Am I getting too much vitamin D?

Although most people take vitamin D supplements without any problems, it’s possible to take too much. This is called vitamin D toxicity. Vitamin D toxicity, where vitamin D can be harmful, usually happens if you take 40,000 IU per day for a couple of months or longer, or take a very large one-time dose.

Vitamin D is fat-soluble, which means your body has a hard time getting rid of it if you take too much. When you take large amounts of vitamin D, your liver produces too much of a chemical called 25(OH)D.

When your 25(OH)D levels are too high, this can cause high levels of calcium to develop in your blood. High blood calcium is a condition called hypercalcemia.

The symptoms of hypercalcemia include:

• feeling sick or being sick
• poor appetite or loss of appetite
• feeling very thirsty
• passing urine often
• constipation or diarrhea
• abdominal pain
• muscle weakness or pain
• feeling confused
• feeling tired

In some rare diseases, you may be at risk of hypercalcemia even if you have low vitamin D levels and haven’t taken much vitamin D. These diseases include primary hyperparathyroidism, sarcoidosis and a few other rare diseases. See our Hypersensitivity page page for more information.

How do I know if I have taken too much?

A blood test to measure your 25(OH)D levels can tell you whether you have too high of vitamin D levels. If your 25(OH)D levels are above 150 ng/ml this is considered potentially toxic and potentially harmful to your health. You know if your 25(OH)D levels are toxic by a blood test to measure calcium. If calcium is high and 25(OH)D is high, then you are getting too much vitamin D.

Very high levels of 25(OH)D can develop if you:

• take more than 10,000 IU/day (but not equal to) everyday for 3 months or more. However, vitamin D toxicity is more likely to develop if you take 40,000 IU/day everyday for 3 months or more.
• take more than 300,000 IU in a 24 hour period.

If you have taken this much vitamin D, seek medical attention. Your health providers will get your calcium and 25(OH)D levels tested.

The current recommended daily allowances for vitamin D set by the Food and Nutrition Board are conservative, so you don’t need to feel worried about toxicity if you take more than their recommended daily allowance. You can find out more about daily vitamin D supplementation on our page, How do I get the vitamin D my body needs?

What should I do if I think I have taken too much vitamin D?

Have you taken more than 300,000 IU in the past 24 hours OR have you been taking more than10,000 IU/day for the past three months or longer?

• If yes, check to see if you have symptoms of toxicity (listed above); symptoms like feeling sick, feeling thirsty, constipation or diarrhea, poor appetite and feeling confused. If so, you may have hypercalcemia and need medical attention.
  • If you do not have any symptoms, you likely do not have hypercalcemia. However, you should get a blood test for 25(OH)D and make sure that you do not have a level above 150 ng/ml. Consider lowering your vitamin D dose. See our page How do I get the vitamin D my body needs? for more information.
• If no, you likely do not have hypercalcemia and are not toxic. If you are still concerned, you may choose to get a blood test to measure 25(OH)D to see what your levels are. See ourTesting page for more information.
  • If you have symptoms of toxicity but have not taken more than 300,000 IU in 24 hours or more than 10,000 IU/day for the past three months, you may have a very rare condition that is sensitive to vitamin D. Please see our Hypersensitivity page for more information.

What about children?

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The more you weigh, the more vitamin D your body can handle; the less you weigh, the less vitamin D your body can handle. The above cutoffs of 300,000 IU in 24 hours or more than 10,000 IU/day for three or more months apply to average adult weight (125-200 lbs).

So, how do you know if your child has gotten too much vitamin D?

• For children that weigh 25 lbs or less, more than 50,000 IU in 24 hours or 2,000 IU/day for over three months is too much and potentially toxic.
• For children that weigh between 25 and 50 lbs, more than 100,000 IU in 24 hours or 4,000 IU/day for over three months is too much and potentially toxic.
• For children that weigh between 50 and 75 lbs, more than 150,000 IU in 24 hours or 6,000 IU/day for over three months is too much and potentially toxic.
• For children that weigh between 75 lbs and 100 lbs, more than 200,000 IU in 24 hours or 8,000 IU/day for over three months is too much and potentially toxic.

If your child has taken too much vitamin D, seek medical attention.

I already tested my 25(OH)D. Is my level too high?

If your level is greater than 150 ng/ml, this is considered too high and potentially toxic. Seek medical attention if you have symptoms of hypercalcemia (listed above). If you do not have symptoms, consider lowering your level. Please see our pages on 25(OH)D reference ranges and our page on how to get the right amount of vitamin D:

• Testing for vitamin D
• How do I get the vitamin D my body needs?

If your level is not greater than 150 ng/ml, then you are not potentially toxic in vitamin D. Please read our pages on vitamin D levels and how to interpret your results:

• I tested my vitamin D level. What do my results mean?
• How do I get the vitamin D my body needs?

References

1. Cusano NE, Thys-Jacobs S and Bilezikian JP. “Hypercalcemia Due to Vitamin D Toxicity.” In Vitamin D, Third Edition, by Feldman D, Pike JW and Adams JS. Elsevier Academic Press, 2011.
2. Vieth, R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. American Journal of Nutrition, 1999.

Vitamin A (retinol)

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in individuals with a known sensitivity or allergy to vitamin A or any part of the formulation.

Side Effects and Warnings

Vitamin A is considered safe when consumed in recommended dietary allowances (RDAs). Adults who eat fortified foods with vitamin A, such as low-fat dairy products and a lot of fruits and vegetables, generally lack the need for supplements or multivitamins that contain vitamin A.

Vitamin A may cause bleeding in the lungs, blurry vision, bone pain, breathing difficulty, changes in immune function, chronic inflammation of the liver, cirrhosis (scarring of liver), cough, cracked fingernails, cracked lips, death, decreased thyroid function, depression, diarrhea, feeling of fullness, fever, fluid around heart, hair loss, high cholesterol, increased pressure in the brain, increased risk of HIV transmission (through breastfeeding), increased risk of lung cancer, increased risk of heart disease, increased white blood cells, indigestion, inflammation of the conjunctiva (conjunctivitis), injection site pain, irritability, joint pain, mouth ulcers, muscle pain, psoriasis flare-ups, pain, perisinusoidal fibrosis (in the liver), redness (from skin use), respiratory infection, seizure, skin irritation, sore eyes, steatosis (fatty change), stomach and intestine adverse effects, and suicidal thoughts.

Vitamin A toxicity is rare in the general population. Vitamin A toxicity can occur with high amounts of vitamin A taken over short or long periods of time. Consequently, toxicity can be short or long-term. Symptoms of acute (short-term) toxicity include nausea, headache, fatigue, loss of appetite, dizziness, dry skin, desquamation (loss of skin), and cerebral edema (swelling in the brain). Symptoms of chronic (longer-term) toxicity include dry itchy and cracking skin, desquamation, dry lips, scaling anorexia, headache, psychiatric changes, cerebral edema (excess fluid), bone and joint pain, osteoporosis (bone loss), and hip fracture. Severe toxicity can lead to eye damage, high levels of calcium, and liver damage. In children, signs of toxicity include irritability, drowsiness, dizziness, delirium, coma, vomiting, diarrhea, increased pressure in the brain with bulging fontanelles in infants, headache, swelling of the optic (eye) disk, bulging eyeballs, visual disturbances, and skin redness and peeling.

People with liver disease and high alcohol intake may be at risk for liver toxicity from vitamin A supplementation. Vitamin A toxicity may lead to intrahepatic cholestasis, where bile cannot flow from the liver into the intestines.

Vitamin A may cause low blood pressure. Caution is advised in people with low blood pressure or in those taking drugs or herbs and supplements that lower blood pressure.

Use cautiously in combination with bile acid sequestrants, mineral oil, neomycin, or orlistat, due to reduced absorption of vitamin A.

Use cautiously in combination with contraceptives taken by mouth, due to increased levels of vitamin A.

Use cautiously in combination with alcohol or anticancer agents, due to the potential for increased risk of adverse effects.

Smokers who consume alcohol and beta-carotene may be at an increased risk for lung cancer or heart disease. Use cautiously in smokers who consume alcohol.

Use cautiously in children and infants, or in people with osteoporosis, skin disorders, thyroid disorders, affective disorders, or those taking agents for depression.

Avoid taking vitamin A in high doses, due to increased risk of toxicity and death.

Avoid in combination with tetracycline antibiotics, agents that are toxic to the liver, or retinoids, due to the increased risk of toxic effects.

Avoid in people with poor fat absorption, intestinal infections, severe protein energy malnutrition, liver disease, or type V hyperlipoproteinemia (a genetic disorder).

High-dose vitamin A and beta-carotene should be avoided in patients at high risk of lung cancer.

Vitamin A may increase the risk of bleeding. Avoid use when taking agents that affect bleeding and clotting.

Avoid in individuals with a known sensitivity or allergy to vitamin A or any part of the formulation.

Pregnancy and Breastfeeding

Vitamin A should only be used within the recommended dietary allowance, because vitamin A excess, as well as deficiency, has been associated with birth defects. Excessive doses of vitamin A have been associated with central nervous system malformations.

Vitamin A is excreted in human breast milk. The benefits or dangers to nursing infants are unclear.

Tretinoin that is applied to the skin is likely low risk for breastfeeding infants given its poor absorption; however, due to a lack of evidence, caution should be taken to prevent direct skin contact to the nursing infant and only water soluble cream or gel products should be applied.

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What is vitamin D toxicity, and should I worry about it since I take supplements?

Vitamin D toxicity, also called hypervitaminosis D, is a rare but potentially serious condition that occurs when you have excessive amounts of vitamin D in your body.

Vitamin D toxicity is usually caused by megadoses of vitamin D supplements — not by diet or sun exposure. That's because your body regulates the amount of vitamin D produced by sun exposure, and even fortified foods don't contain large amounts of vitamin D.

The main consequence of vitamin D toxicity is a buildup of calcium in your blood (hypercalcemia), which can cause poor appetite, nausea and vomiting. Weakness, frequent urination and kidney problems also may occur.

Treatment includes the stopping of excessive vitamin D intake. Your doctor also may prescribe intravenous fluids and medications, such as corticosteroids or bisphosphonates.

Taking 50,000 international units (IU) a day of vitamin D for several months has been shown to cause toxicity. This level is many times higher than the Recommended Dietary Allowance (RDA) for most adults of 600 IU of vitamin D a day.

Doses higher than the RDA are sometimes used to treat medical problems such as vitamin D deficiency, but these are given only under the care of a doctor for a specified time frame. Blood levels should be monitored while someone is taking high doses of vitamin D.

Although vitamin D toxicity is uncommon even among people who take supplements, you may be at greater risk if you have health problems, such as liver or kidney conditions, or if you take thiazide-type diuretics. As always, talk to your doctor before taking vitamin and mineral supplements.

How should I use this Viagra medication?

The usual recommended dose is 50 mg taken as needed, approximately 30 to 60 minutes before sexual activity. However, the medication may be taken any time from 4 hours to half an hour before sexual activity. Based on the effectiveness and side effects of the medication, the dose may be increased to 100 mg or decreased to 25 mg.

The maximum recommended dose is 100 mg and it is not recommended to take more than one dose per day. Sildenafil may be taken with or without food, but taking it with a high-fat meal may increase the time before the medication starts working.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. Do not take higher doses of this medication than those prescribed by your doctor. Contact your doctor if you take a greater dose of sildenafil than prescribed.

Store this medication in its original package at room temperature, protect it from moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

What form(s) does this medication come in?

25 mg
Each blue, round, diamond-shaped tablet, marked "PFIZER" on one side and "VGR 25" on the other side, contains sildenafil citrate equivalent to 25 mg of sildenafil. Nonmedicinal ingredients: anhydrous dibasic calcium phosphate, croscarmellose sodium, FD&C Blue No. 2 Aluminum Lake, hypromellose, lactose, magnesium stearate, microcrystalline cellulose, titanium dioxide, and triacetin.

50 mg
Each blue, round, diamond-shaped tablet, marked "PFIZER" on one side and "VGR 50" on the other side, contains sildenafil citrate equivalent to 50 mg of sildenafil. Nonmedicinal ingredients: anhydrous dibasic calcium phosphate, croscarmellose sodium, FD&C Blue No. 2 Aluminum Lake, hypromellose, lactose, magnesium stearate, microcrystalline cellulose, titanium dioxide, and triacetin.

100 mg
Each blue, round, diamond-shaped tablet, marked "PFIZER" on one side and "VGR 100" on the other side, contains sildenafil citrate equivalent to 100 mg of sildenafil. Nonmedicinal ingredients:anhydrous dibasic calcium phosphate, croscarmellose sodium, FD&C Blue No. 2 Aluminum Lake, hypromellose, lactose, magnesium stearate, microcrystalline cellulose, titanium dioxide, and triacetin.

Who should NOT take this medication?

Do not take sildenafil if you:

• are allergic to sildenafil or any ingredients of this Viagra medication
• are taking any type of nitrate medication in any form (oral, sublingual [under the tongue], skin patch, or spray). Nitrate medications include nitroglycerin and related medications that are used for the relief of chest pain or angina. They also include amyl nitrite "poppers." Use of these medications with sildenafil could cause a sudden severe drop in blood pressure that could lead to dizziness, fainting, heart attack, or stroke.
• have been advised by your doctor not to engage in sexual activity
• have a history of vision problems related to nerve damage to the retina caused by decreased blood flow

Nitrates are found in medications that are used to treat angina (chest pain). If you are not sure if you are taking nitrates, ask your doctor or pharmacist.

Nitrates must NOT be taken by anyone who is using sildenafil because they can cause your blood pressure to drop very low. This may cause dizziness, fainting, heart attack, or stroke.

Erectile dysfunction

Erectile dysfunction: Viagra and other oral medications

By Mayo Clinic Staff

Viagra, Levitra or Cialis is often the first oral medication tried for erectile dysfunction. For most men who have trouble keeping an erection firm enough for sex (erectile dysfunction), these medications work well and cause few side effects.

Sildenafil (Viagra), vardenafil (Levitra or Staxyn) and tadalafil (Cialis) are all medications that reverse erectile dysfunction by increasing nitric oxide, a chemical naturally produced by your body. Nitric oxide opens and relaxes blood vessels in the penis, helping you get and keep an erection. These erectile dysfunction medications don't increase your sex drive and only cause erections when you are sexually stimulated.

 

Viagra, Levitra and Cialis — How they're different

Although they work in similar ways, each of these medications has a slightly different chemical makeup. These minor differences affect the way each medication works, such as how quickly it takes effect and wears off, and the potential side effects. Your doctor will consider these factors when deciding if one of these medications is a good choice for you. Your doctor will also consider any health problems you have and possible interactions with other medications you take.

	Viagra, Levitra	Cialis (small dose daily)	Cialis (36-hour)
How to take it	Without food, no more than once a day	With or without food, once a day	With or without food, no more than once a day
When to take it	About 30-60 minutes before sex	Anytime	About 30 minutes before sex
How long it's effective	Up to 5 hours	Anytime between doses	Up to 36 hours

Vardenafil (Levitra) can also be prescribed in a tablet that dissolves on the tongue (Staxyn).

A new medication, avanafil (Stendra), was approved in April 2012 by the Food and Drug Administration for treating erectile dysfunction. Stendra works similarly to Viagra, Levitra and Cialis.

When these medications may not be safe

Not all men can safely take erectile dysfunction medications. They can be dangerous if you have certain health problems or you're taking particular medications. Erectile dysfunction medications may not be safe if you have:

• Heart problems, including reduced blood flow (aortic stenosis or left ventricular outflow obstruction), heart pain (angina), abnormal heart rhythms (arrhythmia) or a recent heart attack
• High or low blood pressure that isn't controlled
• A history of stroke within the last six months
• Eye problems, such as retinitis pigmentosa, or if you have a family history of certain eye problems
• Severe liver disease, including cirrhosis
• Kidney disease that requires dialysis

Never take Viagra, Levitra or Cialis if you take nitrate drugs to treat heart pain (angina). Like Viagra, Levitra and Cialis, nitrate drugs dilate blood vessels. Their combined effects can cause dangerously low blood pressure and loss of consciousness. Medications that contain nitrates include:

• Nitroglycerin (Nitro-Bid, Minitran, others)
• Isosorbide (Dilatrate-SR, Isordil, Monoket, others)
• Illegal drugs such as amyl nitrite or "poppers"

Tell your doctor about any medications you're taking. A number of other drugs can also interact with Viagra, Levitra or Cialis. They include:

• Alpha blockers
• Antibiotics
• Anti-seizure medications
• Blood thinners
• Anti-arrhythmic heart medications

Side effects

Most men who take Viagra, Levitra and Cialis aren't bothered by side effects. When side effects do occur, they can include:

• Headache
• Flushing (with Viagra and Levitra)
• Indigestion
• Stuffy or runny nose
• Back pain and muscle aches (with Cialis)
• Temporary vision changes, including "blue vision" (with Viagra and Levitra)
• Dizziness or fainting (rare)

In a small number of cases, men taking Viagra, Levitra or Cialis have reported more serious side effects:

• Hearing loss or vision loss. Some men have had sudden loss of hearing or loss of vision after taking one of these medications. However, it isn't clear whether vision or hearing loss was directly caused by taking the medication or by a pre-existing condition. If you're taking one of these medications for erectile dysfunction and have sudden loss of hearing or vision, seek medical help right away.
• An erection that doesn't go away on its own. Called priapism, this rare condition can be painful and requires medical treatment to avoid damage to your penis. If you have an erection that lasts more than four hours, seek medical attention.

Blindness Noted in Men Using Impotence Drugs

WASHINGTON — Federal health officials are probing reports of blindness among dozens of men who used Viagra and other impotence drugs — but at the same time cautioning that the vision loss can be linked to the same illnesses that lead to impotence.

The Food and Drug Administration disclosed Friday that it was in discussions with the makers of Viagra, Cialis and Levitra about what the labels of those drugs should say about the rare cases of varying degrees of vision loss, including blindness. The maker of Cialis already has voluntarily added a one-line mention to its label.

At issue is sudden vision loss when blood flow to the optic nerve is blocked, a condition called NAION or non-arteritic anterior ischemic optic neuropathy.

The FDA has 43 reports of NAION among the impotence drug users: 38 for Viagra, four for Cialis and one for Levitra, said spokeswoman Susan Cruzan.

Those are rare numbers, given that Viagra alone has been used by 23 million men worldwide since its approval in 1998, according to maker Pfizer Inc.

Also complicating the question: NAION is considered one of the most common causes of sudden vision loss in older Americans, and estimates suggest there are anywhere from 1,000 to 6,000 cases a year. Risk factors include diabetes and heart disease, two of the leading causes of impotence.

Still, “we take this seriously,” Cruzan said.

Side effects include vision problems The questions come at a time when federal regulators and the drug industry are facing criticism about what they do to ensure the safety of drugs already on the market. Pressure on the FDA to investigate reports of side effects has increased since Merck & Co. yanked its pain reliever Vioxx from the market last year because of potentially deadly heart trouble.

Big money is at stake. Pfizer Inc. said in its most recent quarterly filing with the Securities and Exchange Commission that sales of Viagra rose 5 percent — to $438 million — in the first quarter of the year.

 

Pfizer shares declined Friday on the New York Stock Exchange after news of the blindness cases.

Viagra and its competitors are blockbuster drugs that revolutionized treatment of erectile dysfunction, and they already come with serious warnings: They’re not to be used by men who take nitrate-containing drugs, because the interaction could cause deadly drops in blood pressure, or by men with heart conditions whose doctors have warned that sex itself could be too much exertion.

We also warn about temporary vision changes — seeing bluish tinges or having difficulty distinguishing between green and blue. The drugs apparently have a temporary effect on the retina, a different issue from NAION.

Viagra also is at the center of controversy over Medicaid’s payment for prescriptions of the drug for convicted sex offenders in New York and other states.

Some evidence of connection 
The possibility of a link with blindness was raised publicly earlier this year, when Dr. Howard Pomeranz of the University of Minnesota reported in an ophthalmology journal seven patients who reported NAION vision loss occurring within 36 hours of a Viagra dose.

“A definite causal relationship cannot be established at this time,” Pomeranz wrote.

Viagra and its competitors work by slightly dilating arteries so that blood flow in the penis increases. Whether it affects blood flow to the eye isn’t known, but Pomeranz argued that some effect on the optic nerve is plausible.

So he urged that ophthalmologists ask NAION patients whether they use impotence drugs, and report any additional cases. Also, Viagra users who suffer NAION in one eye should be cautioned that continued use might raise the risk of vision loss in the other eye, Pomeranz wrote.

The loss of vision is permanent.

Pomeranz told MSNBC Friday that "the drug is doing something to alter the circulation of blood to the optic nerve and in turn causing an injury to the nerve resulting in a loss of vision."

The patients in the study had a history of high blood pressure and an anatomical risk factor involving the optic nerve.

"If a patient takes the medication and 45 minutes later suddenly notices the onset of vision loss, to me that’s certainly some evidence there is a connection between the two," Pomeranz told MSNBC.

Because the drugs affect blow flow a connection "makes sense," NBC's chief science correspondent Robert Bazell told MSNBC Friday. He added that the condition is rare and there isn't yet cause for widespread concern.

But publicity over the FDA investigation could result in more cases coming forward, said Bazell, noting that a bigger study examining the link is needed.

'Confident about safety' 
Levitra is sold in the United States by GlaxoSmithKline PLC and Schering-Plough Corp. and overseas by Bayer AG.

Viagra was approved by the government in 1998. It may aid in the treatment of enlarged hearts that can

How Does an Erection Occur? Complete guide with full of useful instructions.

In order to get an erection, several parts of the body must work together. The brain sends a message of sexual arousal through the nervous system to the penis. This message causes the muscles along the penis to relax. At the same time, the artery to the penis dilates to twice its diameter, increasing the blood flow sixteen-fold, and the veins which carry blood away from the penis are blocked. As a result, the two spongy-tissue chambers in the shaft of the penis fill with blood and the penis becomes firm. A breakdown in any of these systems makes getting or keeping an erection difficult.

How is Impotence Diagnosed?

Virtually all men occasionally fail to get an erection. That's normal. But if a man has trouble getting or maintaining an erection about 25 percent of the time, he should see an urologist. These physicians specialize in disorders of the kidneys, bladder, prostate, penis and urethra.

Usually, after asking questions about when and how the impotence developed, the urologist will give the patient a complete physical exam to determine if his hormone levels are normal and if the blood vessels, nerves and tissues of his penis are working properly. If this initial work-up doesn't pinpoint the cause of the problem, a nocturnal penile tumescence test can be done.

Men with no physical abnormalities almost invariably have nightly erections during sleep. The patient may spend a few nights in a sleep laboratory where a gauge that measures the frequency and duration of nocturnal erections is attached to the base of the penis. A home version of this, the snap-gauge test, can also be used. Before going to sleep, the patient attaches the gauge to the base of his penis. During the night, the gauge will break at different degrees of penile rigidity and show whether a partial or full erection has taken place during sleep. If nocturnal erections do not occur, the impotence is most likely physical. Additional testing is then required to identify the precise cause of the problem.

To Help Prevent Impotence

• Exercise regularly
• Limit the amount of fat and cholesterol in your diet
• Drink only in moderation
• Don't smoke

What Are the Physical Causes of Impotence? 

Physical impotence occurs when there is a problem with any of the systems needed to get or maintain an erection. The good news is that potency can usually be restored when a man is treated for underlying medical conditions, when medications are adjusted or when lifestyle habits are changed.

Here are some of the top causes of impotence:

• Vascular Disease. Hardening of the arteries can affect the artery leading to the penis so that it cannot dilate enough to deliver all the blood necessary for an erection. Impotence can also occur if the nerves that control blood flow to the penis are damaged.
• Diabetes. One out of every four impotent men has diabetes, which can cause nerve deterioration (diabetic neuropathy). Impotence may result if nerves or blood vessels that control the flow of blood to the penis are affected. In some cases, keeping the diet and blood sugar under control can decrease impotence. But permanent nerve damage can result in a chronic problem.
• Disease of the Nervous System. Some conditions, such as multiple sclerosis, Parkinson's disease and spinal cord injuries, can affect or cause impotence.
• Cancer Surgery. Surgery to remove cancer from the prostate, bladder, colon or rectal area can cause impotence if the nerves and blood vessels that control erections are damaged in the process of removing cancerous tissue.
• Medications. Some prescription medications for high blood pressure, depression, spinal cord injury, diabetes and other conditions can cause temporary impotence by interfering with the nerve impulses or blood flow to the penis. Doctors may be able to adjust the dosage of a drug or change the medication to reverse or minimize the problem.
• Smoking. A recent study at the New England Research Institute in Watertown, Massachusetts, found that impotence was equally common among smokers and non-smokers in general. However, among men with certain health problems, those who smoked were much more likely to have potency problems. For example, 56 percent of smokers with heart disease were completely impotent compared with only 21 percent of non-smokers with the disease.
• Alcoholism. Excessive alcohol consumption disrupts hormone levels and can lead to nerve damage. This type of impotence may be reversible or permanent depending on the severity of the nerve damage. Some clinical studies suggest about 25 percent of all alcoholics become impotent -- even after they stop drinking.
• Hormone Imbalance. Abnormal testosterone levels are rare, but they can cause impotence. In addition, other illnesses, such as kidney failure and liver disease, can disrupt the balance of hormones.

What Are the Psychological Causes of Impotence?

A man who is depressed, under stress, or worried about his "performance" during sex may not be able to have an erection. Qualified therapists or counselors who specialize in the treatment of sexual problems can often help diagnose and sort through these problems. Some impotence problems can be solved when a man understands the normal changes of aging and how to adapt to them. For example, as men get older they generally need more direct stimulation to achieve an erection. They may also have less firm erections, take longer to ejaculate and need more time between erections.

Impotency and Viagra

Background and information on alternatives to Viagra

The penis is a vascular organ which requires exercise. A healthy male will normally experience 3 to 4 erections during their sleep which may last a hour or more each. They are a normal body function whose purpose is to oxygenate the penile erectile tissue. Its inability to achieve and maintain an erection suitable for vaginal intercourse is called "male erectile dysfunction" (ED) or impotency, for short. Impotency affects over 30 million men and their partners. To some men impotency is a symbol of the loss of their manhood, and can be critical to a man’s ego and self-image. And often, because of this, some men are afraid to seek help. And, often when he does, the physician feels uncomfortable or is unable to help because many aren’t aware of the options. If the truth were known, however, virtually 100% of impotency problems can be successfully diagnosed and treated, whether physical or emotional, unless there is permanent injury or severance of the nerves and or vascular supply necessary in the erectile process.

The appropriate treatment for impotence depends upon whether the cause is physical or psychological. A man whose impotence is psychologically based generally still has erections during sleep, whereas an individual whose impotence is physical in origin usually does to. One easy, inexpensive way to test for nocturnal erections is with postage stamps. Glue a strip of stamps around the shaft of the penis before going to bed. If the ring of stamps is broken in the morning, the cause of the impotence is likely psychological. If the strip is unbroken, the impotence is likely physiological. You can also purchase a kit called Snap Gauge from UroHealth Corporation. This test is designed to detect the measure the rigidity of erections experienced during sleep. Call 800.328.1103 for more information.