Illness and Other Health Conditions Affecting Sexuality

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Certain illnesses and health conditions can have a major impact on sexual function. Obviously, people with physically disabling conditions such as multiple sclerosis, spinal cord injury, stroke or cerebral palsy may be limited in their ability to have traditional intercourse. Painful conditions such as arthritis and rheumatism also can take their toll. Other diseases may affect the sexual organs themselves, the nerves and blood vessels that play a role in sexual response and sex hormone levels. Here are four examples of illnesses known to have some effect on sexuality and sexual function.

Cancer: In some cases, cancer can have a direct impact on sexual functioning if it affects hormone production or an organ involved in sex itself, such as the prostate, penis, ovaries, cervix or vagina. Treatment for most forms of cancer, not just those affecting sexual and reproductive organs, can make people feel uncomfortable about their bodies and sexually unattractive. Chemotherapy and radiation therapy are intense treatments that can cause more illness and discomfort than the cancer itself. Patients often experience unpleasant side effects such as fatigue, nausea, hair loss, skin irritation and weight changes. Surgery for cancer, such as removal of a breast or testicle, can make patients self-conscious and affect their sexual self-image.

Diabetes: People with diabetes can develop diabetic neuropathy nerve damage caused by decreased blood flow and high sugar levels. This damage can interfere with sexual response.

Stroke: Along with causing problems with motor function and control, stroke can affect a person’s body image. A stroke survivor may not be aware of one side of the body; the mouth may droop; feeling on the paralyzed side may be different; and speech may be garbled and emotions hard to control. The patient also may be afraid that sexual activity could bring on another stroke. Stroke survivors and their partners need to work together to overcome these physical and emotional issues.

Heart conditions, coronary artery disease, high blood pressure: Treatment of these conditions with medications that lower blood pressure can interfere with the blood flow to the genitals that is necessary for sexual response. Also, people with a history of heart attack or heart conditions may fear that sex could bring on an attack. They should work with their partners and physicians to deal with these issues.

Sexual Dysfunction: a Widespread Problem

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Four of 10 women and three of 10 men experience sexual problems, according to a study in the Journal of the American Medical Association. The most common problems reported by women were low sexual desire (22 percent), problems with arousal (14 percent), and pain during intercourse (7 percent). Men most commonly reported problems with premature ejaculation (21 percent), erectile dysfunction (5 percent) and low desire (5 percent).

Other key findings include the following:

The prevalence of sexual problems in women tends to decrease with increasing age, except for those who report trouble lubricating. As men get older, however, they are more likely to experience sexual problems, such as erectile dysfunction and lack of desire for sex.
Younger women are more likely to experience sexual problems, perhaps due to lack of experience and the greater likelihood that they’re not in a stable relationship (for example single as opposed to married).
Married women and men are at lower risk for sexual problems than their non-married counterparts.
Women and men with lower educational levels report less pleasurable sexual experience and raised levels of sexual anxiety.
Emotional or stress-related problems, as well as financial difficulties, are important risk factors for sexual problems.
Past sexual trauma such as forced sexual contact or sexual assault is associated with long-term sexual problems, whether the person was the victim or aggressor.
Sexual problems are associated with unsatisfying personal experiences and relationships, lack of physical and emotional satisfaction, and low feelings of happiness.
Of course, these results don’t apply to everyone in exactly the same way, but they do create a compelling profile of sexual problems. The authors of the study conclude there is a “strong association between sexual dysfunction and impaired quality of life,” and that sexual dysfunction “warrants recognition as a public health concern.”

Erectile Dysfunction: Cialis, Viagra and Levitra to Treat ED

There are only three oral medications approved by the FDA to treat erectile dysfunction: Cialis, Levitra, and Viagra. All work by increasing the flow of blood into the penis so that when a man is sexually stimulated, he can get an erection.

What Are the Differences Between Cialis, Levitra, and Viagra?

Cialis, Levitra, and Viagra work by a similar mechanism to cause erections. There are subtle differences in how long the medication works and how quickly it works. Levitra works a little longer than Viagra. They both take effect in about 30 minutes. With Levitra, the effects last for about 5 hours. With Viagra, the effects last approximately 4 hours. Cialis works a bit faster (within about 15 minutes), and the effects last much longer — up to 36 hours in some cases. If One of These medications Isn’t Effective for Erectile Dysfunction, Can I Try Another?
Yes, but because these medications work the same way, it’s unlikely that you’ll have success with one if you’ve failed to achieve an adequate erection with another.

What Precautions Should I Take Before Taking One of These medications?

There are certain situations in which these medications may not be safe to take. Before taking them, tell your doctor:

If you are allergic to any medications, including Viagra or other ED medications. About any prescription or nonprescription medications you are currently taking, including herbal and dietary supplements. If you are scheduled for surgery, including dental surgery. If you take nitroglycerin or a long-acting nitrate to treat chest pain. The combination of Cialis, Levitra or Viagra with these medications can cause dangerously low blood pressure. If you take alpha-blockers for blood pressure or prostate problems. The combination of Cialis or Levitra with these medications can also cause dangerously low blood pressure. In addition, always follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any part that you do not understand. Take these medications exactly as directed. Do not take more or less or take it more often than prescribed by your doctor. Do not take these medications more than once a day.

Results of the first prospective trial specifically designed to evaluate erectile function in erectile dysfunction (ED) patients with dyslipidemia show that LEVITRA(R) (vardenafil HCl), used in treating ED, significantly improves the ability of men with ED and dyslipidemia to achieve and maintain an erection for successful sexual intercourse. These data were presented at the Sexual Medicine Society of North America (SMSNA) Fall Meeting held in Chicago, IL. The double-blind, placebo-controlled study is the first study to measure the safety and efficacy of a PDE 5 inhibitor in a cohort of men who all had ED and dyslipidemia. Results from the study of 395 men show that LEVITRA significantly increased rates of penetration (as measured by SEP2 scores,levitra vs cialis) and the ability to maintain an erection (as measured by SEP3 scores,levitra vs cialis) compared to placebo.”ED is associated with high cholesterol, yet many physicians are not treating ED, a life-changing condition,” said Dr. Martin Miner, Clinical Associate Professor of Family Medicine at Brown University’s Warren Alpert School of Medicine. “This study provides further support that LEVITRA can successfully treat ED, even in men with a serious common condition like high cholesterol.”Nearly 70 percent of the estimated 30 million men in the United States who have ED also have other common conditions such as dyslipidemia (including high cholesterollevitra vs cialis), hypertension, or diabetes, which may lead to erectile dysfunction. Previous studies have demonstrated the efficacy and safety of LEVITRA in men with ED who also have high blood pressure or diabetes.

About the Study

In the double-blind, placebo-controlled study, 395 men ages 18 to 64 that had ED and dyslipidemia were randomized to treatment with LEVITRA or placebo for 12 weeks.Men treated with LEVITRA had statistically significant and clinically relevant improvements in SEP2 scores (a rating system that measures penetration) and SEP3 scores (a rating system that measures maintenance of erection) versus placebo (79.1% and 66.7%, respectively, for LEVITRA, vs. 51.9% and 33.8%, respectively, for placebo,levitra vs cialis). IIEF-EF (International Index of Erectile Function,levitra vs cialis) scores also were significantly higher for the LEVITRA group compared to the placebo group. These scores are evaluated based on a patient questionnaire and their daily diary response to specific questions about sexual performance.LEVITRA was well tolerated. Treatment-emergent adverse effects (occurring in = 5% of patients,levitra vs cialis) included headaches (9% for LEVITRA, 1% for placebo,cialis vs levitra) and upper respiratory tract infections (5% for LEVITRA, 3% for placebo).

Background: Erectile dysfunction

Erectile dysfunction (ED) is the consistent or recurrent inability of a man to attain and/or maintain a penile erection sufficient for sexual performance. ED can be a total inability to achieve an erection, an inconsistent ability to do so, or a tendency to sustain only brief erections. It is estimated that some degree of ED affects up to 30 million men in the United States.Some of the most common treatments for ED include adjustments to lifestyle and better control of concomitant medical conditions as well as the use of oral medications or other forms of therapy. Treating related health conditions or reducing stress may help maintain erectile function.

About LEVITRA

LEVITRA (vardenafil HCl) is a prescription medicine that is indicated to treat erectile dysfunction (ED). Consistent with the effects of PDE5 inhibition, administration of LEVITRA with nitrates and nitric oxide donors is contraindicated.Caution is advised when PDE5 inhibitors, including LEVITRA, are used concomitantly with stable alpha-blocker therapy, because of the potential for lowering blood pressure.

LEVITRA is not recommended for patients with uncontrolled hypertension (>170/110 mmHg,levitra vs cialis).

In men for whom sexual activity is not recommended because of their underlying cardiovascular status, any treatment for erectile dysfunction, including LEVITRA, generally should not be used.In patients taking certain CYP3A4 inhibitors (eg, ritonavir, indinavir, saquinavir, atazanavir, ketoconazole, itraconazole, erythromycin, and clarithromycin), lower doses of LEVITRA are recommended, and time between doses of LEVITRA may need to be extended. See prescribing information for LEVITRA for dosing guidance.In clinical trials, the most commonly reported adverse events with LEVITRA were headache, flushing, and rhinitis. Adverse events were generally transient.Nonarteritic anterior ischemic optic neuropathy (NAION) has been reported rarely postmarketing in temporal relationship with the use of PDE5 inhibitors, including LEVITRA. Sudden loss of hearing, sometimes with tinnitus and dizziness, also has been reported rarely in temporal association with the use of PDE5 inhibitors, including LEVITRA. It is not possible to determine if these events are related to PDE5 inhibitors or to other factors. Physicians should advise patients to stop use of PDE5 inhibitors, including LEVITRA, and seek prompt medical attention in the event of sudden loss of vision or hearing.

The recommended starting dose of LEVITRA is 10 mg. Titrate up to 20 mg or down to 5 mg based on efficacy and side effects.