A sexual problem, or sexual dysfunction, refers to a problem
during any phase of the
sexual response cycle that prevents the individual or couple from
experiencing satisfaction from the sexual activity. The sexual response cycle
has four phases: excitement, plateau, orgasm, and resolution.

While research suggests that sexual dysfunction is common (43%
of women and 31% of men report some degree of difficulty), it is a topic that
many people are hesitant to discuss. Fortunately, most cases of sexual
dysfunction are treatable, so it is important to share your concerns with your
partner and doctor.

What Causes Sexual Problems?

Sexual dysfunction can be a result of a physical or
order generic viagra
problem.

• Physical causes. Many physical and/or medical conditions can cause
  problems with sexual function. These conditions include diabetes, heart
  disease, neurological diseases, hormonal imbalances, menopause, chronic
  diseases such as kidney disease or liver failure, and alcoholism and drug
  abuse. In addition, the side effects of certain medications, including some
  antidepressant drugs, can affect sexual desire and function.
• Psychological causes. These include citrate generic sildenafil viagra
  stress and anxiety,
  concern about sexual performance, marital or relationship problems, depression,
  feelings of guilt, and the effects of a past sexual trauma.

Who Is Affected by Sexual Problems?

Both men and women are affected by sexual problems. Sexual problems occur in
adults of all ages. Among those commonly affected are those in the geriatric
population, which may be related to a decline in health associated with
aging.

How Do Sexual Problems Affect Women?

The most common problems related to sexual dysfunction in women
include:

• Inhibited sexual desire. This involves a lack of sexual desire or
  interest in sex. Many factors can contribute to a lack of desire, including
  hormonal changes, medical conditions and treatments (for example cancer and
  buy viagra now online
  ), depression, pregnancy, stress and fatigue. Boredom with regular
  sexual routines also may contribute to a lack of enthusiasm for sex, as can
  lifestyle factors, such as careers and the care of children.
• Inability to become aroused. For women, the inability to become
  physically aroused during sexual activity often involves insufficient vaginal
  lubrication. The inability to become aroused also may be related to anxiety or
  inadequate stimulation. In addition, researchers are investigating how blood
  flow problems affecting the vagina and clitoris may contribute to arousal
  problems.
• Lack of orgasm (anorgasmia). This is the absence of sexual climax
  (orgasm). It can be caused by sexual inhibition, inexperience, lack of
  knowledge and psychological factors such as guilt, anxiety, or a past sexual
  trauma or abuse. Other factors contributing to anorgasmia include insufficient
  stimulation, certain medications, and chronic diseases.
• Painful intercourse. Pain during intercourse can be caused by a
  number of problems, including
  endometriosis, a pelvic mass, ovarian cysts,
  vaginitis, poor lubrication, the presence of scar tissue from surgery, or a

  sexually transmitted disease. A condition called vaginismus is a painful,
  involuntary spasm of the muscles that surround the vaginal entrance. It may
  occur in women who fear that penetration will be painful and also may stem from
  a sexual phobia or from a previous traumatic or painful experience.

How Is a Female Sexual Problem Diagnosed?

The doctor likely will begin with a physical exam and a
thorough evaluation of symptoms and a physical exam. The doctor may perform a

pelvic examination to evaluate the health of the reproductive organs and a

Pap smear to detect changes in the cells of the cervix (to check for cancer
or a pre-cancerous condition). He or she may order other tests to rule out any
medical problems that may be contributing to the problem.

An evaluation of your attitude regarding sex, as well as other
possible contributing factors (fear, anxiety, past sexual trauma/abuse,
relationship problems, alcohol or drug abuse, etc.) will help the doctor
understand the underlying cause of the problem and make appropriate
recommendations for treatment.

A sildenafil citrate and discount is a food or part of a food that allegedly provides
medicinal or health benefits, including the prevention and treatment of
disease. Grapefruit juice has been touted as containing many compounds that can
reduce hardening of the arteries (atherosclerosis) and even the risk of cancer.
Grapefruit juice can, therefore, be justifiably referred to as a classic
nutraceutical. However, for many persons taking certain medications, grapefruit
juice might actually better be termed a “nutrapollutical!”

It turns out that grapefruit juice can directly or indirectly interact in
important ways with a number of medications. This is especially important since
grapefruit juice is consumed by approximately one fifth of Americans for
breakfast - a time of the day when medications also are commonly taken.

Grapefruit juice blocks special enzymes in the wall of the small intestine
that actually destroys many medications and prevents their absorption into the
body. Thus, smaller amounts of the drugs get into the body than are ingested.
When the action of this enzyme is blocked, more of the drugs get into the body
and the blood levels of these medications increase. This can lead to toxic side
effects from the medications.

Amazingly, this remarkable food-drug interaction was discovered completely
by accident over a decade ago! Researchers were investigating whether alcohol
could interact with felodipine (Plendil) and used a solution of alcohol with
grapefruit juice to mask the taste of alcohol for the study. Researchers
discovered that blood levels of felodipine were increased several fold more
than in previous studies. This increased blood level caused an increase in the
effect and side effects of felodipine. Further research revealed that the
grapefruit juice itself was actually increasing the amount of the study drug in
the body.

Research about the interaction of grapefruit juice with drugs suggests that
compounds in grapefruit juice, called furanocoumarins (e.g. bergamottin), may
be responsible for the effects of grapefruit juice. Researchers believe that
furanocoumarins block the enzymes in the intestines that normally break down
many drugs. One glass of grapefruit juice could elicit the maximum blocking
effect, and the effect may persist for longer than 24 hours. Since the effects
can last for such a prolonged period of time, grapefruit juice does not have to
be taken at the same time as the medication in order for the interaction to
occur. Therefore, unlike similar interactions, where the interaction can be
avoided by separating the administration of the two interacting agents by a
couple of hours, administration of grapefruit juice with susceptible drugs
should be separated by 24 or more hours to avoid the interaction. Since this is
not practical for individuals who are taking a medication daily, they should
not consume grapefruit juice when taking medications that are affected by
grapefruit juice.

The grapefruit juice-drug interaction can lead to unpredictable and
hazardous levels of certain important drugs.

These are medications with which grapefruit juice should NOT be consumed
unless advised by a doctor:

• Statins (Cholesterol Drugs): lovastatin (Mevacor), atorvastatin Lipitor,
  Simvastatin Zocor, simvastatin/ezetimibe Vytorin
• Ed pills
  : Ebastine, Seldane (terfenadine, taken off the U.S.
  market)
• Calcium Channel Blockers (Blood Pressure Drugs): nimodipine (Nimotop),
  Felodipine (Nitrendipine, Plendil), Pranidipine, nisoldipine (Sular),
  nicardipine (Cardene), verapamil (Verelan)
• Psychiatric Medications: buspirone (Buspar), triazolam (Halcion),
  carbamazepine (Tegretol), diazepam (Valium), midazolam (Versed), sertraline
  (Zoloft)
• Intestinal Medications: cisapride, taken off the U.S. market
  (Propulsid)
• Immune Generic erectile dysfunction drugs
  : cyclosporine (Neoral), (tacrolimus) Prograf
• Pain Medications: Methadone
• Impotence Drug (erectile dysfunction): sildenafil (Viagra)
• Ant-HIV medication : saquinavir (Invirase)
• Erectile dysfunction medicine
  : amiodarone (Cordarone)

Toxic blood levels of these medications can occur when patients taking them
consume grapefruit juice. The high blood levels of the medications can cause
damage to organs or impair the organs normal function, which can be dangerous.
If you or a family member are taking any of these medications, beware of the
“nutrapollutical” grapefruit juice.

Sept. 7, 2006 — The first drug developed erectile dysfunction pill
for premature
ejaculation performed well in two clinical trials, but the new treatment
probably won’t be available in the U.S any time soon.

Men in the study who took the experimental drug Dapoxetine, developed by
Johnson & Johnson Pharmaceuticals in conjunction with ALZA Corp., were able
to maintain erections longer than men who took placebos.

Dapoxetine is a selective serotonin reuptake inhibitor (SSRI) but is
slightly different from the SSRIs (such as Zoloft, Paxil, and Prozac) widely
prescribed for depression and other
psychiatric disorders.

The drug was designed to be taken as needed, one to three hours before sex,
instead of every day. Also, it is eliminated from the body more quickly than
other SSRIs.

Hopes that Dapoxetine would become the first drug approved for premature
ejaculation dimmed last October, when the FDA sent a “not approvable”
letter to the manufacturer.

The FDA’s concerns about the drug were not made public. In a news release,
ALZA Corp. promised to “address questions raised in the FDA
letter.”

A cheap tadalafil
for Johnson & Johnson told WebMD Thursday that the
company “remains committed to the global development” of
Dapoxetine.

A Common Complaint

Although it is rarely talked about, premature ejaculation is a common
problem, affecting as many as a third of men.

Far fewer men seek treatment, however.

Those who do are often advised on practice techniques to help. Some receive
a ed meds
for a traditional, long-acting SSRI, since delayed ejaculation
is a common side effect among men who take SSRIs for depression.

This use of traditional SSRIs would be considered off-label since the
medications are not specifically indicated for this problem.

Other potential sexual side effects of SSRIs include erectile
dysfunction and loss of libido, however, making the traditional
antidepressants less than ideal for treatment of premature ejaculation, Jon L.
Pryor, MD, tells WebMD. Pryor is a urology professor at the University of
Minnesota.

Longer-Lasting Sex

In the generic prices viagra
study, Pryor and colleagues compared 30-milligram
and 60-milligram doses of Dapoxetine to a placebo in roughly 2,600 men with
moderate to severe premature ejaculation.

Prior to treatment, the men’s average ejaculation time was just under a
minute.

With treatment, the average time to ejaculation was 1.75 minutes in the
placebo-treated men, 2.78 minutes in the men treated with 30 milligrams of
Dapoxetine, and 3.32 minutes in the men treated with 60 milligrams of the drug.
The study lasted three months.

“A couple of minutes may not sound like much but for these guys it was
huge,” Pryor says.

Men who took the short-acting SSRI also reported having more control over
their erectile dysfunction new drugs
than the placebo-treated men; and they and their female
partners reported improved sexual satisfaction.

The Snicker Factor

Pryor says an effective, specific treatment could do for premature
ejaculation what Viagra did for erectile dysfunction
– taking away the ’snicker’ factor by stimulating open discussion about the
disorder.

“Viagra wasn’t a magic pill, but it did bring ED into the open and men
who had it learned that they were not alone,” he says. “The discussion
that followed stimulated research that led to other treatments.

“Premature ejaculation is more common than ED, but no one talks about
it,” adds Pryor.

Ira Sharlip, MD, a urology professor at the University of California, San
Francisco, tells WebMD there is a definite need for an effective treatment for
premature ejaculation.

“I have patients who are really disturbed by this issue, and so are
their wives,” he says. “The current treatments are far from
perfect.”

Sharlip says traditional SSRIs work best when they are taken every day, and
even then they only work for around two-thirds of patients.

“Premature ejaculation is certainly one of the most common forms of
sexual dysfunction among men,” Sharlip says. “Not everyone who has it
is bothered by it, but for those who are, it can be a very big
problem.”

In the 1970s, parents worried that their longhaired, bell-bottomed teenagers were getting drunk or smoking marijuana. Today, dangers also come in the form of prescription medicines — from opioid pain relievers such as OxyContin to ADHD drugs such as Ritalin.

Prescription drug abuse appears to be on the rise in this country. Wilson Compton, MD, director of the division of epidemiology services and prevention research at the National Institute on Drug Abuse (NIDA), says the reasons aren’t clear.

But he suspects that increasing numbers of erectile dysfunction meds
written for certain drugs, such as ADHD medications, afford greater sildenafil citrate and discount. “A certain portion of those will be diverted for abuse purposes,” he says.

Compton also says that in the current environment it seems almost normal to pop pills. “All of the cheap uk viagra
for pills may play a role in our willingness to try them.”

Roughly 6.3 million Americans report that they’re currently using prescription drugs for nonmedical reasons, according to the U.S. Department of Health and Human Services.

Prescription drug abuse knows no age. The elderly are vulnerable because they’re more likely to take many medications, often long term. Also, women may be as much as 55% more likely as men to be prescribed drugs that can be abused, such as narcotics and tranquilizers; therefore, their risk is greater, according to the NIDA.

Teens and Prescription Drug Abuse

Abuse is most common among young people, Compton says. “Prescription drug abuse — like most drug abuse — tends to peak in the teens and 20s,” he tells WebMD.

Almost one in five teens — roughly 4.5 million — has tried getting high with prescription drugs (typically with pain relievers such as Vicodin or OxyContin, or stimulants, such as Ritalin and Adderall). That’s according to a recent national study on teen abuse of prescription and over-the-counter drugs by the nonprofit Partnership for a Drug-Free America.

The study also found that teens’ abuse of prescription and over-the-counter medicines is equal to or higher than abuse of drugs such as cocaine and crack, Ecstasy, methamphetamine, and heroin.

Some teens say that prescription medicines are much safer to abuse than illegal drugs. But just because prescription drugs aren’t cooked up in someone’s garage doesn’t mean that they’re safe. According to Compton, the main risk for many drugs is addiction.

“As people try these substances, some of them will find that they really like them,” he says. “They take more of them and they continue to take them, even when they no longer want to. And that’s the hallmark of addiction. It creeps up on people in very subtle and unexpected ways. No one starts out taking a drug, saying, ‘I want to be an addict.’”

Besides addiction, prescription drug abuse can bring on a host of health problems, such as irregular heartbeats, seizures, hostility, and paranoia — even infections with HIV or other agents if someone dissolves and injects pills to get a quick high. Overdoses can be fatal. To combat the potential for abuse, some drug companies have marketed newer, timed-release versions that are harder to misuse.

It’s important to remember that most people can reap benefits from prescription drugs without problems. But a minority will run into trouble. “Using these substances outside of a doctor’s prescription is already a red flag and a warning,” Compton says.

Which drugs are commonly abused? Who’s most susceptible? How could they be endangering their health? Here’s the rundown.

July 12, 2006 — The FDA today warned consumers not to purchase or consume
seven products that are promoted and sold on web sites as “dietary
supplements” for treating erectile dysfunction
(ED) and enhancing sexual performance.

The products — Zimaxx, Libidus, Neophase, Nasutra, Vigor-25, Actra-Rx, and
4EVERON — are “illegal drugs that contain potentially harmful undeclared
ingredients,” states an FDA news release.

“These products have not been approved by FDA, and there is no guarantee
of their safety and cialis vs viagra
, or of the purity of their ingredients,”
the FDA’s news release continues.

The FDA is advising consumers who have used any of these products to
discontinue use and to consult their health care provider. The FDA also
encourages anyone experiencing ED to seek guidance from a health care provider
before purchasing a product to treat this medical condition.

Stealth Ed medicine

“These products threaten the public health because they contain
undeclared chemicals that are similar or identical to the active ingredients
used in several FDA-approved erectile pill drug products,” says Steven
Galson, MD, MPH, in the FDA’s news release. Galson directs the FDA’s Center for
Drug Evaluation and Research.

“This risk is even more serious because consumers may not know that
these ingredients can interact with medications and dangerously lower their
blood pressure,” Galson continues.

The banned products contain chemicals similar to those in the prescription
ED drugs Viagra and Levitra. The FDA analyzed the products and found that
Zimaxx contains sildenafil, Viagra’s active ingredient. The other illegal
products contain chemical ingredients that are similar to either sildenafil or
vardenafil, Levitra’s active ingredient.

“There is no mention of any of these ingredients in any of the illegal
products’ labeling,” states the FDA.

Health Risk

The illegal products’ undeclared ingredients may interact with nitrates
found in some prescription drugs (such as nitroglycerin, Isordil, and Imdur)
and lower blood pressure to dangerous levels.

People with diabetes, high
blood pressure, high cholesterol, or
heart disease
often take nitrate medications. ED is a common problem in men with those
conditions, the FDA notes.

Those men may seek ED products that claim to be “all natural” or
that claim to lack the active ingredients used in FDA-approved ED drugs, states
the FDA. But those claims are false, misleading, and potentially dangerous,
according to the FDA.

The FDA also warns that because it doesn’t know where the illegal products
are made, there is no assurance that the ingredients are safe, effective, or
pure.

The FDA has sent warning letters to the products’ marketers, is working to
stop Libidus and 4EVERON from entering the U.S., and may take other enforcement
actions.

The FDA’s actions follow its first survey of 17 dietary supplements marketed
on the Internet to treat ED and enhance men’s sexual performance.

“Our survey found that many of the so-called ‘dietary generic viagra in canada

marketed as treatments for erectile dysfunction actually contain nondietary
chemicals, including chemicals used as active ingredients in FDA-approved
drugs,” says Margaret Glavin, the FDA’s associate commissioner for
regulatory affairs, in the FDA news release.

“The claims made for these products were in fact claims made for the
undeclared nondietary chemicals they contain, which rendered them illegal
drugs,” Glavin continues. She adds that the FDA “is committed to
protecting the public health by removing such illegal and dangerous products
from the market.”