ALL ABOUT DYSFUNCTION & MALE HEALTH

Hypertension and erectile dysfunction

Between 20% and 30% of hypertensive men suffer from this sexual disorder

Talking about sexual health in a medical office is still a taboo subject, although this is a major source of discomfort and concern. Hypertension is one of the causes behind sexual dysfunction in hypertensive men, who tend to live in silence and not discuss it with your doctor, when there are remedies to treat drug. Only necessary that medical professionals ask for this problem to their patients and that these lose the shame and fear to talk about it.

Common causes: Why dysfunction originates?

Hypertension not only has consequences for the cardiovascular health of those affected, but also an important part of life over which, at times, difficult to talk about: sexual health. It is estimated that between 20 and 30% of hypertensive men suffer erectile dysfunction at some time of diagnosis. This problem can be caused by the disease itself self-hypertension-or, more frequently, the drugs that these patients should take to control blood pressure, as described Josep Maria Pomerol, director of the Andrology and Sexual Medicine Barcelona, who has participated in the 22 Catalan Conference on Hypertension, held recently in Barcelona.

Erectile dysfunction is the first symptom of the existence of cardiovascular problems: This disease is characterized by a dysfunction of the lining inside the blood vessels, also the penis, where the vessels are smaller and easier to affect the arrival of the blood. Even before the heart and coronary arteries. Moreover, "we now know that erectile dysfunction is a risk factor for cardiovascular disease of equal importance to diabetes, high cholesterol or smoking. In fact, it is recognized as the first symptom of the existence of cardiovascular problems. It can be an important symptom and a warning in terms of overall health.

Antihypertensive drugs can also cause dysfunction: lower blood pressure and, in turn, causes the penis to fill with blood and that there is no erection. In addition, these drugs can also cause alterations in hormones such as testosterone and prolactin, which is related to the lack of sexual desire and sexual dysfunction. The drugs most often are behind this disorder in humans are diuretics and, within these, thiazides or spironolactone. Adrenergic vasodilators are central to an action that may affect erections, sexual desire, ejaculation and lead to impotence. In contrast, other families of drugs such as angiotensin converting inhibitors (ACEIs) and antagonists of angiotensin II receptors (ARBs) have fewer side effects of this type and even, on occasion, can improve sexual function. This holds true especially with the ARA II.

PHARMACOLOGICAL SOLUTIONS FOR DYSFUNCTION

The appearance of a specific enzyme inhibitors of the penis, phosphodiesterase 5 (such as sildenafil, tadalafil and vardenafil) have increased considerably the prospects for a satisfactory treat erectile dysfunction. Already ten years have elapsed since the introduction of the first of these drugs, sildenafil, and since then has been observed that they are all safe and effective. The experience over this decade has shown that, taken together, are effective in 70% of patients and even some counteract the effect of antihypertensives. Also, you can take as long as no sexual activity is contraindicated or that patients suffer a major heart problem that requires them to undergo treatment with nitrates.

Attitude of doctors and nurses

Each time you see an older man in the office of the urologist, one should question him about his sex life as he takes the blood pressure. But the reality is that not all doctors are asking, and that many patients do not discuss out of shame. "Although in recent years have seen a 'boom' of drugs to treat erection problems and this has improved communication between doctor and patient, there is still training in the health field," he says.
Hypertensive patients with impaired do not have to give up their sex life and should see a doctor as soon as possible. These impressions are corroborated specialist in a study conducted by Wong Tai-Ho Mooi, nurse Nephrology Service, Hospital del Mar (Barcelona). It analyzes the opinions and attitudes of 50 professional-service of Nephrology and Cardiology, concerning the approach to sexual health in patients.

The study examines the relationship between certain variables (age, sex, occupational category, work experience and religion) and the opinion and attitude of those professionals when discussing sexual health consultation. According to Tai-Mooi reported, although most acknowledged that the sexual health of chronically hypertensive patients is a very important, nearly 100% of the participants admitted that they never discussed this issue with their patients. For the professional category, it was observed that nurses were more difficult for doctors to explain the issue and most of them brandished as the principal reasons for not addressing the lack of education in sexuality and shame. In addition, some consider that sexual health is personal and private and should not be asking for it, unless the patient starts the conversation.

Other variables (age, sex, professional experience and religion) have no influence, according to the results, the decision to investigate the sexual health of the patient. Stresses that 98% of professionals said they would change their attitude if they received adequate training on this topic.

SPEAKING TO THE DOCTOR

Patients with hypertension who have sexual health problems should consult their doctor or specialist because good solutions are available and need not conform or give up their sex lives, it brings a lot of beneficial aspects. There are many possibilities to solve the problem they have and regain a normal sex life. To encourage the patient to talk about a matter so intimate, Wong Ho says that it is essential to create a climate conducive to dialogue. It should be an empathetic attitude, not subdue. One way is that in the first visit, while we review the medications to be taken, explaining that one of the side effects of these drugs is sexual problems and ask if you have any concerns. Sometimes this issue is not addressed in the first visit, but in the second.

In either situation, it is essential to have empathy with the affected, creating a good relationship of trust between the nurse or doctor and patient, and treat a subject as intimate as this with the utmost discretion and confidentiality, not to mention remarkable with a solution. The patient must know that if this is an issue that concerns and affects him, practitioners can treat, which can lead to a specialist or expert service and that there is no medication to treat it.

Erectile dysfunction, an increasingly common query

One in three patients suffering from erectile dysfunction, in addition, high cholesterol, diabetes, hypertension or anxiety. Almost half of sexual consultations taking place in primary care relate to erectile dysfunction (specifically, 48%), as measured by the Spanish general practitioner. Premature ejaculation, lack of sexual desire or female anorgasmia are other problems related to sexuality that have to deal with these specialists.

In recent years the Spanish have been losing modesty in the consultation and more and more often poke questions related to sexuality. In addition to erectile dysfunction or premature ejaculation, are also frequent questions regarding the application of the morning-after pill, the nature of sexually transmitted diseases (STDs) and family planning. Doctors emphasize, however, that despite the frequency with which these problems appear, the sexual sphere remains an intimate look at both doctors and patients spontaneously raise costs in the query. Data from the Institute of Sexology and Psychology, released in Valencia during a national gathering of family doctors a few weeks ago found that nearly one in two consultations on sexuality that attend these specialists deal with erectile dysfunction (48%). Other changes such as premature ejaculation (28%), lack of sexual desire (8%), anorgasmia women (7%) and vaginismus (1.6%) follow as a percentage.
Comprehensive approach to health

Doctors are calling for greater presence of sexuality in their plans for university education, given the limited body of knowledge that is taught today in the race and the increasing number of queries that are registered in this vital area. Although they feel responsible and comfortable in this type of care, demanding greater expertise. Chronic dental problems can not only harm the heart of a man, but also penile erection. "A comprehensive approach to the health of patients can not ignore a fundamental aspect of human health such as sexuality, hence the need, firstly, that doctors take advantage of our communication skills, and another, that we have specific training to give the best possible response to the needs of citizens in this area, "said José Zarco, coordinator of the Conference on Update in Family Medicine held in Valencia, organized by the Spanish Society of Family and Community Medicine (semFYC) and the Valencian Society of Family and Community Medicine (SVMFIC).

The meeting enabled participants practitioners update their knowledge and learn practical skills to address problems of many kinds, from sexually transmitted infections parkinsonism, through diabetes, vaccines, treatment of stroke or bioethical issues that may encountered in primary care consultation.
A query more than justified. Addressing sexuality from the doctor's family was the main focus of the conference. Zarco considered essential, in view of the training of family physicians, to establish what must acquire skills and attitudes of health professionals to identify these problems and provide appropriate solutions. "In addition to expanding our scientific training, doctors must enhance our communication skills to facilitate the diagnosis and treatment of sexual diseases," stated the expert.

The need for comprehensive care for patients with a sexual disorder is even more important when you consider that one in three patients with erectile dysfunction, for example, usually has other hidden diseases such as high cholesterol (27%) diabetes (22%), hypertension (20%) or anxiety (18%). The results of a survey descriptive study completed by physicians on how to address sexuality in the primary care clinic show that 95% believe the sexual sphere as an essential element in the health of citizens and expresses interest further training in this field. The survey also reveals that a significant percentage of physicians does not include the sexual life of the patient's medical history. As noted Zarco, "is necessary to give family physicians the tools necessary to improve the clinical approach and treatment of sexuality in their practice and promote the investigation of these professionals in the field of sexology." Add to that consideration the importance of using the situation of the family doctor at the gateway to the health system, "a unique position to prevent or resolve alterations of sexuality."

What would a patient whether to make an inquiry about erectile dysfunction ask your doctor to open his mouth and said "A"? I would think wrong, for sure, but it would be correct, recent studies show that chronic dental problems can not only harm the heart of a man, but also their penile erection. Yehuda Zadik, the Center for Health Promotion and Preventive Medicine in Israel, evaluated the sexual function of 305 men over 30 years of age and considered in addition, the dental radiographs. Purported to show that teeth and gums are not isolated in the body, and that bacteria of the oropharynx easily invade the bloodstream and can trigger a systemic inflammation. "Periodontal disease," says Zadik, not only related to sexuality, but also with diabetes, low birth weight or respiratory and cardiovascular disease. " The specialist also emphasizes the existence of aggressive periodontitis may occur in very young individuals and is related to immunological factors.

On the other hand, those who think that alcohol is an antiseptic and a mouth "alcohol" dispels the bacteria are likely to discover that what really scares alcohol is sexual function. The prevalence of sexual dysfunction among alcoholics is high and varies according to various studies, between 3.2% and 64.4.

Female sexual dysfunction

About 40% of women display some degree of sexual dysfunction which causes dissatisfaction and poor quality of life. In the same way that men, women may have sexual difficulties in the area with their partners. The latest data show that approximately 33% of women between 18 and 59 years and 45% of women after menopause may have sexual dysfunction. In the last National Meeting of Health and Medicine for Women, which was just held in Madrid, has launched the first Guide to Female Sexual Dysfunction of the Spanish Association for the Study of Menopause. Its purpose, to help gynecologists and family doctors to combat the problems of dysfunction were more prevalent in our society.

There are still more men than women attending the specialist sexual problems. Although there is a high incidence of sexual dysfunction, only 10% sought medical or psychological help and that 10%, women represent only 25%. The problem of female sexual dysfunction (FSD), little known and investigated so far, is changing in third. Nevertheless, recent data collected indicate that approximately 40% of them suffer from these problems in silence. Experts recommend for a proper diagnosis and accurate treatment, the multidisciplinary approach, although the cause is strictly physiological. The first Spanish guide for DSF is intended for gynecologists and primary care physicians to help treat reviewing issues such as physiology, epidemiology and classification, and disease and drugs that affect the female sexuality.

Psychological reasons for female dysfunction

Recent studies by 33% eligible women between 18 and 59 years who have reduced sexual desire and origin, reveal, may be psychological, hormonal, or both. During the National Meeting of Health and Medicine Woman (SAMEM), Cheryl Brown, a psychologist-sexologist Unit Sexual Dysfunction Palacios Institute of Health and Medicine Women and Sexuality Group coordinator of the Spanish Association for the Study of Menopause (EMEA), said that lack of sexual desire in women is one of the most common dysfunctions queries gynecology and sexology.

In perimenopause, many women experience changes related to lack of lubrication, decreased sensation or pain during intercourse. In addition, hypoactive sexual desire disorder in women leads to more anxiety-related disorders only orgasm. Experts say the relationship between hormonal changes with the DSF is very significant as they determine the sex drive. The changes with perimenopause and during menopause, sometimes, if it is a biological dysfunction can be treated pharmacologically. At this time, many women experience changes related to lack of lubrication, decreased sensation or pain during intercourse.

While hormones are not the exclusivity, the data collected by the experts also reveal that the loss of desire to influence psychological factors, both individual and couple. Among the singles: depression, anxiety and distress, among the partner: sense of obligation toward sex, sexual saturation, the concern of men to be at the level and frustration in the female orgasm, the different evolution of sexual codes with age or marital conflict.
Smoking and sex, bad combination. One of the conclusions reached in the latest edition of SAMEM is that smoking causes other than traditionally male institutions such as lung cancer and cardiovascular diseases, arteriosclerosis. This thickening and hardening of the artery wall leads, in turn, a decrease in blood flow resulting in increased risk of vaginal dryness and vaginal atrophy.

Similarly, smoking, advancing age of menopause and causes a reduction of estrogen level which aggravate the lack of sexual desire in women or hypoactive sexual desire disorder. The lack of sexual desire is one of the most common sexual diseases. And the most worse quality of life. The group also have pointed out that there is a strong correlation between premenstrual symptoms and nicotine withdrawal. The effect of nicotine on weight and appetite control and lack of awareness of the risks of this addiction makes the decision to quit smoking. They, more addiction than men, have higher withdrawal symptoms when you stop smoking because smoking by the sense of relief that tell against psychological pressure and stress. For the whole package of reasons, according to the latest survey by the Sociological Research Centre CIS in late 2006, over 50% of women who quit smoking in the attempt fails.

DRUG hindering and female viagra

It is true that many drugs hinder sexuality in both men and women. Some antidepressants and drugs that fight allergies (antihistamines) and birth control pills reduce vaginal lubrication, as well as alcohol, snuff and marijuana. Among those that decrease sexual desire in women are antihistamines, barbiturates (widely used to treat insomnia, anxiety, stress and epilepsy, among others), cimetidine (which reduces the amount of acid produced by stomach), spironolactone (to remove fluid used to treat hypertension and fluid retention caused by various conditions). Tricyclic antidepressants, chlorpromazine (antipsychotic) and estrogen administration would also be part of this group.

Just as tricyclic antidepressants and corticosteroids may cause worsening associated with arousal and orgasm. On the other hand it is documented that some may increase sexual desire, including androgens, some anxiolytics and benzodiazepines, the latter used for its hypnotic effect, anxiolytic, anticonvulsant or muscle relaxant. Most of these drugs can be used in lower doses without losing the therapeutic effect or may seek an alternative that does not affect sexuality. The specialist, in any case, is the only person who can recommend appropriate changes.