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Respiratory Disease and Erectile Dysfunction: Spinal Cord Injury, Cerebrovascular Accidents

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Spinal Cord Injury The nature of ED caused by spinal cord injury (SCI) is dependent on the acuity and location of the injury. Estimates of the preservation of erectile function vary widely, and are as high as 95% for reflexogenic erection.

Erections in men with SCI are characterized as reflexogenic when the stimulus is tactile or psychogenic when visual, auditory, or memory serve as the stimulus. Since erections are the result of parasympathetic output to the penis arising from S2 to S4, reflexogenic erection is maintained in suprasacral injuries or those not involving the lower motor neurons (LMN).

Cerebrovascular Accidents Cerebrovascular accidents (CVA) are another important cause of sexual dysfunction and, specifically, ED. As with other neurological diseases, the pathophysiology of ED in these patients is multifactorial and related to the physical, psychological, and social consequences of stroke. Sexual complaints in stroke patients include the loss of libido, frequency of sexual intercourse, ED, and sexual satisfaction.

These complaints are most attributable to interpersonal variables, such as the inability to discuss sexuality with a spouse or changed attitude toward sex, but the fear of impotence is a significant variable. Erectile dysfunction increases from 36% prestroke to 76% poststroke, and is associated with the degree of depression poststroke.

In a study that specifically assessed ED in stroke patients, approximately half of stroke patients reported ED.

A more important finding in this study was that preexisting diabetes, hypercholesterolemia, obesity, and smoking increased the prevalence of ED after stroke. The neurogenic component of ED in stroke patients is complex due to the various central structures involved in erectile physiology and the complexity of stroke distributions. Only one study to date has attempted to associate lesions on MRI with sexual dysfunction. Erectile dysfunction was only weakly associated with lesions involving the right pons.

While the specific nature of neurological insults that determine ED in stroke patients is yet to be determined, it is evident that psychosocial factors are an important determinant of sexual dysfunction after stroke.

Cardiac Risk Association with Severity of ED

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A cohort of nearly 30,000 men evaluated through a screening questionnaire reaffirmed the previous concepts – patients with ED are more likely to suffer from cardiovascular disease. But the study also suggested that it is important to take into account the degree of ED. Authors stated that the greater the severity of ED, the greater the risk of presence of a medical comorbidity in the patient. Degree of ED severity can therefore be used as a prognostic marker for overall health risk, particularly cardiovascular disease risk.

Specific degrees of ischemic coronary disease and their association with ED in male patients were researched in a group of men with an average age of 56. These men underwent coronary angiography for the purpose of documentationof the specificextent of coronary disease in order to compare this with sexual function.

Sexual function was evaluated using an extensive questionnaire focused on sexual desire, erectile function, and ejaculation. A statistically significant correlation was made between ED and the number of coronary vessels involved. Those patients with one-vessel coronary disease were much more likely to achieve erection than those with two- or three-vessel disease.

It is well understood that only a small fraction of men with ED seek treatment. With the positive correlation between ED and cardiovascular risk, this underreporting by male patients to their healthcare providers should be taken seriously. Perhaps all men over a particular age should be screened for the presence of ED, much like the current recommendations for prostate cancer screening. If ED is present, it could be argued that these men should then undergo investigation for underlying subclinical cardiovascular disease. Endothelial dysfunction appears to be the link between the two disease entities. Increased awareness of the association between ED and cardiac disease should lead general practitioners to inquire as to the presence of ED symptoms in their male patients.

An important issue in patients with cardiac risk and ED is the safety of ED treatment. Topics including the risk of sexual activity eliciting a cardiac event and risk of drug interactions were addressed in an algorithm developed by the First Princeton Consensus Panel. They designated patients to low, intermediate, or high risk for the treatment of ED and participation in sexual activity. They support lifestyle interventions in patients with ED, including weight loss and increased physical activity

Cialis and Its Variant: Generic Cialis

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There are variants of Generic Cialis available in the market – they are called generic Cialis or generic Tadalfil. They have the same composition as the branded Cialis. One can buy generic drugs as they only may look different because in the US, FDA does not allow it to look the same. Cialis is generally used to treat the difficulties in having and preserving an erection, encountered by men, which also beares the name of impotence.

What does Cialis exactly?

What Cialis does is creating some effects produced by some substances in one’s body, during the sexual arousal. This has as a result a growth of the blood flow into one’s penis. This is what an erection is: the increase of blood flow into the internal areas of the penis.

What is the difference between Cialis and other products used for treating the same problems?

The one difference between Cialis and some other products approved by ED is the fact that it persists longer in one’s body. Other differences regarding safety or effectiveness which could separate Cialis from other products of its kind have not been studied yet.

How should one take Cialis?

Cialis is ought to be taken orally before any sexual act, but it is not advisable to take it more than once a day.

– One should consult his health care provider if taking Cialis because in the case of heart problems the doctor or health care provider must know when Cialis was last taken.

– One should know that after having used one talet of Cialis, the ingredients may persist in his body for more than two days in the case of liver or kidneys problems, or whenever using other treatment.

What should one say to his doctor if he considers it is necessary to take Cialis?

Taking into the fact that the sexual activity is ought to provoke a growth in the heart’s work, your doctor should definitely whether Cialis is or is not good for one’s heart. In the case of the heart disease named ‘left ventricular outlet obstruction’ from valvular issues or heart muscles enlargement side effects may appear: fainting, strokes or headaches. Patients who have suffered of heart diseases: anginas, heart failure or strokes, recently, should not take Cialis as long and painful erections may appear. This condition is extremely serious and needs urgent medical attention. In the case of an erection which lasts for more than 4 hours medical attention is needed.

What persons are forbidden to take Cialis?

Patients who are using nitrates(nitroglycer) or alpha blockers( excepting for FLOMAX) should not take Cialis because there may appear lower blood pressure which is the cause of fainting or even death in some cases.

What if the patient is taking other type of drugs?

In this case, one should discuss with his health care provider or doctor because he is the person who could best advice in this case. However, Cialis is not recommended for persons who are using Nitroglycerins or alpha-blockers.

How will one find Cialis?

Cialis can be found as oral tablets in 5mg, 10mg and 20mg strength.

In conclusion, we hope this article comes in hand for the persons who are intending to use Cialis because it is very important to take into account all the facts so that no problems should be en countered.

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