Archive for the 'Reproductive Endocrinology' Category
Saturday, May 31st, 2008
Answer:
Alpha2-adrenergic receptor blocker: yohimbine (oral).
Phosphodiesterase 5 inhibitors: sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis). All three are administered orally, but none should be used in combination with nitrates.
Intracavernosal injections of vasodilating medications: alprostadil (Caverject), prostaglandin E1, papaverine, phentolamine.
Transurethral alprostadil suppositories (MUSE)
Reference: Basa ALP, Afsharkharaghan H (Zollo A, ed): Endocrinology in Medical Secrets, 3rd ed. 2001.
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Friday, May 30th, 2008
Answer:
Correction of any hormonal abnormality (testosterone replacement for hypogonadism after carefully determining etiology, correction of thyroid dysfunction, maximal glycemic control in diabetes, treatment of hyperprolactinemia with dopamine agonist)
Treatment of any underlying systemic disorders, including depression (SSRIs can cause ED but may help to prevent premature ejaculation)
Mechanical devices (rings, vacuum pump device): cumbersome to some patients, [...]
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Thursday, May 29th, 2008
Answer:
The most important step is to reverse the underlying organic etiologies and discontinue any offending medications, if possible.
Reference: Basa ALP, Afsharkharaghan H (Zollo A, ed): Endocrinology in Medical Secrets, 3rd ed. 2001.
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Wednesday, May 28th, 2008
Answer:
A typical initial evaluation includes history (with particular attention to medications), physical exam, and laboratory testing to rule out endocrine abnormalities. Start by checking TSH, prolactin, and testosterone and ruling out systemic disease with urinalysis, complete chemistry panel and blood count, and HbA1c level in patients with diabetes. Carefully review the patient’s medication list and [...]
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Tuesday, May 27th, 2008
Answer:
Hormonal: hypogonadism (primary or secondary), hyperprolactinemia (with resultant hypogonadism), hyperthyroidism or hypothyroidism, and diabetes. Less common: adrenal insufficiency and Cushing’s syndrome.
Pharmacologic: long list of implicated medications: antihypertensives (clonidine, beta blockers, vasodilators, thiazide diuretics, spironolactone); antidepressants (selective serotonin reuptake inhibitors [SSRIs], tetracyclic antidepressants), antipsychotics, anxiolytics, cimetidine, phenytoin, carbamazepine, ketoconazole, metoclopramide, digoxin. Alcohol is a major culprit. [...]
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Monday, May 26th, 2008
Answer:
ED is the inability to obtain and maintain an erection sufficient for sexual intercourse. ED is usually multifactorial in etiology, and most men have at least some psychogenic factors that contribute to the disorder (i.e., performance anxiety can exacerbate underlying organic etiology).
Reference: Larson PR, et al: Williams Textbook of Endocrinology, 10th ed. Philadelphia, W.B. Saunders, [...]
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Thursday, December 13th, 2007
Answer:
Yes. Impase acts pathogenetically in endothelial insufficiency. Prevention of endothelial dysfunction by impase allows both to stop progression of cardiovascular disease and to prevent erectile dysfunction.
A total of 58 patients with ischemic heart disease and angina of effort (FC II) (mean age 55.6 years) participating in the study were diagnosed to have erective dysfunction (ED) [...]
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