Not the Same; A Bit Worse

Listen up, people, to words of wisdom:

"Any intervention that you do to a patient, whether it be surgical or radiation, is never going to make the person (function) better than they are at the present time." ~ Dr. Tracey Krupski, an assistant professor of urology at the University of Virginia

This statement was in reference to a recent study of 152 men that underwent prostate removal surgery (some only partially).  The men were counseled to educate them of the risks, like erectile dysfunction (ED) and urinary incontinence, and surveyed before the surgery.  The survey questions asked about their expectations of urinary, bowel and sexual function a year post-surgery.

About half of men expected that they would have the same function after surgery as before, and 17% of men anticipated better sexual function after the surgery.  Better sexual function...hmmm....

Following up one year later, the researchers found that  just 36% of men's expectations for urinary function matched the true outcomes, and 40% of the expectations for sexual function matched reality.

Daniela Wittmann, the sexual health coordinator in the urology department at the University of Michigan and a researcher on the study, said doctors are unable to tell patients specifically how well they are likely to recover their urinary and sexual functions.

"We can only (inform them) in terms of overall statistics, we can't predict for the individual man" how well he will recover, Wittmann said, "which means that, if in doubt, people tend toward being hopeful and optimistic."

Duh!  Not that knowing the risks to sexual and urinary function should, or would stop men from getting the surgery; but what's important to me is that I'm sure most people feel this way with any medical intervention.  Sure, we can call it hopeful...but we can just as well call it misguided.

Far too many people think the progress of modern medicine is such that we can be made 'good as new'.  Some even believe that we can become bionic--better, stronger, faster...c'mon, geez!

Let me reiterate what the good Dr. Krupski said: You are never going to come out of a surgery or radiation the same or better than you were before.  Duh!  This ain't science fiction, people!  I know, I know...you saw it in a movie...not there yet! 

Listen, you gotta have your prostate removed, so be it.  But elective c-sections, ass-implants, low back surgeries, two, three, four carpal tunnel surgeries, double mastectomies, hysterectomies--what the f....????? You better understand that the minute your tissue is cut--YOU AREN'T THE SAME!

I see it everyday in my Los Angeles chiropractic practice: people coming in following a bad auto accident, and we work hard to get them back to one hundred percent.  How many do we actually get there?  Not many.  Trauma is trauma.  Cut the flesh...it ain't no paper cut.  I had an appendectomy five years ago--I'm not the same; wiser but not 'better'.  That's a fantasy, peeps.

Let me spell it out:  If you've got a choice between letting the innate healing ability of the body do its thing, or removing a body part, think hard.  Looking at enhancing yourself surgically, think hard.  Doctor recommending a 'routine' surgery, think hard.  That's all.  If you still decide to go for it, and they have you take a survey...check the box next to, "not the same; a bit worse."

Cannabis Might Make You Limp

Passing the joint may not be a marijuana thing after all, as recent research shows the penis to be filled with receptors for THC, marijuana's active ingredient.  As a result, marijuana may have a negative impact on male sexual performance, ultimately leading to erectile dysfunction.  Doh!

Rany Shamloul, a physician with appointments at the University of Ottawa and Queen's University in Canada as well as the University of Cairo, conducted a review of studies on marijuana to determine how weed affects male sexual function.  He found that many of the studies were not only contradictory, but rife with problems as well. 

Some early studies found marijuana to have positive effects, sexually, for men.  For instance, in a 1982 survey 75% of men reported sexual enhancement from smoking marijuana (...love weed, baby).  But a study published last year in the journal European Urology found the penis to contain receptors for tetrahydrocannabinol (THC), the active ingredient in the Mary Jane.  The receptors are located mainly throughout the smooth muscle of the penis.  Additional lab studies suggest that THC has an inhibitory effect on the muscle.

Says Shamloul, "This is a more serious effect on the erectile function because the smooth muscle makes up 70 percent to 80 percent of the penis itself."

According to The United Nations Office on Drugs and Crime, 162 million people worldwide use marijuana every year.   More than 22 million use it daily.  That makes understanding long-term effects important, Shamloul said.

Check it and weep, stoners.

As Shamloul says, many of the older studies showing marijuana to have positive effects on sexual performance are flawed in their lack of controlling for perceptual alterations caused by the THC itself.  Other studies from the same year showed male marijuana smokers to have twice the rate of erectile dysfunction as non-smokers.  Another study showed the effects of marijuana on sexual function to be dose specific--small doses having positive effects and larger doses working in the negative.

"What we are really missing are clinical studies," Shamloul said. "We are stuck with only animal studies and molecular studies, and some clinical studies done in the '60s and '70s, most on a very small number of men… We need well-designed, placebo-control studies examining marijuana's effect in both the short-term and long-term."

Hmmm...pot and sex...any volunteers?

Aging Doesn't Prevent Clap

Get this: Geriatric gentlemen popping Viagra are more likely to have VD.  Doh!  Yes, it's true--middle-aged and elderly men that take the erectile dysfunction (ED) med seem to be more likely to practice risky sexual behavior.  This the latest report in the recent issue of the Annals of Internal Medicine.

According to the report, individuals most likely to fall into this group are men that have sex with men.  The data comes from a study conducted at Massachusetts General Hospital and the University of Southern California, where researchers looked at a representative sample of privately insured older men.  The study was unable to determine if the men were primarily homosexual or bisexual.

Researchers examined health insurance claims records covering 1997 though 2006 from 44 large U.S. employers. The study group included about 34,000 male beneficiaries over 40 who used ED drugs, for whom the researchers collected data covering one year before and one year after the first prescription was filled, and nearly 1.37 million men over 40 who were non-users, for whom claims data was also collected.

They found that men using Viagra or other ED drugs were two to three times more likely than non-users to have sexually transmitted diseases (STDs).   The most frequently reported STD was HIV/AIDS, followed by chlamydia. The researchers did not know if ED drug use itself increased STD risk but they plan on investigating that in future studies.

The study's authors conclude that:

1. Drugs like Viagra are not only being prescribed to men with ED but also to those engaging in risky behavior.  This blog has reported for a long time the use of ED drugs to party.
2. Age is not an inherent protection against STDs.  On the contrary, it appears that men (and women) partying with older men might want to carry their own protection (or demand health records).
3. Doctors are doing a poor job of discussing STD risk with older gentlemen.
4. HIV was probably most reported because its symptoms are most likely to bring men into doctors' offices.
5. Men that do not use condoms 100% of the time or are not in a mutually monogamous relationship need routine STD screening with repeated follow-ups.

All I can say is that I think it's human nature to make assumptions, and most people probably don't think of their gray-haired neighbor as the typical clap carrier.  But making assumptions is foolish.  Now you know.  Carry your own rubbers, doggone it.

Our Greatest Sexual Concerns

More on sexual dysfunction. A recent European study looking at male and female sexual concerns when calling a helpline* disclosed the following:

• Users were more often male (62.2%), aged between 26 and 35 years
• Males most frequently reported sexual difficulties were erectile dysfunction (ED) and premature ejaculation
• The majority of female callers reported vaginismus and orgasmic disorder (OD)
• There was a definite association between desire disorder (DD) and ED in men (41.7%)
• There was a definite association between OD and DD in women (36.8%)

Although erectile dysfunction and orgasmic disorder are old hat for me (I mean what I know about them...now stop!), I had never heard of vaginismus. For others that don't know, vaginismus is the tensing up of vaginal/pelvic musculature preventing penetration. It is comparable to to the response of the eye shutting when an object comes towards it. It is not under the conscious control of the woman affected.

And I was rather amazed in my research that there exists an actual association for asexual people. How 'bout that--I had no idea. The incidence of people exhibiting asexuality, also known as non-sexuality, is reported at 1%. Wow! Like I said, never had a clue. Well, different strokes for different folks, if you'll forgive the pun.

The study on sexual concerns concludes with placing an importance on sexual counseling--talking about the problems. For men, I'll refer back to the last post. For women, the good news is the capacity for orgasm increases with age, especially as women acquire more knowledge about the responses of their bodies. And masturbatory training is available (I do NOT make this stuff up) to help women with orgasmic disorder.

Finally, for asexuals...be who you are. Join the association if you are looking for like minded people as support. Other than that just focus on what you love. That's what life is ultimately about anyway.

*The study included selected records of the calls received during the 3-year period between 2006 and 2008.

Momentary Humiliation Beats Dying

"Hey doc...I can't get it up." There now that wasn't so bad was it? Say it again. Go on, say it. I promise you, your doctor will not laugh. Trust me, it's a hell of a lot better than buying counterfeit Viagra online. Duh!

A recent study published in the International Journal of Clinical Practice reports that fake drug sales via the internet have skyrocketed over the last couple of years. In fact, seizures of fake drugs in Europe have quadrupled between 2005 and 2007; in the U.S. FDA investigations have increased eightfold from 2000 to 2006. The distribution of fake drugs is a booming business: one estimate has the sale of fake drugs hitting $75 billion in 2010.

The problem is not just that consumers are being ripped off, the fakes can actually be harmful to health. Two pregnant women died after they were given injections of a counterfeit iron preparation for anemia, and 25 children died in Bangladesh of kidney failure after taking paracetamol syrup that was contaminated with diethylene glycol, which is also used as antifreeze in cars.

However, the purchasing of fake drugs on the internet persists. Viagra seems to be the big one, but the consumers of such pharmaceuticals know not what they take. According to lead author of the study, Dr. Graham Jackson, a cardiologist at London Bridge Hospital in the UK, "The first danger is people don't know what's in it. Some are just talcum powder or brick dust, while some have a bit of Viagra or Cialis and some chemicals that have nothing to do with it."

According to the study, one-third of men surveyed reported sidestepping a health-care professional when buying erectile dysfunction drugs. Why? What IS the big deal? Do you think your doctor finds this funny, pathetic, or what? C'mon guys, you would rather buy fake stepped-on garbage than risk a moment of humiliation I guarantee will pass the minute your doctor says okay? How much you want to bet he or she doesn't even look up at you and just writes the scrip. There...I given you support. Now get off the damn net and get to your doctor's office pronto. Just one humiliating second and it'll be happy days are here again....

P.E.--Believe the Hype?

E.D. or P.E.? No problem, Mon--we've got a drug for every penile predicament. That's erectile dysfunction and now premature ejaculation for those of you not familiar with the LOL/OMG vernacular. You've got it--drug makers have created a spray and a pill and that help delay ejaculation. Hallelujah for modern medicine! I can see the three hour porn scene on the horizon.

PSD502--which combines the drugs lidocaine and prilocaine--is sprayed on the head of the penis before intercourse. A study of men in Canada, Poland and the United States found that those treated with the spray five minutes before intercourse were able to delay ejaculation up to five times longer than those who used a placebo. In addition, men who used the spray and their partners reported improved sexual satisfaction. Throw in a little Viagra and WATCH OUT!

Johnson & Johnson has also developed a pill called Priligy that delays ejaculation. The company studied the product on several hundred men who had a typical ejaculation time of about 36 seconds. After using the product, the typical time from penetration to ejaculation was about 2.6 minutes, about a two minute increase--not a big deal for most of you stallions, but for the typical P.E. sufferer...that's heaven.

As exciting as this news is, controversy looms: Some people in health care circles believe, accurately in my opinion, that too many disorders these days are created only after a drug has been developed. This is certainly the case with antidepressants, and probably with erectile dysfunction and premature ejaculation, too.

Listen, no doubt some men can't hold on for dear life, but enough to create a mega-selling drug in the Viagra vein? I doubt it. Variation exists in all physiological functions, including staying power--and there's no shame in that, but let's hear the arguments:

According to Dr. Wayne J. G. Hellstrom, professor of urology at the Tulane University School of Medicine in New Orleans and, not surprisingly, previous consultant for Johnson & Johnson, "[Premature ejaculators] don’t usually last in their relationships." Excuse the pun. He goes on to say that 20 to 30 percent of men experience premature ejaculation at some point in their lifetimes.

But Leonore Tiefer, a clinical associate professor in the psychiatry department at the New York University School of Medicine specializing in sexual disorders, believes that pharmaceutical companies are medicalizing every aspect of our daily lives, from mood to sleep to sexual function. My regular readers know I agree with this wholeheartedly. If you haven't had the chance to check out to my podcast on lifestyle drugs (episode 3), it's definitely worth the listen.

Tiefer says, “Rapid ejaculation as opposed to slow ejaculation is common, but there is slow and fast everything in the world: slow and fast walkers, slow and fast eaters, slow and fast breathers. When you tell someone they are a fast ejaculator, it makes it sound like there is a right time to ejaculate and, if you ejaculate before, it’s a medical problem."

She goes on to say, "It is going to become a problem once enough publicity is given to it."

Exactly. Don't let me ruin the party but...come on (not too quickly, now)! Thirty percent? Uh huh. Today, marketing is everything in the world of pharmaceutical sales. And sadly, it even dictates disorder classifications. That's the world we live in.

Bevy of Sex News

Have I caught your attention? Good. You're gonna like this post, either for its usefulness or its sheer absurdity. Either way, listen up--there's something in it for everyone.

First things first, doctors urge the use of erectile dysfunction drugs. According to a clinical practice guideline issued by the American College of Physicians, men with erectile dysfunction should be on oral phosphodiesterase type 5 (PDE-5) inhibitor drugs, such as Viagra, Cialis and Levitra, unless, of course, they are on nitrate therapy for cardiac conditions.

OK, no surprises there. This news in the face of another study that discloses that "hardness is the way to happiness." Men have known this forever, but now science confirms it. Here's the scoop: Pfizer, the makers of Viagra, surveyed men and women from twelve European countries. They found that 95% of respondents believe that a man's sexual confidence is the essential ingredient for a good sex life. And 84% of men surveyed believe that the most important element of a man's sexual confidence is his ability to please his partner sexually, while almost three quarters of women questioned agreed. So, guess what? More vi--agra, Olé!!!

The humor lies in the fact that when it comes to erection hardness, Spaniards are the least confident, while Germans are the most. This is in complete contrast to another survey in which women rated German men as the worst lovers, and Spanish men the best. Hmmm...either Spaniards are modest, Germans are dense, or women prefer men who lack confidence in their erections. Let's see, happy women, unhappy men....yeah, that sounds right.

Anyway gents, dont worry about long-term Viagra use for now. It appears that scientists can't find any long-term risks at the moment. There are, however, plenty of short term reactions. Dr. Alexander Tsertsvadze, from Ottawa Health Research Institute, Ontario, Canada, and colleagues report that men who took Viagra were 56% more likely than those given a placebo to experience any side effect, like headache, flushing difficulty breathing, and vision problems. The way I see it, most Spanish men would gladly endure flushing and gasping for a few hours of good wood.

But women--Aussie women primarily--beware the British male tourist travelling Down Under (now stop!). According to a recent report, Englishmen backpacking through Australia are speading sexually transmitted diseases like wildfire through risky behavior (unprotected sex with multiple partners). That's right, "liberal" Aussie girls are foolishly practicing "no glove-love" with British travelers. And, well...you know that's dumb.

American truckers ain't doin' much better. But I'll spare you the dirty details. Check here if you're interested.

Finally, in Detroit, one liquor store was busted trading Viagra, liquor and pornography for food stamps. U.S. Agriculture Department officials are pissed. I don't get why. Don't they understand it's the key to happiness? Why, just ask a Spaniard.

The Mad, Mad World of Erectile Dysfunction

Oh, the madness of erectile dysfunction. Seems like there are stiff problems surrounding the pharmaceutical and herbal remedies meant to treat this malapropos malady. According to new reports from the U.S. Food and Drug Administration, taking the impotence drugs Viagra, Cialis, or Levitra can bring on sudden hearing loss. A review done by the governmental agency found that 29 cases of sudden hearing loss were reported with use of these three drugs, with two thirds of the cases being ongoing.

And if that ain't bad enough, researchers in Hong Kong report that many "herbal remedies" sold over-the-counter have untested variants of the same pharmaceutical agents named above. The illegal analogues of sildenafil and vardenafil (Viagra and Levitra respectively) are produced with minor changes to the chemical structures and then added to, or more accurately--concealed in--the supposedly natural mix. Unfortunately, chemical variants are neither tested nor reviewed by regulatory bodies, like the FDA, as patented pharmaceuticals are, and this can lead to problems.

For instance, a previously healthy 28-year-old man was recently hospitalized with an unsteady gait (called ataxia--a neurological issue) and frequent falling. It was discovered that he had been taking an anti-impotence "health product" for over a week before showing those symptoms. Funny that a healthy young buck would need an anti-impotence drug. But as you all know from my podcast on lifestyle drugs (Episode 3), many a young stud is taking erectile dysfunction drugs to enhance performance. Bad, bad idea, Padners.

For men who truly suffer from erectile dysfunction (ED), let it be known that problems with impotence may underlie an even more serious problem--heart trouble or vascular disease. Erectile dysfunction, or the inability to gain an erection is the result of poor circulation to the penis. In fact, drugs like Viagra work precisely by increasing blood flow--vasodilation it's called--which allows the penis to engorge with blood. Failure to do so means that the body has encountered an obstacle, most likely a problem with the pump. So simply treating ED with drugs isn't the answer. On the contrary, not only may it mask the true issue, but that kind of cover up can also prevent men from seeking out the care they really need; or prevent them from changing their lifestyle to promote good heart health.

Unfortunately, many doctors are missing this connection. Not a surprise considering the mass volume of impotence drugs prescribed every year. Furthermore, many men with erectile problems aren't aware of the vascular implication, so they don't discuss it in depth with their physicians. According to Dr. R. Parker Ward, an assistant professor of medicine and director of the cardiology clinic at the University of Chicago Hospitals, and lead author of the study linking ED to heart disease, "We as physicians should be asking about, and men should be reporting to their physicians, symptoms of ED, so it can be considered as we work to modify their risk -- treat blood pressure, cholesterol more aggressively, advise healthy lifestyle changes like exercise and healthy diet." Always better to treat the cause than to put on a band-aid, I always say. And this is one of those situations where a band-aid can ultimately cost you your life.

So if your having trouble standing up to the task, take it as a firm warning--get your heart checked, start exercising, and start eating a healthy, wholesome diet. And please be cautious of purchasing that "natural" impotence herb you've been considering. Chances are it's not all that natural.