Impotentie brengt een constant ongemak met zich mee, net als fysieke en psychologische problemen in uw leven cialis kopen terwijl generieke medicijnen al bewezen en geperfectioneerd zijn
Guidance for healthcare professionals to
open discussion about sexual dysfunction
Erectile dysfunction and female sexual dysfunction may be
“Smoking causes more than lung cancer, it can lead to
a pointer to undiagnosed diabetes or an indicator of a
sexual dysfunction (woman) / impotence (man).”
Because of this it is important that healthcare
Excessive alcohol affects the nervous system and interferes
with the signals from the pituitary gland and the genitalia.
• alert to the possibility of the problem
It can also reduce the levels of ‘sex’ hormones in the body,
• confident to instigate a consultation about it.
testosterone and oestrogen.
Smoking causes a reduction in penile blood pressure
decreasing the inflow of blood to the penis probably due
The person who pauses at the door of the consulting
to atherosclerosis. Nicotine can cause vasoconstriction or
room may just have found the courage to approach the
spasm within the penile arteries causing them to almost
subject. You must make time to listen or the moment
close so preventing an erection developing.
In women this would be translated to the flow of
Use the correct terminology when talking to your patient,
• Surgery/trauma to prostate, bladder, pelvis, spinal
but be ready to explain what you mean if you recognise
that they do not understand. If you are embarrassed, they
“Were you told after your operation/accident that you
may find problems with getting or maintaining anerection/having sex? If this happens, you must come and
A direct question may not produce any workable reply.
Note for hcp –
This may be due to temporary or
Possible ‘lead in comments’ could include:
permanent damage to nerves or arteries near the penis.
“The doctor has started you on a tablet for your blood
“You have a very busy life/stressful job/lot of travelling. Try
pressure. Were you told that it could cause you to have
to make sure that you take time for yourself to relax as
problems with impotence/sexual dysfunction?”
stress, tiredness or overwork can lead to sexual problems
Note for hcp –
Some diuretics, beta blockers, ACE
such as erectile dysfunction/female sexual dysfunction”
inhibitors can cause erectile dysfunction. It is possibly due
Note for hcp –
Stress, anxiety, guilt, depression may
to the reduction in pressure flowing through the arteries
follow diagnosis of diabetes and contribute to erectile
but reassurance for the patient that alternatives therapies
There are other groups of drugs which also cause
If your patient has decided to talk to you about sexual
problems eg – antidepressants, tranquillizers, appetite
dysfunction it may be a useful starting point to mention
that oral medications, Cialis, Viagra and Levitra, areavailable through the NHS.
• Substance use
“Too much alcohol (over the recommended limit of 14
This work has been taken forward by Dr John Andrews, Prof.
units for women and 21 units for men) can cause erectile
Wallace Dinsmore, Ms Pat Shannon and Diabetes UK Northern
dysfunction often referred to as ‘brewer’s droop’ (or sexual
Ireland with the support of an educational grant from Eli Lilly
Registered charity no. 215199 Code: 6240/1007/a
PLENO ORDINARIO NÚM. 01 ACTA DE LA SESIÓN ORDINARIA DEL PLENO DEL EXCELENTÍSIMO AYUNTAMIENTO DE ESTA CIUDAD DE XÁTIVA CELEBRADA EL DÍA 20 DE ENERO DE DOS MIL CINCO, EN PRIMERA CONVOCATORIA.- En el Salón de Sesiones de la Casa de la Ciutat de Xàtiva, siendo lasdoce horas y cinco minutos del día veinte de enero de 2005, bajo laPresidencia de D. Alfonso Rus Terol, Alcalde de Xàtiva, a
SPECIFIC TOPICS Returning Home After Surgery Most patients who have had either an anterior or a posterior cervical operative procedure will leave the hospital a day or two after surgery. Withtheir neurosurgeon’s approval, they may return home even ifthey live a considerable distance away. Pain after cervical spinesurgery is usually treated with a combination of analgesics, suchas Darvoce