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This article is going
to move around in time a little but, as always, to a purpose. There has been a
long line of studies examining the relationship between erectile dysfunction
(ED) and other conditions. In 2006, a piece of metaresearch was concluded, i.e.
a study that examines the existing published research to look for a balance of
evidence.
The theme was the
relationship between endothelial dysfunction which is the most common
underlying cause of ED, and hyperlipidemia, cardiovascular disease, high blood
pressure and heart disease. It confirmed a strong signal to the medical
profession that should you appear for a consultation with ED, the physician
should not routinely prescribe Viagra, Cialis or Levitra. Assuming there is no
obvious cause for your ED, e.g. some kind of traumatic injury, you should first
go through a full screen for cardiovascular diseases including measurement of
the levels of lipids and blood glucose.
Even though you may
have no obvious symptoms of vascular or coronary disease, you will be treated
as at risk until the contrary is proven. This will particularly apply if you
are carrying excessive weight and lead a sedentary life. At the very least, you
will find someone counselling you on the subject of lifestyle modification. You
are also likely to be invited to go through an exercise electrocardiogram to
get a better view of the level of risk. If you show reasonable strength and
stamina, you will be advised to increase physical activity. Thus, in addition
to treatment for the ED (probably using Viagra, Cialis and Levitra if your
cardiovascular profile checks out), you will probably find yourself engaged in
a preventive programme to avoid or reduce the development of cardiovascular
diseases.
Similarly, there is
clear evidence of the relationship between ED and depression so that if you
have both of these conditions, any change or alteration in one may cause some
change or modification in the other. So there are four ways in which to explain
the relationship:
1.the fact that they
can occur at the same time is simple coincidence;
2.ED may be a symptom
of depression;
3.ED can be a side
effect of taking antidepressants; or
4.men with ED as the
primary condition may react to the stress of losing sexual function by
developing a secondary depression.
The accumulating
evidence is that mild to moderate depression is quite common but frequently
misdiagnosed among older men. Thus, ED and depression are intimately associated
with the ageing process, and thereby linked to diabetes, hyperlipidemia,
hypertension and heart disease, and in lifestyle, with poor general health,
smoking, alcohol and substance abuse.
In 2001, there was a
twelve week, randomised, double-blind, placebo-controlled trial at twenty
urologic clinics in the USA. Men who came with symptoms of ED were
screened for evidence of untreated depressive illnesses. Those who were found
depressed and had suffered ED for more than six months were invited into the
trial. Viagra was randomly allocated and led to marked improvement in erectile
function. Furthermore, those participants who responded favourably to the
treatment (including those in the placebo who showed some improvement as a
result of the psychological screening process and the general commitment of
resources to them), showed a clinically significant relief of depressive
symptoms and improvement in the quality-of-life indicators as against those
participants whose ED did not respond to treatment at all.
This does not mean, of
course, that Viagra can be used to treat depression. But the evidence is clear.
In other trials involving Viagra, the measurement of quality-of-life showed
improvement in 46% of diabetic men and 72% of men with spinal cord injuries. In
this case , 90.9% of those with untreated depression reported a significant
improvement in the quality of their lives. This would seem good evidence that
successful treatment of the ED removes it as a cause of secondary depression.
It is not good evidence that Viagra itself (or the other PDE-5 inhibitors
Cialis and Levitra) alters mood. You always have to do that for yourselves.
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