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Posts tagged Erectile Dysfunction

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What causes erectile dysfunction and what can I do about it?

Posted 21 September 2016 in Erectile Dysfunction, Men's Health, Sexual Health

Erectile dysfunction, or impotence as it’s sometimes called, is a very common condition that distresses men of all ages. It’s the inability to achieve or maintain an erection that is sufficient for satisfactory sexual activity.


Listen to our Superintendent Pharmacist, Margaret Hudson, discuss ED in a recent radio interview


In the UK erectile dysfunction, or ED, is thought to affect more than 50% of men over 40 years of age.1

Most men are unaware that ED could be a symptom of a more serious underlying medical condition, and so if you suffer from ED you should get a health check from your GP. The most common of these conditions are high blood pressure, high cholesterol and diabetes.

ED can have a range of causes but the main culprits are physical problems, psychological factors and the side-effects of certain medications.

Physical problems include narrowing of the blood vessels going to the penis; commonly associated with high blood pressure (hypertension), high cholesterol or diabetes. Hormonal problems such as an over or under active thyroid gland and surgery or injury to the penis, pelvis or surrounding area can also cause it.

Some examples of causative neurological conditions are Parkinson’s disease and multiple sclerosis while the psychological causes of ED include stress, anxiety, depression and relationship problems.

Lifestyle can also cause ED and so if you’re overweight, smoke, drink excessively or take recreational drugs, you are more likely to suffer from these symptoms.

In younger men, it may be caused by anxiety, nervousness about having sex, inexperience in using a condom or even fear of causing an unwanted pregnancy.

The most common health conditions causing ED are cardiovascular disease and diabetes but the medications for high blood pressure, prostate problems, high cholesterol, depression and anxiety can also cause ED and therefore compound the situation. For example, you might have high blood pressure which causes ED, then you take a medication for your blood pressure which also causes ED making your symptoms even worse! 2

In fact, there is a long list of medications that may cause ED, including:

  • Diuretics - “Water tablets”
  • Beta-blockers - used to treat high blood pressure
  • H2-antagonists - used to treat stomach ulcers
  • Antihistamines - used to treat allergic health conditions, such as hay fever
  • Antipsychotics - used to treat some mental health conditions, such as schizophrenia
  • Anticonvulsants - used to treat epilepsy
  • Corticosteroids - medication that contains steroids, which are a type of hormone

Speak to your GP if you are concerned that a prescribed medicine is causing erectile dysfunction as alternative medication may be available. However, it is important never to stop taking a prescribed medicine unless you are advised to do so by a qualified healthcare professional who is responsible for your care.

Most men blame themselves for having ED as they think it’s a reflection of their masculinity and don’t realise that it’s caused by a health problem that they may or may not be aware of.

It is believed that if more men were aware of this fact then they would be much more willing to go to their GP for a health check. Not only would the individual find out if they have an important health condition but they would also be more confident about seeking a solution to their ED.

Most men don’t talk about ED when they meet up with their friends for a drink or for any other social activity. It’s a topic that they would rather avoid at all costs!

In fact, most men even find it difficult to speak to their partner about it and it’s thought that ED causes the breakdown of about 20% of all relationships. 3 It seriously impacts on all aspects of a man’s quality of life and his self esteem. It can also affect how a man interacts with his friends and co-workers as it may cause him to lose confidence, reduce his morale and enjoyment of life generally. Furthermore, since ED is not openly discussed, a man may feel isolated and alone as he struggles with these symptoms.

Some men find counselling helpful as a means of exploring psychological causes for ED. Some sexual health clinics (also known as GUM clinics) offer this service or your GP may be able to direct you to someone who can help. 4

If someone was too embarrassed to go to their GP about ED, there are other options. The first line treatment for ED is a group of drugs called phosphodiesterase -5 inhibitors (PDE-5 inhibitors) that dilate the blood vessels leading to the penis and, with sexual stimulation, give a much firmer and longer lasting erection.

In the UK there are four PDE-5 inhibitors available for treating erectile dysfunction.

They are:

  • Sildenafil – sold under the brand name Viagra or generic name sildenafil
  • Tadalafil – sold under the brand name Cialis
  • Vardenafil – sold under the brand name Levitra
  • Avanafil – sold under the brand name Spedra

There are differences between the various products available. They differ in the time it takes for them to act and how long they act for. This is due to the different pharmacokinetics* of the active ingredient. The pharmacokinetics, which include the half-life** of a medication, dictates how long it stays in the blood.

* Pharmacokinetics – How the drug moves through the body

**Half-life – The time taken for the levels of medicine in your blood to fall by half. This directly relates to how long the medicine acts for.

Sildenafil (Viagra) has a half-life of 4 hours and vardenafil (Levitra) has a half-life of 4-6 hours while tadalafil (Cialis) has a half-life of 17.5 hours and is active for up to 36 hours.

This means that vardenafil (Levitra) should act longer than sildenafil (Viagra) but the clinical significance is not known although some studies have shown that vardenafil (Levitra) is more suitable for diabetics. Tadalafil (Cialis) has the longest half-life and duration of action and so allows you to take the medication and not relate the sexual activity to its immediate use. It’s been called the “week-end pill” because of its long duration of action and in lower doses can be taken continuously each day, for those who are more sexually active and struggle to plan ahead.

The most recently introduced Avanafil (Spedra) has the quickest onset of action and only takes about 15 minutes but its effects last about the same time as vardenafil and sildenafil.  

ED drugs: How soon they start working and how long they last

MedicationOnsetDuration
avanafil (Spedra)15-30 minutes4-6 hours
sildenafil (Viagra)30-60 minutes4-6 hours
tadalafil (Cialis)30-45 minutesUp to 36 hours
tadalafil (Cialis) dailyContinuous after 4- 5 dayscontinuous
vardenafil (Levitra)30-60 minutes4-6 hours

It’s very important that men realise that they don’t have to suffer in silence as ED is a very common condition that’s easily treated, in most cases, with oral medication that can dramatically improve their performance and general well-being.  Swingometer

References

1 NHS. Choices. Department of Health. Erectile dysfunction (impotence); 2016 Jun 21 [cited 2016 Sep 21]. Available from: http://www.nhs.uk/Conditions/Erectile-dysfunction/Pages/Introduction.aspx

2 Miller S. Medline Plus. Drugs that may cause impotence: MedlinePlus medical encyclopedia; 2015 Jan 21 [cited 2016 Sep 21].
Available from: https://medlineplus.gov/ency/article/004024.htm

3 Health Centre. Access to health & medical information on Internet; 2016 [cited 2016 Sep 21]. Available from: http://www.healthcentre.org.uk

4 Charitable Company. Sexual Advice Association. Sexual Advice Association. Factsheets [cited 2016 Sep 21].
Available from: http://sexualadviceassociation.co.uk/factsheets/

Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 23/09/16


Are you buying fake medicines online?

Posted 17 March 2016 in Erectile Dysfunction, Men's Health, Sexual Health, Weight Loss

We have all become familiar with the great convenience and ease of buying goods online but what about when it comes to medicines?

Buying medicines online, in the comfort of your own home, without having to take time off work or interrupt your busy schedule to visit your GP is a service we would all like to access. It becomes even more attractive if the nature of your treatment is for sensitive or intimate conditions.

How do you know if you are buying genuine medicines from a reputable registered seller?

ED to the left and STI's to the right

It is illegal to buy any prescription only medicine unless a doctor has written a prescription specifically for you.

More importantly, if a website or indeed any supplier is willing to sell you a prescription only medicine without a prescription then these unscrupulous dealers do not have any concerns about the dire consequences of supplying you fake, potentially harmful medicines.

Fake medicines range from being useless to highly dangerous as they often contain the wrong amount of active ingredient or a completely different ingredient to the one advertised. Some fake medicines have even been found to contain highly toxic substances such as rat poison, lead paint, floor wax and printer ink. The medicines may be made in dirty factories with no quality control and so the person taking the counterfeit medicine may find they are putting their health, even their life, at risk. These fake medicines may look identical to the genuine article and are often packaged to a high standard, making it very difficult to tell the difference.

The  World Health Organization (WHO) estimates that up to 1 per cent of medicines available in the developed world are likely to be counterfeit. This figure rises to 10 per cent globally, but in some areas of Asia, Africa and Latin America counterfeit goods can form up to 30 per cent of the market.

This does not mean that all websites which sell medicines are doing so illegally or without a prescription but it’s very important to be sure that the website that YOU are using is selling genuine medicines from a UK regulated and registered pharmacy.

How can you check that the website you want to use to obtain medicines is a legitimate online pharmacy?

All websites selling prescription medication in England should be registered with the Care Quality Commission (CQC), who are a government appointed independent regulator of health and social care.

CQC Regulated LogoAll fully approved and regulated websites should have a clickable link that will take you to the CQC register to show that they are compliant.


All medicines must be supplied from a pharmacy that is registered with the General Pharmaceutical Council (GPhC). 

If you are thinking of obtaining medicines from an online pharmacy, we would advise you to check if the website is legitimately registered by looking for the General Pharmaceutical Council, GPhC, voluntary logo and the mandatory EU common logo

We would then recommend that you click on each logo which should take you through to that particular pharmacy’s entry on the GPhC register and the Medicines and Healthcare products Regulatory Agency (MHRA) register.

All websites operating in the UK, but outside of England, must be registered with the CQC equivalent body in each country: Healthcare Improvement Scotland, Healthcare Inspectorate Wales, and Regulation and Quality Improvement Authority (Northern Ireland).

The common logo for legally operating online pharmacies/retailers in the EU Member States was introduced by Directive 2011/62/EU (the Falsified Medicines Directive) as one of the measures to fight against falsified medicines.

Therefore, since 1st of July 2015, all online pharmacies or retailers legally operating in the EU have to display the following logo:-

EU Registered Pharmacy
 

How does the logo work?

The logo links to the website of the national competent authority listing all legally operating online pharmacies/retailers. National websites are listed with the European Medicines Agency. By simply clicking on the logo a purchaser of the medicines online will be sent to the entry of the pharmacy on that national list, thus completing the verification process.

The logo can be trusted only if a purchaser, after clicking, is redirected to the entry of that pharmacy on the list of legally operating on-line pharmacies and retailers registered in that Member State on the national authority web-page

Also, all pharmacies in Great Britain, including those providing internet services, must be registered with the GPhC and meet their standards for registered pharmacies.

GPhC Registered Pharmacy logo
 
The GPhC operates a voluntary internet pharmacy logo scheme to provide reassurance to patients and the public that they are purchasing medicines online from registered pharmacies who have to meet GPhC standards.

Therefore, anybody buying medicines from an online pharmacy can check if the pharmacy is legitimately registered by clicking on the logo or going directly to the GPhC website and searching their online register.

The EU common logo is a legal requirement across Europe that applies to all retailers of medicines whilst the GPhC voluntary logo is applicable only to UK registered pharmacies.

What other checks can be made?

You should be able to easily find the name and address of the pharmacy operating the website, as an online supplier who conceals its physical address is a warning sign that their products could be dangerous. The WHO estimates that 50 per cent of medicines available from such websites are counterfeit.

You should avoid websites which offer to supply prescription only medicines without a prescription as registered pharmacies are required to check that a medicine is suitable for a patient before selling it. Therefore, if you are not asked to provide information about your health before making a purchase then you would be wise to go elsewhere.

When you order any medication from our UK registered and regulated pharmacy you can be assured that you are doing so safely, legally and discreetly.

WebMed Pharmacy Ltd, a fully approved and Regulated UK Pharmacy (https://www.pharmacyregulation.org/registers/pharmacy/registrationnumber/9011118), only supplies medicines from a MHRA accredited wholesaler. You can confidently order from us, knowing that you can complete an online medical questionnaire in the comfort of your own home and if suitable can be prescribed by our GMC regulated doctor.

WebMed Pharmacy specialises in treatments where patients may feel embarrassed or awkward talking to their GP or simply find it difficult to get an appointment or don’t want to take time off work. We provide a confidential, discreet next working day delivery, of your chosen medicine, within a 1 hour time slot to the vast majority of postcodes in the UK or New Click & Collect from a store near you, with a choice of 2,500+ stores nationwide.

Quick easy links to our most popular pages with the confidence of knowing we are a fully approved and regulated pharmacy, only supplying UK sourced medication:

Erectile dysfunction | Sildenafil | Tadalafil

Gonorrhoea treatment | Chlamydia treatment

Hair Loss treatment | Finasteride

STI Tests | HIV Test Kits

Medically reviewed by: Super intendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 17/03/16. Updated and reviewed 02/05/17.

Why Ignorance isn’t always Bliss! ( Did you know that your ED is probably caused by your medication?)

Posted 29 August 2015 in Erectile Dysfunction

Erectile dysfunction (ED) can affect men of all ages. In the UK, ED is thought to affect 1 in 10 men and more than 50% of men over the age of 40 will experience some form of ED. It can also be a symptom of an underlying health condition and if it becomes a chronic problem then it is best to consult your GP.

ED can be caused by physical conditions that restrict the flow of blood to the penis, such as narrowing of the blood vessels, high blood pressure, heart disease and diabetes.

It’s also caused by conditions involving the nervous system, e.g. Multiple Sclerosis, Parkinson’s disease, after a stroke and diabetes (which also involves the nervous system).

Hormonal problems can also cause it; deficiencies in testosterone production, an overactive or underactive thyroid gland and Cushing’s syndrome (where the body doesn’t produce enough of the steroid, cortisol).

Furthermore, depression and anxiety are psychological problems that can cause ED.

There are a whole range of medications that can cause ED and even more frustratingly, a lot of the treatments for the aforementioned medical conditions can make existing ED even worse!

Old Soldier

Some members of a group of drugs called ACE inhibitors, used for high blood pressure, such as Ramipril and Lisinopril cause it. Also, other medications for hypertension, called Calcium-channel blockers; amlodipine,felodipine and Nifedipine. Other culprits are beta-blockers, used for angina and hypertension, such as carvedilol, metoprolol and atenolol.

Another group of drugs causing this unwanted side-effect are diuretics (used to treat high blood pressure, kidney disease or heart failure), for example, bendoflumethazide and furosemide. The widely used statins and fibrates used for high cholesterol and commonly used antihistamines, for hayfever and other allergic conditions, also cause ED. Treatments for urinary retention such as Tamsulosin and Doxazosin are guilty too. Anticonvulsants used for epilepsy, cytotoxics used in chemotherapy and medications for ulcers may cause ED.

This list is not exhaustive but gives you an indication of the large number of medications that do cause this sensitive and embarrassing condition. However, it is extremely important never to stop your prescribed medication if you suspect it may be the cause of your ED but go and speak to your GP as an alternative medication may be available that doesn’t cause this unwanted side effect.

There is a huge stigma surrounding ED and many men find it embarrassing and awkward to even talk to their partners about it never mind discussing it with their GP. Although attitudes to gender have improved greatly over the years and the division of labour in the home is now far more evenly distributed than in our parents’ days, we still live in a society where the majority of men like to appear as “macho” and dislike discussing anything that may have a negative impact on their perceived masculinity or sexual prowess.

As a result, when men have difficulties achieving an erection, the majority would rather avoid intimacy and suffer in silence rather than bring attention to the problem and try to find a solution. This attitude is alien to the way a typical man would normally deal with a problem in his everyday life where he usually tries to be the problem solver!

I think if more men were aware that their medical condition and/or their medication was responsible for their ED then they would be more willing to discuss it with their partner and seek out a remedy.

The vast majority of men with ED can be optimistic and anticipate a return to satisfying sexual activity with the various treatments now available and successfully transform their lives.

Medically reviewed by: Superintendent Pharmacist Margaret Hudson BSc(Hons)MRPharmS 29/08/15

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