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Sex and the prostate: Overcoming erectile dysfunction when you have prostate disease
Chronic stomach pain in children: What's the most common cause? Monitoring blood pressure at home? Make sure you follow these steps. Prostate cancer: An emerging surgical alternative shows promise in older men. If so, consider the experiences of two patients, both of whom were taking some type of medication for BPH. Recently retired, he looked forward to a weekly round of golf with friends at a local country club.
One evening, while driving home to meet his wife for dinner, Jack suddenly became lightheaded. He felt as if he were about to faint. He managed to pull the car over to the side of the road and call for help.
Your benign prostatic hyperplasia medication: When to consider a change - Harvard Health
At 77, Henry was generally in good health, but had been taking terazosin Hytrin for his BPH for years. At one point, after Henry experienced a bout of unexplained abdominal pain, his internist ordered an abdominal CT scan to determine the problem. As instructed by the radiology department, Henry drank large quantities of water before the procedure. The CT scan itself went fine, but afterward, Henry found he could not urinate, even though his bladder was full.
Instead of returning home after the CT scan, Henry wound up in the emergency room, where he had to have a catheter inserted. Jack and Henry experienced unexpected consequences while taking a BPH medication. Fortunately none of these consequences had long-lasting health effects — and they could be avoided in the future by making some adjustments. Although many men use both medications without difficulty, some may need to take precautions.
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The two classes of drugs currently approved to treat BPH — alpha-1 blockers and 5—alpha-reductase inhibitors — work in entirely different ways, and therefore raise different types of issues. As the prostate gland enlarges, it constricts the urethra, which carries urine out of the body, and may expand up into the bladder itself. This not only impedes urinary tract functioning, but also reduces the volume of urine the bladder can hold.
Alpha-1 blockers attach to certain receptors in the muscle walls — much as a key fits into a lock. By blocking alpha-1 receptors, alpha-1 blockers prevent insertion of the chemical keys that signal a muscle to contract. The muscles relax and urine flows more freely. The 5—alpha-reductase inhibitors have a different mechanism of action: They neutralize 5—alpha reductase, the enzyme that initiates conversion of testosterone into dihydrotestosterone, or DHT, the form of the hormone that is usable in the prostate.
By blocking the action of the chief male hormone responsible for growth of the prostate, these drugs eventually cause the prostate to shrink.
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The alpha-1 blockers are classed into two groups. The selective agents, alfuzosin Uroxatral , silodosin Rapaflo , and tamsulosin Flomax, generic , work primarily on the tissues of the urinary tract. The nonselective agents, doxazosin Cardura, generic and terazosin Hytrin, generic , affect both the urinary tract and other tissues elsewhere in the body. The 5—alpha-reductase inhibitors, which include dutasteride Avodart and finasteride Proscar, generic , act directly on the prostate.
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These medications are used to quiet overactive bladder muscles, which can lead to urinary incontinence. Investigators have discovered in the past few years that more than half of men with BPH also suffer from overactive bladder, and that this may further exacerbate urinary difficulties.
Researchers are now investigating whether taking anticholinergic drugs can ease BPH symptoms.
Where to buy generic Viagra. Related Drugs. Talk to your doctor to determine if an ED drug is appropriate viaggra you. This form of high blood pressure affects the arteries of the lungs and those on the right side of the heart. You can buy ED medicationslike Cialis and its generic versionthrough a variety of online platforms.
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When it comes to recommending one drug or another, urologists often use some general guidelines: Alpha-1 blockers are better at relieving urinary symptoms such as difficult or frequent urination, and are best for men with smaller prostate glands. But 5—alpha-reductase inhibitors may be in order if you have a large prostate gland or have not obtained sufficient relief from alpha-1 blockers.
Sometimes the medications are prescribed in combination. The alpha-1 blockers work quickly, taking effect in days to weeks. But the nonselective agents may require some patience, as doses have to be increased slowly at first, to avoid lowering your blood pressure too much. Doctors usually start with 1 milligram mg at bedtime, then gradually increase it as needed to a maximum of 10 mg of terazosin or 8 mg of doxazosin. This process, known as titration, may be frustrating for you as well because you will need to wait to find the correct therapeutic dose.
Dosing is simpler for the selective alpha-1 blockers. For tamsulosin, you take 0. Alfuzosin is a time-release formulation, so a single mg tablet is taken once a day immediately after a meal. With the 5—alpha-reductase inhibitors, it takes longer to feel the results. These drugs shrink the prostate by reducing levels of the male hormone dihydrotestosterone DHT , which promotes prostate growth.
Levels of DHT fall precipitously after several weeks of taking a 5—alpha-reductase inhibitor, but it may take at least three to six months, and perhaps even longer, before you notice any improvement in urine flow.
When it comes to BPH, are two drugs better than one? In the study, 3, men with BPH were randomly assigned to take doxazosin Cardura , finasteride Proscar , a combination of the two, or a placebo.
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New England Journal of Medicine ;— PMID: Marberger M. European Urology Supplements ;— Some men with large prostates try combination therapy to get fast relief for their symptoms from the alpha-1 blockers. In six months or so, when the 5—alpha-reductase inhibitors begin taking effect, these men may stop taking the alpha-1 blockers.
However, you should consider two additional pieces of information when contemplating whether to start combination therapy: cost and side effects. First, taking two pills is more expensive. If you have to pay for medications on your own, or if your insurance company requires some type of co-pay, you may want to figure cost into the equation.
Second, although the MTOPS study found that side effects were similar whether men took one drug or the combination, many experts feel differently, based on the patients they see. The nonselective alpha-1 blockers block alpha receptors in the heart and blood vessels as well as in the prostate, lowering blood pressure in the process.
While these agents are usually not the first choice for blood pressure control, they may be a good choice for men who have both BPH and high blood pressure.
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If you want to limit the number of different medications you are taking, ask your doctor whether using a nonselective alpha-1 blocker might enable you to control both your BPH and your blood pressure — and then monitor both your urinary symptoms and your blood pressure to make sure the medicine is really working for you.
If you are already on another medication to control your blood pressure, or are taking an erectile dysfunction drug, then taking a nonselective alpha-1 blocker carries the risk that you will experience lightheadedness, faintness, dizziness, or postural hypotension a drop in blood pressure that occurs when you sit or stand quickly, as when getting up from a chair or out of bed.
Viagra Improves Urinary Tract Symptoms In Men With Erectile Dysfunction -- ScienceDaily
Sudden episodes of low blood pressure can be dangerous if you already have some type of vascular disease, because it increases your risk of suffering a heart attack or stroke. Similarly, because of these side effects, the nonselective alpha-1 blockers may not be the best choice for you if your blood pressure is already on the low side.
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The selective alpha-1 blockers, alfuzosin, silodosin, and tamsulosin, have less of an impact on blood pressure, so they may be good alternatives in these situations. Men taking silodosin may notice a drop in blood pressure upon standing. Or consider taking a 5—alpha-reductase inhibitor. The nonselective alpha-1 blockers doxazosin and terazosin are available now in generic as well as brand name formulations, and so may save you some money see Table 1.
Of course this may also depend on what type of drug coverage is included in your health insurance plan, and how much of a co-pay you need to contribute. The costs below are based on average wholesale prices to pharmacists and the lowest dosage; costs to patients may be more. Because they affect levels of the male hormone testosterone, the 5—alpha-reductase inhibitors may cause a variety of sexual side effects. In the original clinical trials, 3.
Another 3.
Taking tamsulosin with other medicines and herbal supplements - NHS
In addition, one of the selective alpha-1 blockers, tamsulosin, causes ejaculation problems in some men who take it. The other alpha-1 blockers may cause less of this problem.
Only 2 left in stock. Before deciding to try an OTC erectile dysfunction treatment, speak with a doctor. Thus, one pill targets a physical aspect of sexual dysfunction.
Most read in The Sun. This one should be taken fifteen to thirty minutes before sex.
Erectile dysfunction is treatable with three medications, and it is generally safe to take these drugs when you are taking your BPH medication, whether it is an alpha-1 blocker or a 5—alpha-reductase inhibitor; however, we offer some important cautionary advice. If you develop problems with ejaculation during sex, the solution depends on what medication you are taking.
If you are taking a 5—alpha-reductase inhibitor, the only way to resolve the ejaculation difficulties is to stop taking the BPH medication, so you may need to decide on another medication or surgery to deal with your urinary difficulties.
Tamsulosin: a medicine for symptoms of an enlarged prostate - NHS
Investigators asked men with BPH to take 0. If the men responded to tamsulosin, they were randomized to one of three groups.
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One group continued taking the medication daily, the second took the same dose every other day, and the third stopped taking the drug. Men taking tamsulosin every other day did just as well as those taking it daily, and experienced fewer side effects such as ejaculation problems. Journal of Urology ;—7.
Gynecomastia breast enlargement , another possible side effect of the 5—alpha-reductase inhibitors, is rare but is distressing when it occurs. Stopping the medication may reverse the problem.
Your benign prostatic hyperplasia medication: When to consider a change
But not always: Some men have had to undergo breast reduction surgery — or learn to live with the changes. Three medications have been approved for the treatment of erectile dysfunction: sildenafil Viagra , tadalafil Cialis , and vardenafil Levitra.
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These medications are all PDE-5 inhibitors, which generate nitric oxide, a chemical that enables arteries to widen. The increased blood flow to the penis helps to produce an erection. The problem is that arteries elsewhere in the body widen as well, causing a slight drop in blood pressure.
Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. No Thanks. Sildenafil belongs to a group of medicines called phosphodiesterase 5 PDE5 inhibitors. Product Review: "Excellent service would recommend them. The combination can lower blood pressure, causing fainting, dizziness, and in some rare cases, heart attack. PT to address any questions you may have.
But whatever the cause, it is really important to communicate and take the time to understand each other in your relationship.
However, if you are currently using, or considering, an alpha-1 blocker, you may want to take some precautions when adding one of the PDE-5 inhibitors. This seems especially to be a problem when taking sildenafil Viagra and vardenafil Levitra ; tadalafil Cialis is a longer-acting PDE-5 inhibitor, and the risks are less clear.
As a result, some doctors recommend that if you are using a nonselective alpha-1 blocker for BPH, you should avoid taking an erectile dysfunction medication altogether. However, our panel of Harvard experts think the concerns are overblown.
Or you can lower the dose of your alpha-1 blocker or PDE-5 inhibitor.
Our caring team an Mayo Clinic vizgra can help contiflo xl and viagra with your health concerns. Is there an alternative to Viagra. Some research suggests that it may help treat ED symptoms, but contiflo xl and viagra do tesco sell viagra is needed to draw definitive conclusions.
This content does not have an Arabic version. Many online companies claim to aand Viagra without a prescription, but this is illegal. Brand-name vs. Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.
Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. It works exactly the same as Viagra; Viagra is the brand and Sildenafil the active ingredient in it. Many of the companies on this list advertise free consultations where you will be evaluated for a prescription within 24 to 48 hours alongside with fast and free shipping, which means that you could potentially receive your ED medications in only a couple of days.
That is what Jack Muriel eventually decided to do. The combination created the dizziness that caused him nearly to run off the road.
Or, if that dose was not sufficient, he could try 50 mg of Viagra.
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