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Symptoms of erectile dysfunction

Last Updated on: January 19, 2024
Edited By: Alfred

The symptoms of erectile dysfunction can be classified as

  • Primary
  • Secondary

Primary:
An inability to achieve or maintain an erection is the primary symptom of impotence.   This can be due to a history of impotency since childhood, inability to attain an erection after a certain age or inability to sustain the erection for penetrative sex to take place. Most men, post the age of 35 experience a decline in their libido with temporary loss of erection. This does not necessarily mean that they are suffering from erectile dysfunction. It could be due to mental stress, fatigue, depression, trauma or duet to some medication. Once the underlying cause is removed, the patient reverts back to his healthy self.   Erectile dysfunction is diagnosed only if the condition persists at least 25 % of the time. Having this disorder does not mean loss of sexual desire in a man, or the inability to ejaculate. Patients do get aroused and have climax even in the flaccid state.  
Secondary:
Besides the primary cause it can also manifest itself in the form of stress, low self-esteem, social withdrawals, strained relationship with the partner, lack of interest in sex, anxiety and depression.   Clinical symptoms:

  1. A physical examination may reveal penile plaques, prostrate infection, hypertension and possibility of prostate cancer.
  2. Studies suggest a correlation between hypertension and erectile dysfunction. This can be taken into account as they both are manifestations of vascular disorders.
  3. Some studies also suggest a correlation between benign prostatic hyperplasia and erectile dysfunction
  4. Evaluation of texture of the testes, the presence of the epididymis and vas deferens, and abnormalities of the male organ for reproduction such as hypospadias and Peyronie plaques.

Warning Signs:
Though sex is not required to keep a man alive, it may also be a symptom of various other underlying causes that can prove fatal.  

  • Medical records prove that men presenting with erectile dysfunction may be suffering from cardiovascular disorder.

Erection occurs due to sudden rush of blood to the male organ for reproduction which leads to engorgement of male organ for reproduction. If there is a disease that affects the blood vessels, it can interfere with the blood flow to the male organ for reproduction. Atherosclerosis (hardening of the arteries) and hypertension can cause abnormal blood flow to the male organ for reproduction and can affect the patients ability to have an erection.  

  • Low testosterones

Testosterones are important for sex drives. Patients of erectile dysfunction may demonstrate a low count of testosterones which could arise due to thyroid abnormalities; liver problems; and abnormalities within the testes themselves.  

  • Nerve damage

If the nerves that carry signals to the brain get damaged, it can result in an inability to get an erection. This can happen due to

  1. Diabetes: People who are not able to control their sugar levels may develop neuropathy (nerve damage) which can affect the limbs and venereal.
  2. HIV: Studies have shown that people who test positive for HIV can develop this disorder as the virus can damage the nerves and the antiviral treatments also result in neuropathy.
  3. Multiple sclerosis: This is a disease that affects the nerves and patients of this disease can suffer from ED.
  4. Spinal cord injuries can cause nerve damage that can result in this disorder.
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Erectile Dysfunction Overview

Last Updated on: January 19, 2024
Edited By: Alfred

Erectile dysfunction is the repeated inability, without treatment, to keep an erection firm enough for penetrative intercourse or sex. There are some men who experience temporary episodes of lack of erection which could be due to fatigue, stress, anger or depression. But these are brief and usually pass on as the mental upheaval subsides.   Also known as impotency, erectile dysfunction is different from other sexual disorders such as decreased libido (results in decreased sexual desire) or premature climax though they frequently co exist together.   Severity:
This disorder varies in severity. There can be cases where the patient has never experienced an erection since childhood. These problems can be treated through medications or surgery. The other cases involves patient having erection but inconsistently. These inconsistent cases are presented in two forms the first being the cases where patients experience sudden and complete loss of erection though they have a history of active, healthy sexual life and the second case of patients inconsistent ability to achieve an erection. There are some who can achieve it, but only for a brief period of time that does not allow penetration. Previously, due to social norms, patients were hesitant to discuss this issue with doctors and hence many people suffered in silence.   But in the face of an aware and more health conscious population, decreasing social stigma associated with this disorder and an increasing availability of effective oral therapy for its treatment, more people are seeking treatment and getting cured.   There are cases of men diagnosed with this disorder who may be able to attain sexual satisfaction, but due to psychiatric stress, the relationship with their partner gets affected which can in turn aggravate the physical problem.  
Research:
Due to this reason, estimating its incidence becomes difficult. According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for ED in 1985. By 1999, that rate had nearly tripled to 22.3.? But even today, only 10% of the affected population seeks medical aid for treatment of this disorder.   In 2003 researchers from the Harvard School of Public Health conducted a study to assess the relationship between age and erectile dysfunction. The studies indicated that men who were physically active and possessed a lean frame had lower chances of encountering ED than men who opted for a sedentary life style and had a heavier body. During the study, less than 2% men reported that they experienced erection problems before the age of 40 while 4 % experienced this problem between the age 40 and 49. Post 50, more than 26% men reported ED, while 40 % of men between 60 and 69 complained of this disorder. After crossing the age of 70, there was steep rise in the occurrence of this disorder with over 61% of men suffering from it.   Though these studies show that the prevalence of erectile dysfunction increases with age, it is not a part of normal aging process as assumed by some men. Since erection occurs due to hormones, blood vessels, nerves and muscles working in coordination, lack of erection simply implies that its time to seek medical help and not put it off as an age related disorder. Though studies do suggest that with age, sexual desire decreases to the extent that post 55 the need to have sex is three times lesser than that of an 18 year old boy.
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Essential Information on Men’s Eating Disorder

Last Updated on: January 19, 2024
Edited By: Alfred

Eating disorders can be defined as physical conditions usually recognized by uneven eating habits that may include inadequate or excessive intake of food causing detriment to physical as well as mental conditions of the victim. It is widely believed that this state of unwellness is generally seen in Christian adolescent; but it should be understood that this malfunction can affect any individual, irrespective of religion, age and sex. A person affected with this disease may not find it easy to gain at least of 85% of the ideal weight suggested for their age and height. Men who are suffering from eating disorder are often afraid of adding on excess weight to their body and have an ill-shaped physique. This unhealthy physical condition usually involves Anorexic and Bulimic issues which are common in case of this physical malady.

 
Anorexics and Bulimics
Anorexic is also scientifically referred to as Anorexia nervosa. Anorexia is chiefly related to conditions in which a person truncates his diet severely. Under such conditions a person desire to put down calories by means of skipping meals or not eating sufficient amount of food.   Bulimics is also technically known as bulimia nervosa, which involves bingeing of food and also purging it. In this case a person usually eats more than his capacity and then purges the food through various measures such as clysters, purgatives, diuretic drugs etc. It is widely seen that, most victims usually perform self inducted vomit to remove the food from the body.  
Causes of Eating Disorder:
To your information, eating disorder is general noticed with the feminine sect of the society; hence, most experts may fail to recognize it in case of males. It is suggested that men are more prone to inappropriate eating habits due to mental disturbance which may influence their appetite. It should be understood that eating disorder usually occurs due to various reasons. Apart from mental disturbance, in cases of men, there are other causes of truncated appetite. Media can be considered as one of the reasons which frequently promote extremely slim models which influence the audience. Inferiority Complex can be considered as another reason why men cut down or skip their meals in order to achieve slimmer body image. In most cases biological or/and genetic conditions can also be blamed for any such abnormal eating habits. Most men, in effort to become fit, may omit necessary diet and insidiously surpass the threshold of appropriate weight which may also result in eating disorder.   Some men desire to cope well with their profession which may require them to be lighter in terms of body weight. Some of such professions may include modeling, swimming, running, dancing, jockey etc. Individuals in similar profession may also be affected by this disorder.  
Symptoms of Eating Disorder:
The list of symptoms of eating disorder is quite extensive; hence, to determine this health issue one should look for abnormal eating habit. However, below listed are few symptoms that are generally noticed in case of eating disorder.  

  • Remarkable weight loss or weight gain in comparatively less time.
  • Worry about weight and frequent complaints regarding weight related issues.
  • Self famishment and restricted eating habit.
  • Noticeable purging or bingeing of food.
  • Consuming diet pill such as clysters, diuretic pills, purgatives, etc
  • Enigmatic eating style.
  • Obsession of eating away from the crowd.
  • Paled skin or loss of hair.
  • Head pain and giddiness.
  • Low blood pressure
  • Incontinency
  • Constipation
  • Weariness and depression.
  • Inadequate sleep.

These aforementioned points are some of the known symptoms which may suggest diagnosis for the disorder. However, there are other signs that may denote about such chaotic physical conditions; hence, as mentioned above any in case of strange and odd eating habit or dramatically rapid change in weight of a person, the individual should be immediately diagnosed for eating disorder.

Consequences of eating disorder:
Though eating disorder is not considered as a severe disorder such as cancer, arthritis etc, during its initial stages; the gradual results of this physical issue can also be fatal as well.  

  • Malnutrition: The most basic and common result of eating disorder is ‘malnutrition’ which usually occurs due to overeating or eating significantly less food. This malfunction is the deficiency of important nutrients such as protein, energy, vitamins etc. This can also lead to severe health problems and can hinder the functioning of the body organs leading to kidney failure, heart issues and lethally death.
  • Dehydration and Hyponatremia: A person with eating disorder may also feel dehydrated which is generally caused due to lack of fluids in the body. Ironically, this eating disorder can also lead to another disease known as Hyponatremia which is caused due to insufficient sodium in blood. Drinking more than eight ounce of water within few hours can lead to Hyponatremia which may deposit fluids in lungs, swelling in brain, vomiting etc.
  • Rough Fingers: One of the noticeable results of eating disorder is abrasive fingers which are caused due to constant self inducted vomiting.
  • Fatal effects of laxative and other drugs: It should be understood, especially by victims of eating disorder that consuming diet pill, clysters, emetic syrups, diuretic medicine etc may not be suitable for most and may lead to immediate death

Mulling over the abovementioned consequences it can be understood that eating disorder can lead to severe adverse results. Hence, it is wise to diagnose and cure the disease at its earlier stages in order to prevent any unfortunate outcomes.

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Obesity Overview

Last Updated on: January 19, 2024
Edited By: Alfred

Obesity is defined as having a body mass index (BMI) greater than 30. The BMI is a calculation of the body weight with that of the height is used to define underweight, overweight and obesity in individuals. After tobacco, obesity is rated as the second most common cause of preventable death in the U.S. The developing nations have also seen a rise in prevalence of this disease. With rich supply of food and physical labor being reduced due to high dependability on machines, obesity has taken the form of an epidemic. The medical field views obesity as chronic disease which occurs due to years of negligence of health and acts as the pioneer for many leading diseases. Body mass index, also known as the Quetlet index is calculated as weight/height2 where weight is in kilograms and height is in meters. These values are age independent for both the sexes.  WHO classification of obesity
Grade 1 – overweight is a BMI of 25-29.9 kg/m2
Grade 2 – obesity is a BMI of 30-39.9/m2
Grade 3 ‘ severe obesity is greater than or equal to 40 kg/m2   Studies suggest that fat distribution across the body affects the incidences of a concomitant but unrelated pathological or disease processes. A degenerated metabolic process resulting in android obesity could be due to high abdominal fat content including visceral and subcutaneous abdominal fat. Gynecoid obesity is due to heavy fat distribution on the gluteal region.   Though there are still debates over obesity being the cause of a host of concomitant disorder, medicos have observed an aggravation of the underlying pathological or diseased condition whenever a person has diagnosed with obesity.  
Pathophysiology
An increase in adipocytes is said to be the main cause of obesity. Adipocytes are cells that are specialized in synthesis and storage of fats. These cells serve the function of maintaining proper energy balance. They store all the calories in form of lipids and when stimulated they mobilize energy sources in response to hormonal stimulation.   The pathogenesis of obesity is multifaceted and stretches beyond the simple explanation of excess energy intake in comparison to decreased energy output. It been observed that children with obese parents tend to get obese, while in case of twins, mostly if one twin is obese the other one also tends to? be overweight directing the study to the fact that obesity could be genetic in predisposition .  
Etiology
The factors responsible for the development of obesity can be classified as  

  • Primary
  1. Metabolic factors
  2. Genetic factors
  3. Level of activity
  4. Behavior
  5. Endocrine factors
  6. Race, sex, and age factors
  7. Ethnic and cultural factors
  8. Socioeconomic status
  9. Dietary habits
  10. Smoking cessation
  11. Pregnancy and menopause
  12. Psychologic factors
  13. History of gestational diabetes
  14. Lactational history in mothers
  • Secondary
  1. Hypothyroidism
  2. Cushing syndrome
  3. Insulinoma
  4. Hypothalamic obesity
  5. Polycystic ovarian syndrome
  6. Genetic syndromes (eg, Prader-Willi syndrome, Alstr??m syndrome, Bardet-Biedl syndrome, Cohen syndrome, B??rjeson-Forssman-Lehmann syndrome, Fr??hlich syndrome)
  7. Growth hormone deficiency
  8. Oral contraceptive use
  9. Medication-related (eg, phenothiazines, sodium valproate, carbamazepine, tricyclic antidepressants, lithium, glucocorticoids, megestrol acetate, thiazolidinediones, sulphonylureas, insulin, adrenergic antagonists, serotonin antagonists [especially cyproheptadine])
  10. Eating disorders (especially binge-eating disorder, bulimia nervosa, night-eating disorder)
    Hypogonadism
  11. Pseudohypoparathyroidism
  12. Obesity related to tube feeding
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Men Beware-Insomnia Can Make You Die Young

Last Updated on: January 19, 2024
Edited By: Alfred

Latest studies have revealed that there is a direct link between life expectancy and sleep. However, this differs in sexes as men are more affected by insomnia than women. According to the study, men who suffered from insomnia were at a higher risk of dying in the next 14 years than men who enjoyed healthy sleep.  What is insomnia?

The inability to fall asleep, remain asleep or awaken too early is termed as insomnia.

Men who suffered form insomnia were followed for 14 years and it was found that one in five men died in that span. The average age of the subjects was 50. The subjects were kept in a lab and their sleep patterns were observed including how well the slept and the duration of their sleep. The researchers observed that even after some patients were cured of underlying disorders such as sleep apnoea, there was a difference in death rates between self-described insomniacs and good sleepers. The study showed that more than 51 % of the subjects who were insomniacs died during the study period compared to 9 % of men who enjoyed a healthy sleep.  
Relation between insomnia and general health

  • Sleep is essential for our survival: Sleep in the time when the body replenishes the lost energy. This is one of the reasons why the doctors recommend people to rest when they are tired. Nonetheless, the current lifestyle has deprived men of vital sleep due to which they sleep 90 minutes less than the men 40 years before. The risk also increases with age. In America alone, there were 55 million sleep directional dispensed in the year 2009. If the person is not able to catch on to lost sleep, he can start suffering from chronic fatigue which can make him lethargic and decrease his concentration. This affects their personal and professional life.
  • Repairs wear and tear: The body goes through a lot of wear and tear in the day time. From the skin to the organs, all of them get affected. Due to lack of sleep, the organs are not able to undergo the repair that is needed due to which their condition keeps worsening. This may even trigger some diseases and deteriorate the functioning of the organs.
  • Snoring: Snoring can cause disruption of sleep and in severe cases can lead to cardiovascular problems.
  • Medications: Some medications can deprive people of their sleep and this includes both directive medicines and medicines that one can get over the counter.
  • Obesity: Studies have shown that obesity and insomnia are interrelated. Obese men are more likely to suffer from cardiovascular diseases, cancer and organ failure which can prove fatal over time.
  • Decreased immunity: Bad sleep can weaken the immune system and make the person more susceptible to infections. It can also trigger various chronic problems such as kidney and liver failure.

Insomnia in the form of disorders has various side effects. It can be treated medically and through counseling.

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Link Between Testosterones and Body Weight

Last Updated on: January 19, 2024
Edited By: Alfred

Effect of increased level of testosterones–In women who are on testosterone therapy, they tend to gain weight. The weight gain is more because of increase in muscle mass and bone density than increase in fat content. This occurs as testosterones help in increasing the level of muscles in the body and make the women appear muscular and manly. In males also, it has similar affects. This is one of the reasons which make men and women who are under testosterone therapy gain weight. Testosterones can also drastically increase the appetite due to which people eat more calories than the amount that is burnt. This in turn tends to make them gain weight.  
Effect of decreased level of testosterones-
Testosterones help in normal functioning of the metabolism. Studies conducted on fat men revealed that men who had access weight have low level of testosterone. Low testosterone decreases the basal metabolic rate due to which the rates at which the fats are burnt to convert them into calories are low. A decrease in the level of testosterones is termed as hypogonadism and as been linked to various other problems such as erectile dysfunction, low sperm count, fatigue, mood changes and weaker bones. Studies have also revealed that low level of testosterones can cause increase in the abdominal fat especially in men. As men age, their level of testosterone decreases due to which the stomach continues to protrude. This is one of the reasons why old men tend to have a huge paunch. For men who are suffering from this disorder, there is testosterone replacement therapy but this should be taken under medical guidance as it can lead to an increase in the level of testosterones which can again cause an increase in weight.
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Methadone and Severe Back Pain

Last Updated on: January 19, 2024
Edited By: Alfred

Methadone is a synthetic narcotic pain reliever with opioid properties.? It’s medically relevant as an analgesic, antitussive and is also a part of primary treatment for drug addiction and maintenance programs. This drug was originally developed by scientists in Germany in 1937 as an opiate-based painkiller. It drug is different from other opioids such as morphine and heroin in its chemical constitution but has similar effects as it also acts on the opioid receptors. This drug has long lasting effect and thus it is used to manage chronic pain. Added to that, it is also available at a reasonable rate making it highly popular among doctors and patients.During drug addiction therapy, this drug is also known to reduce withdrawal symptoms in people addicted to heroin and other narcotic drug without having the same effects that is found in drug addiction.   Action of methadone on pain
This drug binds to the opioid receptor and produces analgesia. These receptors are bound to endogenous opioid compounds and are classified as mu, kappa and delta. This medicine occupies the mu receptor which is located peripherally (on the outer side) on the sensory nerves and immune cells and on the central side in the spinal cord and brainstem. This drug is prescribed for severe cancer pain, post operative pain and other forms of severs body pains. This drug can successfully treat both local and generalized pain and is recommended by the WHO in limited dosage .   This drug is contraindicated in the below mentioned cases.

  • Respirator disorders like asthma, COPD or sleep apnea (snoring)
  • hypothyroidism
  • abnormal curvature of the spine
  • a history of head injury or brain tumor
  • epilepsy or other seizure disorder
  • gallbladder disease
  • Addison’s disease or other adrenal gland disorders
  • enlarged prostate, urination problems;
  • mental illness
  • low blood pressure
  • History of drug or alcohol addiction.
  • liver or kidney disease

  Side effects

  • Prolonged use of this drug can cause addiction that is far more serious than other opioits as it takes more than 6- 5 weeks for recovery while the others may take a week to ten days. Withdrawal symptoms include severe muscle and bone pain, respiratory disorders, nausea and vomiting, tachycardia, involuntary twitching and kicking, intestinal spasms, depression, anxiety, mood swings, hallucinations along with suicidal thoughts.
  • Overdose of this drug can slow the breathing to such an extent that it can lead to death.
  • Combining this drug with alcohol can have serious side effects and may even cause death. It can impair a persons thinking or reactions

  Usage
It’s important to have the same amount of dose as prescribed by the physician and only for the given time. Over dosing and prolonged usage can have severe side effects. It’s also advised not to stop taking this drug suddenly as even that can have adverse effects.

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Loss of Lordosis – Its Definition, Causes and Treatment

Last Updated on: January 19, 2024
Edited By: Alfred

Lordosis is an excessive inward curvature of a part of the spine. This curvature is abnormal and differs from the spine’s normal curve. The shape of the spine is different at the cervical, thoracic and lumbar regions which in a healthy body are in two directions i.e. kyphotic (around region near the neck) or lordotic (near the lower back).   Spine and Its Functions The spine is located on the posterior or dorsal (back) side of the body and runs along the whole length from the base of the brain to the pelvis. The functions of the spine are as follows.

  • It gives the body a structure and shape and provides the necessary support to stand. It also allows the body to move around. Without the spine, humans would have been vegetables, and wriggled around, without a proper support to stand.
  • It protects the spinal cord which is a column of nerves that connects the brain with rest of the body and enables humans to control their movements.
  • It is also important for normal functioning of the organs as it carries messages from the brain to rest of the body parts.
  • The natural curve of the spine between the brain and the pelvis is designed to functions as a shock absorber during movements.
  • It distributes body weight evenly.

In the initial phases (hyper-lordotic), the patients may be mildly affected, where the issue may not cause any pain or symptoms. But if the spine is subjected to abnormal stress, it can lead to loss of lordosis.   Lordosis Causes:-  

  1. Congenital anomaly – During fetal development, there may be irregular lordotic development due to which the front and back discs do not have the same thickness. Due to this, the individual vertebra tips slightly and increases the normal curvature of the spine.It is one of the major lordosis causes.
  2. Tight low back muscle- In this case it may cause an imbalance on the posture and exert excess pressure on the spine.
  3. Weak hamstrings and tight hip flexors
  4. Pregnancy- During pregnancy, the anterior weight of the women can increase, due to which the pressure on the spine is more than what it can take. This leads to loss of lordosis.
  5. Flat back– It can occur after spinal fusion surgery and is called as flat-back.
  6. Deficiency of vitamin D– The deficiency of this vitamin causes rickets which can also lead to this condition.
  7. Pot belly/Paunch– Men with a heavy stomach have a similar effect on the spine as pregnant women. Due to this the spine develops an abnormal curve causing loss of lordosis.
  8. Sitting posture- Wrong sitting posture, continuously for hours, which are characterized by stooped shoulders, can also cause this condition.
  9. Discitis – inflammation of the intervertebral disc space.
  10. Osteoporosis- The decrease in the bone density can cause vertebrae to loose strength and have an abnormal curvature which leads to loss of lordosis.
  11. Spondylolisthesis– this is a condition in which one vertebra in the lumbar spine slips forward in relation to an adjacent one.
  12. Hereditary– Usually loss of lordosis has a family history, where most of the members suffer from this condition after a certain age.
  13. Obesity- The spine is deigned to support a certain amount of weight. When the weight rises above the spines carrying capability, it tends to develop an abnormal curve which leads to loss of lordosis.

  Lordosis Symptoms:-   The??lordosis symptoms vary depending on the part of the spine that is affected. The generalized lordosis symptoms consists of ‘

  1. Pain in the localized area especially during movements.
  2. Abnormal standing posture especially while standing.
  3. Forward spinal curvature of the lower back.
  4. Numbness in the affected area such as the nape of the neck, or small of back
  5. Muscle spasms.
  6. Tingling sensation in the affected area.
  7. Weakness and bowel/bladder changes.

The best way to diagnose this disorder is by taking PA (posterior/anterior or back to front) and lateral (side) X- rays. The X-rays show the degree of curvature.   Lordosis Treatment- Depending on the level of curvatures, the doctor chooses between surgical and non surgical lordosis treatments.  

    • Non surgical Lordosis Treatment – This is when the curvature is not to steep and is not affecting the movements of the body.
      1. Pain killers and anti-inflammatory medications help to ease the pain and ensure that there is no inflammation.
      2. Physiotherapy- this helps to rebuild the strength, flexibility and helps to perform daily tasks better.
      3. The patient may be put on braces around the affected area, especially if the patient is an adolescent who is in the growing phase.
      4. If the cause of loss of lordosis is obesity, then the patient is advised to loose weight.

 

  • Surgical Lordosis Treatment – Surgery is considered if the spinal cord is getting affected which is leading to tingling, loss of sensation or muscle spasm. Based on the condition, front or back surgery is performed.

Post non-surgical Lordosis Treatments doctors recommend back exercises and a healthy diet that is rich in calcium. This can help correct the posture, strengthens the abdominal muscles and increases the spine flexibility. Post-operative care involves regular follow-ups with the doctor. Usually the doctor recommends home customized programs.

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What you should know about Directive and non Directive Drug?

Last Updated on: January 19, 2024
Edited By: Alfred

Drugs or medicines are essential part of every individual’s life today, as almost all of us consume drug to get cured of some or the other heath related disorder. Medicinal drugs can be categorized into two categorize Directive Drugs and Non-Directive Drugs which bear some difference in term of law and miniscule dissimilarity in terms of functions. It is always better to have information about the relevant subjects; hence, here is some information on both the categories   Directive Drugs: Directive drugs are nothing but medicines which are licensed by the legislation. These medicines mandate the requirement of a directive, by a health care specialist or other medical experts in order to be obtained from chemist or druggist. It should be understood that various jurisdiction inflict dissimilar regulation in regards with the definition of directive drugs. Directive drugs usually are distributed with required monograph which significantly provides detailed information on the particular medicine. This monograph can either be in the form of small descriptive literature on the side of the package or in form of leaflet usually found inside the package. The reason why this monograph is considered essential is that it carries vital information about the drug such as doses, adverse reactions etc.   Directive drugs are usually suggested by certified medical practitioners, dental practitioners, vet or veterinaries, ophthalmologist etc. A directive should be generally authorized by Doctor of Medicine, Doctor of Osteopathic Medicine, Physician Assistant, Doctor of Optometry, Doctor of Podiatric Medicine, Doctor of Veterinary Medicine, Doctor of Dental Surgery or Doctor of Dental Medicine. In the United States, Food and Drug Administration is the body that looks after the definition of laws passed in respect with Directive Drugs. Directive drugs were also commonly referred to as Legend or Rx Only drugs. However, you may find that most packaging of legend drugs usually has the Rx Only indication.   Nondirective Drugs: Nondirective Drugs are also prominent by the name OTC or Over-The-Counter. These medicines are drugs which can be directly vended to the consumer without any requirement of any directive by health care experts such as aforementioned doctors. OTC drugs are also usually examined and authorized by some regulatory body. These agencies ensure that nondirective drugs are manufactured with safe and efficient ingredients which will be useful to the consumer and does not cause any harm when consumed without doctor’s directive. These nondirective drugs are generally manufactured using API or active pharmaceutical ingredients which are biologically active. By eradicating the need of drug formulation, the government permits the drugs producing companies to devise sole ingredients or mixture of ingredients into patented formulas. Nondirective drugs are usually placed on shelves, like any other conventional packet product, in stores. In some cases, few medicines may be classified as Over The Counter drugs, but may require a chemist employee to evaluate the patient’s requirement before providing the drug. You may also find some OTC drugs being sold in stores other than pharmacy, for example supermarkets, conventional stores etc. These nondirective drugs are usually of low power and are examined of any side effects or harm to the consumer before they are introduced. One of the suitable examples of nondirective drugs would be general low power anodyne often sold at pharmacies.   Similar to directive drugs, even nondirective drugs are practical and effective in curing relevant physical conditions. The only difference would be the requirement of evidencing directive of doctors to obtain directive drugs. Directive drugs may be high power drugs which are prescribed by doctors in severe medical cases; hence, both the category of drugs stands fair at their respective levels.
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Impotence Causes in Details

Last Updated on: January 19, 2024
Edited By: Alfred

Impotence is the disorder of the male reproductive system that disables the capability of the men to get is strong during the love-making activity. Nowadays, the impotence issue is being discussed a lot as people are getting more and more vocal about their health problems. Basically, impotence occurs due to the inconsistent flow of blood to the male reproductive system. The disturbance in the blood flow incapables men to attain the hard state for male reproductive organ. For this process to work properly, adequate blood flow in mandatory. It is only after the blood fills the veins and arteries in the male reproductive organ that man is able to attain the stiffness of male reproductive organ.   As per the recent survey carried out by the International Journal of Impotence Research and Studies, around 60% of the men are noted to be suffering with the impotence, either temporarily of permanently. Previously only old-aged or middle-aged men were observed to be suffering with the impotence, but nowadays even young men are noted to be facing the problem of the impotence. This is basically noted due to the unhealthy lifestyle pattern that we are following.   The issue of impotence puts an adverse impact on the overall health of the individual. As the man is not able to perform during the love-making activity he gets frustrated and loses his mental stability.   In many of the cases due to the negligence of the married men toward the impotence problem, it leads to the divorce. So, to stay away from all these problems it is necessary to overcome impotence or better is to prevent the occurrence of the impotence. But, it is very sad to know that men are very shy to discuss about this problem, which leads to the negligence and makes the situation more problematic. Thus, it is my advice to all the men to be open about their health problem and share it with your partner and discuss it with doctor to overcome it.  

Causal Factors

Causal factors of impotence are many. Some factors contribute directly, whereas some other factors contribute indirectly toward the occurrence of impotence. Basically the cause of impotence is noted to be the insufficient blood supply to the penile region.  

Process of Impotence Occurrence

In the male reproductive system, the process of stiffness of male reproductive organ is being guided by the namely the two enzymes, cyclic guanoyl monophosphatase (cGMP) and phosphodiesterase 5 (PDE-5). The enzyme cGMP is coordinates the process of improving the blood supply to the male reproductive system. This signal is being given by brain to the male reproductive system. This way the man attains the stiffness of male reproductive organ.   Once man achieves the climax, the process of enzyme PDE-5 begins. It withdraws the blood from the penile region. So the stiffness subsides. The impotence occurs when the amount of the enzyme PDE-5 in the male reproductive system is more. This enzyme curtails the blood flow from the male reproductive organ even before the person attains climax. As a result the stiffness subsides very shortly and person faces the problem of impotence.  

Factors that cause impotence are as follows

Hormonal imbalance is being statistically observed to be one of the prominent causes of the impotence in men. Less amount of the testosterone in the man’s body, make the male reproductive organ gets flimsy. The muscles in the penile region don’t get the enough amounts of the blood flow and the required nitric oxide. As a result these muscles don’t get sturdy and the man fails to attain the stronger erections. So, to avoid such impotence you must pay a good attention toward the hormone levels in the body. If you are facing the hormonal imbalance then please try to treat it as it may later on lead to the impotence.  
Injury to Male Reproductive System
Physical injury to the male reproductive organ damages the penile muscles, nerves, or veins in the male reproductive system. Even the injury to the testis is noted to malfunction the normal functioning of the male reproductive organ. This impotence arises due to this. The person with any physical injury to the male reproductive system has 90% chances of suffering with the impotence. The worst thing of the impotence caused due to the physical injury is that it is incurable. This is permanent impotence and can be treated only through the vascular reconstructive surgery, but the success rate of this mode of treatment is only 20%. Thence it would be better if you take a good care of the male reproductive system and should stay away from any thing that would cause physical injury to the male reproductive system  
Psychological Conditions
Pressure to perform and anxiety occurring during the love-making sessions is the reason for the impotence in majority of the men. Thinking a lot about the performance during love-making is nevertheless going to work in your favor. Instead this will make your anxious about the performance and ultimately you will face the problem in getting the necessary erections. Sometimes, man thinks a lot about his image, he then get conscious about his male reproductive organ size which is okay, but he still feels it to be smaller. This way he feels ashamed of his insufficient male reproductive organ size and gets in tension about how will he be able to satisfy his ladylove? This is how he gets depressed, which ultimately disturbs his mental stability and reduces his stamina. Thus, he fails to hold on for sufficient time. Many times the impotence arising from the psychological imbalance can be cured easily by improving the methodology and practicing the technique.  
Heart Problems
Healthy heart is a key to satisfactory love making activity. Your heart health is important to enjoy the love making activity to its best. As per the research studies it has been concluded that more than 60% of the heart patients suffer with the impotence. The unhealthy heart doesn’t perform well. So, the blood supply to the different parts of the body gets very improper. This way the sufficient blood doesn’t reach the body organs. The insufficient blood flow to the male reproductive organs results in the impotence. Atherosclerosis is the heart disease that deposits the plaque in the arteries and disturbs the blood supply thus increasing the chances of suffering with the impotence.  
Diabete
Impotence is being closely linked with the diabetes. The abnormal sugar levels in the body keeps the density of the blood fluctuating. If the sugar amounts are more then it ultimately increases the density of the blood that makes it difficult to transfer to other body parts. As a result the blood doesn’t reach the male reproductive system. Nearly 40% of the diabetes patients are found to be suffering with the impotence. Whether you are suffering with type 1 or type 2 diabetes, the chances of suffering with malfunctioning of male reproductive system are doubled. It would be best for the diabetes patients to keep their sugar levels at constant level in order to stay away from the impotence.  
Neurological Disorders
Neurological disorders disturb the functioning of the overall body. So, even the normal working of the male reproductive system is being perturbed. It is the brain that guards the functioning of the men during love making activity. The activity of the neurons gets improper due to the neurological disorders. The signals that are sent by the brain to the male reproductive system after the stimulation are not being delivered as the functioning of the brain is improper due to the neurological disorders. This is how the male reproductive system doesn’t get the required blood. As a result, the person starts facing the impotency problem. Working of the erection mechanism is being noted to be going wrong due to the neurological disorders like Alzheimer disease, multiple sclerosis, and Parkinson disease. If you suffer with any of these diseases then you need to get them treated at the initial stage because this will later on lead to the impotency in men.  
Alcohol Consumption
Alcohol consumption if not good for the overall health, additionally it has a severe adverse impact on the normal functioning of the erectile mechanism. Due to the excessive alcohol intake the kidney of the person malfunctions as it is not able to cope with so much of alcohol present in the body. It then throws out this excessive alcohol through the urinary tract. The person gets the urination feeling frequently when he drinks a lot. When the alcohol passes through the urination tract it damages the nerves in the penile region. Sometimes even these penile nerves get broken. This way the blood is unable to stay into the male reproductive organ for the sufficient time as a result men loses the erection quickly. Thus, alcoholic men suffer with impotence.  
Chewing or Smoking Tobacco
We all know smoking is injurious to health, but we all still smoke. Now, I want to make you aware of one more ill effects of smoking i.e. Smoking tobacco will make you impotent. Remember your love life would be completely devastated by the use of the tobacco. Either you chew or smoke, both contain high amount of the nicotine that influences the blood supply to the male reproductive organ and certainly reduces the amount of blood reaching to the penile region. As a result, men are not able to attain the erection or sometimes they lose the erection very quickly during the love-making session. This way the smokers get prone to the impotence.  
Peyronie’s Disease
Peyronie’s disease is the abnormal condition of the male reproductive organ. This disease is characterized by the slightly angular curvature of the male reproductive organ. The person is said to be suffering with Peyronie’s disease when his male reproductive organ is noted to be bending in between. The bend is not from the base, but it is from the central position. In this disease the veins and nerves in the male reproductive organ gets constricted due to the bend. This way the blood doesn’t reach to the all parts of the male reproductive organ. Due to the improper distribution of the blood in the penile region the men with Peyronie’s disease also gets prone to the impotence.  
Obesity
Obesity is the disease that is caused by the excessive weight gain. As per the research studies the person who is obese is double the times prone to the impotence. During the study from 100 men about 37 obese men were observed to facing some kind of erection problems. During the obesity the excessive amount of the fats and carbohydrates gets deposited in the body. Excessive amounts of fats put the stress on the subordinate veins and arteries that supply blood to all parts of the body. The nerves and veins get narrow and thus the blood supply gets disturbed. As a result male reproductive system doesn’t get the required blood flow to enact the erection process. This leads to the failure in the erection and finally it leads to the impotency in men.  
Drugs and Surgeries
Impotence is being observed prominently among the men who have undergone the surgeries. Specifically the men who have undergone heart surgeries, kidney replacement face the problem of impotence. Even the men who undergo major surgeries for bladder cancer (radical cystectomy) and for prostate cancer face the problem of impotence as they need to remove the nerves from the male reproductive organ. You may face the impotence problem due to the intake of drugs like tranquilizers, heart medications, and high blood pressure controlling medications, antidepressants, and sedatives. These drugs may cause either temporary or permanent impairment of the erection mechanism, so please avoid taking these drugs without any reason.