Claremont Sexual Health News March2005

Erectile dysfunction (ED) is an important marker for cardiovascular disease.

In the presence of other risk factors such as family history, smoking, high cholesterol diabetes or obesity, the presence of ED is probably the most important marker of significant vascular disease. Up to 50% may have major disease when investigated. Angina sufferers often have a history of ED predating the onset of heart disease by an average of 3 years. Oral treatments for ED are effective but may also have a positive effect on other disease processes. Long term use has been associated with a reduction in mortality in several studies.

ED is always an important symptom and should be fully evaluated by an experienced doctor.

Treating ED in depressed patients may cure their depression.

A placebo controlled study published in 2004 showed that treating ED with an oral agent improved depression scores by 50% in over half the patients and led to complete remission in their depression for 58%.

Not only can ED be a symptom of depression it can be a contributor; recognizing and treating sexual dysfunction is extremely important in the management of depression.

Unfortunately antidepressant medication can cause sexual dysfunction which may undermine their effectiveness. The correct choice of type and dose of medication is very important as is recognition and treatment of sexual problems where possible.

The loss of the ability to enjoy one’s sexuality can have a devastating effect on self esteem. Not only can this contribute to depressive thoughts but also to relationship problems.

There are a lot of vicious circles involved and a holistic approach is necessary to optimize treatment of depressed patients and their partners.

Sleep Apnoea.

Sleep apnoea is emerging as an important cause of various medical, psychological and social problems. It has been associated with sudden death, heart disease, high blood pressure, stroke, metabolic problems, depression and sexual dysfunction. One common effect is that of reducing testosterone, the male sex hormone that is important in both male and female sexual function. Sleep apnoea be excluded before starting testosterone therapy as the treatment itself can worsen the sleep apnoea and actually make matters worse.

A family history, being male, obesity, excess alcohol, sedatives  and inactivity increase the risk of developing sleep apnoea.

Sleep apnoea causes both low libido and erectile dysfunction / arousal disorder. Both problems can be alleviated with treatment by lifestyle modification or the use of positive pressure masks.

NB. WE HAVE A 15% DISCOUNT ON CONDOMS AND LUBRICANTS RUNNING AT THE MOMENT

Stephen