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Your Common Sense Guide to Malaria

Posted Friday 03 May 2019 12:44 by in Anti Malaria by Johanna Galyen

High Fevers. Bone-breaking Chills. Abdominal Pain. And, oh, those muscles aches. Like you’ve just hiked 10 kilometres straight uphill with no relief! With symptoms like these, should you even visit countries that are at risk for malaria? Is it worth taking the chances? What should you do? Should you even travel?

The answer is a cautious maybe. Careful planning and taking the right precautions can help to ease any fears you have about travelling abroad. And it is always wise to “think about health in advance of your trip," says Bradley Connor, MD, a travel health specialist at Weill Medical College of Cornell University.

Here is some common sense advice to help keep you free of malaria:

1. Understand What Malaria Is

According to the World Health Organisation (WHO), malaria is caused by the Plasmodium parasite that the female Anopheles mosquito is infected with; this incredibly tiny parasite attaches itself to the mother mosquito and when she bites humans to feed her growing eggs, she injects the parasite into the human host as well.

The parasite makes its way through the bloodstream and eventually lands within the liver to grow. Each little parasite attaches itself to red blood cells, and produces more parasites until the red blood cell bursts open. When this happens, it releases all the growing parasites to attach themselves to even more red blood cells, and you start to feel very, very sick.

There are five specific species of the Plasmodium parasite that a mosquito can carry:

Plasmodium falciparum

Plasmodium malariae

Plasmodium vivax

Plasmodium ovale

Plasmodium knowlesi

Of the five types, plasmodium knowlesi is rarely contracted by humans, as it typically only infects monkeys. The deadliest of the types is Plasmodium falciparum. Scientists Against Malaria say, “Almost every malarial death is caused by P. falciparum” as it has a unique ability during the multiplication of the parasite to make the red blood cells become very sticky in the veins and capillaries. If the parasite is not treated (and killed) by medication, it can kill the person by clogging the blood supply that feeds the brain or other vital organs.

The other three types of malaria (malariae, vivax, ovale) can cause a great deal of misery, but they are rarely fatal.

2. Know the Hotspots for Malaria

When considering places to visit, remember, mosquitoes like warm and moist areas. Warm areas that have lakes, streams, rivers, and jungles. Most notably these will be in the tropics and subtropical areas where mosquito populations are greatest. Deserts typically have much lower mosquito populations due to the dry, arid conditions but in areas with water, such as an oasis, malaria-carrying mosquitos may be found.

According to the Centers for Disease Control, “The highest transmission is found in Africa, South of the Sahara, and in parts of Oceania such as Papua New Guinea.” If you are travelling anywhere along the equator, it is good to research your trip’s locations to see if you are at risk of contracting malaria. Fit for Travel is one such excellent website that can provide you with the most up-to-date information.

3. Be Prepared

Anti-malarial medications can help to kill the Plasmodium parasite within your body, and there are three main options to choose from:

Malarone – This medicine is started two days before your trip and continues for one week after you return. Side effects are usually minimal as this medicine is well tolerated in most people, but they can include coughing, headache, nausea, dizziness, and weakness.

Doxycycline – The medicine is taken two days prior to the beginning of your travels, and it continues until four weeks after your return. Side effects can be a heightened sensitivity to sunlight (you can get a nasty sunburn), and it can also cause blurred vision, headache, thrush, and diarrhoea.

Lariam – A once-a-week table to prevent malaria; this medicine is started (preferably) two weeks prior to your trip and continued until four weeks after your return. Lariam can cause some noticeable side effects like nausea, headache, abdominal pain, convulsions, nightmares and even depression.

4. Understand Your Current Health

Dr. Bradley Connor also says “If you have a chronic health problem, get a check-up before you leave." Travelling can bring out the best and worst in your health, so it is good to know what you are dealing with prior to leaving to ensure that you will feel great on your trip.

There are some travellers who should not visit areas that are endemic with malaria. Women who are currently pregnant should avoid travelling to areas with malaria if at all possible. The CDC states “infection in pregnant women can be more severe than in nonpregnant women. Malaria can increase the risk for adverse pregnancy outcomes, including prematurity, abortion, and stillbirth.”

Those who previously lived in endemic malaria areas, moved away, and want to return should also carefully reassess their health. For some types of malaria, the body can create immunities against the parasite. However, this immunity can quickly lessen over time, and they will be at the same risk as a first-time traveller.

Who else should be cautious about their health in areas with malaria?

Those on immune-suppressing drugs

Organ transplant patients

People undergoing chemotherapy or radiation therapy

Those who have recently undergone surgery or suffered a heart attack or stroke

5. Prevention 101: Don’t Get Bitten!

One of the best ways to avoid being bitten by the mosquito is to keep it away from your skin. Try these easy steps:

Stay inside during the late evening and early morning hours when mosquitoes are most active.

Wearing long sleeved clothing, trousers, and long skirts can help to shield you from the bites. Note: keep those shirt-tails tucked in to protect your back and stomach areas.

Wear socks and shoes; no sandals. It also helps to tuck your trousers into your socks to ensure that no skin is exposed.

Always sleep under a mosquito net – preferably one that has been treated with an insecticide.

Use bug spray that has 20-40% DEET in it. Picaridin and Lemon Eucalyptus oil are DEET-free options that can be used, but remember, they should be applied more frequently to provide the right protection.

6. Know The Symptoms

Most children and travellers know the sight of a mosquito bite; it is a red, raised itchy bump on your skin. However, the female Anopheles mosquito does not leave a mark at all. Additionally, the mosquito’s saliva can act as an anaesthetic, so most people do not even know that they were bitten by the mosquito until the symptoms start showing. Because of this, it is important to know the symptoms of malaria. The treatment of the disease works better and faster when it is first discovered versus waiting until you are extremely sick.

According to WebMD, the symptoms are shaking chills, high fever, profuse sweating, headache, nausea, vomiting, abdominal pain, yellowing skin, diarrhoea, muscle pain, convulsions (like a seizure), and bloody stools.

7. Keep Your GP Informed

Your general practitioner (GP) should be informed of your travels to areas that have malaria. This information can help them prepare you for the trip and keep you healthier. Additionally after, returning from these areas, you may want to have a follow-up appointment as well. This may seem as if you are overdoing it, but malaria can mimic many different illnesses initially. It can appear as flu-like symptoms, migraines, gastrointestinal illness (stomach bug), and even worse conditions like seizures or bleeding in the intestines. If your GP knows that you have visited areas with malaria, they can be vigilant to order the right tests if you do become ill.

Another important consideration is Plasmodium vivax. This type of malaria is one of the more confusing types. It can lie dormant (asleep) within your body for months or years, and then suddenly arise causing many symptoms. While it is typically not fatal in of itself, it can interfere with your current health problems and worsen them. If you already have difficult, chronic health conditions, you may struggle more than usual

It is our goal here at Express Pharmacy that you return from your travels with happy memories and are as healthy (or even healthier!) than when you left. Being prepared for malaria is very important, and we are here to help you get ready in the most effective way possible. Discover medications for your anti-malarial needs – here at Express Pharmacy. We can help you gain access to effective treatment swiftly and discreetly. Contact us today by calling 0208 123 07 03 or by using our online Live Chat service.

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Can Kegel Exercises Prevent Premature Ejaculation?

Posted Friday 26 April 2019 13:17 by in Premature Ejaculation by Tim Deakin

kegel for premature ejaculation

Premature ejaculation is the term used to describe a situation in which a man reaches climax too quickly during sexual intercourse. It’s the most common ejaculation problem in the UK[1] and estimates of how many men are impacted by premature ejaculation vary widely, ranging from just 5% to 31%.[2] This is largely due to the fact that it can be difficult to define how soon is too soon when it comes to reaching orgasm.

But one potential way to help treat the condition is with kegel exercises. We’re going to take a closer look at these exercises and determine whether they truly are the best way to tackle premature ejaculation.

What are kegel exercises and how can they help?

Kegel exercises are designed to strengthen your pelvic floor muscles, which can impact your sexual function and performance. Generally speaking, your pelvic floor muscles are the muscles on your thighs, buttocks and lower abdomen.

Common kegel exercises involve simply contracting these muscles, holding for five seconds and then relaxing them. Repeat this up to ten times, pausing in between for five seconds of relaxation. These are known as slow kegels.

Over time, you can start to increase the length of time you contract your muscles for. You can also move on to fast kegels, which involve the exact same movements but carried out at a faster speed. Good times to practice kegel exercises include when you wake up in the morning, after going to the toilet and before going to bed.

Pelvic floor rehabilitation such as kegel exercises have been shown to be an effective means of delaying premature ejaculation, as they help to strengthen the pubococcygeus muscle. One study found that, after 12 weeks of pelvic floor muscle rehabilitation, 82.5% of participants had gained greater control of their ejaculatory reflex.[3]

Other ways to treat the condition

Although kegel exercises have proven to be an effective means of treatment for some premature ejaculation sufferers, their effectiveness has not been officially established and they are not guaranteed to prevent premature ejaculation in everybody.

Other treatment options include the “stop-start technique”, in which the male sex partner pauses sexual interaction or masturbation if they feel they are close to orgasm, and waits until the feeling passes before continuing.[4] If the sufferer is in a relationship, talking openly with your partner about your concerns and working around the issue together is highly recommended. Behavioural therapy is thought to help 60-90% of men with the condition, but it requires cooperation from both partners.[5]

What is the most effective way to tackle premature ejaculation?

Finding the right treatment for premature ejaculation depends largely on the individual case, and particularly what has caused the problem. If the issue is psychological, it may be that therapy is the best course of action. For many people, effective medication is the most dependable means of treatment.

Studies have revealed the effectiveness of medication options like Priligy. In one study, sexual satisfaction of participants increased from 50% at the beginning of the study to 80% at the end of the study, compared to 55% from participants using a placebo drug.[6]

Discover effective premature ejaculation treatment from Express Pharmacy by clicking here. For more information on the condition, get in touch with our team by calling 0208 123 07 03 or by using our discreet online Live Chat service.


[1] NHS UK. Ejaculation problems. 2016

[2] Sexual Advice Association. Ejaculation problems. 2016

[3] Pastore, AL. et al. Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach. 2014. Therapeutic Advances in Urology. 2014.

[4] NHS Lanarkshire. Sexual Difficulties: Premature Ejaculation. Lanarkshire Sexual Health. 2019

[5] Harvard Health Publishing. Premature Ejaculation. Harvard Medical School. 2017

[6] McCarty, EJ. And Dinsmore, WW. Dapoxetine: an evidence-based review of its effectiveness in treatment of premature ejaculation. Core Evidence. 2012

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Can Premature Ejaculation Be Controlled?

Posted Sunday 21 April 2019 12:52 by in Premature Ejaculation by Tim Deakin

premature ejaculation medication

You may not always hear men admit it, but premature ejaculation is one of the most widespread sexual health concerns amongst males in the UK, along with erectile dysfunction. As many as one in three men suffer from premature ejaculation, although less than a quarter of men with the condition actually seek medical help for it.[1]

And because men find the condition difficult to talk about, it’s common for those suffering with premature ejaculation to feel completely alone and almost powerless. But this doesn’t have to be the case. We’re exploring the different means and methods involved in controlling this condition, from potential home remedies to psychological factors and effective medications.

Self-Help for premature ejaculation

There is no guaranteed way to determine how soon is too soon when it comes to ejaculation. This makes it difficult to define what we mean by premature ejaculation. Often, it comes down to sufferers of the condition finding a treatment which helps them last as long as they feel comfortable with, rather than aiming for a specific time.[2]

There are some simple precautions and measures you can undertake yourself at home which have shown signs of improving symptoms of premature ejaculation for some sufferers. These are listed as self-help treatments by the NHS[3] and include:

  • Using a thick condom in order to decrease the stimulation caused by intercourse
  • Taking a deep breath to briefly stop the ejaculatory reflex
  • Having sex with your partner on top, allowing them to pull away when you are close to climax
  • Masturbating oneto-two hours before engaging in sexual intercourse
  • Taking breaks during sex and thinking about other things to distract yourself

Treating the psychology of premature ejaculation

It’s common for psychological factors to be involved in many cases of premature ejaculation. Some health professionals believe that early sexual experiences can establish a pattern that becomes difficult to change, such as situations where climax had to be hurried in order to avoid being discovered.[4]

Factors like anxiety and relationship problems are also thought to make sexual conditions like premature ejaculation more likely to occur, so dealing with these wider issues through means such as couples’ therapy can often help to lessen symptoms. Often, premature ejaculation can increase symptoms of anxiety and depression, which can in turn make premature ejaculation even worse, creating a vicious cycle.[5]

Working together with your partner to prolong the sexual experience can be helpful, such as increasing foreplay or making use of the ‘start-stop’ technique.[6]

Premature ejaculation medication

Medical treatment for premature ejaculation is often found to be the most reliable and long-lasting of options for sufferers. These treatments can range from oral medication in the form of SSRIs to topical anaesthetic creams.

Priligy, or dapoxetine, is the first pharmacological treatment for premature ejaculation to be licensed in the UK. Results from clinical trials found that many more men reported that their symptoms were ‘better’ or ‘much better’ with Priligy than with a placebo drug.[7]

Safe and effective medication for premature ejaculation is available from Express Pharmacy. Discover Priligy and the topical cream Emla on our site today. If you have any further queries about your condition, don’t hesitate to get in touch by calling 0208 123 07 03 or by using our discreet online Live Chat service.


[1] The British Association of Urological Surgeons. Premature Ejaculation. 2019

[2] Waldinger, MD. Relevance of an evidence-based ejaculation time cut off point for neurobiological research of premature ejaculation. J.Comp. Neurol. 2005

[3] NHS UK. Can premature ejaculation be controlled? 2017

[4] Psychology Today. Premature Ejaculation: Causes and 10 Tips for Treatment. 2015

[5] Patrick, DL., Althof, SE., Pryor, JL. et al. Premature ejaculation: an observational study of men and their partners. J. Sex. Med. 2005.

[6] Cooper K., Martyn-St James M., Kaltenthaler, E. et al. Behavioural therapies for management of premature ejaculation: a systematic review. Sex. Med. 2015

[7] National Institute for Health and Care Excellence. Premature ejaculation: dapoxetine. 2014

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Your Guide to Understanding Erectile Dysfunction

Posted Wednesday 17 April 2019 15:00 by in Erectile Dysfunction by Johanna Galyen

“Almost all men have [Erectile Dysfunction] at some point. It’s how they deal with it that counts.” says Mark L. Held, PhD, a clinical psychologist.

While Erectile Dysfunction (ED) solely affects men, it is both women and men who are impacted by this condition. It is rarely the man who seeks help for this condition alone, but it most frequently the woman who encourages the man to seek out help for this condition. The knowledge and understanding of ED can make all the difference in your relationship – and perhaps be the key to enabling genuine sexual chemistry to prevail.

What is Erectile Dysfunction?

As silly as this question may be, this is not a laughing matter. It is a very important question because while it may seem that everyone knows what erectile dysfunction is, it is always important to clarify the terms. Erectile Dysfunction, according to the Urology Care Foundation, is “trouble getting or keeping an erection that's firm enough for sex.”

For a man to perform the act of sexual intercourse, the penis must become very firm and erect. To become erect, the penis needs sexual arousal to produce chemical and biological changes. Dr. Burnett, professor of urology at Johns Hopkins Medicine, says the “release of the chemical nitric oxide, a neurotransmitter that is produced in nerve tissue, triggers an erection by relaxing muscles that allow blood to fill the penis.” This allows the penis to become hard and rise up, which is called an erection. This erection lasts until the sexual arousal dies down or a man ejaculates and the trapped blood slowly returns to the rest of the body.

For a man struggling with ED, the penis does not become engorged with blood and neither does it become erect in position. This may happen occasionally to some men and they are able to resolve it in a few moments, and others are not able to have an erection at all.

What Causes Erectile Dysfunction?

There are a number of stigmas and misconceptions attached to erectile dysfunction. For example, you may have heard that impotence is purely a sign of a man's age or that it is related to a man's lack of sexual prowess; perhaps you've read somewhere it is due to a porn addiction or that it is caused by a lack of attraction. Some may say that it is caused by medications, and others blame poor diets and a lack of exercise. The cause and reality of ED is much more complex than one simple answer.

Medical Conditions

The Mayo Clinic lists 16 possible medical causes of ED in men. Here they are:

  • Heart disease
  • Clogged blood vessels (atherosclerosis)
  • High cholesterol
  • Diabetes
  • Obesity
  • Metabolic syndrome – a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
  • Parkinson's disease
  • Multiple sclerosis
  • Certain prescription medications
  • Tobacco use
  • Alcoholism and other forms of substance abuse
  • Sleep disorders
  • Treatments for prostate cancer or enlarged prostate
  • Surgeries or injuries that affect the pelvic area or spinal cord

So as you can see from the above list, there are many possible causes. But go back to the list, and pause for a few moments. How many of these can actually be seen by your eyes? Sure, as a woman, you may see that your man has gained some weight, or that he uses tobacco or alcoholic beverages. And for sure, you would probably know if he is in the later stages of Parkinson’s Disease or Multiple Sclerosis – but the early stages may not present with traditional symptoms.

High blood pressure and high cholesterol have very few recognizable traits. Type II Diabetes is rarely recognized in its early stages, and is only found if other problems are seen or if a General Practitioner (GP) performs a physical. Medications come with a very long list of side effects, and most people do not read the entire lists, and ED may be a side effect. The point here is this: the medical causes of ED are often hidden in men.

Psychological Causes

Sexual intimacy requires a man to mentally present to the situation. The mental stimulation is vital for the body to respond with the right chemical responses. There must be some kind of incitement in the man’s mind before the penis changes into a full erection. A man’s mind will not be fully present if he is struggling from depression or anxiety.

Depression is a confusing condition when combined with ED. Men who are already struggling with symptoms of sadness, low self-esteem, hopelessness may begin to have erection difficulties as a result of their depression. On the opposite side, men who already have ED, may start to show symptoms of depression because they are unable to sexually perform. Unfortunately, either way you look at depression as the cause of erectile difficulty or a side effect of depression.

Anxiety is similar to depression in that it can be a causing factor or a side effect. However, anxiety around intimacy can begin to be a greater issue. In depression, the man may have a reduced desire to be physically intimate. Anxiety can quickly turn into performance anxiety where sex becomes something to be feared or dreaded.

Past sexual problems or abuse can also interfere with obtaining an erection in men. Sometimes the problems may have occurred many years ago, but over time the memories start to resurface. A triggering event (such as a comment, a certain smell, a similar situation, or visiting friends) can cause a man to remember something that he had forgotten for a while and instead of being able to be intimate, his mind is focused on the event. These triggering events can come from trauma.

However, traumatic events do not have to relate to serious past traumas, sexual or otherwise, and they may simply relate to painful arguments or recent stresses in life that the man is dealing with at that moment. Traumatic events can be something as little as a painful argument or an inappropriate touch from years ago.

Lifestyle Causes

Stress is one of the worst causes of erectile difficulties in men. If a man is overly stressed with work, family life, finances, or health concerns – he will be less inclined and able to perform sexually. We know that we all face increasing amounts of stress each day, and while we wish that there was a turn-off switch in our minds to be intimate, men don’t have that ability anymore than most women.

The impact of pornography in a sexual relationships is one that scientists are trying to establish and many studies seems to contradict each other. In one Italian study of 28,000 men, it was found that “Men are suffering from 'sexual anorexia' and are unable to get erections because of Internet porn use that started in their mid-teens”. On the other side, Nicole Prause, PhD, a sexual psychophysiologist and licenced psychologist at the Sexual Psychophysiology and Affective Neuroscience Laboratory states that “In one case, the study found stronger sexual arousal in men who reported viewing more sex films at home.” The men who did had erectile dysfunction were “those whose personal values contradict with viewing sex films may be experiencing general shame around sex that also influences their erectile functioning.”

What scientist do know about pornography viewing and men is this: pornography usage can stimulate a man’s appetite for vivid sex, and it can be difficult to be aroused if not exposed to that same level of stimuli with a partner.

What Treatments are Available?

Self Care

Like most conditions, the first step in treating a problem is to ensure that you are in the best health possible. Here are some excellent ways to improve your health:

Non-Medical Helps

Acupuncture and natural supplements have been found to be helpful for some men. Supplements such as L-arginine, Propionyl-L-carnitine, Yohimbe, Red Ginseng, and Maca have been studied by scientists, and while some are more beneficial than others, they should only be taken with the proper permission. L-arginine, according to the Mayo Clinic, can interfere with Viagra and should never be taken together. Supplements, like all medications, can have interactions and negative side effects such as diarrhea, acne, stomach pain, increased anxiety, and an irregular heartbeat.

Other non-medical helps that a man might use would be a penis ring or a vacuum pump to enhance penile size. Both of these can assist in increasing the blood supply to the penis and allowing it to become engorged with blood to become erect.

Medications

Available by prescription only, there are specific medications that can help create an erection for a man.

Viagra / Sildenafil: The most popular of all erectile medications is Viagra. It is also available in its generic form Sildenafil. The generic form is cheaper, but they both work to increase blood flow to the penis.

Benefits: Improve the man’s ability to get and maintain an erection; this medication works in approximately 60 minutes and can last for 4 hours.

Cons: Does not enhance sexual arousal. Medication has to be taken prior to planned intimacy. Excessive alcohol mixed with this medication headaches, dizziness, or an unsafe drop in blood pressure. Possible side effects are headache, dizziness, upset stomach (nausea), back pain, and muscle pain.

Spedra / Avanafil: If you are wanting a quick medication for impromptu intimacy, then speak to your GP about this medicine. Avanafil is similar to Sildenafil; they both work the same way to increase blood supply to the penis, but this medication works much faster.

Benefits: Body can absorb this medicine in as little as 15 minutes. The medicine lasts up to 5 hours.

Cons: A large meal can slow down absorption. The penis will not harden without sexual intimacy; this medicine must be used in tandem with intimacy.

Levitra / Vardenafil: Like Viagra, this medicine helps men achieve an erection.

Benefits: Works faster than Viagra, and often has fewer side effects. It is also considered safer for men who have diabetes, high blood pressure, or high cholesterol. The medicine also has a shorter half-life, which means the body is able to remove the medicine faster.

Cons: The shorter half-life means it does not work as long as Viagra

Cialis / Tadalafil (as needed): This medicine works just like Viagra and Spedra, but it has the ability to last much longer in the man’s body.

Benefits: Can be taken up to 36 hours prior to intimacy. This medicine has been approved for men who suffer with high blood pressure.

Cons: Similar to Viagra

Cialis / Tadalafil (every day): While this medicine is almost identical to Cialis (as needed), it is a much smaller daily dose. This daily dose allows the man to be sexually active without the need to remember to pre-dose on medication prior to intimacy.

Vitaros / Alprostadil: Is the only approved medication that is not a pill, but it is a cream that is applied to the penis. The medication permeates the skin of the penis and relaxes the blood vessels just like the other medications work.

Benefits: Works in as little as five minutes, and not have to taken orally

Cons: The medicine needs to be stored in a refrigerator, and can lose potency if kept in a warm place for more than a few days. Additionally, the cream may be irritating to your partner; a latex condom should be placed over the penis and cream to protect them from the irritation.

What is the Psychological Impact of ED?

Anybody who believes that the way to a man's heart is through his stomach flunked geography. Robert Byrne

The impact on men

If I as a writer and a registered nurse had one wish, it would be this: slow down and read this section very carefully. Erection difficulty is not a problem that can be fixed by one call to the GP or one visit to a therapist. The answer could be as simple as your partner purchasing new lingerie, a fancy date night, or a prescription, but that often does not address the whole issue. ED is not merely a penis problem. Here’s why:

  • Men identify with their penis much like women identify with their breasts.
  • The penis (specifically the size) is a symbol of manhood.
  • The level of perceived success in the bedroom equals the level of self esteem for a man.
  • It’s embarrassing for a man to not be able be sexually intimate on demand.
  • A man may feel less-than, humiliated, and painfully vulnerable in his life when he struggles to obtain an erection.
  • It can make a man “fear that their breakdown in penile functioning will result in their being unwanted by a partner and their resulting fears of loneliness, isolation, and impotence.” (Morris Psychological)

Some men, due to the above issues, could eventually obtain an erection with help – but would that be good enough? Would they be able to accept an erection with help? For some men, the answer is no. Obtaining an almost-normal erection will not deal with the “underlying existential anguish” that Dr. Daniel Watter, Board Certified Sex Therapist, addresses. In simple terms? The erection is just a symptom of a greater problem in a relationship. If a man does not feel safe, connected, loved, empowered, and free to express himself in a true way, he will not change if he can get an erection momentarily with help.

The impact on relationships

The impact of feeling connected in a relationship versus feeling isolated must be acknowledged. Men want to feel connected and important in a relationship in many of the same ways that women do, and if they do not feel connected, isolation can start to come into the relationship. If the man feels isolated, the relationship quickly begins to suffer.

Women are also affected by erectile dysfunction in a relationship, and it’s not solely because their partner is unable to get an erection. Andrew McCullough, MD, director of sexual health and male infertility at NYU Medical Center says that women “think when a man can't get an erection is that it's her fault, and nothing could be further from the truth." After blaming herself, the woman often begins to wonder if the man is cheating within the relationship or (even worse) thinking that he does not find her sexually appealing anymore. Before too long, arguments begin to develop all based on erroneous thoughts when none of it may be true.

So You’ve Got the RX, But Now What?

Understand the treatments limitations

A prescription for medication is just one of many possible treatments for Erectile Dysfunction. As you can see from the above lists, there are many options available and each of them have varying benefits and side effects. The medications are not the only answer, they are merely a tool in a toolbox to assist a man to be intimate. They will not create or produce intimacy within a relationship – that part is up to you and your partner.

Focus on romance and lovemaking versus intercourse

Focusing on romance does not mean that the partner should just stroke the man harder or pull out more lingerie. When the spotlight is merely on traditional penis-in-the-vagina intercourse, it puts a lot of pressure on the man to perform. ”There are lots of different ways to be sexual, and if one way becomes difficult or even impossible, you have to explore, together, the things you can do with each other than are sexually exciting," says Jennifer Downey, MD, a psychiatrist at New York State Psychiatric Institute suggests.

Keep communicating

The morning after the first erectile difficulty is not the best time, nor is everyday after it happens. “The best thing to do is to discuss things outside of the bedroom – not right after it happens, but days or even weeks later," Dr Downey suggests. She further encourages the woman to speak about it like other medical issues, and not make the concern bigger and more difficult. Some men may feel more comfortable if the woman attends the doctor’s appointment, and others prefer to by themselves — whichever they choose, it is always good to offer support and encouragement.

Identify stressors that may be causing ED

One of the ways Medical News Today recommends to stop the cycle of performance anxiety, is to “identify what stressor or worry influenced the symptoms of ED. The cause may be simple, such as an upcoming project at work or planning a family trip.” When you are able to shift “the focus to the cause, rather than the symptoms, may help a person reduce the pressure to perform well every time, especially during times of increased stress.”

Consider therapeutic counselling

It’s understandable that you may feel awkward going and talking to a therapist for sexual difficulties, but trained therapist can help you overcome the “underlying emotional and psychological troubles that may be causing ED.” says Everyday Health. Just knowing what happens in therapy can help relieve some stress. Quality therapy happens in a real office with nicely appointed chairs; there is no sexual contact nor does the client get undressed. Some offices may offer teletherapy using video conferencing so you do not have to leave your phone. If you choose to do this therapy, just make sure they are a qualified, licensed therapist.

Most therapist begin the discussion by asking general questions such as ones about your health, education around sex, and what brought you to the office. Based off of these answers, a treatment plan can be created. One of the unique benefits of therapy is communication strategies, as the International Society for Sexual Health points out. In a session “clients may practice asking for what they want or need sexually or emotionally in a relationship,” and this is crucial because most couples do not know how to ask for intimacy, they just try to do it like they seen on television.

Remember this: real life intimacy requires good communication and learning what the other partner's wants and needs for intimacy to be meaningful.

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April Is Alcohol Awareness Month 2019

Posted Friday 05 April 2019 16:47 by in Weight loss by Tim Deakin

alcohol awareness

Alcohol addiction continues to be an issue on both a national and global scale. In their lifetime, one in every 12 adults – or 17.6 million people – will suffer from an alcohol use disorder or develop dependence on alcohol. [1]

Statistics like these are what make Alcohol Awareness Month so important. With its slogan “Help for Today, Hope for Tomorrow”, this year’s initiative aims to reduce the stigma associated with alcohol addiction by offering information, support and guidance.

Alcohol Awareness Month was founded and sponsored by the National Council on Alcoholism and Drug Dependence. To do our bit for Alcohol Awareness Month 2019, we’re here with further information to raise awareness of exactly what impact alcohol can have on your health.

Alcohol and your body

Alcohol and sleep

Many adults use alcohol to help them fall asleep, but while it can make you fall asleep fast, it also contributes to poorer quality sleep overall.[2] Drinking can aggravate breathing problems, block REM sleep and interrupt your circadian rhythm.

Alcohol and sexual function

One 2007 study found that 72% of male participants experienced sexual dysfunction, most notably premature ejaculation and erectile dysfunction. The amount of alcohol consumed was the most significant factor in determining sexual problems.[3]

Alcohol and urine

Most drinkers are familiar with the sensation of ‘breaking the seal’, which occurs because alcohol is a diuretic. This means it acts on your kidneys and makes you pee out more than you take in. In fact, for every 1g of alcohol consumed, urine excretion increases by 10ml.[4] This can cause significant levels of dehydration.

Alcohol and blood pressure

Drinking too much can also impact your cardiovascular health, leading to a range of symptoms including high blood pressure. A 2013 study found that 16% of hypertension problems in the US are linked to excessive alcohol consumption.[5]

Alcohol and migraines

The NHS lists alcohol as one of the significant dietary triggers for migraines.[6] These can be hugely painful and debilitating headaches, often striking regularly throughout one’s life. You can find effective migraine medication at Express Pharmacy.

Alcohol and disease

Alcohol and liver disease

Currently, one in five people in the UK drink alcohol to a level which could harm their liver. This can lead to conditions like a build-up of fat in the liver, hepatitis and even cirrhosis, which affects one in 10 people who drink harmful amounts.[7]

Alcohol and cancer

Along with smoking, alcohol is one of the biggest preventable causes of cancer. Alcohol can cause up to 7 kinds of cancer, including breast cancer, liver cancer and bowel cancer.[8]

Alcohol and diabetes

There are several risk factors associated with Type 2 diabetes, including family history, age, weight and ethnic background. However, alcohol is another significant factor. Not only can it lead to weight gain, but excessive intake is also associated with an increased risk of Type 2 diabetes.[9]

Alcohol and heart disease

There is a very clear link between alcohol and high blood pressure. Over time, excessive alcohol can put further strain on the heart leading to cardiovascular disease, increasing your risk of heart disease and stroke.[10]

Alcohol and your appearance

Alcohol and physical appearance

Alcoholism can have a significant impact on your physical appearance. Factors like personal hygiene and general grooming can suffer, but excessive drinking can also lead to poor complexion, dark under-eye circles, dehydration, tiredness and an overall more haggard appearance.[11]

Alcohol and ‘beer bellies’

Drink large amounts of beer has been linked to both weight gain and an increase in belly fat. In fact, one study found that men who drank more than three drinks a day were 80% more likely to have a lot of belly fat.[12]

Alcohol and weight management

Alcohol and food equivalents

The average wine drinker takes in 2000kcal from alcohol every month, while drinking 5 pints a week for a year adds up to 44,000kcal. The NHS offers an insight into the calorie content and food equivalents of some of the UK’s most popular drinks. For example:

  • One standard glass of wine (126kcal) = 1 Cadbury Chocolate Mini Roll
  • One pint of 5% strength beer (215kcal) = 1 packet of McCoy’s salted crisps[13]

Alcohol and weight loss

As well as containing significant amounts of calories, alcohol can also prevent weight loss by lowering inhibitions, making a take away or a chocolate bar seem much more appealing. It can also make you less likely to exercise.[14]

You can find safe and effective weight loss medication at Express Pharmacy.

Alcohol and mental health

Alcoholism and dependence

Alcoholism is the most serious form of drinking problem. It describes a strong desire to drink which often can’t be controlled. For alcoholics, drinking takes priority over all obligations including work and family. It usually develops as instances of harmful drinking, or binge drinking, become more and more regular.[15]

Alcohol and anxiety

While alcohol may sedate anxiety in the short term, in the long term it can make it worse. This is true even for moderate amounts of alcohol. The Anxiety and Depression Association of America reports that 20% of people with a social anxiety disorder also suffer from alcohol dependence.[16]

Alcohol and aggression

When we’re drunk, we’re more likely to misinterpret other people’s behaviour and react to things emotionally rather than logically. Alcohol reduces our ability to think straight, hence why aggression and alcohol are so closely linked. Binge drinking increases our chances of both being aggressive and being the subject of someone else’s aggression.[17]

Alcohol withdrawal

Withdrawal symptoms are almost always an aspect of alcohol dependence and are a clear sign that you are drinking too much. They may include physical symptoms like sweating, nausea and tremors, as well as psychological symptoms such as depression, irritability, anxiety and insomnia.[18]

Alcohol and depression

Depression is a common mental health concern, affecting one in five of us in our lifetime.[19] Drinking can make depression more likely. Over time, regular drinking lowers your levels of serotonin, the brain chemical that helps to regulate your mood, making you more susceptible to depression.[20] What’s more, drinking can create a vicious cycle whereby your relationships, work life and social life all suffer, which again can make depression more likely to occur.

Managing alcohol dependence can be a long and difficult road to navigate, but it isn’t one you should suffer alone. Speak to those around you or arrange an appointment with a GP to start making positive changes to your life today – one step at a time.

If you have any queries or concerns about your health, contact Express Pharmacy today. We offer access to effective medication easily and discreetly. Get in touch today using our Live Chat service or by calling 0208 123 07 03.


[1] Facing Addiction. Alcohol Awareness Month — April 2019. 2019

[2] National Sleep Foundation. How Alcohol Affects the Quality — and Quantity — Of Sleep. 2018

[3] Aracknal, B.S., Benegal, V. Prevalence of sexual dysfunction in male subjects with alcohol dependence. 2007

[4] Drink Aware. Why Does Alcohol Make You Pee More? 2018

[5] Loyke, H.F., MD. Five Phases of Blood Pressure in Alcoholics. 2013

[6] NHS. Migraines. 2019

[7] British Liver Trust. Alcohol and Liver Disease. 2019

[8] Cancer Research UK. Does alcohol cause cancer? 2018

[9] Diabetes UK. Alcohol and diabetes. 2018

[10] British Heart Foundation. Effects of alcohol on your heart. 2017

[11] Alcohol Awareness. What are the physical signs of alcoholism? 2016

[12] Schröder, H. et al. Relationship of abdominal obesity with alcohol consumption at population scale. 2007

[13] NHS. Calories in Alcohol. 2016

[14] Drink Aware. How does alcohol affect weight loss? 2017

[15] Drink Aware. What is alcoholism? 2019

[16] Anxiety and Depression Association of America. Social Anxiety Disorder and Alcohol Abuse. 2018

[17] Home Office. Violence in the night-time economy: key findings from the research. 2004

[18] Drink Aware. Alcohol withdrawal symptoms. 2017

[19] Royal College of Psychiatrists. Depression. 2019

[20] Pietraszek, M.H. et al. Alcohol-induced depression involvement in serotonin. 1991

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