Since Viagra was approved by the FDA in 1998, the number of men diagnosed with erectile dysfunction in the United States has increased by 250 percent. So there is no wonder why two new drugs for the condition have recently hit the market. The January issue of Harvard Health Letter examines Levitra and Cialis and assesses how these drugs measure up against the groundbreaking Viagra. Levitra offers a much smaller dose, 10 milligrams (mg), compared with the usual starting dose of 50 mg for Viagra. Levitra may also work faster- 25-30 minutes compared with an hour for Viagra. Cialis, on the other hand, stays active in the body much longer than the other two drugs 24-36 hours-compared to 4-5 hours for Viagra and Levitra.
The January Harvard Health Letter also examines the three drugs' similarities:
* They all work by relaxing smooth muscle cells, thereby widening blood vessels.
* None of the drugs automatically produce an erection. Rather, they make an erection possible with sexual arousal.
* Resulting side effects are comparable and may include headaches, heartburn, and flushing.
* The FDA advises against mixing these drugs with alpha blockers and nitrate medications.
Even with the introduction of these two new drugs, the decision to medicate erectile dysfunction should be carefully considered with a physician and will vary among male patients.
Monday, January 28, 2008
Thursday, January 24, 2008
Testosterone and memory.
Testosterone may improve mental function, from the Harvard Men’s Health Watch
When we think about the powers of testosterone, we usually do not consider mental processes. However, research suggests that testosterone levels may affect men’s cognitive performance, reports the January 2008 issue of Harvard Men’s Health Watch.
All the body’s attributes change with age, and mental functions are no exception. Memory is the most fragile mental function. With age, new learning is slower, new information is processed less carefully, and details often slip. These changes give rise to the “senior moment” in healthy elders and to cognitive impairment and dementia in others.
Testosterone levels decline with age, just when memory begins to slow. Might falling hormone levels account for some of the problem? Perhaps, says Harvard Men’s Health Watch. The data are far from conclusive, but studies have found some connections. For instance, higher testosterone levels in midlife have been linked to better preservation of tissue in some parts of the brain. And in older men, higher testosterone levels have been associated with better performance on cognitive tests.
If higher testosterone levels are associated with better mental function, do treatments that reduce testosterone lead to cognitive decline? Three studies linked impaired performance on cognitive tests with androgen deprivation therapy, which is sometimes used in treating prostate cancer. However, the effects were modest and certainly should not deter men from receiving this treatment if needed.
This research also raises the question of whether testosterone therapy might improve mental function in healthy older men, or even in those with cognitive impairment. Only a few small, short-term studies have examined this, and some have reported subtle improvements on cognitive tests. However, high testosterone levels may have harmful effects as well. Harvard Men’s Health Watch suggests that until more research findings are available, men should not use testosterone or any other androgen to improve mental function.
When we think about the powers of testosterone, we usually do not consider mental processes. However, research suggests that testosterone levels may affect men’s cognitive performance, reports the January 2008 issue of Harvard Men’s Health Watch.
All the body’s attributes change with age, and mental functions are no exception. Memory is the most fragile mental function. With age, new learning is slower, new information is processed less carefully, and details often slip. These changes give rise to the “senior moment” in healthy elders and to cognitive impairment and dementia in others.
Testosterone levels decline with age, just when memory begins to slow. Might falling hormone levels account for some of the problem? Perhaps, says Harvard Men’s Health Watch. The data are far from conclusive, but studies have found some connections. For instance, higher testosterone levels in midlife have been linked to better preservation of tissue in some parts of the brain. And in older men, higher testosterone levels have been associated with better performance on cognitive tests.
If higher testosterone levels are associated with better mental function, do treatments that reduce testosterone lead to cognitive decline? Three studies linked impaired performance on cognitive tests with androgen deprivation therapy, which is sometimes used in treating prostate cancer. However, the effects were modest and certainly should not deter men from receiving this treatment if needed.
This research also raises the question of whether testosterone therapy might improve mental function in healthy older men, or even in those with cognitive impairment. Only a few small, short-term studies have examined this, and some have reported subtle improvements on cognitive tests. However, high testosterone levels may have harmful effects as well. Harvard Men’s Health Watch suggests that until more research findings are available, men should not use testosterone or any other androgen to improve mental function.
Friday, January 18, 2008
Cialis improves sexual function for prostate cancer survivors.
October 2 -- In the first randomized trial of its kind, Tadalafil, a drug typically prescribed for erectile dysfunction in men, has been proven to increase the sexual function of prostate cancer survivors, according to a study released today from the International Journal of Radiation Oncology*Biology*Physics, the official journal of ASTRO.
Prostate cancer is the most commonly diagnosed cancer in men, with an estimated 235,000 Americans expected to be diagnosed with it this year. In its early stage, prostate cancer can be treated with surgery and radiation therapy or a combination of the two. With more advanced cancer, treatment options can vary.
The walnut-sized prostate is located near the tubes that carry urine and semen. After treatment, some patients report trouble achieving an erection sufficient for sexual activity, also called erectile dysfunction or ED. In this study, doctors wanted to test whether the drug Tadalafil, which sells under the brand name Cialis, would help prostate cancer survivors with ED who were treated with three-dimensional conformal radiation therapy (3D-CRT). This is the first randomized, placebo-controlled, double-blind trial to examine Tadalafil's lasting effect in treating patients who have ED after radiation therapy for prostate cancer.
Nearly 360 patients were treated for prostate cancer at the Erasmus MC-Daniel den Hoed Cancer Center in The Netherlands between 1998 and 2002. Among them, 60 patients complaining of erectile dysfunction after radiation therapy were included. Patients were eligible if they were treated with 3D-CRT at least 12 months before the study entry, agreed not to use any other treatment for ED and agreed to make at least one sexual intercourse attempt every week during the 12-week trial. Patients were given an initial 4-week course of no treatment at all; however, patients had to attempt sexual activity at least once a week in this 4-week period.
Patients were given 20mg of Tadalafil or a placebo for 6 weeks. Patients were allowed to take the drug or placebo at-will with no restrictions on food or alcohol, but no more than once per day. The men were instructed that the drug would be effective for as long as 36 hours after dosing. After the first 6-week period of the trial, participants were moved onto alternative treatment; patients who were given placebo were switched to Tadalafil and vice versa.
Doctors found that successful intercourse was reported in 48 percent of the survivors who took Tadalafil versus the 9 percent of the men who were given placebo. There was also a reported improvement of the quality of erections in 67 percent of the patients versus only 20 percent of the placebo group.
"Fortunately, prostate cancer is a very curable disease with most patients living at least five years after diagnosis. Now that we've proven we can beat the disease, it's imperative that we work to help maintain the quality of life for the men who survive it, including preserving their sexual function," said Luca Incrocci, M.D., Ph.D., lead author of the study. Dr. Incrocci is a radiation oncologist at the Erasmus MC-Daniel den Hoed Cancer Center in The Netherlands. "This study proves that the drug Cialis is effective in helping men maintain their sexual health."
Prostate cancer is the most commonly diagnosed cancer in men, with an estimated 235,000 Americans expected to be diagnosed with it this year. In its early stage, prostate cancer can be treated with surgery and radiation therapy or a combination of the two. With more advanced cancer, treatment options can vary.
The walnut-sized prostate is located near the tubes that carry urine and semen. After treatment, some patients report trouble achieving an erection sufficient for sexual activity, also called erectile dysfunction or ED. In this study, doctors wanted to test whether the drug Tadalafil, which sells under the brand name Cialis, would help prostate cancer survivors with ED who were treated with three-dimensional conformal radiation therapy (3D-CRT). This is the first randomized, placebo-controlled, double-blind trial to examine Tadalafil's lasting effect in treating patients who have ED after radiation therapy for prostate cancer.
Nearly 360 patients were treated for prostate cancer at the Erasmus MC-Daniel den Hoed Cancer Center in The Netherlands between 1998 and 2002. Among them, 60 patients complaining of erectile dysfunction after radiation therapy were included. Patients were eligible if they were treated with 3D-CRT at least 12 months before the study entry, agreed not to use any other treatment for ED and agreed to make at least one sexual intercourse attempt every week during the 12-week trial. Patients were given an initial 4-week course of no treatment at all; however, patients had to attempt sexual activity at least once a week in this 4-week period.
Patients were given 20mg of Tadalafil or a placebo for 6 weeks. Patients were allowed to take the drug or placebo at-will with no restrictions on food or alcohol, but no more than once per day. The men were instructed that the drug would be effective for as long as 36 hours after dosing. After the first 6-week period of the trial, participants were moved onto alternative treatment; patients who were given placebo were switched to Tadalafil and vice versa.
Doctors found that successful intercourse was reported in 48 percent of the survivors who took Tadalafil versus the 9 percent of the men who were given placebo. There was also a reported improvement of the quality of erections in 67 percent of the patients versus only 20 percent of the placebo group.
"Fortunately, prostate cancer is a very curable disease with most patients living at least five years after diagnosis. Now that we've proven we can beat the disease, it's imperative that we work to help maintain the quality of life for the men who survive it, including preserving their sexual function," said Luca Incrocci, M.D., Ph.D., lead author of the study. Dr. Incrocci is a radiation oncologist at the Erasmus MC-Daniel den Hoed Cancer Center in The Netherlands. "This study proves that the drug Cialis is effective in helping men maintain their sexual health."
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