 12 weeks, men who took Cialis — first 5 milligrams a day and
then up to 20 milligrams — had significantly higher scores on a standard index
of erectile function, he says.

He especially wanted to see if they were as likely to do well if their
urinary problems were severe as opposed to moderate. “They are equally
statistically likely to respond to a dose of Cialis,” he says.

The study was funded by Lilly, which is the maker of Cialis.

In another study, 223 men aged 45 to 64 who had urinary symptoms due to an
enlarged prostate were assigned either to a group given 10 milligrams of
Levitra twice daily for eight weeks or a placebo for the same time period.

Compared with placebo, treatment with the ED drug significantly improved the
men’s quality-of- life scores and their reports of urinary obstruction and
irritation, says Boris Schlenker, MD, a urologist at
Buy generic online viagra
Hospital in Munich, Germany, who presented the
data. Erectile function improved in those who took the ED drug.

“Levitra is a promising new drug for men with lower urinary tract
symptoms, but we need long-term data on how it might affect the progression of
the disease,” he says.

The Viagra Study

In a third study, McVary assigned 369 men aged 45 and up who had both
erectile dysfunction and lower urinary tract symptoms to take either 50
milligrams of Viagra every night, 50 milligrams of Viagra an hour before
planned sexual activity, or to take a placebo. The dose increased to 100
milligrams after two weeks.

When he evaluated their erectile function and urinary symptoms, he found 73%
of the men with severe symptoms improved to having mild or moderate symptoms at
the end of the study.

“The changes in prostate symptom scores were dramatic,” he says.
“They compete with alpha blockers.” Alpha blockers are one type of drug
commonly prescribed to treat urinary symptoms associated with an enlarged
prostate. The more severe the urinary symptoms, the greater the
relief, he says.

The study was funded by Pfizer, which is the maker of Viagra.

“This really is cutting-edge,” says Gittelman.

The experts aren’t sure if the ED drugs will eventually supplement or
replace drugs used for urinary problems associated with an enlarged prostate,
or if new formulations might be developed to deal with both conditions.

Some men on the ED drugs did report side effects, says Schlenker, with the
most common in his study being headache.

It’s not known exactly why the ED drugs also help the urinary symptoms,
McVary says. By increasing blood flow to the pelvic area, the ED drugs may help
relax the bladder enough to relieve the urinary problems.

Medication Choices

Estrogen. If you only have vaginal
dryness and irritation (and not other symptoms such as hot flashes), you can
use a limited amount of
estrogen in a cream, tablet, or ring in the vagina.
The daily estrogen makes your tissue less thin and sensitive and more moist.
Many women find that using a cream or tablet twice a week is enough. This may
increase vaginal tone and lubrication, which will decrease
vulvar dryness, irritation, and shrinkage (atrophy).

If you also have other
menopausal symptoms that affect physical and mental
well-being, talk to your health professional about taking daily (systemic)
estrogen therapy.
Estrogen can increase the blood flow in the
vagina, as well as reduce hot flashes and other
symptoms of
menopause.
Estrogen therapy or
estrogen-progestin therapy can be oral (pills),
vaginal, or transdermal (with a patch). In a small number of women, hormone
therapy causes heart disease, breast cancer, dangerous blood clots, stroke, and
dementia. Talk to your health professional about whether this therapy is right
for you.

Testosterone. This hormone may play a part
in a woman’s sex drive and cheapest cialis generic viagra
. The ovaries make
buy now online viagra
throughout a woman’s lifetime. Women have
the most testosterone in early adulthood; testosterone levels drop by half
between the early 20s and the early 40s.

In women who have their ovaries removed (oophorectomy),
testosterone drops by 50%.¹⁰ If you have had an
oophorectomy, your health professional may suggest trying
testosterone therapy. But the U.S. Food and Drug
Administration (FDA) has not approved any testosterone therapy for women.

What To Think About

The fast generic shipping viagra
formula called Estratest is
not approved by the FDA. The company that makes it
markets it for moderate to severe
menopausal symptoms. It is also prescribed to some
menopausal women to improve sexual desire and
response. But Estratest is made with
methyltestosterone, which the body uses differently than testosterone. It does
not directly raise the amount of testosterone in your body. And, taking a
testosterone by mouth does put you at risk for problems with your liver and
possibly your heart. Using a patch or cream does not.

At this time, there is no testosterone pill, patch, or cream
approved for women-those made for men have too high a dose for women. Side
effects of too much testosterone include acne, facial hair, and loss of hair
and a deepening of the voice, which may be permanent.

No studies have looked at the benefits and risks of taking
testosterone for longer than 6 months. The long-term effects of testosterone
therapy in women are not known.¹⁰

Sildenafil (Viagra) is used to treat
erectile dysfunction in men. The maker of this
medicine has decided not to market it for improving women’s sexual desire and
arousal. This was based on research showing that sildenafil was not effective
for most women. The maker has commented that women’s sexuality is a complex mix
of physical, emotional, and generic viagra overnight delivery
factors, and it is not as simple to
treat with a medicine as male erectile dysfunction is.¹¹

Currently no medications are approved by the FDA to treat female
sexual problems, although several paths are being studied, including
cause of male impotence of certain molecules (receptors) in the brain and increasing blood
flow to the genitals. It is still too early in the process to know whether any
of these medications will prove to be effective and safe treatment
options.¹²

Seek care erectile dysfunction tablets
if you have taken
erectile dysfunction answers
5 inhibitors (such as Viagra,
Levitra, or Cialis) in the past 24 hours and are having chest pain. Tell your
health professional you are taking this medication. Do
not use any form of dysfunction pill
if you have chest pain and have taken
Viagra, Levitra, or Cialis in the past 24 hours.

Call a health professional if erection problems occur with:

• Any type of injury to the back, legs, buttocks,
  groin, penis, or testicles.
• A loss of pubic or armpit hair and an
  enlargement of the breasts.

Make an appointment to see a health professional within 1 to 2
weeks if an erection problem occurs more than 25% of the time and the
problem:

• Occurs with a persistent
  backache.
• Occurs after you start taking a new medication or change
  the dose of a medication.
• Is affecting your self-image or sense of
  well-being.
• Has not improved despite self-care.

If your erection problem is occasional, there is no reason to call
your health professional. If it occurs frequently but does not bother you or
your partner, you may or may not choose to call your doctor. However, an
erection problem that develops suddenly may be a sign of a disease; it is
recommended that you see your doctor.

Watchful Waiting

Watchful waiting is a period of time during which you and your
health professional observe your symptoms or condition without using medical
treatment. A single episode of an erection problem is often a temporary and
easily reversible problem. Do not assume it will happen again. If possible,
forget about it and expect a more successful experience the next time. If you
or your partner is concerned about it, talk about the problem and openly
discuss your fears and anxieties.

If self-care has not helped after 2 weeks and you are concerned
about your inability to have an erection, see a health professional who has
experience in dealing with erection problems.

Who To See

Some health professionals, including doctors and mental health
professionals, may not feel generic viagra soft tab
discussing sexuality and erection
problems. Ask your health professional if he or she feels comfortable with and
has experience in working with men who have erection problems.

The following health professionals can evaluate symptoms of
erection problems:

• Family medicine
  doctor
• Internist
• Nurse
  practitioner
• Physician assistant
• Urologist

If it is possible that a ed medicine
problem is contributing to
your erection problem, your doctor may refer you to a health professional such
as a:

• Psychiatrist.
• Psychologist.
• Certified licensed social
  worker.
• Counselor with special training in sexuality or
  relationship problems.

To prepare for your appointment, see the topic Making the Most of Your Appointment

Nov. 16, 2005 — A drug called Revatio may help treat an aggressive condition called pulmonary arterial hypertension.

Patients with pulmonary hypertension have elevated blood pressure in the pulmonary (lung) blood vessels. The condition often arises from lung problems, but some cases are without a known cause. It can result in heart failure and early death.

Dysfunction erectile pill
, most of the erectile pill that are used to treat this serious condition are not easy to take and are given by IV, injection, or inhalation — with real risks of unwanted side effects.

Revatio has the same active difference between cialis and viagra
— dysfunction pills
— as Viagra. Revatio and Viagra are made by Pfizer.

Pfizer funded the new study, which appears in The New England Journal of Medicine. Pfizer is a WebMD sponsor.

The researchers included Nazzarene Galie, MD, of the cardiology institute at Italy’s University of Bologna.

Walking Test

The study lasted for 12 weeks. It included 278 patients with pulmonary hypertension. The patients lived in the U.S., Mexico, South America, Europe, Asia, Australia, South Africa, and Israel.

Three times daily, the patients took Revatio (20, 40, or 80 milligrams) or an empty drug (placebo) orally. That was in addition to any other standard pulmonary hypertension medications.

The big question was how far patients could walk in six minutes. That’s an important exercise test for patients with pulmonary hypertension. The farther patients can walk, the better.

Walking Farther

All of the patients taking Revatio walked farther at the end of the study:

• 20-milligram group: Walked about 148 extra feet (a 13% increase).
• 40-milligram group: Walked about 151 extra feet (a 13% increase).
• 80-milligram group: Walked about 164 extra feet (nearly a 15% increase).

Higher doses didn’t bring a notable increase in distance walked, the researchers report.

Patients were then allowed to take Revatio for up to a year; 230 did so. The researchers looked at the walking tests of 222 of those who were only taking Revatio as treatment. After a year, they walked about 167 extra feet, on average, compared with the beginning of the study.

How Patients Fared

Most of the patients included in the study had milder stages of pulmonary hypertension. Few cases worsened, regardless of treatment type, the study shows.

Patients taking Revatio weren’t any more or less likely to have their symptoms worsen during the trial.

The study wasn’t designed to see if Revatio helped patients live longer. Four died during the study. No deaths were judged to be linked to the treatments, write the researchers.

Side effects seen with Revatio were mild or moderate and included headache, flushing, muscle pain, and diarrhea, report Galie and colleagues.

WASHINGTON - For the first time, manufacturers of vitamins, herbal pills and other dietary supplements will have to test all of their products' treat erectile dysfunction the best. The Food and Drug Administration said Friday it is phasing in a new rule that is designed to address concerns that existing regulations allowed supplements onto the market that were contaminated or didn't contain ingredients claimed on the label.

Last year, the agency found that some supplements contained undeclared active ingredients used in erectile dysfunction tabs
drugs for erectile dysfunction. In the past, regulators found supplements that didn't contain the levels of Vitamin C or Vitamin A that were claimed.

If, upon inspection, the FDA finds that supplements do not contain the ingredients they claim, the agency would consider the products adulterated or misbranded. In minor cases, the agency could ask the manufacturer to remove an ingredient or revise its label. In more serious cases, it could seize the product, file a lawsuit or even seek criminal charges.

Dietary supplements — pills, liquids or other products — are a $22 billion industry.

Most companies already test their raw ingredients, said Steve Mister, president and CEO for the Council for Responsible Nutrition, a trade association erectile dysfunction remedy
about 65 manufacturers.

“This raises the bar so that all have to comply,” Mister said.

The new rule goes into effect Aug. 24 and will have a three-year phase-in that gives smaller manufacturers more time to comply. Even the largest of the viagra vs cialis
won't have to comply until June 2008.

The rule applies to all domestic and foreign companies that manufacture, package and label supplements for sale in the U.S. It requires them to analyze the identity, purity and strength of all the ingredients that go into their products before they are distributed.

It also includes requirements for record keeping and handling consumer complaints.

Dr. Sidney Wolfe, who has testified before Congress on problems with dietary supplements, said the new rule does not ease his concern that unsafe supplements are too easy to bring to market.

“You still don't have to show the product is safe. You don't have to prove it works,” said Wolfe, director of Public Citizen's Health Research Group.

Consumers Union, publisher of Consumer Reports, called the rule a good step toward improving consistency in the ingredients that go into supplements.

“However, consumers still have no idea if a given product works, or whether it is dangerous,” said Janell Mayo Duncan, senior counsel for Consumers Union, publisher of Consumer Reports.

Congress limited the Food and Drug Administration's oversight of vitamins and other dietary supplements in 1994. The new rule is a product of that law, meaning that the rule took nearly 13 years to develop.

Under the old regulations, supplements were governed by the same rules that applied to producing foods, such as cans of soup.

“The final rule will help ensure that dietary supplements are manufactured with controls that result in a consistent product free of contamination, with accurate labeling,” said Dr. Robert E. Brackett, director of FDA's Center for Food Safety and Applied Nutrition.

___

On the Net:

FDA: http://www.fda.gov/