A new study may be an important motivational tool for obese men to lose weight! According to a study published in The Journal of Sexual Medicine, the official journal of the International Society for Sexual Medicine, obese men with erectile dysfunction (ED) are shown to have low levels of hormones, such as testosterone. A correlation between certain conditions associated with obesity, particularly hypertension, are the most important determinants of obesity-related ED.

The link between obesity and male potency dates from the Byzantine era, when it was thought that a large stomach impaired a man’s ability to have sexual intercourse. This is particularly relevant today, as the prevalence of obesity has more than doubled in the last 25 years. Excess abdominal fat, cardiovascular disease, high blood lipids and type-2 diabetes characterize a condition known as metabolic syndrome, which has recently been associated with erectile dysfunction. (more…)

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The Royal Australian College of General Practitioners (RACGP) has voiced concerns about the prescribing practices of erectile dysfunction clinics currently under review by the House of Representatives Standing Committee on Health and Ageing, Roundtable on Impotency Treatments.

“Of the greatest concern is the use of telemedicine to treat erectile dysfunction,” said Dr Chris Mitchell, RACGP President and GP in Northern NSW . “The danger is that a condition will be treated in isolation without due regard to other physical and emotional factors, which might be affecting a patient”.

“General practitioners provide whole person, comprehensive and coordinated care and often have an established relationship with their patients,” said Dr Mitchell. “This allows the GP to explore a range of interventions, both pharmaceutical and non-pharmaceutical, as part of the continuing care of a patient.”

“GPs should be the first point of contact in the health care system and are well placed to deal with erectile dysfunction,” Dr Mitchell said. “The RACGP supports the House of Representatives review of the frameworks in place that allow such erectile dysfunction clinics to operate. It is of utmost import that health services are delivered in the context of continuous, safety and high quality care.” (more…)

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The American College of Physicians (ACP) has issued recommendations for the treatment of erectile dysfunction (ED). ACP, the nation’s largest medical specialty organization and second-largest physician group, strongly recommends that physicians initiate therapy with an oral phosphodiesterase type 5 (PDE-5) inhibitor in men who seek treatment for ED unless they have a contraindication to PDE-5 inhibitors, such as nitrate therapy.

As for which PDE-5 inhibitor to use, ACP recommends that physicians base the choice on the individual preferences of patients including ease of use, cost of medication, and adverse effects profile.

“The evidence is insufficient to compare the effectiveness or adverse effects of different PDE-5 inhibitors for the treatment of ED because there were only a few head-to-head trials,” explained the lead author of the guideline, Amir Qaseem, MD, PhD, MHA, FACP, senior medical associate at the American College of Physicians.

The guideline authors analyzed evidence gathered from 130 randomized controlled trials that evaluated oral PDE-5 inhibitors alone or combined. Treatment with a PDE-5 inhibitor resulted in statistically significant and clinically relevant improvements in sexual intercourse and erectile function in patients with ED, regardless of the cause (e.g., diabetes, depression, prostate cancer) or baseline severity. The magnitude of benefit increased with severity of ED.

Overall, the evidence showed that PDE-5 inhibitors were relatively well-tolerated and were associated with mild or moderate adverse effects, such as headaches, flushing, upset stomach, and runny nose. (more…)

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Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that although surveyed primary care physicians (PCPs) are generally satisfied with the efficacy of available phosphodiesterase type 5 (PDE5) inhibitors such as Pfizer’s Viagra, Eli Lilly’s Cialis and Bayer Healthcare/Schering-Plough/GlaxoSmithKline’s Levitra, they are less satisfied with the efficacy of this drug class in difficult-to-treat patient subpopulations. PCPs’ satisfaction with available PDE5 inhibitors on key measures of clinical efficacy suggests that opportunity exists for improvement in the treatment of erectile dysfunction patients with comorbid conditions such as hypertension and diabetes.

The new report entitled Erectile Dysfunction: Physicians Seek Improvements in Efficacy for Underserved Patients and Product Differentiation on Onset and Duration of Action finds that a therapy that provides greater improvement in erectile function than Levitra in patients with hypertension and that is priced at a five percent discount to Levitra would earn a 50 percent patient share in the United States and a 40 percent patient share in Europe, according to surveyed U.S. primary care physicians and European general practitioners.

Additionally, while there are several second-generation PDE5 inhibitors in clinical trials for the treatment of erectile dysfunction, interviewed experts do not expect these agents to provide efficacy superior to that of currently marketed drugs in this class. The report also finds that limited reimbursement for erectile dysfunction drugs and the availability of less-expensive generic versions of Viagra beginning in 2012, will constrain the uptake of emerging PDE5 inhibitors. (more…)

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An innovative drug-delivery system nanoparticles encapsulating nitric oxide or prescription drugs shows promise for topical treatment of erectile dysfunction (ED), according to a new study by scientists at Albert Einstein College of Medicine of Yeshiva University.

The new system, tested successfully on a small number of animals, could potentially prevent side effects associated with oral ED medications, if study results can be replicated in humans. That could mean safer and more effective ED therapy for millions of men with heart disease and other health problems affecting erectile function. The study is published today in the online edition of the Journal of Sexual Medicine.

Tens of millions of men worldwide have benefited from oral ED medications such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). However, these medications which belong to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors have limitations. They can cause systemic side effects that can be serious. These side effects include headache, facial flushing, nasal congestion, upset stomach, abnormal vision as well as isolated reports of hearing and vision loss. Men who’ve recently suffered a heart attack or stroke or have severe heart disease should use these drugs with caution or not at all. In addition, “an estimated 30 to 50 percent of men with ED do not respond to oral use of PDE5 inhibitors,” says senior author Kelvin P. Davies, Ph.D., associate professor of urology at Einstein. (more…)

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