Firstmed Blog

As everyone is aware the planet is heating up. Global warming is being discussed everywhere I turn these days but we not longer need experts or scientists to tell us that change is afoot. We can see it and feel it for ourselves. Daffodils blooming in November and sweltering summer days that stretch into September. But what affect if any does this have on the average person’s sex life?

The rising temperatures have prompted us to pay more attention to what we throw out, to how often we get on a plane, to what kind of fuel we put in our cars, but should we also paying attention to the effect the heat has on our sexual performance.

Traditionally, hotter weather is considered something of an aphrodisiac in the same way as spicy food, oysters or chocolate. This may have something to do with raised body temperatures and indeed the practise of the midday siesta in hotter climates. It shouldn’t come as a surprise then that Mexicans came in tops in the global survey of sexual satisfaction.

There is a darker side to this story. People should be aware that Doctors have warned that having sex in steamy summer temperatures could be fatal. High temperatures may boost the desire for sex but also increases the risk of heart attacks.

So the next time that a heat-wave alert is issued, those of you who get the urge should wait until the evening hours, when the air gets cooler or alternatively have a cold shower and pray for the next downpour.

Now that Viagra has been on the market for about a year, the impotence drug appears to have a lower rate of efficacy than originally reported. At the annual meeting of the American Urological Association, a doctor explained that the 80% success rate widely reported when Viagra was approved by the FDA came from studies that included men with all forms of erectile dysfunction.

As the research continues, doctors are finding that the efficacy rate differs according to the reason for erectile dysfunction. For example a doctor said that the highest failure rate occurred in men who had a form of radical prostatectomy that damaged some of the nerves crucial to an erection. On the other hand, the highest success rate (90%) occurs in men with spinal cord injuries and psychogenic erectile dysfunction. When men with one or the other of the latter two causes of impotence were excluded from the doctor’s study, Viagra’s success rate dropped to 64%.

The nerve-sparing radical prostatectomy was introduced about 20 years ago to preserve sexual function, though it fails to do so in about 35-60% of cases. Only 25% of men whose erectile dysfunction occurred after this type of prostatectomy had a good response to Viagra, according to a team of researchers from Nashville who presented their work at the urology meeting. The doctor noted that 130 American men died while taking Viagra as of March 1999, most of cardiovascular events. Headaches are the most commonly reported side effect, with gastrointestinal upset as a close second.

Urologists were warned that the major caveat surrounding Viagra was its potential for causing catastrophic hypotensive events in patients with cardiovascular disease who are taking nitrates. An Italian research team found that men with chronic stable angina can take Viagra if their symptoms and exercise tests showed that their condition has been controlled with beta-blocker drugs.

Doctors at the urology meeting were reminded that Viagra is not an aphrodisiac and does not have an effect on libido. A man must be aroused sexually for the drug to have an effect.

A once-daily version of the erectile dysfunction treatment Cialis has been approved by European officials.

Yesterday, the drug’s maker Eli Lilly said that receiving approval from the European commission meant that Cialis was the first medicine to be developed to treat impotence over a continuous period.

The drug has been developed to be taken all the time, in comparison with Viagra which is usually taken as and when it is needed.

Men who anticipate that they will have intercourse at least twice a week will be eligible to use the drug, which is expected to come into the commercial market in Europe during the second half of this year.

“ED is typically a chronic disease and, for some men, Cialis for once-a-day use will eliminate the need to plan sex within a limited timeframe as they would with other therapies,” said Abbas Hussain, president of European operations for Lilly.

So what is Multiple Sclerosis?

Multiple Sclerosis, also referred to as MS, is an inflammatory disease of the Central Nervous System (the brain and the spinal cord). It most commonly affects the “white matter” tissue. White matter is made up of nerve fibres which are responsible for transmitting signals both internally within the CNS and between the CNS and the nerves supplying rest of the body.

In individuals affected by MS, patches of damage known as plaques or lesions appear in areas of the CNS white matter. At the site of a lesion myelin (a nerve insulating material) is lost. Clinically, MS is a hard condition to characterise because it is very unpredictable and variable. Depending on which areas of the CNS are affected and how badly they are damaged, the type and severity of symptoms can vary greatly.

How does it cause Erectile Dysfunction?

Since multiple sclerosis affects nerves (it is a deteriorating condition), chances are that in some individuals it can affect the nerves which supply the penis (the Pudendal nerve) and surrounding area. The Process of achieving an erection is a very complex one involving multiple inputs from various areas of the brain and the nervous system (spinal cord). The nervous system plays a very important role in penile erection. The nervous system is involved in the creation of an erection and process of ejaculation itself. The first part of the penile erection is controlled by the brain and is referred to as a psychogenic erection and occurs in any sort of mental or erotic stimulation. Sexual difficulties may arise from damage to the nervous system (such as multiple sclerosis).Conditions like multiple sclerosis lead to deterioration in erectile function (in either a stepwise or gradual manner. Initially it is a direct result of demyelination of the nerve and may also be the result of indirect effects as the condition deteriorates.

Ejaculatory dysfunction among disabled people is most common in men with spinal cord injury, multiple sclerosis, spina bifida, and transverse myelitis. Ejaculation involves closure of the bladder neck (through sympathetic nerve stimulation) and relaxation of the external sphincter in the penis. Patients with nerve often experience retrograde ejaculation into the bladder because of sympathetic damage, and various procedures have been used to induce an ejaculate. Some patients with nerve damage can be helped by electroejaculation. This involves the insertion of a stimulatory probe into the rectum to stimulate the midsacral roots directly, but it requires hospital attendance because of the complexity of the procedure and the potential side effects of pain and autonomic dysreflexia.

There may also be problems with other organ systems in individuals suffering from multiple sclerosis as well, like fatigue, anxiety, depression, and, indeed, altered desire of the patient’s partner. Disability services and general practitioners can address the sexual needs of not only the patients but also their partners at times of need.

With the ban on smoking in public places only around the corner it occurred to us at Firstmed that this would be a good time to highlight the effect smoking has on erectile function.

Smokers should expect to be hit with a nationwide campaign highlighting the damage smoke is doing to your health, to the health of those around you and now to your social life. The ban should be bearable during those warm summer months but come winter, huddling outside for the sake of a cigarette wouldn’t seem so appealing. If that isn’t incentive enough to give up, we at Firstmed would like to highlight the fact that smoking also greatly enhances the chances of impotence in men.

Recent studies have show that smoking increases the risk of erectile dysfunction by around 50% for men in their 30s and 40s. It is estimated that up to 120,000 UK men in their 30s and 40s are impotent as a direct consequence of smoking. This figure is likely to be an underestimate, because it does not include ED due to previous smoking in men who no longer smoke.

Along with erectile dysfunction, smoking can also lead to a reduction in the volume of ejaculate, a reduced number of sperm, abnormally shaped sperm and a reduction in the response to any fertility treatments undergone.

Cigarette smoke contains more than 4000 chemicals and many of these have been implicated as a cause of disease to the vascular (blood) system. With regards to the penis this directly impacts on the arteries and veins that supply blood to the penis.

Erection problems in smokers may be an early warning signal that cigarettes are already damaging other areas of the body - such as the blood vessels that supply the heart.

So there you have it. Men beware. The days when smoking was considered ‘sexy’ are surely numbered. Smoking is spoiling the romance, not only by giving your clothes, hair and breath that unmistakable pungent odour but worse, by taking the lead out of your pencil.

Smokers in Ireland are lighting up less often in the home since the smoking ban was introduced in 2004, new research has revealed, which could lower their risk of erectile dysfunction.

According to a study part-funded by Cancer Research, the new smoke-free laws do not automatically put children’s health at risk by forcing adults to smoke at home.

Professor Gerard Hastings, director of the charity’s UK Centre for Tobacco Control at the University of Stirling and co-author of the study, said that the findings echo the experiences of other countries.

He said: “Given that smokers accept it is dangerous and unfair to expose strangers to the poisons in their cigarette smoke, it would be illogical for them to go home and expose their families to the same toxic chemicals.”

The research team also studied smokers’ drinking behaviour and found that smokers in post-ban Ireland consumed the same quantities as smokers in the UK.

Recent findings from Action on Smoking and Health and the British Medical Association showed that 120,000 men in their 30s and 40s in the UK are impotent as a direct consequence of smoking.

As I was trawling through the latest news regarding the treatment of impotence I noticed a voting poll on the site of Men’s Sexual Health Center. This poll gives new insight as to the percentage of younger men using Viagra, Cialis and Levitra impotence prevention drugs for their love making experience.

I knew there has always been some evidence to suggest that these pharmaceuticals have caught on as recreational drugs in some circumstances and that men who have never suffered from impotence or performance anxiety, are using ED treatments anyway, in some cases as an insurance policy against the effects of alcohol, in others simply to enhance endurance. But this poll suggests that more than half the men less than 20 years old polled used Viagra Cialis or Levitra.

This is a very worrying trend. Erectile-dysfunction drugs such as Viagra and its newer rivals, Levitra and Cialis, were developed and intended for those suffering from erectile dysfunction due to age or any number of medical or psychological conditions not for young men who want a performance boost after a night on the town.

Viagra is also being combined with ecstasy in drug club culture to produce an aphrodisiac drug called ‘sextasy’. Most worrying of all is the trend in the gay clubbing community of mixing Viagra and Amyl nitrate(otherwise known as ‘poppers’). Combining the two chemicals can cause dangerously low blood pressure. Anyone who uses amyl nitrate is denied treatment as a result.

Taking ED treatments when you don’t need them may help to alleviate performance anxiety but Urologists warn that some men who don’t need the medication might develop a psychological dependency. And the long-term effects are still unknown.

All that said, not all under 30’s are taking ED treatments for recreational purposes. Indeed, Pfizer contends that if someone can feel the effect of Viagra, then they, by definition, have lost some sexual function.

If you are of a young age and have erectile dysfunction you should take a good look at your health and make sure that you go and see a doctor rather than just popping an illegally gained erectile dysfunction drug.

There are two main causes of peptic ulcer disease (PUD): Helicobacter pylori bacteria and the use of aspirin (ASA) and other no steroidal anti-inflammatory drugs (NSAIDs).

Helicobacter pylori (H. pylori) bacteria are responsible for the most of ulcers (about 80-85% of duodenal ulcers and 60-80% of gastric ulcers). The bacteria can expend into the protective mucus lining of the stomach and small intestine, causing damage. Not all people infected with these bacteria will actually develop ulcers.

Smoking also contributes to PUD, poor ulcer healing, and ulcer complications such as bleeding. It is not known exactly how this happens, but smoking is believed to block prostaglandins that can help repair damaged cells in the protective mucus layer. It may also make it easier for H. pylori to cause PUD. Excessive use of alcohol can put people at higher risk for PUD.

Use of aspirin (ASA) and other no steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can cause PUD. NSAIDs block natural chemicals called prostaglandins that can help repair damaged cells in the protective mucus layer. This makes the mucus layer weaker and less able to protect the delicate stomach and intestine lining. Using ASA and NSAIDs regularly for a long time such as for arthritis pain increases the risk of developing PUD. Since NSAIDs are painkillers, they can mask the discomfort of ulcers.

Some people have certain risk factors that make them more vulnerable to peptic ulcers caused by NSAIDs. If you are taking an NSAID and have one of these risk factors, your doctor may prescribe a stomach protective drug or an acid-suppressing drug. These risk factors are:

- Being older than 50 years
- A history of previous ulcers
- Using high doses of NSAIDs or multiple NSAIDs
- Using corticosteroids
- Blood clotting disorders
- Chronic health problems with major organs
- Heavy cigarette smoking
- H. pylori infection
- Poor general health

A new study on Viagra has shown that the drug improves the sexual satisfaction of both the man and his partner in a relationship.

According to the Kinsey Institute for Research in Sex, Gender and Reproduction, the younger the men with erectile problems, the more their sexual satisfaction improved with the use of Viagra.

Meanwhile, the women whose partners took Viagra reported an improvement in their sexual satisfaction and in their arousal and orgasms.

Julia Heiman, lead author of the study and director of the institute, said: “The nice thing about this study is that it reminds us that when people engage in a treatment, even taking a pill, it doesn’t stop at the edge of their skin.

“It can - and often does - affect others. In this study, changes in one partner were correlated with changes in another.”

The study, funded by Pfizer, involved 176 couples within which the male had erectile dysfunction and the female expressed dissatisfaction with their sex life.

Last week, a physician at Lund University in Sweden revealed that men with impotence problems should seek help as soon as possible as the condition can be an early sign of heart disease.

Men who smoke during their 30s and 40s double their risk of suffering from erectile dysfunction, the Observer has reported.

In addition to taking three days off work per year through illnesses and other smoking-related complaints, men who are addicted to the habit are more likely to become impotent, according to the newspaper.

It added that it takes eight hours for the nicotine and carbon monoxide levels in a smoker’s blood to reduce by half and for oxygen levels to return to normal after they stop smoking.

Last week, the British Acupuncture Council stated that acupuncture can be “very effective” for those who wish to give up smoking.

Acupuncturist Daniel Maxwell said: “With acupuncture, it helps to reduce the cravings - it doesn’t stop them but it powerfully reduces them.

“It detoxes the body of the nicotine, so that the cold turkey lasts not as long and it also rebalances the body and relaxes you.”

He added that stress is often a trigger for smoking and that acupuncture can reduce that stress.