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TREATING ERECTILE DYSFUNCTION

Descriptions of treatments for combating erectile problems have been documented in literature and folklore. As long ago as 2000 BC, Egyptian papyrus records contained specific recipes for curing impotence. In Africa, the mandrake root has been used extensively as a traditional cure for male erectile problems.
Over the centuries, many other treatments have also been used to try and combat this condition. To improve the sex drive, Spanish fly, oysters, peanut butter and red wine have been tried. To strengthen and lengthen the penis, men have and continue to use extracts from ginseng, rhinoceros horn and tiger's penis. Some men have gone as far as inserting steel rods into the penis along the urethra. Still others have attached electrical wiring to their genitalia, trying to shock the penis back into action
Throughout most of the 20th century, the focus has been on psychotherapeutic techniques. There are also some patients who have been trained to avoid cognitive distraction because it was found that visual stimulation was the cause of their problem. These men could continue to function well with just audio stimulation. That is to say, some men need to approach intercourse with minimal distraction. Not seeing their partner or keeping the lights off, can make a significant difference in their ability to achieve and maintain an erection.
It has been known for quite some time that the male hormone testosterone is responsible for the normal development of male sexual characteristics. It was thought that this hormone could also be responsible for erectile strength. Testosterone was found to be produced in the testicles. The hormone was first isolated from bulls' testicles in 1935 by Ernest Laueur, a professor of pharmacology in Amsterdam. Four years later, in 1939, the Nobel Prize was awarded to Leopold Rirdia and Adolf Biterandt for developing a technique of converting normal cholesterol into a synthetic testosterone hormone. It was thought, during the years after its discovery, that a difficiency was responsible for the loss of potency. More recently, it has been proven that testosterone does not have a direct effect on erectile strength, however, it does appear to indirectly heighten the sex drive and boost energy. Since then, testosterone has been used by medical doctors in treating the symptoms of male sexual dysfunction. It improves the sex drive, but has been shown to have very little effect on erectile strength.
The development of mechanical devices has also revolutionised the treatment of erectile dysfunction over the last 50 years. Sex aids such as the simple constriction ring (or 'cock ring' as it is more commonly known), vacuum devices, creams and oils have helped many men.
The first highly successful form of pharmaceutical treatment was discovered by chance less than 20 years ago. It was a unexpected complication of a vascular operation performed by the vascular surgeon Dr. Ronald Virag, using a drug called papavarine. Papaverine was joined with another vasodilator called Phentolamine. These two drugs and others are used as vasodilators. Vasodilators help widen the blood vessels allowing more blood to reach the penis. The result is a stronger erection. In the late 1980s, Prostaglandin Ei was found to have the same effect. Combination therapy using a number of injectable drugs together was found to be the most effective. Over the last decade, tri-mixtures and quad-mixtures of these medications have revolutionised the approach to treatment and analysis of erectile dysfunction.
Eventually, large pharmaceutical companies realised that finding new and more user-friendly methods of treating erectile dysfunction was an enormous business opportunity. It was apparent that a large number of people suffered from this condition. The transurethral medication, 'Muse', was released onto the market in the United States in 1997. A transurethral medication is one that is inserted by means of a spring loaded applicator into the urethra, the tube running along the inside of the penis through which urine passes. The medication is then absorbed through the lining of this tube into the surrounding penile tissue. At first, this drug seemed to be ideal for patients already receiving injection therapy but, unfortunately, its effectiveness has since been shown to be disappointing. A significant number of users experienced discomfort during application and it occasionally caused bleeding. However, it is still used for individuals who are not adverse to the application method. The quest continues for the ideal treatment for erectile dysfunction. An idealtreatment should be simple, non-invasive and relatively painless. It should also cause minimal side effects and have a high success rate. With the release of Viagra, it has been shown that there is a big pot of gold at the end of this rainbow.

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EPILEPSY AND PREGNANCY

Women with epilepsy are quite often concerned about getting pregnant. There appear to be five reasons for this concern. They wish to know:
if they are likely to hand their epilepsy on to their children;
whether their fits will get worse during pregnancy;
whether it is safe for the baby that the mother should take anticonvulsants drugs during pregnancy;
if there will be any problems in the newborn baby from these drugs;
if they can safely breast feed the baby.
With regard to handing on epilepsy to one’s children – as mentioned earlier, if one parent has epilepsy, the chances of one of the children having epilepsy are no greater than in the population at large. If both parents have epilepsy, it would appear that the risk of a child having epilepsy is about 10 per cent. So in fact the chance of a child inheriting epilepsy, particularly idiopathic epilepsy, is negligible.
As far as seizures during pregnancy are concerned, the situation is not as clear as it might be. There is evidence that for some women, seizure control may deteriorate, while for others there may in fact be no change or even an improvement. A patient told me recently that “she would like to remain pregnant forever” as she had not had a single fit during her pregnancy, compared with six fits in the preceding nine months!
As a general working rule, it is suggested that people who have more than one grand mal fit a month are those who are most likely to have a deterioration in seizure control during pregnancy. The deterioration, if it occurs, is most likely during the first three months of pregnancy. There are a number of theories why this may happen, but none has been proved. It may be of value to check the blood anticonvulsant levels during pregnancy, especially if there is a deterioration in seizure control. The blood levels may fall, necessitating an increase in dosage during the pregnancy.
The main concern for parents is whether the anticonvulsants can harm the unborn baby (foetus). It is known by most people with epilepsy that this is a potential hazard. The effects include physical abnormalities in the baby, a process known as teratogenesis. Abnormalities have been reported in the offspring of mothers on all the commonly used anticonvulsants with the exception of carbamazepine. This is particularly applicable to phenytoin, barbiturates and sodium valproate. Babies born to mothers who have been on carbamazepine have not been shown to have any physical abnormalities, but have a smaller head size than other babies. This has not been shown to be any handicap to the babies who have been followed up for five years.
The risk of abnormalities in the baby is difficult to assess, but it seems to be most common in mothers on polytherapy (receiving numerous drugs), especially if they are on three or more anticonvulsants. The risk in mothers on phenytoin, with or without other medications, appears to be about a 10% chance of the baby showing features of the ‘foetal hydantoin’ syndrome. This syndrome consists of cleft palate, abnormalities of the fingers, possible heart abnormalities and mild mental retardation. Thus, at present, if it is possible, it would seem wise to try to change patients over to carbamazepine before conception. This may not be possible in all patients and, of course, many women will first visit their doctor when already pregnant, at which time there is no purpose in making the change.
Anticonvulsants taken by the mother during pregnancy may have some effects on the baby immediately after birth, as they are transmitted to the baby across the placenta. These include the possibility of a mild bleeding tendency and some drowsiness. In mothers who have been taking barbiturates, the infant may occasionally show features of a withdrawal reaction with irritability, jitteriness and poor sucking. None of these features is [...]

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ERECTILE DYSFUNCTION SYMPTOMS

Most patients have a combination of two or more of these problems. They are usually first given a thorough medical history and examination to determine the extent of the prob­lem and to hopefully pinpoint a cause. I want to briefly outline the nature of these four symptoms so that your problem will make more sense to you as a patient if you are experiencing any of them.

PRESCRIBED DRUGS

Taking prescribed medications with most vitamins is safe as is taking herbal complexes that are available through health food stores. However, you should always check with your doctor, your pharmacist or your naturopath. They are all trained to know what can go with what.

Weight loss

Overweight is most commonly a result of overeating and lack of exercise. Overweight and fluid retention often go together with people who have glandular problems or under-active thyroids. In such cases an iodine and phosporous deficiency may be the cause.