Archive for September, 2014

Diabetes and the Consequences. Canadian pharmacy

Sunday, September 28th, 2014 No Commented
Under: Diabetes

Diabetes and the Consequences

It is no laughing matter when one contracts this horrible disease. Early symptoms might include headaches, dizziness, thirst, hunger and a few other mild out of sort’s conditions. It’s when the other more serious symptoms start that one generally becomes very anxious.

The feet may lose feeling, the centre of the brain feels numb, the eyes are not what they used to be and balance is fading. You head to the doctor’s and a sucrose tolerance test is ordered. You suspect high blood sugar because you have a sweet tooth and a great love of chocolate and ice cream. So will that explain why you are so thirsty, particularly when you wake up in the morning? What about that funny feeling in your tongue?

Some of these symptoms go with high cholesterol and high blood pressure and these too are warning signs for diabetes.

During my lifetime there have come and gone many with the disease and the thing noticed most about them is the smell of their breath. It is a somewhat sickly artificial smell that might be explained by the intake of insulin. My grandmother had diabetes and that smell was prominent on her breath and would see me avoiding coming too close to her face, although her affection was much sought after.

Lately some diabetics have come to my attention in hospitals where they were having lower limbs removed. In the eye hospital some were being treated for blindness and other things.

This is a preventable disease although if you have the diabetic gene it only takes careless abuse of your body to get it. Obesity is one of the primary causes and here blood pressure and cholesterol are always present. People with the latter can contract heart disease, suffer strokes and die suddenly. All types of viagra medications online at global canadian pharmacy

These are all reasons to avoid sugar at all costs and yet parents feed masses of it to their children. Soft drinks or sodas are full of it, some worse than others. Chocolate bars and candies are quite potent poisons and ice cream loaded with sugar is also full of fat.

Human Body: Cells

Friday, September 26th, 2014 No Commented
Under: Cell, Men's Health

Life comes from the Great, from the infinity, which has no a beginning and an ending. Life comes from an essence, but not from the small, but from the big. Scientists say that life has come from one small cell, and actually this cell is only a conductor of life in the way faucets are conductors of water. However, the faucet itself does not give water. Water comes from a totally another source. The cell is only a conductor of life, but an intelligent conductor.



Some cells build the brain, others – the stomach, third ones – the lungs, forth ones -the nervous system, etc. They are excellent chemists. They know how to combine elements. They are smarter even than the one, in whom they are located. Man is considered to be a master of his body, and actually some of his servants know more than their master. The master should turn to God by the words: “God, I would like to know at least as much as my servants in my head know”. Man shall be a little more humble and admit that he does not know much. If his life does not go well, if his blood is not clean, what does man know?

What is man Viagra pharmacy online Canada? A sum of milliards of small souls or creatures, which have agreed, in the name of God’s love, to enter in man and work for him and give him an appearance of a person. They have sacrificed their lives for him. They have become his servants and when he does not understand them, he says: “What is the body? It is nothing else than a machine.”

There is one rational matter in the world, which penetrates into all cells all over he body, of which we even do not imagine. Round this matter, which is rational, there is a rational power, which surrounds them both. That rational matter and that rational power surround externally all cells and penetrate through all smallest particles of our organisms.

In human organism, there is one immortal cell – the original one, which everybody shall find. It is the ancestor of all cells. This original living cell distinguishes from the others by the fact that it contains horny substance in itself. The nourishing materials in it are more than in the other cells, and thanks to the horny substance, it differs with great stability. It can stand even the worst conditions.

There are specific cells in the human body, which perform the duties of the best doctors. If we get ill and leave ourselves to those cells, they can cure us. They have a laboratory, where they prepare their medications and thanks to them they perfectly heal our wounds.

Human organism is composed of approximately 60 trillion cells, which distinguish with great intelligence. All of these cells include in themselves qualities and abilities of creatures of a different culture and intelligence.

Anti-Inflammation. A few words about.

Thursday, September 25th, 2014 No Commented
Under: Detoxification

Over the years, I have continually tried to simplify the Zone Food Block system, and I came up with the development of Zone Points. Zone Points are simply another accounting system to keep your glycemic load under control from meal to meal. Since you are only as hormonally good as your last meal and will only be as hormonally good as your next meal, you want to have the same glycemic load at every meal. This is because the glycemic load at each meal determines the amount of insulin that will be secreted.

Zone Points are based on the glycemic load of various carbohydrates in serving sizes that will keep you satiated without being stuffed. A good rule of thumb is to make sure that your total Zone Points for any one meal are no more than 15 if you’re female, and no more than 20 if you’re male. A typical Zone snack would contain about 5 Zone Points. Just as with the Zone Carbohydrate Blocks, you just keep adding carbohydrates to your dish until you hit the maximum you are allowed at that meal and then stop.

Let me use the Zone Point system to illustrate why I am not a big fan of whole-grain carbohydrates, even though they are politically correct. First, most foods labeled “whole grain” really aren’t. Whole-grain foods are extremely perishable. Real whole-grain products contain fats that go rancid at room temperature, and that’s why they are found in the frozen section of the supermarket. When was the last time you bought a loaf of bread from the freezer section? Dried whole grains, like steel-cut oats, need to be cooked for at least 30 minutes before eating. Even though I love real whole grains (especially oatmeal and barley), I still consume them sparingly.

Lifestyle without erectile dysfunction

Tuesday, September 23rd, 2014 No Commented
Under: Erectile dysfunction, Men's Health

Sources of ED we discussed Lifestyle sources of ED such as smoking, excess alcohol and carrying a few extra pounds. We have also seen how party drugs can crash your party and take you to another party. In the introduction we discussed how stress and inflammation can be the intermediaries that enable baddie





free radicals. This stress can be both physical and emotional. So, let’s look at some Lifestyle changes you can start to apply to give your Dick the best chance.

Lifestyle: Eat Regularly

Skipping or delaying a meal stresses your body and could start baddie free radical reactions. It doesn’t even help with weight loss as your metabolism slows down to preserve energy. Eating regularly keeps your energy levels up and your metabolic rate optimal.

Lifestyle: Exercise, Exercise and Exercise

It cannot be stressed enough that exercise is crucial to your body systems that affect erections and ED. Strong evidence links a sedentary lifestyle to ED.

Dickxy reports findings that men who were physically active reported better erections with a 30% lower risk of ED than those who didn’t exercise regularly. A recent study published online in the journal of Sexual Medicine, found an association between physical activity and better erectile function even in young, healthy men aged 18 to 40. So, it’s irrefutable. Whatever your age, exercise enhances erectile function.

Regular exercise can enhance sexuality through a variety of mechanisms that affect both the mind and body. Physical improvements in muscle strength and tone, endurance, body composition and cardiovascular function (specifically, enhanced peripheral blood flow) can all enhance your sexual ability. Yet another study showed that those who exercise are more likely to experience a greater level of positive perception of themselves. This makes them more sexually desirable and enhances their sexual prowess.

As regular exercise seems to feature so much, here are 6 medically reviewed exercises that can improve your sexual prowess:

(1) Weight lifting. Strength training causes the body to produce testosterone, can strengthen the upper body and improve stamina during intercourse.

(2) Pelvic Floor Muscle exercises (also known as Kegels). We will get into these exercises in great details as part of the behavioural exercises in later steps. These arc also useful to delay ejaculation.

(3) Yoga. This exercise helps you become more flexible, making you more creative in your sex positions. Specifically, get into yoga poses that improve pelvic muscles such as the Bow Pose, Peacock Pose (also called the Forearm or Elbow Balance), and Shoulder Stand.

(4) Fast walking, running and other aerobic activities can help improve one’s sex life by improving circulation and blood flow. If you don’t like running, just find time to walk briskly for 30 minutes a
day. Preferably first thing in the morning.

(5) Short intense exercise has also been proven to boost testosterone. This is intense exercise for 30 seconds, recovery for say 90 seconds and repeated again 7 times.

(6) Swimming. Swimming for at least 30 minutes three times a week will increase sexual endurance.

Note that I have underlined regular. Dickxy has found research (PMID 16874149) that shows that whilst a single dose of exercise can increase Nitric Oxide for about 48 hours, daily and regular exercise causes a four-fold increase that can last up to a week.

The relatively new subject on how the brain works, Neuroplasticity, has replaced the formerly-held position that the brain is a physically static organ. It is proving that exercise actually changes the way the brain works Kamagra Australia shop for the better and more importantly counters some of the effects of aging on brain function. It makes sense that as the brain has so much influence on erections anything that improves brain function has to be good for your erections.

Insulin is also a stimulator of Nitric Oxide and exercise increases Nitric Oxide production in response to insulin (PMID 16889802). Exercise also increases the activity of an important circulating antioxidant, para-oxinase-1 that is usually decreased in men with ED (PMID 12798217). Need we say more about regular exercise? No matter how hard, inaccessible or boring, you have to find some kind or regular exercise routine to help with good erections.

Sinobronchial Allergic Mycosis

Monday, September 22nd, 2014 No Commented
Under: Allergies

The five convincing case reports of patients with concomitant AFS and ABPM reviewed here clearly demonstrate that these diseases occur together and constitute a syndrome of sinobronchial allergic mycosis (SAM). A classification of sinopulmonary syndromes is presented in Table 2. Patients with SAM are atopic individuals who have asthma, rhinosinusitis, and high levels of total and fungal-specific ige.

The common histopathologic findings of eosinophilic mucin with layers of cellular debris and scant degenerating hyphae in both the upper and lower airways support the conclusion that these are similar hypersensitivity reactions to fungal elements occurring at different locations in the same airway.

Other data also suggest that the pathogenesis of these diseases is similar. In a review of the his topathologic features of AFS, Kahn et al 24 noted the histopathologic similarities between ABPM and AFS. There is evidence for the active contribution of both eosinophil-derived and neutrophil derived products, including eosinophil major basic protein and neutrophil elastase, like that seen in late-phase cutaneous reactions. Australia viagra information

Their findings support earlier suggestions that ubiquitous fungal spores induce a robust, IgE-mediated inflammatory response that induces the viscous mucous secretions these patients experience. Eosinophil derived and neutrophil-derived toxic proteins have the capacity to induce tissue destruction leading to the layers of eosinophil and epithelial cellular debris that are component parts of the allergic mucin. The mucin obstructs the airways leading to ongoing infection. Since the presence of only small quantities of fungal hyphae in the airway is necessary to initiate the eosinophilic inflammatory process associated with the disease, obstruction to normal drainage of the airway seen in both asthma and chronic sinusitis could be a common feature predisposing an individual to the development of these conditions.

Alcohol and Drugs

Monday, September 22nd, 2014 No Commented
Under: Drugs, Health care

Alcohol – a Good Servant and a Bad Master

Alcohol is the most widely used and abused drug among Irish men and is a major risk factor for ill-health and premature death. Alcohol-related problems are epidemic in Irish society, as a weekend visit to an accident and emergency department in any Irish hospital will testify. Problems associated with drinking alcohol include increased numbers of accidents and injuries; increased violence; increased absenteeism from work; a risk of suffocation through choking on one’s own vomit; alcohol poisoning, which is potentially fatal; and an association with many physical and mental health disorders, including depression and suicide.

There is no doubt that some men drink more when they are under stress. However, using alcohol as a means to de-stress may only give temporary relief of symptoms, followed the next day by a worsening of the stress feelings – one step forwards and two steps back! Using alcohol as a stress buster can make you more likely to become dependent on alcohol.

There can undoubtedly be significant health and social benefits to low-dose alcohol, if drunk by the right person at the right time in the right amount. But it is very much a case of‘less is more’.

How to Calculate the Number of Units in a Drink

The system of‘units’ of alcohol in drink was thought up years ago as a means of estimating the amount of alcohol in different drinks so as to work out how much alcohol someone is consuming. The strength of drink is measured as ‘ABV, which means alcohol by volume.

The most accurate way to calculate the number of units in an alcoholic drink is to look at the percentage of alcohol by volume (% ABV) of a drink. This equals the number of units of alcohol in 1 litre of that drink. For example, wine with 12 per cent ABV has 12 units of alcohol in a litre of wine, so if you drink half a litre of wine (500 mls), which is four small glasses, then you have had 6 units of alcohol.

Ordinary strength beer, at 4 per cent ABV, has 4 units of alcohol in a litre, so if you drink half a litre, which is just under a pint, then you will have had 2 units of alcohol. Strong beer, at 6 per cent ABV, has 6 units in a litre, so a half litre of this equates to 3 units. So you can see that the number of units of alcohol can vary widely from beer to beer, depending on the ABV.

One unit of alcohol is about equal to:

  • A half pint of ordinary strength beer (3-4% ABV) or
  • A small pub measure of spirits (40% ABV) or
  • A standard pub measure (50 mls) of sherry or port (20% ABV)

Calculating the number of units of alcohol in a drink isn’t rocket science and certainly doesn’t require a degree in maths.

A few words about lung cancer

Monday, September 22nd, 2014 No Commented
Under: Cancer

This border-zone subset of stage IIIA patients, which lies between the generally resectable stage I and II tumors and unresectable stage IIIB patients, has been the subject of a wide variety of clinical trials incorporating various combinations of chemotherapy, radiotherapy, and surgery. Unfortunately, most published studies have significant limitations since they are not randomized, lack rigorous pretreatment staging, or involve a significant lack of homogeneity in the study population, making interpretation of the results difficult. There are a few more rigorous randomized trials, which will be discussed subsequently, that suggest a combined modality approach may be beneficial in stage IIIA disease. The approach showing the greatest promise in selected patients employs initial treatment (induction or neoadjuvant therapy) with chemotherapy or chemoradiotherapy followed by surgery. Nevertheless, more widespread use of induction therapy followed by surgery for lung cancer has been used for only 7 years, and as a result there is little reliable data with larger patient groups. This lack of meaningful, larger, randomized data underscores the importance of enrolling patients in clinical trials whenever possible. Canadian health care mall shop

Since staging and treatment are so very interdependent, intraoperative staging with systematic mediastinal node sampling or dissection is critically important. Unless histologic conformation of mediastinal node status is obtained at the time of surgery, postoperative pathologic staging will be inaccurate, as will further treatment recommendations and the discussion of prognosis. Therefore, the standard of care in modern thoracic surgery dictates that mediastinal node sampling or dissection must be performed at the time of every lung resection for lung cancer.

Under the 1997 revised lung cancer staging system,1 stage IIIA encompasses all tumors with ipsilateral mediastinal lymph node metastases (T1–3, N2). Also included in this stage are tumors with resectable chest wall involvement and hilar node metastases (T3N1), added primarily because of similar survival rates. However, the treatment recommendations and applicable clinical trials for T3N1 are the same as for stage II. Therefore, for the purposes of these current guidelines, T3N1 tumors are discussed in the preceding chapter on stage II tumors. The present chapter will deal only with N2 disease.

Sexually transmitted infections

Friday, September 19th, 2014 No Commented
Under: Health care, Infections

Symptoms and Signs of an STI

If you are sexually active and notice any of the following symptoms, you should make an appointment to see your doctor as soon as possible:

  • Pain or a burning sensation while urinating
  • Pain during intercourse
  • Itching or irritation in the genital area
  • Any unusual discharge from your penis
  • Pain or discomfort in the genital area
  • A rash on the skin or genitals
  • Soft, cauliflower-like bumps or blisters on genital areas
  • Swollen glands, with or without sore throat and fever
  • Red bumps that turn into painful blisters or sores on the penis, buttocks or thighs
  • Severe fatigue, aches and pains, nausea and vomiting, loss of appetite, darkening of urine, abdominal tenderness, or yellowing of the skin and whites of the eyes (called jaundice)
  • Unexplained weight loss, flu-like symptoms, persistent fevers, night sweats, headaches
  • Blood in your urine or faeces

Remember, not all STIs have symptoms. Men often have no symptoms. Because of this fewer men seek treatment, and many are carriers without even knowing it. People who have no symptoms can still have an STI and can spread it to others.

Getting Tested

If you have symptoms that suggest an STI or if you have had unprotected sex, do not delay to get yourself checked out. This can be done confidentially by your own family doctor, or alternatively you can go to an STI clinic.

The sooner an STI is diagnosed and treated, the greater the chance of it being properly treated without complications. It is also important to alert your partner, as they need to be examined and treated if necessary. Diagnosis usually involves analysis of swabs taken from any unusual sores or discharge. In some cases a urine or blood test is also required. Do not be embarrassed; it is worse to live in ignorance than to put your own long-term health and that of your partner at risk.

STIs in Men – The Not So Good, the Bad and the Downright Ugly

  • Genital warts
  • Crabs (pubic lice)
  • Chlamydia
  • Gonorrhoea
  • Syphilis
  • Genital herpes
  • Hepatitis B and C

Genital Warts

This is the most common STI in Ireland. Genital warts are caused by the human papillomavirus (HPV), which is a cousin of the virus that causes hand warts. Genital warts are highly contagious and can have a very long incubation period, meaning they may not appear for up to a year after exposure. Genital warts in themselves are not a serious infection in men but they may indicate the presence of other STIs, which must be screened for and appropriately treat-Infection with the human papillomavirus is the leading cause of cervical cancer in women. Therefore wearing a condom can not only protect you against acquiring sexually transmitted infections but can also potentially protect your partner against cervical cancer.

Erectile Dysfunction: Medical Treatment

Thursday, September 18th, 2014 No Commented
Under: Erectile dysfunction, Medications

There are three different types of drug available at present:

  • Viagra (sildenafil)
  • Cialis (tadalafil)
  • Levitra (varenafil)

How Do They Work?

They all work slightly differently but all affect hormonal chemicals that come from the brain during sexual arousal. These drugs work by increasing the amount of nitric oxide produced. This chemical does two important things: it causes the nerve connections between the brain and the penis to become more fine-tuned; and it also increases the blood supply to the penis and causes the blood vessels in the penis to widen, causing an erection. These drugs in themselves do not create erections but they make an erection much more likely after sexual arousal. Ideally they should be taken about an hour before sexual activity and the effects can last several hours.

Do They Work?

Yes, in the majority of cases (about 70-80 per cent) these drugs can produce a good erection. Some men may find that one drug works and another doesn’t so it can be a trial-and-error process. Also, the dosage may vary. However, these medications can produce a good erection even when the blood supply to the penis is narrowed, as in cases of atherosclerosis and nerve damage, for example.

Do They Have any Side Effects?

Like all medicine there is a potential risk of side effects. Discuss this with your doctor. Common side effects include headache, facial flushing, nasal congestion and stomach upset. About 3 per cent of men who take Sublingual Viagra get visual disturbances, most commonly affecting colour vision. This is often described as a bluish tinge.

It is felt that Viagra is generally safe to take for men with heart disease, provided their condition is stable and well-controlled. Discuss this further with your doctor if you have concerns.

Do They Interact with Other Medicines?

There is a risk of severe interaction with nitrates (used in patients with heart disease and angina) and for this reason drugs like Viagra cannot be taken if you are on nitrates. Check with your doctor or pharmacist about other potential interactions. The effectiveness of some of these drugs is affected if taken after a fatty meal – another good reason to watch your diet.

Injection Therapy

An injection of a drug called Caverject with a very fine needle is made into the penis, which usually causes an erection to occur within about 15 minutes that can last up to an hour. While this can sound scary, most men can learn the technique. The erection occurs even if you are not sexually aroused (unlike medication).

Side effects can include penile pain and discomfort. A rarer side effect of this injection is a prolonged painful erection, which is known as priapism. This condition needs emergency treatment Canadian Viagra pharmacy Pharmacyto prevent long-term damage to the penis.

Injection treatment is less popular now that oral medication is available, for obvious reasons.

Heart Disease – The Silent Killer

Monday, September 15th, 2014 No Commented
Under: Heart Disease

Symptoms of Heart Disease

The main symptoms of heart disease are chest pain and tightness. As a muscle, the heart needs a good oxygen supply to keep pumping effectively. When there is narrowing of the coronary arteries there is less oxygen going to the heart muscle. This heart muscle can then develop cramp, just like any other muscle in the body. This heart cramp is known medically as angina. Initially, angina tends to come on when the heart is under extra pressure, for example, when exercising, such as climbing stairs or walking in cold weather, or when we are under stress. In other words, any situation where the heart has to work harder and therefore needs more oxygen can cause angina. Angina typically causes central-chest tightness and discomfort, often radiating upwards towards the jaw and sometimes down the left arm. It is often described as being like a tightness or pressure on the chest. An attack of angina is generally eased by rest.

Other symptoms of heart disease can include feeling short of breath when exercising, not being able to do as much as previously and getting tired easily. However, many people with heart disease have no symptoms at all until they have a heart attack.

Heart Attack

This is the biggest killer in Irish men. It is also known as myocardial infarction or coronary thrombosis. What happens is that one of the coronary arteries becomes completely blocked, causing severe cramp in the heart and causing the affected area of muscle to die if its blood supply is not restored relatively quickly. This can lead to serious irregularities of the heartbeat and the heart can stop completely. If the heart is not restarted within 3 minutes, either by resuscitation (CPR) or by the use of an external defibrillator, then irreversible brain and heart damage will occur.

Symptoms of a Heart Attack

Symptoms of a heart attack include a central crushing chest pain (like an elephant sitting on your chest), often radiating upwards to the neck and down either arm, more commonly the left arm, or down into your tummy area. This is often associated with profuse sweating, dizziness, shortness of breath, a sense of nausea or vomiting, and feeling acutely unwell. These symptoms are often compounded by an acute sense of fear or stress, which causes a massive adrenaline release to make the heart try to work Viagra for sale in Canada even harder and harder, which makes the pain worse and worse. Clearly symptoms such as these need immediate medical attention. Early detection and treatment of heart attack can be life-saving. Clot-busting drugs have become available in recent years that can literally dissolve the blockage in your artery if given quickly enough.

Partner ED Syndrome

Thursday, September 11th, 2014 No Commented
Under: Erectile dysfunction

If you have a permanent or even temporary partner, another type of ED Syndrome may set in. This is what I call Partner ED Syndrome. Can you relate to some of these ED consequences?

– Her Post Coital Double Whammy. It’s a fact that men and women have different sex agendas. Women seek intimacy before and after sex whilst men seek intimacy through sex. After another Mr ED let-down you may beat yourself up, apologise and even worse, withdraw emotionally. Mr ED’s reaction is to drive an emotional wedge through your relationship because he’s far better off
keeping you all to himself. But let’s think about the partner for a second: she has just suffered a double whammy. Not only did she not have sexual intercourse with you but, in addition, she’s left with an emotional void just when she would like intimacy!

– Frustration for both of you. This is especially true if your partner thinks she might have an orgasm through intercourse if only you could get and keep your Dick erect for long enough! Frustration aggravates relationship issues. Some couples may try to deal with this by using other means to help her come. This is commendable but, let’s not fool ourselves and rely on this as a solution when it’s possible to overcome your ED issues and have a more fulfilled sex life. What have you got to lose? Apart from the speedboat you got for your birthday?

– Withdrawal from your partner. You feel you let your partner down. You may become angry with yourself and lose the special connection with your partner that you enjoyed during the early stages of your lovemaking life.

– You both lose interest in having sex together. After repeated failures, your partner may dread the thought of getting excited only to be let down by another frustrating non-event. She may start exploring other ways to fulfill herself which could undermine or ultimately ruin your relationship.

– She fears or does not want to hurt you and does not raise the issue. This internal festering of issues will eventually undermine your relationship. Worse still, she blames herself and thinks you don’t desire her any more.

– Even if you are trying to impress her with prolonged foreplay and get her turned on, your ED can get her to return to the unaroused state which becomes uncomfortable. And then watch the bedroom turn into Antarctica.

– She starts to wonder if your ED  is deliberate because you don’t care about her any more. She may think you want to deprive her of pleasure, or that you are being plain selfish.

– She can’t understand why you cannot have any control over your Dick. Anger and frustration follow. And if you’re really unlucky, her mother comes to console her.

– She tries various acts to stimulate you to get your Dick erect. Her actions interrupt your intimacy and you are both uncomfortable.

If one or more of these situations sounds all too familiar to you, you may begin to feel like the worst guy in the world. Or the first and only one to be such a burden or disappointment to your partner. But you should not feel isolated or inadequate. It’s a fact and I repeat: you are not alone. Oh dear, you may think, does this mean there’s a whole army of Mr EDs out there? Over half of all men between 40 and 70 suffer from some form of ED. So, you could say there is an army out there. But, it’s not an invincible army, and one that can be easily overcome.

Erectile dysfunction and Canadian pharmacy viagra

Monday, September 8th, 2014 No Commented
Under: Erectile dysfunction, Men's Health

Erectile dysfunction and canadian generic viagra, while not life threatening, is a common condition that can result in withdrawal from sexual intimacy and reduced quality of life. ED is associated with chronic illnesses and medications used to treat these illnesses. Psychological or relationship issues often coexist and can contribute to, or result from, ED. Therefore, a wide range of health care providers must be aware of ED and knowledgeable about the etiology of ED and its treatment options. Advocates of particular ED treatments have suggested that peer-reviewed published randomized trial reports may exaggerate the costs and adverse events associated with these treatments. Other sources of drug safety data (e.g., drug company press releases or the FDA Web page) that are not peer-reviewed may provide more biased data and, therefore, were not extensively used in this report.
This report estimates potential costs to VHA for providing Viagra and other treatments using sets of reasonable assumptions about ED prevalence, dosage and frequency of use. Literature searches conducted in the course of this systematic review discovered no published economic analyses of ED treatments. In the absence of data collected specifically for cost estimation and of rigorously conducted economic analyses with sensitivity analyses, other sets of assumptions may be equally reasonable and would lead inevitably to different aggregate cost estimates. Thus, postulating or hypothesizing as to a true net cost-utility or cost-benefit ratio at this time could be incorrect in either direction.

The prevalence of ED increases with age and comorbid conditions such as diabetes, heart disease, hypertension, neurologic and psychiatric conditions, smoking and some surgical therapies. Because these conditions are highly prevalent in patients treated within VA, ED is likely to be a major and increasingly important health care issue both in terms of quality of life as well as resource utilization. If results from non-VA population based studies are extrapolated to male veteran users of the VA medical system, an estimated 1.7 million veterans may have some degree of ED. The number of men seeking help is likely to increase with enhanced awareness of ED and its increased treatment options.

Advocates of particular ED treatments have suggested that men seeking these treatments may have undiscovered underlying serious diseases, which cause ED, diagnosed and treated. The availability of ED treatments could thus contribute to improving health care quality and possibly to improving population health. This hypothesis remains untested; its validity would rely on the extent to which early intervention in these diseases does lead to improved outcomes.

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