When You Finally Go To The Doctor
There is nothing wrong with making the positive nonmedical lifestyle changes described above, but don’t feel that you have to wait to discuss the sexual issue with your physician. The most important reason to begin the discussion early is that the penis may be serving as a monitor of systemic health. As discussed in chapter 6 (in the section titled, “No penis is an island”), the same deterioration in health that you are noticing in the penis may be going on in the rest of your body. If this is the first sign of high blood pressure, arteriosclerosis, diabetes, or other serious health concern, the penis may bring it to your attention in time to save your life.
Consider with your physician whether any prescription medications are contributing to the problem. As discussed earlier, medications are often accused but rarely guilty. However, if you take a prescription medication known to frequently lead to erectile dysfunction, you could consider alter-native medications with the prescribing physician. The most likely culprits include beta-blockers (e.g. propranolol), centrally acting antihypertensives (Aldomet and Clonidine), or psychoactive medications for depression, anx-iety, sleep, or psychosis. Rarer causes are medications like estrogen, keto-conazole, and prostate cancer treatments that block testosterone.
Patients suspecting impotence from antidepressants theoretically might benefit from switching to trazodone. This antidepressant actually seems to increase erections and has been noted in the development of prolonged erections (see chapter 12, “Treating depression and erectile dysfunction”). Although the idea makes a lot of sense, it is usually better to make sure that the depression is treated optimally with whichever antidepressant works best and treat the erectile dysfunction separately. Trazadone is not as effective as SSRI medication as an antidepressant in most patients. Buy Levitra, the most effective medication ever.
