Firstmed Blog

Here at Firstmed we often get asked to describe what the Viagra experience is really like. Most people have heard of ED treatments but a lot fewer actually understand what to expect when they seek treatment. In spite of the notoriety in the press, Viagra and its lesser known competitors Cialis and Levitra remain largely misunderstood. Beyond the name people don’t really understand the treatment of erectile dysfunction

Men who use it rarely talk about ED treatments openly. But in the UK an estimated 33% of all men ages 40 to 70, suffer from some significant level of erectile dysfunction. Most of them, about 80%, never seek treatment.

So, from doctors who prescribe it and people who use it, over the course of the next week, Firstmed will attempt to answer some of the more common questions put to our customer service team.

What Happens When a Man First Takes an ED Pill?

Absolutely nothing. Pfizer Inc., the maker of Viagra, long has said the drug isn’t an aphrodisiac, but many men who take it still expect to feel something. The nothingness is so intense that the most common reaction is a slight panic that the drug isn’t going to work. Though you may not feel anything, things are happening in the body. As the pill moves into the bloodstream, it starts to block an enzyme called PDE-5. Blocking the enzyme eventually increases blood flow to areas where PDE-5 is most heavily concentrated, the penis, nose and skin. Diminished blood flow to the penis is the cause of most erectile-dysfunction problems.

So How Do You Get It to Start Working?

Viagra takes about 30 minutes to kick in. Men who don’t normally have problems, or who have only mild dysfunction, say it takes only a minor stimulus, such as the brush of a hand that wouldn’t cause arousal under normal circumstances, to trigger an erection.

For men who have serious erectile dysfunction, getting things going may still require extra effort, partly because of nervousness or embarrassment about unsuccessful past attempts at intercourse.

Viagra gets the blood flowing, but your brain has to be in the mood as well. The biggest misperception is that it changes your psychology and makes you want sex.

I recently came across an article by The Stress Management Society, offering advice to men who suffer from erectile dysfunction.

They warned that, if you focus on the fact that it is not working, you’re visualizing that and ultimately your body will give you whatever it is you visualize subconsciously.

We at Firstmed agree. Though 80% of ED cases are related to physical issues, the importance of the psychology of impotence can never be underestimated. Men who suffer from erectile dysfunction either as a result of stress or of a physical condition, such as Diabetes, should try not to work themselves up about the condition as this could potentially make the situation worse.

People with sexual dysfunctions should try to relax rather than focusing on the problem, taking time to connect with their partner. Regardless of the cause of impotence, there frequently tends to be an impotence-anxiety-impotence cycle that is hard to escape from. It is a vicious circle because men get more stressed about the fact they’ve got erectile dysfunction and the more they focus on how terrible that is, the more stressed they inevitably get.

Doing exercise, managing time better and getting enough rest can help a person to relax and to escape from stress related impotence.

If you agree and have any advice for those newly seeking treatment for ED please let us know.

A review of existing erectile dysfunction research suggests that Group therapy could be used to help men with impotence. The review, which appears in the latest issue of The Cochrane Library, found that group therapy appeared to have just as much of a positive impact as drugs and suction devices. It called for the integration of sex therapy and other psychological techniques into practices that utilize drugs.

We at Firstmed question these findings. The majority of ED sufferers are affected due to a physical complaint. For those suffering with conditions such as Diabetes or recovering from Prostate Cancer, group therapy may be a useful tool for mental preparation but there is no substitute for medication that can increase blood flow in the body. Erectile dysfunction was largely deemed a psychological disorder before drugs treating the condition became widely available in the 1990s and it was this outdated ‘it’s all in your head’ attitude that deters many from seeking treatment.

Dealing with psychological aspects is fundamental to achieving a successful outcome but intensive therapy, group or otherwise can’t alone remedy ED, when the cause is physical.

I also wonder how many people would be interested in group therapy. It’s not uncommon for men to be uncomfortable talking to their partners about ED. Many won’t even broach the issue with their own doctor in a private consultation. The chance of many men being interested in sharing their experiences in a group context seems ambitious at best and very naïve at worst.

Having said all that, I could be very mistaken. I am curious to know how many people would consider group therapy. If you think group therapy could be the way forward, please let me know.

200 years ago Parkinson’s disease was first discovered, but little progress has been made since then about the cause. Now, in the largest study of its kind, researchers from the Mayo Clinic have discovered that genetics may play a small but significant role in determining one’s risk for the disease.

The study found that genes play as much as a 3 percent role in one’s overall risk for developing Parkinson’s disease. With this new information, further research on the role of these genes may lead to better treatments or even a cure.

This is an important step forward, said a lead study investigator, because the contribution of common genetic risk factors to the development of Parkinson’s has long been suspected.
The researchers collected genetic information from almost 2,700 patients with Parkinson’s disease and compared it with that of healthy men and women of the same age. They found that in many of the Parkinson’s patients, there was one segment of DNA that was a bit longer than in the healthy patients. This section of DNA supports the expression of another gene, alpha-synuclein. So, in Parkinson’s patients this gene is over expressed, or turned on more than in a person without Parkinson’s disease.

While it is not yet known how this genetic defect leads to Parkinson’s, the researchers were able to determine that people with the extra-long DNA segment have a 1.5 greater risk for Parkinson’s disease than someone who doesn’t.

Parkinson’s disease affects around 1 million people in the United States and causes the decay of brain cells. This can cause symptoms of uncontrollable shaking, stiffness, imbalance and uncoordinated movements. There are a few treatments to reduce these symptoms, but, in general, their impact is short-lived.

With this new information, however, researchers can turn their attention to the alpha-synuclein gene.

Findings support the development of therapies that reduce alpha-synuclein gene expression. Such therapies have the potential to prevent or delay the beginning of Parkinson’s disease or to stop or slow its progression.

Treatment of a hamstring strain is again dependent on the severity of the injury. The RICE method is the essential treatment for treating hamstring injuries in the early stages. Rest, Ice, Compress and Elevate. Due to the bleeding and swelling, patients should stop the activity that caused the strain, rest immediately to allow healing to take place and prevent further damages done to the muscles. Ice should be used at once to control the swelling and relieve the pain caused. Heat should not be applied to the affected area since this may increase swelling and bleeding within the muscle. To assist with the swelling control, an elastic wrap or compressive stocking can be applied. Finally, lying down periodically with you leg elevated allows gravity to assist with your effort to control the swelling.

The RICE treatment described above can be performed by individuals or a trained professional; it can be used for first degree, second degree and third degree severity. However, both second and third degree require longer recovery time and there are possibilities that specialised techniques or treatments will be prescribed by doctors to enhance healing and recovery.

In the first phase of the recovery stage, some gentle stretching and light resistive exercises will help to prevent stiffness, improve range of motion, and restore the joint’s normal flexibility and strength. These exercises should be done several times a day, it is very important to stick to the exercises because they help reduce swelling, prevent stiffness, and restore normal and pain-free range of motion. The second phase consists of more demanding exercises to increase strength and regain flexibility as pain decreases and function improves. At the final stage of recovery, patients are allowed to return to full daily activities including sports. However, it is utmost important to return to full activity only when the problem is fully recovered, that is when the patients have gained normal range of motion, flexibility and strength. Attending to full activity with pain or muscle soreness will increase the chance of re-injury and may lead to a chronic problem.

A hamstring strain is caused by twisting or pulling a muscle or tendon and can be both acute and chronic. Acute hamstring strain associated with a recent trauma or injury, it occurs during an isolated athletic activity or it can also occur after improperly lifting heavy objects or overstressing the muscles. Chronic hamstring strain is resulted from persistent repetitive stress. Some examples of causes are shown below:

* No or a poor stretching routine before activities causing inadequate flexibility of the hamstrings which can result in injury.
* Inadequate strength or endurance of the hamstrings to sustain workload caused by athletic activities or repetitive stress.
* Returning to activity before full recovery, this can lead to recurrence of the problem.

Sports athletes are most vulnerable to hamstring injuries; sports for example require jumping, running and kicking. Many cases also suggested hamstring injuries increase with age, though they can occur in people of all ages.

What are the symptoms of Hamstring Strain?

The symptoms of a hamstring strain depend on the severity of the injury. The injury is usually very sudden and painful. Other common symptoms include:

* Bruising - It is caused by bleeding within the muscle from small tears. It usually begins in the back of the thigh and passes down below the knee and into the foot as time elapse
* Swelling – This is caused by the accumulation of blood within the muscle where the tears occurred. This makes further muscle contraction difficult and painful.
* Spasm – the stimulation of the muscle caused by confusion of contraction signals and subsequent spasm. People usually experience spasm when they have pulled their hamstring. It is very common and painful symptom of a hamstring injury.
* Difficult Contraction – it causes the knee to flex and if severe, it may even prevent the patient from walking normally.

In First Degree, patients might feel only tightness in the thigh and should be able to walk normally. It’s very unlikely that swelling will take place due to only moderate damage to the muscle. In Second Degree, patients might not be able to walk properly due to the difficulty of contracting. There might be noticeable swelling on the affected area and causes pain if pressed in. Finally in Third Degree, due to severe damage to the muscles, patients will be unable to walk without the necessary aid of supports. There will be continuing pain and bad swelling appears immediately after impact.

To understand what hamstring strain is, we need to understand what muscles comprise the hamstrings and how they work. Hamstrings consist of three types of muscles found in the back of the thigh. They are as follows:

* Biceps Femoris
* Semitendinosus
* Semimembranosus

The function of the hamstrings is a very simple. It is the contraction of the 3 hamstrings muscles that causes the knee to bend and the thigh to move backwards relative to the trunk. The hamstrings play an important role in our everyday life, such as walking, running, jumping, and controlling movements of the trunk.

A hamstring strain is an excessive stretch beyond its limits and the muscle tissue maybe torn. A tear in a muscle is referred to as a strain. Hamstring strains can occur at any point along the length of the muscle. The injuries are classified as either first, second or third degree depending on the severity.

1. First Degree – involves excessive stretching or minor tearing of a few muscle fibres. There will be some stiffness in the affected area and if exercise is attempted, the pain or stiffness may decrease however, the pain becomes greater afterward. Patients with a mild strain usually experience minimal pain, swelling, and little or no loss of functional ability.

2. Second Degree – refers to a more severe muscle tear covering a larger area than the first degree strain. Patients with a moderate strain might notice bruising, moderate pain, and swelling. There will be stiffness and weakness on the affected area creating significant limping when walking and running.

3. Third Degree – this is a complete tear or rupture of the muscle. Swelling, bruising are usually quite severe and immediate. The patients will be unable to put weight on the joint, i.e. it is impossible for them to walk without use of crutches.

The sexual behaviour of older people is more often the target of jocularity or ridicule than the subject of serious scientific research. The Sunday Times article ‘Viagravation’, which has been the subject of this blog all week, has climbed aboard this bandwagon. It paints a picture of an aging population of ‘horny men’ who upon discovery of the ‘magic blue pill’ are rampaging around the red light districts of the world.

The article claims that elderly men are shunning their wives in favour of prostitutes and backing this up with unsubstantiated claims in the media that the recent raise in sexually transmitted diseases and divorce rates can be attributed to pensioners taking Viagra.

The availability of ED treatments such as Viagra is only one factor in enabling older people to have sex in the golden years. This is an age where people are living longer, plastic surgery is getting better and divorce rates are soaring, with or without the help of the ‘little blue pill’

For many people the idea of lowered desire, less frequent sex, and an inevitable slide toward the platonic, characterizes the picture of what old age brings to their sex lives. But older people have always been having sex. Age doesn’t curb the desire for human contact yet recognition of this is considered taboo. Viagra has simply brought to the fore the issue of old age sex and enabled many older men to remain sexually active following medical conditions associated with old age such as prostrate cancer and diabetes. It is the very same generation who began the sexual revolution in the late 1950s that are now finding new passion and partners in their retirement.

In light of these facts, it seems naïve at best to attribute the reported rise in elderly promiscuity to Viagra alone.

Many people ask whether or not Viagra can become addictive. Pfizer denies the notion of addiction dependency and less still addiction. Yet the notion of Viagra dependency is one which is raised time and again, most recently in the Sunday Times Article ‘Viagravation’.

There is vigorous debate surrounding growing concerns that Viagra may be addictive. According to The Times, Viagra addiction is culpable in many divorces and women are becoming increasingly concerned that men need a chemical
prop to find them attractive

The short answer to this issue is that taking Viagra (sildenafil citrate) is not addictive. Viagra will not cause a man to become dependent on the medication. This is because Viagra is not an addicting or habit-forming medication.

There are many causes of impotence, including medical conditions (such as high blood pressure or diabetes) and psychological issues. If a person’s impotence is due to a medical condition, (such as high blood pressure or diabetes), it is important to understand that Viagra will not improve the condition that is causing the impotence. The patient will continue to need to use Viagra. This does not mean he is dependent on Viagra; it simply means that he is continuing to have a problem with impotence.

Viagra does not cause any long-term changes in sexual function and will not affect a man’s ability to perform sexually in the future. In fact, if his impotence is related to performance anxiety about sexual activity, it is possible that Viagra might give him the confidence to overcome his problems with impotence.

While a man may continue to need Viagra to achieve an erection, this does not mean he is addicted. It simply means that he still has problems with impotence. For those who have erectile dysfunction, Viagra is a wonder drug. But for everybody else, there is absolutely no reason to use it.

Continuing from yesterday’s Blog, I will be continuing to discuss some of the issues raised in The Sunday Times regarding the use of Viagra.

One of the most striking messages of the article regards the effect Viagra has on relationships and the impact it has had on female, as well as male sexuality. The article asks the question, whether or not, Viagra simply highlights the incompetence of their lovers for many women. Viagra can’t turn men into good lovers; it merely gives them mechanical capabilities.

According to The Journal of Sexual Medicine, lack of involvement of women in the therapy decision is cited as the main reason why many men discontinue treatment.

Here at Firstmed we agree that Viagra cannot cure your relationship or your ability to communicate with your partner. Penetrative sex is only part of it. Poor communication and technique will never be fixed by a pill. We have recently added a women section to our site to reflect the importance of both partners in the treatment of impotence.