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Unstable angina (chest pain due to coronary artery disease that occurs at rest or with minimal physical exertion) Vacuum devices "We do need more effective therapies for jet lag and for sleep difficulties that occur as a consequence of shift work," said Dr. Robert Vorona, an associate professor at Eastern Virginia Medical School who's familiar with the study findings. Replacement androgens are available in oral, injectable, gels and transdermal preparations. Oral therapy is the least effective and the most likely to be associated with hepatotoxicity, even though this is a relatively small risk. Parenteral therapy is most likely to restore androgen levels to the reference range, but this therapy requires periodic injections, usually every 2 weeks, to sustain an effective level. Peak and trough levels are suggested when using injectable agents to avoid symptomatic troughs and supernormal peak levels. Weekly injections using lower doses can be used to minimize the wide swings in blood levels with less frequent dosing. Skin patches deliver a sustained dose and are generally accepted by patients. Androgen creams (AndroGel and Testim) are now available for daily topical use for male hypogonadism and have the advantage of minimizing the peaks and troughs of injectable agents. However, they require daily dosing and are relatively expensive. Do you suspect that my or my partner's erectile dysfunction might be caused by an underlying medical condition or psychological disorder? Why or why not? Using a diaphragm, cervical cap or contraceptive sponge may increase the risk of urinary tract infections in some women. Some women have allergic reactions with these methods. A. MUSE (available since 1997) employs a small, specially-designed plastic plunger that is placed on the tip of the penis. Once the plunger is pressed, a rice-size pellet of medication (alprostadil) is pushed into the urethra. Moisture left by urine causes the pellet to dissolve, triggering an erection minutes later. Certainly less invasive than a hypodermic injection of medication, MUSE, an acronym for "medicated urethral system for erection," turns out to be a poor solution. Many men complain of a burning pain in the penis after the drug has been inserted, and there is a small risk of urethral injury. Since the efficacy of MUSE is extremely low - 10 percent or less, according to on 1998 study and the side effects are worse than injection therapy, I don't recommend it as a first-line treatment after a radical prostatectomy. Treatment Take it one moment, one hour, one day at time. Cravings to smoke are usually short-lived and will go away whether or not you have a cigarette. Missed Signals continued... To bypass roadblocks along the brain-to-penis highway, drugs can be injected or inserted directly into the penis. While some men find this painful to think about, many others find that it can restore a satisfying sex life and is highly effective. Erectile dysfunction -- also called "ED" or impotence -- is the inability to achieve or sustain an erection on repeated occasions. It's estimated that about two of every 100 American men have erectile dysfunction serious enough to warrant a doctor's visit, according to the U.S. National Institute of Diabetes and Digestive and Kidney Disorders. As men age, the risk of erectile dysfunction increases. brand viagra for sale Tests such as the bulbocavernosus reflex test are used to determine if there is sufficient nerve sensation in the penis. The physician squeezes the glans (head) of the penis, which immediately causes the anus to contract if nerve function is normal. A physician measures the latency between squeeze and contraction by observing the anal sphincter or by feeling it with a gloved finger inserted past the anus. Specific nerve tests are used in patients with suspected nerve damage as a result of diabetes or nerve disease. Other essays touched on different aspects of the issue. For example, Troy Duster, professor of sociology at New York University, wrote about the medicalization of race -- specifically, about the approval in the United States of medications designed specifically for black Americans. ANTHONY J. VIERA, LT, MC, USNR,

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