Lots of Sex May Prevent Erectile Dysfunction

(HealthDay News) -- Frequent sexual intercourse may cut down on a man's chances of developing erectile dysfunction, Finnish researchers report.

"This is the same as any other part of the body. It's what we in vascular surgery refer to as the 'use it or lose it' concept," said Dr. Hossein Sadeghi-Nejad, an associate professor of urology at UMDNJ New Jersey Medical School Hackensack University Medical Center. "Sexual activity will promote maintenance of normal erectile function down the line."

The report was published in the July issue of The American Journal of Medicine.

In the study, led by Dr. Juha Koskimaki, from Tampere University Hospital's Department of Urology, researchers collected data on 989 Finnish men aged 55 to 75 years old.

The researchers found that men who said they had sexual intercourse less than once a week had twice the risk of developing erectile dysfunction, compared with men reporting having sexual intercourse once a week.

Among men who had sexual intercourse less than once a week, there were 79 cases of erectile dysfunction per 1,000 men. That number dropped to 32 cases per 1,000 among men who said they had sexual intercourse once a week, and it dropped even further, to 16 per 1,000, among men who said they had sexual intercourse three or more times a week, the researchers reported.

The frequency of morning erections was not associated with the incidence of moderate erectile dysfunction, the researchers noted.

However, the development of complete erectile dysfunction could be predicted from the frequency of morning erections. Among men with less than one morning erection a week, the risk of developing erectile dysfunction was 2.5-fold greater than among men who had two to three morning erections per week.

"Regular intercourse has an important role in preserving erectile function among elderly men, whereas morning erection does not exert a similar effect," Koskimaki said in a statement. "Continued sexual activity decreases the incidence of erectile dysfunction in direct proportion to coital frequency."

Sadeghi-Nejad said there is a scientific basis for this finding, and it also has implications for rehabilitation of patients after prostate cancer treatment.

"What is very hot these days is what we can do to rehabilitate people who develop erection problems after prostate cancer surgery or radiation therapy," Sadeghi-Nejad said. "Anything you can do to increase oxygenation in the penis will help get patients back to normal."

If one can naturally engage in behaviors that increase blood flow to the penis, it will have a positive effect in preventing erectile dysfunction, Sadeghi-Nejad said.

Sadeghi-Nejad noted that the study only addressed intercourse, and not masturbation. "This is essentially the same concept," Sadeghi-Nejad said. "Anything you can do to bring blood to the penis is beneficial," he added.

More information
For more about sexual dysfunction, visit the U.S. National Library of Medicine.

Telemedicine a Cost-Effective Alternative to ER Visits

(HealthDay News) -- Telemedicine is a cost-effective way to replace more than a quarter of all visits to the pediatric emergency department, according to a community-wide study conducted in New York.

Ailments, such as ear infections or sore throats, that virtually always prove manageable by telemedicine made up almost 28 percent of all pediatric ER visits in Rochester, N.Y., during one year, according to investigators from the University of Rochester Medical Center.

Their findings were presented recently at the 2008 Pediatric Academic Societies annual meeting, in Honolulu.

"We learned that more than one in four local patients are using the pediatric emergency department for non-emergencies," lead investigator Dr. Kenneth McConnochie, a professor of pediatrics at the University of Rochester's Golisano Children's Hospital at Strong, said in a prepared statement. "This mismatch of needs and resources is inefficient, costly and impersonal for everyone involved."

McConnochie and his colleagues, who direct a Rochester-based telemedicine program that provides interactive, Internet-based pediatric health-care service to the area, analyzed data for all pediatric visits to the largest emergency department in the city. Based on their experience, they determined at least 12,000 visits were ones they routinely treat with success via telemedicine.

The other visits were either problems that sometimes are treatable through telemedicine, such as asthma attacks; or ones beyond the scope of the technology, such as a serious wound or injury.

"This would've not only freed up emergency resources to people who needed them more, it would have afforded smaller co-pays for parents and more timely, personalized care," McConnochie said.

In related research presented at the meeting, McConnochie suggested that telemedicine could also help insurers and the community by providing better quality care at a lower price -- saving insurers more than $14 per child per year in that local community.

The conclusion was reached by studying two groups of children that were almost identical, but one had access to their doctor's office, the emergency department and telemedicine technology for care, while the second had only the first two options.

"We found that the first group of families, which had access to telemedicine for their children, did in fact access care for illness overall nearly 23 percent more often than the second group," McConnochie said.

But since children with telemedicine access had 24 percent fewer ER visits, which cost about seven times the cost of a doctor office or telemedicine visit, the telemedicine group ultimately still cost insurers less per child over a year.

More information
The Nemours Foundation has more about children's health.

1 in 4 Men Over 30 Has Low Testosterone

(HealthDay News) -- New research suggests that one out of four men over 30 have low testosterone levels, but only one out of every 20 men have clinical symptoms linked to such a deficiency.

As men age, they are more likely to experience symptoms such as lack of sex drive and erectile dysfunction as a result of low levels of testosterone, the researchers explain.

Low testosterone is defined as 300ng/dL (nanograms per deciliter) of total testosterone and less than 5 ng/dL of free testosterone. Free testosterone is the amount of hormone not bound to other proteins.

Low testosterone can indicate androgen deficiency if it is accompanied by low sex drive, erectile dysfunction, osteoporosis or fracture, and two or more of the following: sleep disturbance, depressed mood, lethargy or diminished physical performance.

"Low levels of testosterone impact many aspects of male physiology," lead author Andre B. Araujo, a research scientist at the New England Research Institutes in Watertown, Mass., said in a prepared statement. "This is particularly significant because the ongoing aging of the U.S. male population is likely to cause the number of men suffering from androgen deficiency to increase appreciably."

New England Research Institute scientists analyzed data from almost 1,500 men enrolled in the Boston Area Community Health Survey. The survey tracks people aged 30 to 79 years and compiles data on factors such as testosterone, symptoms of hormone deficiency, and medications that may impact sex hormone levels.

Approximately 24 percent of the men surveyed had low total testosterone and 11 percent had low levels of free testosterone. Many of the men had no symptoms related to their low testosterone.

About 5.6 percent of the men in this study suffered from symptomatic androgen deficiency. Older men were especially prone: over 18 percent of men over age 70 met the criteria for this deficiency.

Based on these results, the researchers predict that by 2025 there may be as many as 6.5 million American men between 30 and 79 years of age with symptomatic androgen deficiency, an increase of 38 percent from the year 2000 population estimates.

"This study did not assess whether men with symptomatic androgen deficiency are good candidates for testosterone therapy," said Araujo. "Well-designed, randomized, placebo-controlled trials would be needed to address the risks and benefits of testosterone therapy."

The study is available online and will appear in the November issue of the Journal of Clinical Endocrinology & Metabolism.

More information
To learn about androgen deficiency in men, visit The Men's Health Network.

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7 Keys to Prostate Cancer Management

(HealthDay News) -- Early detection and treatment are crucial to defeat prostate cancer, says a Johns Hopkins Health Alerts report that outlines seven key ways to treat prostate cancer and provides advice on how to prevent it.

The 7 Keys to Treating Prostate Cancer report was written by Dr. Jacek L. Mostwin of Johns Hopkins' James Buchanan Brady Urological Institute. The report is meant to help prostate cancer patients make informed decisions about their medical care.

Men over age 50, black Americans and men with a family history of prostate cancer have the greatest risk for the disease and should undergo regular testing for prostate cancer, says the report, which also explains prostate screening and detection methods.

The report offers the following seven keys to prostate cancer treatment:

Understand your prostate biopsy.
Get a second (and third or fourth) opinion.
Choose the right treatment.
Deal with erectile dysfunction.
Seek extra help if needed.
Understand the role of diet.
Consider complementary techniques.
An estimated 232,000 new cases of prostate cancer will be diagnosed in the United States in 2006, according to the American Cancer Society.

The report was released by Johns Hopkins Health Alerts, a consumer health information Web site, in conjunction with Johns Hopkins Medicine.

More information

Here's where you can find the 7 Keys to Treating Prostate Cancer report.



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New Drug Treats Premature Ejaculation

(HealthDay News) -- A new antidepressant drug designed specifically to treat premature ejaculation proved safe and effective in two large trials, researchers report.

However, it's not likely that dapoxetine, a short-acting selective serotonin reuptake inhibitor (SSRI), will win U.S. approval anytime soon because it can produce side effects, one expert said.
SSRIs, which are used to treat depression and other psychiatric disorders, are now also used "off-label" as a treatment for premature ejaculation. They work because one of their side effects is to delay ejaculation. But, continued SSRI use can have some negative side effects, such as psychiatric problems, skin reactions, weight gain, and loss of libido, experts said.

"This is the first drug specifically developed for premature ejaculation," said lead researcher Dr. Jon L. Pryor, a professor and chairman of urologic surgery at the University of Minnesota. "It worked both in lengthening ejaculation time and in patients' feeling control over ejaculation and both subjects' and partners' feelings of satisfaction with intercourse," he said.

The findings are published in the Sept. 9 issue of The Lancet.
Premature ejaculation is the most common male sexual problem, even more common than erectile dysfunction, affecting 21 percent to 33 percent of American men.

In the study, Pryor and his colleagues looked at the combined results of two trials that tested dapoxetine. The trials included 2,614 men who had moderate to severe premature ejaculation.
The men were randomly assigned to receive a placebo or different doses of dapoxetine. They were told to take the drug one to three hours before having sex. At the start of the study, the men ejaculated, on average, in less than a minute after penetration.

However, after 12 weeks, men taking dapoxetine increased their time to ejaculation to 2.78 minutes for those receiving a 30-milligram dose, and to 3.32 minutes for those receiving a 60-milligram dose, the researchers found. For men taking a placebo, the time to ejaculation averaged 1.75 minutes.

Pryor thinks this study will get people talking more about the problem of premature ejaculation. "I hope this paper brings premature ejaculation out of the closet," he said. "I hope it allows for mature discussion about it, and that people realize that there is hope."

One expert familiar with dapoxetine thinks the drug has promise but will not be available in the United States.

"The problem is that dapoxetine was presented to the U.S. Food and Drug Administration last year, and they rejected it out-of-hand as a treatment for premature ejaculation," said Dr. James Barada, director of the Center for Sexual Health in Albany, N.Y.

The drug can produce side effects such as nausea, headache, upset stomach and weakness. It is being released in Europe, Barada said.

"Premature ejaculation is a real clinical condition that causes distress for the man, his partner and especially the relationship," he added. "Because we have no approved therapy, we are at somewhat of a loss to treat it. For many years, we have been using off-label therapies -- SSRIs -- because of the side effect they have of delaying ejaculation."

Doctors can still use SSRIs, Viagra, and psychotherapy to treat the problem, Barada said. "We need to get better research to understand the mechanisms of premature ejaculation and hopefully design a medicine that has good efficacy and safety that is not an SSRI," he said.

More information
The U.S. National Library of Medicine can tell you more about premature ejaculation.



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Erectile Dysfunction: Solving a Common Problem

by Leonard DeRogatis, Ph.D.
Many men who suffer from erectile dysfunction (ED) experience a quiet catastrophe. They feel that their sex life, as they have known it, is over. They experience a sense of humiliation and loss of manhood. They also feel quite alone with their problem, as though each one of them is the only man on earth with ED.

It turns out that ED is common among men, particularly as they age. A large-scale study called the Massachusetts Male Aging Study showed that the prevalence of moderate to severe ED ranges from 8 percent at age 40 to nearly 50 percent at age 70. Factors such as diabetes, high blood pressure, heart disease, smoking, and high cholesterol all appear to undermine healthy erectile functioning. Even without these factors, erectile functioning can be a problem if testosterone levels are not high enough.

Fortunately, help is already here. Over the past decade, a class of drugs known as PDE5 inhibitors has given us three drugs to treat ED: Viagra, Levitra, and Cialis. All of these drugs have a good record of effectiveness and help 60 percent to 75 percent of men who take them. These drugs also are quite safe. Side effects experienced by most men include facial redness, stuffy nose, headaches, and some heartburn.

If for some reason a man cannot take one of the PDE5s, there are a number of second-line treatments available. Prostaglandin E1 (alprostadil or MUSE), available in a small suppository form, can be inserted in the penile urethra with a special device and has a good track record. A topical cream version of alprostadil is now in late-stage clinical trials. Alprostadil alone or in combination with several other drugs also is available in a form that is injectable directly into the side of the penis. The effectiveness of the injections is quite good; however, there are concerns about side effects such as penile scarring.

Although pharmacological treatments for ED have a very good track record, keep in mind that some causes of ED are psychological or interpersonal in nature. Drugs can help make the penis functional but they can’t fix a dysfunctional marriage or definitively treat a case of performance anxiety. In such cases, a good sex therapist or couples counselor (in many instances the same professional) can often be very helpful in treating the problem.

If you have ED, don’t let yourself feel isolated and alone with your problem. Ask your doctor for help and, if he or she doesn’t feel comfortable treating your problem, ask for a referral to an expert in sexual medicine. There’s a good chance that your problem is easily treatable, so don’t let potential embarrassment stand in the way of a rewarding sex life.



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