Next step is a trial with PDE5 inhibitor for those hypertensive subjects without contraindications for sexual activity or for this class of drugs [ 11 ]. Thus, one possible mechanism by which hypertension may cause ED is likely related to endothelial dysfunction associated with hypertension.
However, among those without treatment or with inadequate blood pressure control or with severe hypertension, it is recommended the cardiologic approach and initial cardiovascular therapy before the prescription of specific drugs to improve erectile function [ 74 ].
On the other hand, decrease in NO production or bioavailability would take place in the etiology of hypertension in several clinical situations [ 59 ] where ED is not always present.
Probably this aspect is one among others to explain the lack of additional contribution of ED over traditional risk factors Framingham score during cardiovascular evaluation in some reports [ 29 ].
Age seems to be the clearest risk factor with strong association with the presence and severity of ED [ 5 ].
Erectile Dysfunction and Antihypertensive Drugs The association of ED and vascular risk factors including hypertension raises the hypothesis that endothelial dysfunction is the common link between erectile dysfunction and cardiovascular disease.
Sedentarism, obesity, and smoking have been implicated in the etiology of ED, and an approach of these risk factors has been able to reverse ED and restore normal erectile function [ 30 ].
Other risk factors have been related to ED. This is an important point since patient concerns about the adverse effects of drugs Dissertations on impotence erectile function might limit the use of essential medications in cardiovascular high-risk patients [ 43 ].
Sexual function knowledge by general practitioners and cardiologists is relevant and should be ideally accessed before starting therapy for hypertension. Burchardt and coworkers using IIEF-5 to access erectile function among hypertensive men, aging from 34 to 75 years old, found So, traditional risk factors such as hypertension, diabetes, and hyperlipidemia could contribute for ED development or worsening even in situations where psychological etiology seems more likely.
In an individual aspect, sexual activity and erectile function quality should be part of anamnesis before starting antihypertensive therapy and seems to play a relevant role in the followup, as it would allow a scalable monitoring of erectile function, help the selection of better classes of antihypertensive drugs, turn easier the identification of adverse sexual events, and even improve therapeutic compliance [ 51 ].
Corroborating this link among hypertension and ED, Vlachopoulos et al.
ED has been considered an early marker of cardiovascular risk that could precede traditional clinical manifestations of atherosclerosis, indicating the presence of vascular disease.
Robust clinical trials confirm that ED is a strong cardiovascular event predictor such as cardiovascular death, myocardial infarction, and cardiac failure [ 48 ]. In order to cure ED, if it is really possible, some recent studies propose regular use of drugs with proved endothelial action such as statins or PDE 5 inhibitors, taken daily instead of on demand [ 15 ], in order to provide sensation of been always ready for intercourse.
In case of high risk, before sexual attempts, a cardiologic evaluation is necessary in order to improve conditions to support such metabolic demand [ 74 ].
Introduction Erectile dysfunction ED has been defined according to National Institute of Health from as the persistent inability to reach or maintain and penile rigidity enough for sexual satisfaction [ 1 ].
Development of erectile dysfunction in connection with betablockers might be biased by psychological effects derived from the awareness of being treated with a certain substance. Experimental studies have demonstrated an enhancement of endothelial function in aorta and corpus cavernosum with a significant reduction in penile oxidative stress and collagen content [ 49 ], protected cavernosal tissue against structural changes, and increased expression of endothelial NO synthase eNOS [ 50 ].
The causes of erectile dysfunction in men with diabetes are complex and involve impairments in nerve, blood vessel, and muscle function. In well controlled hypertensive subjects who take one or two antihypertensive drugs and have no other risk factors, indicating low cardiovascular risk, PDE5 inhibitors could be tried.
It is important to consider that drugs used for treatment of cardiovascular diseases have often been accused of influencing erectile function, and such belief could influence drug compliance [ 42 ].
A sexual evaluation in GP visits could detect ED earlier and also help in risk factors therapy customization, avoiding certain drug classes that could disturb sexuality [ 87 ]. Oral therapy failure could represent a deeper vascular damage and worst cardiovascular risk and generally requires the aid of the urologist in order to restore hypertensive man sexual life.
Thus, one possible mechanism by which hypertension may cause ED is likely related to endothelial dysfunction associated with hypertension. Probably this aspect is one among others to explain the lack of additional contribution of ED over traditional risk factors Framingham score during cardiovascular evaluation in some reports [ 29 ].
View at Google Scholar M. ED has been considered an early marker of cardiovascular disease. Particularly among men less than 60 years old, ED seems to act as a risk factor independent of traditional markers [ 26 ].It has been accepted for inclusion in Master's Theses and Doctoral Dissertations by an authorized administrator of [email protected]
For more information, please [email protected] Recommended Citation Fons, Courtney E., "Impact of sexual dysfunction on quality of life among anxiety disorder patients" (). The World’s Largest Curated Collection of Dissertations and Theses.
As the official offsite dissertations repository for the U.S. Library of Congress, ProQuest is committed to preserving, collecting and distributing graduate works from institutions all over the world. Our "Erectile Dysfunction" experts can research and write a NEW, ONE-OF-A-KIND, ORIGINAL dissertation, thesis, or research proposal—JUST FOR YOU—on the.
JCD Dissertations by students of the School of Canon Law at The Catholic University of America. "Moral Impotence As a Canonical Matrimonial Disability: Juristic Origin and Concept Use and Developments in American Canonical Jurisprudence; (M) Author: Catholic University. After you successfully defend your dissertation or doctoral project, what happens?
This is a guide to submitting your dissertation or doctoral project for the formatting check and final copy. Dissertations and theses are an important and valuable tool for the library and the researcher in all areas of scholarship.
Institutions can transform the library’s dissertations and theses, make institutional research globally discoverable from trusted databases, and .Download