Erectile Dysfunction

Erectile Dysfunction

Erectile Dysfunction Overview

 

Erectile dysfunction (ED) is the inability to obtain and maintain and erection for sexual intercourse. 

 

If this is an ongoing or consistent issue, it can cause stress, affect one’s self-confidence and contribute to relationship problems. 

 

Diagnosing ED is important as it can be a sign of an underlying health condition such as heart disease. 

 

 

Signs and symptoms

 

  • Inability to achieve an erection 

  • Inability to maintain an erection

  • Reduced sexual desire

 

 

Causes 

 

Achieving an erection requires function from various bodily systems including nerves, blood vessels, and the brain. Sexual stimulation cases nerves to send signals to blood vessels in the penis to dilate. The dilation of these blood vessels cause increased blood flow to the penis and results in an erection. An underlying problem to any of these structures can contribute to ED.

 

Psychological factors 

  •  
  • Depression, anxiety, stress, PTSD

 

Hormonal 

  • Diseases such as diabetes, hypogonadism or hypothyroidism 

 

Drugs 

  • Blood pressure medications, antidepressants, antihistamines, drugs for prostate conditions, heavy alcohol use

 

Injuries

  • Damage to nerves or arteries that control erections

 

Blood Vessel Diseases

  • High blood pressure, smoking, high cholesterol can all cause atherosclerosis which can narrow blood vessels that cause erections

 

Neurological 

  • Parkinson’s disease, Multiple Sclerosis, previous stroke

 

 

Treatment

An important part of treatment for ED is to be properly assessed by a health care professional of any underlying condition that can be causing your ED. Options for treating ED include: oral medications, injections, and penis pumps/implants

 

Oral medications: 

 

  • Sildenafil (Viagra)
  • Tadalafil (Adcirca, Cialis)
  • Vardenafil (Levitra, Staxyn)

 

These medications all work my increasing the amount of nitric oxide – a natural chemical in the body –  to induce expansion of blood vessels causing in erection. Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves.

 

Side effects of these medications include flushing, nasal congestion, headache, visual changes, backache and stomach upset. 

 

Before taking these medications, get the OK from a health care professional as they may be dangerous while taking nitrates for heart disease. 

 

Injections 

 

  • Alprostadil (Prostaglandin E1) 
  • Phentolamine (OraVerse) 

  • Papaverine (Papaverine)

 

These medications are administered through self-injection taken before intercourse. They begin to work about 10 minutes after injection. All three require a prescription from a health care provider. 

 

Pumps, surgery and implants

 

If medication are not effective or cannot be used, your health care provider may prescribe a device. 

 

Penis pumps 

This is a tube that goes around your penis and when turned on, creates a vacuum. This allows blood to flow into the penis. Once an erection is achieved, a ring can be places at the base of the penis to keep it firm. Once intercourse is complete the ring is removed. 

 

Penile implants   

Penile implants require surgery and are placed by a urologist. A portion of the penis called the corpus cavernosum is removed and replaced by an implantable, inflatable device. The inflator pump is placed in the scrotum. When an erection is desired, pumping of the scrotal pump allows air to rush into the implant giving an erection. Air can also be released when desired. As with any surgery, there's a risk of complications, such as infection. Penile implant surgery is not recommended if you currently have a urinary tract infection.

 

 

Prevention

 

Exercise 

Evidence has shown that moderate to vigorous aerobic activity can improve symptoms of ED. Exercise can also reduce your risk of developing or worsening your ED. It is important to discuss an exercise plan with your health care provider. 

 

Psychological counselling 

if the course of your ED is stress or other psychological reasons, then visiting a counsellor may help with this. 

 

Smoking Cessation 

Smoking causes damage to blood vessels which can eventually cause blockages. Quitting smoking can prevent the build up of blockages 

 

Weight loss 

Loosing weight can improve ED and also prevent the onset. 

 

 

How Can We Help?

 

Book an appointment today and speak to a licensed healthcare professional. They will be able to assess your issues and design a customized treatment plan which could require a prescription medication. The healthcare professional will write and make the prescription available to you if required.

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Birth Control

Birth Control Overview

 

Birth control methods prevent pregnancy. If you have sex without using birth control there is a high chance of becoming pregnant. If you act quickly and believe you may be at risk of being pregnant then there is emergency contraception available.

 

Types of Birth Control

 

  1. Long Acting Reversible Contraception

 

    • These are long acting and reversible

    • Once removed you can become pregnant again

    • Some of these methods also involve hormonal regulation

    • Example - Intrauterine devices (IUDS). 

      • This is placed in the uterus by a doctor

      • There are two types 

        • Copper IUDS

        • Hormonal IUDS

 

  1. Hormonal Methods

 

    • Birth Control Pills

    • Birth Control Shots

    • Birth Control Patch

    • Hormone eluting IUD

 

  1. Barrier Methods

 

    • Condoms

    • Diaphragms 

    • Sponges

 

  1. Permanent Birth Control

 

    • Vasectomy for males

    • Tubal ligation for females 

 

  1. Emergency Contraception

 

    • Backup method if a birth control is not used or a condom breaks

    • This requires urgent treatment without delay

Licensed healthcare professionals help you decide which method would be best for you by providing you with information on the pros and cons of each method. They are skilled to provide you with an appropriate referral or prescriptions for birth control pills.

 

There are health issues that may limit your choices of the types of choices that may be available to you depending on your overall health (e.g. cancer, blood clots) and lifestyle (e.g. smoking)

 

How Can We Help?

 

Book an appointment today and speak to a licensed healthcare professional. A customized personal plan will be developed to help you.

Hair Loss

Hair loss Overview

 

Hair loss is a common condition affecting approximately 50% of men and 25% of women by age 50. The most common form of hair loss or ‘alopecia’ is called androgenic alopecia. This type of hair loss often follows certain patterns. In men, hair loss first occurs above both temples and at the crown of the head. In women, the hair becomes thinner all over the head, and the hairline does not recede.

 

Cause 

Both genetic and environmental factors can play a role in causing hair loss. It is thought that hormones called androgens cause thinner hair shafts and prevent growth. 

 

Additionally there are many other reasons that can cause hair loss and should be investigated by a health care provider. These can reasons can be: 

 

    • Hormonal

    • Autoimmune

    • Toxins

    • Drugs

    • Medication

    • Childbirth

    • Infections

    • Diabetes

    • Autoimmune diseases

    • Lichen plants

    • Sarcoidosis

    • Scalp psoriasis

    • Thyroid Diseases

    • Eating disorders

    • Iron deficiency anemia

    • Celiac disease

    • Syphilis

 

Treatment: 

 

Lifestyle Modification

 

    • Quit smoking

    • Scalp Massage

    • Balanced Diet - Vitamins

    • Regular Exercise

    • Stress reduction

 

Alternative Therapies

 

    • Oils

    • Herbal medications

    • Vitamins (e.g. Biotin)

 

 

Medical 

 

Minoxidil (Rogaine) 

This is a solution of foam that can be applied to the scalp to reduce the rate of lost hair and provides some partial restoration. Minoxidil can be purchased over the counter. 

 

Spironolactone 

This is an oral medication for hair loss that can only be given to women as it blocks the effect of a male hormones. 

 

Finasteride 

This is an oral medication for hair loss that can only be given to males. 

 

Hormonal Replacement

Replacing critical hormone (s) is an effective method of preventing and/or treating hair loss. A diagnostic hormonal test may be required

 

Surgery

 

Hair transplant 

During a hair transplant procedure, a dermatologist or cosmetic surgeon removes tiny patches of skin, each containing one to several hairs, from the back or side of your scalp. Sometimes a larger strip of skin containing multiple hair groupings is taken. He or she then implants the hair follicle by follicle into the bald sections.

 

 

How Can We Help?

 

There can be many reasons for hair loss. Speaking to a healthcare professional is an important first step. They can outline and customize a treatment plan to help you. 

 

Book an appointment today and speak to a licensed healthcare professional.

 

STI Diagnosis and Treatment

Sexually Transmitted Infection (STsI) Overview

 

These infections are very widespread in the world and affect both men and women. More than half of infected individuals are under the age of 25.

 

By engaging in sexual contact STIs can occur. The likelihood of an STI increases with multiple partners and non-condom use. There are some STis that can be transferred with non sexual contacts such as needle sharing among other ways.

 

Certain STIs are also linked to an increase risk of certain cancers and human immunodeficiency virus (HIV). With increased travel STis are a worldwide problem and can easily be transferred if protection is not used. 

 

Many people may not have symptoms yet still have an STI. Therefore,  STI testing is important to identity individuals and begin early treatment if needed. 

 

If you think you have an STI:

 

    • Do not engage in any type of sexual activity and contact a healthcare professional for treatment.

    • Women should no douche and this may spread the disease into the uterus or fallopian tubes and cause further disease

 

Common Sexually Transmitted Diseases

 

    • Chlamydia

    • Cytomegalovirus

    • Genital Herpes

    • Genital Warts or Human papillomavirus (HPV)

    • Gonorrhea

    • Hepatitis A

    • Hepatitis B

    • Hepatitis C

    • HIV

    • Molluscum contagiosum

    • Mycoplasma genitalium

    • Pubic lice

    • Scabies

    • Syphillis

    • Trichomoniasis

 

Common Medications Used to treat STIs

 

    • Antibiotics

    • Azithromycin

    • Cefixime

    • Ceftriaxone

    • Doxycycline

    • Nitrofurantoin

    • Penecillin G

 

    • Antivirals

 

    • Acyclovir

    • Valacyclovir

 

    • Anti Fungals

 

    • Fluconazole

    • Metronidazole

 

How Can We Help?

 

Book an appointment today and speak to a licensed healthcare professional. Depending on your issue a diagnostic test may be given along with an appropriate treatment plan including any medications that may be required