A brief overview

Previously known as impotence, erectile dysfunction is the inability of the male to attain or sustain erection of the penis sufficient for sexual intercourse. The intensity of this

disease can range from:

* Infrequent inability to achieve an erection.
* Inability to maintain erection during intercourse.
* Complete inability to get an erection at any time.

Erectile dysfunction is a very common disease. It has been estimated that one in every ten men has experienced or will experience this disease at some point in life. Recent surveys also show that around fifteen to thirty million men in the United States of America are currently facing this issue.

Causes

Before going into the causes, a sufficient understanding of how the male achieves erection is necessary. The first step is that of the sexual arousal. This can be induced either by physical contact to the penis shaft or by a psychological arousal by words or thoughts, feelings or even imagination. This is followed by a nerve impulse by which the brain sends a signal to the nervous system which results in increased blood flow.

Subsequently, the increased blood flow in the blood vessels of the penis results in erection. Any change or hampering effect to this process can result in erectile dysfunction. Thus the cause of this disease can be physiological or psychological. The psychological causes can be increased stress, depression and fatigue.

The physiological causes include a number of possibilities. A damaged nervous system with spinal cord and brain injuries can be one of the reasons. A hormonal imbalance may result in low levels of testosterone. Cardiovascular issues combined with arterial disorders may result in a poor flow of blood to the penile shaft. Patients, sufferings from diseases such as diabetes, kidney failure can suffer from erectile dysfunction.

The disease can also result as a ramification of medication such as anti-depressants, sleeping pills, tranquilizers. Medicine used to combat high blood pressure can result in an interference with the nervous system leading in a poor blood supply to the penis.

An unhealthy lifestyle can also lead to erectile dysfunction. Alcohol abusers, smokers, drug addicts have commonly complained about erectile dysfunction.

Diagnosis

There are a number of ways by which the disease can be diagnosed. The patient’s medical and sexual history can provide important information. A physical inspection of the penis can be done. Its responsiveness to the physical touch can be analysed.

Other tests include procedures to check the sensitivity (Penile biothesiometry), to check whether the nervous system is still intact (Penile nerves function) and to evaluate whether a proper blood flow is still being maintained in the penile shaft (Duplex ultrasound).

Treatment

The treatment is obviously related to the cause of the disease. A healthy lifestyle is always encouraged by the health experts. Quitting smoking, moderating alcohol intake, eating nutritious food is always a good start no matter what the problem may be.

For the psychological causes, psychotherapy is a good option. Well planned sessions are used to reduce anxiety levels; moderate use of anti- depressants is encouraged. The sex partner’s involvement is essential for intimacy and arousal.

The other treatments more often than not are temporary in nature. They help to carry out the intercourse session properly and the desired effect will last only that long. Oral drugs have been very popular since the introduction of Viagra since 1998. The oral tablets enhance the effect of nitric oxide which helps to relax the penile muscles increasing the blood flow. These drugs can also be used in the form of injections.

Vacuum constrictors can also be used to increase the blood flow in the penis. Creams, applied directly to the penis are also helpful. Surgery is another option. It can be used to plant rods inside the penis to keep it erect. Surgery can also be used to repairs the arteries for proper blood flow or to block veins to reduce blood outflow.

Research is being carried out at various levels to improve such treatments and to reduce their side-affects in the attempt to help men around the globe to retain their ‘masculinity’.

A brief overview

      The word Alopecia itself means any type of baldness or hair loss, whether it’s on the scalp or on any other hairy part of the body. When this word is combined with other terms, it can be used to describe a number of conditions, all relating to hair loss.

      Alopecia Areata is used to describe hair loss which occurs on any part of the body. Alopecia Totalis refers to a condition when the patient loses all of his hair on the scalp. Alopecia Universalis is when the patient loses all of his hair on the scalp, the rest of the body including the pubic hair. Alopecia barbae is when the patient loses only the beard hair. Androgenetic Alopecia, commonly referred to as male pattern baldness, is thinning of hair to such an extent that the scalp is almost visible. It is usually considered a hereditary form of hair loss.

      An interesting thing to note about this disease is that it has almost nil or very insignificant affects on the body. The patients normally are in excellent physical health. The psychological effect is however is more pronounced. Hair loss or even complete baldness results in low self esteem, embarrassment, anxiety attacks and even depression and ironically all of these aforementioned states are known to result in an increase in hair loss.

Causes

      The most recent research shows that Alopecia Areata is an abnormality of the immune system. That is why it is referred to as an autoimmune disease.  The immune system for unknown reasons starts to consider the hair follicles as unfamiliar tissue. The white bloods cell attack the follicle and prevent or reduce hair growth though the follicles are not damaged. This is why there is always a chance of the hair growing back once the normal cycle of the follicle is allowed to begin.

Diagnosis

      The first signs of the disease are small, often round patches of baldness appearing on the scalp. The disease is usually found in young children, teenagers but can happen to almost people of all ages. In males, the baldness usually starts from the forehead and can then move on to the whole scalp.

      Another reliable sign is the exclamation point hair. This is when the part of the hair close to the base reduces to such an extent that it starts to look like an exclamation point. This can be viewed with a hand lens. Another method is where the doctor gently tugs puffs of hair, where hair seems to be unusually less. The force is less than what would be required to pull out normal healthy hair and if still, hair falls, this means the patient is suffering from Alopecia Areata.

Treatment

      Usually hair begins to grow back on the patches. This happens to almost fifty percent of the patients. However there are cases where the disease can be persistent and often increase in intensity. There is no known method to date which can cure the disease hundred percent. Different treatments have different effects on patients and it’s a matter of realizing what helps the most.

      Cortisone Injections are a popular treatment in which cortisone is injected into the bald patch directly usually once a month. This helps only the injected patch; it does not stop other patches from being created. Topical minoxidil has also known to be effective on patients though its effect is varied. It is normally used in concentrations of two and five percent and has insignificant side-effects. Corticosteroids can also be used to stop the increase in patches. Wigs are also an alternate option.

Research is still being carried out to understand Alopecia Areata, its causes and possible treatments as there is still some ambiguity regarding this disease.