ED

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ED

Postby Melody » Tue Oct 10, 2006 6:01 pm

Has anyone here studied the use of Viagra for ED and it's safety. We were at John's neurologist today and he mentioned he was having trouble in this area. Of course I've noted it but really wasn't going to be the one to mention it. To tell you the truth I vacated the room while they discussed it. The trouble is once we got in the car John says he has a perscription for Viagra so I said don't be hasty I need to look up the safety of it's use.I found this and to tell you the truth am not to sure I'm willing to take that risk. Help

Is There a Link Between Viagra and Blindness?
Updated: 9/29/2005 12:08:38 PM
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July 11, 2005—The Food and Drug Administration (FDA) has ordered the makers of Viagra, Cialis and Levitra to add new warnings about rare cases of sudden vision loss. A recent study also noted these vision problems, known as non-arteritic anterior ischemic optic neuropathy (NAION), in seven men who had taken Viagra.
The agency is advising patients to stop taking these medicines or call a doctor or right away if they experience sudden or decreased vision loss in one or both eyes. In a statement, the agency said that a small number of men lost their sight some time after taking Viagra, Cialis or Levitra. "It is not possible to determine whether these oral medicines for erectile dysfunction were the cause of the loss of eyesight or whether the problem is related to other factors such as high blood pressure or diabetes or to a combination of these problems," the FDA said.

Well over 20 million men have taken these anti-impotence drugs, meaning that whatever risk there is of developing vision loss—if there is a risk at all—would seem extremely small. Still, just how serious of a condition is NAION, and what can be done in men who develop it?

What is NAION?
NAION is one of the most common causes of sudden vision loss in older Americans.

The condition leads to swelling around the optic disc, a connection point where the optic nerves reach the back of the eye. Ultimately, this swelling compresses the optic nerves and causes a rapid drop in vision. About 6,000 people develop NAION each year, according to the National Eye Institute.

How does NAION develop?
The symptoms are painless and often appear without notice. In a study led by researchers at the University of Iowa, about three quarters of NAION patients first discovered their vision was blurry and impaired after waking up in the morning. The condition starts in one eye and can cause complete blindness if both eyes are eventually affected.

Is there a risk from Viagra and other anti-impotence drugs?
No one can say for sure. Pfizer, the manufacturer of Viagra, defends the safety of its drug. "A review of 103 Viagra clinical trials involving 13,000 patients found no reports of non-arteritic anterior ischemic optic neuropathy," the company stated. "There is no evidence showing that NAION occurred more frequently in men taking Viagra than men of similar age and health who did not take Viagra."

Andrew Schachat, MD, an ophthalmologist with the Wilmer Eye Institute at Johns Hopkins University, who has no financial ties to Pfizer, is equally skeptical. "With the millions of patients who use Viagra, it is not surprising to find cases of NAION and in fact, one would expect to find some," he said.

The FDA continues to investigate whether there is a connection. Schachat said he doubts Viagra or other anti-impotence drugs cause NAION, "but a careful study would be needed."

So far, the warnings about side effects—such as NAION and erections that last more than four hours—are the same for each of the three popular anti-impotence drugs.

Why is the concern about Viagra and NAION surfacing now?
The chance that Viagra might lead to NAION was first brought up by Howard Pomeranz, MD, an eye expert at the University of Minnesota. In 2000, he reported the case of a man who developed NAION soon after he took Viagra. There have been several other reports since then.

In a study published in the Journal of Neuro-Ophthalmology this past March, Pomeranz noted seven new cases, bringing the total to 14 men who developed NAION possibly because of Viagra. On May 26, the FDA first confirmed to CBS News that they were investigating similar reports in nearly 50 men.

Does NAION lead to permanent vision loss?
Not always. Until a few years ago, it was estimated that only a small minority of patients were likely to regain their vision. But new studies have shown that a surprisingly high number of NAION patients spontaneously recover on their own.

Following some 100 or so men and women who were involved in a major trial sponsored by the National Eye Institute, researchers found that about 40 percent of NAION patients had some improvement in eye sight after three months. Indeed, they fared better than a similar number of patients who underwent an experimental procedure to prevent further vision loss.

"It's much better than we expected," said Kay Dickersin, PhD, a professor of Community Health at Brown University who has helped with the study, known as the Ischemic Optic Neuropathy Decompression Trial.

Is the vision loss substantial?
NAION can be disabling, especially if it affects both eyes. In the National Eye Institute study, whatever gains the patients had were partly lost after two years. But even with declining eyesight, most had better vision than when they were first afflicted with NAION. "These improvements are a noticeable difference," Dickersin said.

Is there any treatment for NAION?
There is no effective treatment as of yet, although researchers are examining different therapies in clinical trials.

Who is at risk for NAION?
Those who have bad eyesight already appear to have the highest chance for developing NAION. While people who have diabetes, hypertension or high cholesterol seem to be a greater risk for NAION as well, there is some debate on how much. "None of these systematic disorders are firmly associated with NAION, and diabetes could only account for only a minority of the cases," stated Simmons Lessell, MD, of the Massachusetts Eye and Ear Infirmary in an editorial for the Archives of Ophthalmology.

Is there a strong reason to suspect that Viagra raises the risk of blindness?
The seven men in Pomeranz's recent study all developed NAION soon after they took Viagra. After taking two blue Viagra pills the day before, one 50-year old man said he felt "a flashbulb go off in my eyes." The onset of vision loss within hours of taking Viagra "supports an association between use of this agent and NAION," Pomeranz wrote.

However, NAION appears suddenly in some 6,000 people a year for a variety of unknown reasons. "We don't really know what the natural history of NAION is," said Dickersin. Pomeranz is also cautious about Viagra causing NAION: "A definite casual relationship cannot be established at this time," he noted.

The Bottom Line
Recent guidelines from the American Urological Association recommended either Viagra, Cialis or Levitra as the first option for treating erectile dysfunction, which have not changed in light of the recent bad publicity about their potential link to NAION.

In general, as many as 80 percent of men will benefit from these drugs, said Drogo Montague, MD, of the Cleveland Clinic in announcing the new guidelines. Men can try injections, external pumps or a penile implants if Viagra or similar drugs fail to work. "For those men who are not helped by these agents, one or more of the remaining treatment options are almost always successful," said Montague.

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John was diagnosed Jan 2005. On lipitor 20mg .On Copaxone since July 4,2005. Vitamin D3 2000iu-4000iu (depending on sunshine months)June 10 2005(RX::Dr. O'Connor) Omega 3 as well Turmeric since April 2005. Q10 60mg. 1500mg liquid Glucosamine Nov 2005.
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Postby robbie » Tue Oct 10, 2006 6:26 pm

Don't worry about it i'm sure John is thinking much more about getting a stiffy than the one in a million chance of going blind...
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Postby Melody » Tue Oct 10, 2006 6:29 pm

A guys point of view :lol:
John was diagnosed Jan 2005. On lipitor 20mg .On Copaxone since July 4,2005. Vitamin D3 2000iu-4000iu (depending on sunshine months)June 10 2005(RX::Dr. O'Connor) Omega 3 as well Turmeric since April 2005. Q10 60mg. 1500mg liquid Glucosamine Nov 2005.
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blindness

Postby jimmylegs » Wed Oct 11, 2006 3:14 am

man it seems like no matter the age or the method, if it's not acting alone, you'll go blind!
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Postby davwhi » Wed Oct 11, 2006 6:54 am

Another option in this area is Papaverin. I think is also known as prosteglandin (probably spelled wrong).

It's injected into the "none response area", works within 10 minutes and lasts for an hour or two. The injection isn't as bad as it sounds once you get use to it.

Papaverin has been around much longer than Viagara and is, to my knowledge, completely safe. I've been using it for nearly 12 years and have never considered switching to Viagara or any other pill.

The neuro may not be too familiar so you may need to see a Urologist.
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Postby bromley » Wed Oct 11, 2006 7:08 am

What I love about this disease is there are no limits. I can't think of one function that it doesn't affect. And the real twist is that when the drugs companies come up with drugs there is a huge list of side-effects some more scary than some of the prolems caused by this disease. My MS nurse told me that one of her male patients with very advanced MS still had a good sex life - she didn't pick up on the look of complete disbelief on my face!

I have tried viagra and it worked but takes away the spur of the moment stuff. But the idea of having to inject into your wedding tackle just prior to the event beggars belief. No doubt in years to come Biogen will be selling super-size injections containing Avonex, liquid viagra, something to help with the walking, something for the pain!
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Postby amelia » Wed Oct 11, 2006 12:55 pm

injection isn't as bad as it sounds once you get use to it.

I guess it is what you want to do and how bad, but Gary's response to this cannot even be typed here! He tried Viagra, but the flushing was more of a problem with him. He has really bad eye sight and did have the "blue"vison" bothersome, but goes away. One day, he'll get brave enough to try the others. By the way, with Gary, it took longer than the usual 30 min to start working. So give yourself plenty of time. And by the way Ian, how is anything "spur of the moment" when it comes to MS and a sex life?
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Postby davwhi » Thu Oct 12, 2006 7:30 am

The aversion to the injection is purely psychological. It really isn't that bad, and a good Urologist will teach you how to do it.

The advantage is that it is GUARANTEED to work within 15 minutes. Plus it keeps working for up to two hours. To be clear that means that even after Gary has, ummm, finished(?), he will stay hard until the two hours is up.

Spontaneous, no not really, but it definitely has advantages. Like I said, I've never even bothered trying any of the pills.
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Postby bromley » Thu Oct 12, 2006 7:57 am

he will stay hard until the two hours is up.


How will he get his jeans back on after he's done the deed (3 mins)?

Amelia strikes me as a model wife, but surely she doesn't have to lay on her back for two hours!
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Postby Melody » Thu Oct 12, 2006 10:39 am

Injections are out just the sound is painful. We actually tried the 1/2(25mg) a pill with luck that means you only go 1/2 blind and John figured with those odds it could be his bad eye. The half pill worked fine and we didn't note any problems with it at all. I do agree the side effects are terrible on half these drugs. On a better note John had absolutely ZERO weakness left when he was just tested at the neuro and they were amazed. Even his bad eye did somewhat better but is still not clear by any means. We plan to keep going on the path we chose of diet and supplements as well as exercise of course and are working on the eye now with bromelain as well as turmeric. Long process but one can always HOPE. :wink: Thanks for your responses it defused the slight panic attack I was having.
John was diagnosed Jan 2005. On lipitor 20mg .On Copaxone since July 4,2005. Vitamin D3 2000iu-4000iu (depending on sunshine months)June 10 2005(RX::Dr. O'Connor) Omega 3 as well Turmeric since April 2005. Q10 60mg. 1500mg liquid Glucosamine Nov 2005.
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Postby amelia » Thu Oct 12, 2006 10:47 am

Melody
Gary has lots of eye trouble. Tell me more about the supplements for the eyes John takes. Gary drinks barley green, small amount, at night to help with spasticiy and resting. Really great if he has to go on steroid treatments. L-Carnatine seem to do him a little good for energy, but he isn't bothered by fatigue too much.
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lutein?

Postby jimmylegs » Thu Oct 12, 2006 5:07 pm

not related to ms, or optic neuritis, my stepdad takes lutein for macular degeneration. not sure what the action of lutein is or whether it could help ms-related vision probs?
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Postby Shayk » Thu Oct 12, 2006 7:42 pm

Melody

Great to learn a half pill worked, if it hadn't, there might be another potential remedy--testosterone.

Testosterone is another recognized treatment for men with ED and low testosterone levels. The abstract from the AAN meeting this spring with data about testosterone levels in men and women indicated about 50% of people with MS had low testosterone levels, compared to about 5% of the general population and I'm wondering if it's possible that in some men with MS the ED might be due to low testosterone levels. Here's that data:
Simon, E. V.; Topalli, I.; Touray, A.; Sadiq, S.A.
Decreased Serum Testosterone Levels in Multiple Sclerosis

Total and free serum testosterone levels were obtained from 100 randomly selected clinically definite MS patients (68 females and 32 males).

Low testosterone levels were defined as 20 ng/dl in females and 295 ng/dl in males. RESULTS: Thirty-nine of 68 females (57%) and 14 of 32 males (44%) had decreased serum testosterone levels

Here's a link with more info on testosterone treatment in men. In the quote, AD =s androgen deficiency. Androgen (Testosterone) Therapy for Men
Who should receive testosterone therapy?

• The panel recommended that treatment be given to men with low testosterone levels and symptoms or signs of AD.

• The panel suggested treatment be given to men with low testosterone levels and low libido, ED, HIV-infection, those receiving high doses of glucocorticoids (such as prednisone), and older men with consistently low testosterone levels on more than one occasion and significant symptoms and signs of AD.

It just seems like testosterone is another option to consider since 44% of the men with MS in that study (small sample I know) had low testosterone levels.

On a slightly different note, I continue to wonder whether all cases of ED or sexual dysfunction in men and women with MS can and/or should automatically be attributed to lesion/spinal cord damage. Could ED/sexual dysfunction be due to the low levels of testosterone in some men and women with MS and not the result of lesions/damage in all cases? Is it another “assumption” about people with MS? I definitely think it needs a bit more research. But then, that's the case with most things. :roll:

I hope everyone is well and having some fun.

jimmylegs--I don't know about lutein. Sorry.

Sharon
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Postby Muu » Fri Oct 13, 2006 1:51 am

That's an interesting point Sharon. I also believe that the emotional impact and self esteem issues of living with ms can also play a role in sexual dysfunction.

As for the Papaverin...If I were male, my papa certainly would be veering if a syringe were produced!!
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Re: lutein?

Postby EyeDoc » Fri Oct 13, 2006 7:58 am

jimmylegs wrote:not related to ms, or optic neuritis, my stepdad takes lutein for macular degeneration. not sure what the action of lutein is or whether it could help ms-related vision probs?


Unfortunately, lutein will do nothing for MS related problems. It has no effect on the optic nerve.
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