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FDA has received 43 reports of varying degrees of vision loss, including blindness, in men taking type 5 phosphodiesterase (PDE-5) inhibitors. Most of these cases of vision loss were due to nonarteritic anterior ischemic optic neuropathy (NAION). The loss of vision in some cases has been irreversible.
As type 5 phosphodiesterase (PDE-5) inhibitors are the main active ingredients in Viagra, Cialis and Levitra, the US Food and Drug Administration (FDA) has issued a news release to advise healthcare providers of the potential risk.
NAION is a vascular event that is presumed to occur due to a decrease in blood flow to the small arteries that supply the optic nerve. A disruption in the blood supply to the optic nerve causes damage to the nerve. Injury to the nerve may result in permanent visual loss in 1 or both eyes. Patients are typically older than 50 years of age; clinical examination reveals unilateral visual acuity and visual field loss and optic disk edema. Despite the frequency with which this condition occurs, its exact cause is not known. Numerous risk factors have been proposed, including a small cup-to-disk ratio, hypertension, diabetes mellitus, arteriosclerosis, hypercholesterolemia, and after intraocular surgery.
As patients with erectile dysfunctions are more likely to have the microvascular risk factors typically associated with spontaneous NAION, an ischemic effect by type 5 phosphodiesterase (PDE-5) inhibitors,on the optic nerve is plausible, but unlikely. In normal adults, PDE-5 inhibitors increased pulsatile ocular blood flow, a result of filling the choroidal circulation.
Despite the differences in the number of cases of NAION among men taking the various PDE-5 inhibitors - 38 cases in men using Viagra, 4 in men using Cialis, and 1 case in a man using Levitra - there is no evidence that one drug presents a higher risk than another. Viagra has been used by more than 23 million men worldwide, Cialis by more than 4.5 million, and Levitra by more than 1.8 million. The difference in the number of NAION cases among all 3 PDE-5 inhibitors reflects the number of each drug used worldwide rather than real differences in risk among drugs.
It can be recommended that patients with a history of monocular NAION be cautioned that PDE-5 inhibitors may increase the risk of NAION in the fellow eye. At the same time, patients who have risk factors for the development of NAION should be referred to an ophthalmologist before being prescribed PDE-5 inhibitors.
Valerian D is a freelance writer specialized in health issues affecting men like NAION blindness causes.
I though the soft tabs would be strips that melted
under your tongue. They are as you know just as hard as hard cialis
however dissolve under the tongue in about 20 mins. The flavor is fine.
Thanks for getting back to me,
- Alan
You must set the tan_unit_111.txt file to be writable (check file name as also).
Erectile dysfunction
Erectile dysfunction (ED) affects the lives of many middle-aged men and their partners. The term erectile dysfunction covers a range of disorders, but usually refers to the inability to obtain an adequate erection for satisfactory sexual activity.
Although erectile dysfunction, formerly called impotence, is more common in men older than 65, it can occur at any age. An occasional episode of erectile dysfunction happens to most men and is normal. As men age, it's also normal to experience changes in erectile function. Erections may take longer to develop, may not be as rigid or may require more direct stimulation to be achieved. Men may also notice that orgasms are less intense, the volume of ejaculate is reduced and recovery time increases between erections. Erectile dysfunction may also be a sign of a physical or emotional problem that requires treatment.
Erectile dysfunction was once a taboo subject, but more men are seeking help. Doctors are gaining a better understanding of what causes erectile dysfunction and are finding new and better treatments.
This Website discusses all about erectile dysfunction, physiology of the normal erection and the pathophysiology, and treatment of ED.
What is Erectile Dysfunction?
Erectile dysfunction or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. There are various underlying causes, such as diabetes, many of which are medically reversible.
The causes may be physiological or psychological. Psychological impotence can often be helped by almost anything that the patient believes in; there is a very strong placebo effect.
Due to its embarrassing nature and the shame felt by sufferers, the subject was taboo for a long time, and is the subject of many urban legends. Folk remedies have long been advocated, with some being advertised widely since the 1930s. The introduction of perhaps the first pharmacologically effective remedy for impotence, sildenafil (trade name Viagra), in the 1990s caused a wave of public attention, propelled in part by the news-worthiness of stories about it and heavy advertising.
The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina. It is now mostly replaced by more precise terms.
Signs and symptoms:
Erectile dysfunction is characterized by the inability to maintain erection. Normal erections during sleep and in the early morning suggest a psychogenic cause, while loss of these erections may signify underlying disease, often cardiovascular in origin. Other things leading to erectile dysfunction are diabetes mellitus (causing neuropathy) or hypogonadism (decreased testosterone levels due to disease affecting the testicles or the pituitary gland).
Here are some causes of Erectile Dysfunction:
* Arousal: The first step is sexual arousal, which men obtain from the senses of sight, touch, hearing and smell, and from thoughts.
* Nervous system response: The brain communicates the sexual excitation to the body's nervous system, which activates increased blood flow to the penis.
* Blood vessel response:. A relaxing action occurs in the blood vessels that supply the penis, allowing more blood to flow into the shafts that produce the erection.
Physiology of normal erections:
Penile erections involve an integration of complex physiologic processes involving the CNS, peripheral nervous system, and hormonal and vascular systems. Any abnormality involving these systems, whether from medication or disease, has a significant impact on the ability to develop and sustain an erection, ejaculate, and experience orgasm. Tumescence, the vascular filling of the cavernous bodies, relies on neural and hormonal mechanisms operating at various levels of the neural axis. This is unique among visceral functions because it requires central neurological input.
Andersson et al summarized some of the information related to the pathways involved in erectile function. The degree of contraction of corpus cavernosal smooth muscle determines the functional state of the penis. The balance between contraction and relaxation is controlled by central and peripheral factors that involve many transmitters and transmitter systems. At the cellular level, smooth muscle relaxation occurs following the release of acetylcholine from the parasympathetic nerves.
Pathophysiology of erectile dysfunction:
Erectile Dysfunction is essentially a vascular disease. It is often associated with other vascular diseases and conditions such as diabetes, hypertension, and coronary artery disease. Other conditions associated with Erectile Dysfunction include neurologic disorders, endocrinopathies, benign prostatic hyperplasia, and depression. Conditions associated with reduced nerve and endothelium function, such as aging, hypertension, smoking, hypercholesterolemia, and diabetes, alter the balance between contraction and relaxation factors. These conditions cause circulatory and structural changes in penile tissues, resulting in arterial insufficiency and defective smooth muscle relaxation. In some patients, sexual dysfunction may be the presenting symptom of these disorders.
Treatment:
Sildenafil Citrate is the way to treat Erectile Dysfunction. Generic Viagra contains sildenafil citrate and contains same ingredients like branded drug.
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