Studies have never defined a "normal" level of sexual desire. Despite that, there's a website and an online quiz to help you decide if you've got a problem. Called "Right to Desire," it brands libido as a feminist "right," and its home page offers the defiant, in-your-face prompt: "Yes, I want my desire back."비아그라 구입
Click a few boxes and you're instantly directed to a remedy (and an online doctor to prescribe it): a pill called Addyi from Sprout Pharmaceuticals. "This particular product should not have been approved by FDA, but it was, and it is not a product that adds value to women's lives," said Susan Wood, assistant commissioner for women's health at the Food and Drug Administration from 2000 to 2005. She added: "There isn't an actual market."The effort, called a "disease awareness" campaign, troubles critics because it attempts to define low sexual desire as a widespread disease that is treatable with a pill. Although doctors recognize that there is (perhaps) a condition called Hypoactive Sexual Desire Disorder, many of the studies defining HSDD were sponsored by the drugmaker. Almost all doctors on the 2016 consensus panel that defined HSDD were consultants or on Sprout's advisory board. 5 myths about 'female Viagra' busted To further complicate matters, in the studies that led to Addyi's approval, results were not terribly impressive. And, for those who would simply like a little more sex in their lives, is it worth a $400-a-month pill? Enter the latest sales pitch, which encourages women to stand up for their rights. The new campaign taps into emotional issues that have long been staples of women's equality movements, like the right to equal access to health care, the idea that women's issues should be taken as seriously as men's, including women in conversations about their health and valuing women as sexual beings. "To hear our language co-opted" is upsetting, Cindy Pearson, the executive director of the National Women's Health Network, said in an interview. "It's really bittersweet to see it co-opted to sell, and sell a product that isn't that good."시알리스 구입 Addyi -- also known as flibanserin -- first gained FDA approval in 2015 after a long and contentious fight. It's often called the "female Viagra" because it's related to sex, but Addyi and erectile dysfunction meds are quite different. While impotence medications work by directing blood to the genitals and are taken before sex, Addyi is taken nightly and works in the brain to increase desire. In fact, it was originally developed to be an antidepressant, but its clinical-trial performance fell short. Along the way, researchers noticed that subjects reported having some increase in sexual desire. Where's my orgasm? "Addyi is believed to work on the part of the brain involved in sexual motivation and response, though its exact mechanism of action is not fully understood," the official website reads. Even during drug trials, Addyi's effectiveness was questioned. On average, women who took it reported one increased sexually gratifying experience every other month, and that was only after the subjects began recording their experiences monthly instead of daily. There are also concerns about side effects like dangerously low blood pressure, fainting, severe drowsiness and insomnia. The FDA rejected Addyi twice before it went before a public advisory council, where patients, doctors and women's groups (some funded by the manufacturer, according to industry researchers) testified in favor of the drug. In the old days, drugmakers developed drugs for known diseases. Now drugs come looking for a market. It's difficult to pinpoint the number of women who report a persistent lack of sexual desire. Even the findings of studies sponsored by the drugmaker vary widely. Such complaints also tend to be more common among post-menopausal women -- a group for whom the drug is not approved.비아그라 구매 Experts say it's difficult to get an accurate picture of the problem medically known as low libido because it has so many possible causes -- depression, poor body image, fatigue, stress, pregnancy and menopause. Even in the Sprout-sponsored study, many women who were distressed about their low sexual desire ascribed it to "relationship issues." "You take something that can occur from a wide range of reasons, some of which have nothing to do with physiological or medical problems, and you turn it into a medical problem, you give it a name and you sell a product to get rid of it," said Diana Zuckerman, the president of the National Center for Health Research. Do women really need 'female Viagra'? Rather than turn to a costly, silver-bullet medication approach, complaints like sexual dysfunction and low desire often need to be addressed by mental health professionals, sexual health professionals or people with more time and training than general practitioners, Zuckerman said. Anyway, Addyi's labeling expressly notes it is not approved for use by women whose low libido is caused by problems in their relationship, menopause, childbirth, medical issues, other medications they are taking or mental illness. While Wood said she thought Sprout would like to market Addyi to "almost all women," there's a "tiny subset of women who suffer from HSDD." "And there's not a big a market of people who actually suffer from this diagnosable condition that could benefit from a medical treatment," Wood added. "Right to Desire" brands itself as a movement for women who are struggling with HSDD. The campaign is heavy on social media, with a strong Facebook presence that includes Funny or Die videos, date night "hacks" and testimonials from patients and doctors. There was a #RightToDesire "girls' night out" Twitter party featuring several mommy bloggers and giveaways. It's not the first time feminism has been used to sell a product, but it's still frustrating for women's health activists who have been working for years to get their issues taken seriously. Insurance won't pay for women to have pleasurable sex At the time, a coalition of groups -- some venerated women's rights groups and some that were formed and funded by the pharmaceutical industry -- known as "Even the Score" pushed for the drug's approval and found traction. The rallying cry was the idea that 26 drugs had been approved for male sexual dysfunction and none for women. "I believe [the FDA] found it hard to keep the product off the market when they were being accused of being sexist," Wood said. "They got, in my view, sort of bamboozled by that argument," she added. Forty-eight hours after Addyi was approved, Sprout sold it to Valeant, now under the umbrella of Bausch Health Companies, for around $1 billion. And it flopped. According to Wood, that's because the drug didn't work, came with safety concerns and wasn't covered by many insurance plans. Addyi cost around $800 a month for a daily pill, which may account for why at its peak in March 2016 only 1,600 prescriptions were written for it. In 2017, Valeant gave up on Addyi, turning it back over to Sprout, which is now trying again to make the drug a sensation. As part of the arrangement, according to press reports, Sprout did not have to pay an upfront fee and, among other parts of the deal, agreed to pay Valeant, now Bausch, royalties on sales of the drug, though early indications say it still isn't successful. Get CNN Health's weekly newsletterSign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.시알리스 구매 "We will receive royalties once they make a milestone," Arthur Shannon, senior vice president and head of investor relations and communications for Bausch, wrote in an email. "We have not received any royalties thus far." The deal paved the way for a lower price tag -- cut in half -- and this trendy pop-feminist ad campaign. Sprout did not make its CEO available for an interview. Originally, the drug's labeling included a prohibition on drinking alcohol while on the medication. This caution, though, resulted from a study whose participants were mostly men. This spring, Sprout funded two new studies to show Addyi was safe to consume with alcohol, but the FDA kept the "black box" warning in place with one change -- the alcohol prohibition is restricted to two hours before and at least eight hours after taking it."Now is the time to lend your voice and demand gender equality when it comes to sexual health," the Facebook page declares as it directs visitors to a Change.org petition to get benefits managers to cover the drug. It also asserts that it's "time to address women's sexual health beyond reproduction alone." It even quotes Eleanor Roosevelt. https://viagra-onlineshop.com/ "[Sprout is] definitely appropriating all that language, making it seem like a feminist issue," said Dr. Steven Woloshin, a professor at the Dartmouth Institute. "This is an issue that involves women, but that doesn't mean that taking this drug is something you should do because you're a feminist." 출처 : https://www.cnn.com/2019/05/08/health/women-libido-addyi-partner/index.html
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Dr. Keith Roach writes a medical question-and-answer column weekdays. Photograph By HANDOUTv비아그라 구입 Dear Dr. Roach: Short of sounding like a conspiracy theorist, why hasn’t the U.S. Food and Drug Administration approved sildenafil in a set dosage for blood pressure medication? I saw a decrease from 150/90 to 115/70 in a reading about an hour after taking a 20-milligram tablet. That’s a far superior result compared with the medications I am on. J.I.C. article continues below TRENDING STORIES
I’m not a big believer in conspiracy theories. If the medication were truly safe and effective for blood pressure control, you can be sure it would be marketed as a blood pressure pill with additional benefits for some people, just as tadalafil (Cialis) is marketed as a treatment for benign prostate enlargement, in addition to its proven role in treating erectile dysfunction.비아그라 구매 Tadalafil is also being studied as a potential benefit in heart-failure treatment. Dear Dr. Roach: I happened to be using a topical steroid for a bug bite when I got a sunburn on the area. To my surprise, the area that had the steroid on it had no redness or pain. Are topical steroids effective sunblocks? If so, why don’t we use them? W.R.R. High-potency steroids are powerful anti-inflammatory drugs. Although they do not prevent the damage done to the skin by the sun, they do prevent the inflammatory reaction that shows up as redness and warmth on the skin. That reaction appears for hours or days after sun damage, depending on the degree of the sun exposure and the individual’s protective skin pigment. Broad-spectrum sunscreens do partially protect a person’s DNA against the sun. In addition to avoiding excess sun by staying out of it, especially during the most dangerous time of the day, other strategies to reduce risk of sun damage and skin cancer include wearing sun-protective clothing and the regular, repeated and liberal use of UVA and UVB sunscreens. High-potency topical steroids are not proven to and probably don’t reduce the risk of skin cancer. More importantly, they have far too many side- effects to use on a large area of the body. I don’t recommend steroids in prevention, nor treatment, of sunburn. Dear Dr. Roach: What are your views on the safety and effectiveness of glucocorticoid nasal sprays, instead of, and in addition to, oral antihistamines and decongestants, for managing allergic rhinitis? P.L.V. My experience, backed up by the research, is that more people will get relief with regular use of nasal corticosteroids, such as fluticasone (Flonase) or triamcinolone (Nasacort), than with oral antihistamines or decongestants. All three classes are generally safe. However, nasal steroids cause nosebleeds in some people; decongestants can raise blood pressure, occasionally strikingly; and some antihistamines are sedating. Older men can have prostate problems with either decongestants or antihistamines.시알리스 구입 Some people may prefer one or the other just for convenience. Some of my patients just cannot stand nasal sprays, even newer ones that have much less sensation upon spraying. Other people don’t like pills. The combination of the two has more potent effects than either by itself. Before taking medications, it may certainly be wise to consider how to reduce contact with substances that trigger one’s symptoms. It may be impossible to avoid triggers entirely. Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers should email questions to [email protected]. https://viagra-onlineshop.com/ 출처 : https://www.timescolonist.com/life/health/your-good-health-viagra-not-truly-effective-in-controlling-blood-pressure-1.23861355 Viagra (sildenafil), Pfizer’s blockbuster drug for erectile dysfunction, is a classic example of how a drug developed for one thing can turn out to be successful for another.
Sildenafil, a PDE-5 inhibitor, was originally being developed for hypertension and angina. During clinical trials, they noticed it caused erections, and the company was quick to develop the drug for that market. “In some ways, repurposing is a standard part of drug development,” Pan Pantziarka, from Brussels’ Anticancer Fund, told Pharmaceutical Journal. “Once [a pharmaceutical company] has a license, they then seek to repurpose [the drug].”비아그라 구입 Pantziarka is director of the Repurposing Drugs in Oncology (ReDO) project. This is an international collaboration between the Anticancer Fund and GlobalCures, a Massachusetts-based not-for-profit drug development group. PDE-5 inhibitors have potential applications in cancer, heart failure, neurodegenerative disease, circulatory disorders and infectious diseases. There are, according to the U.S. Food and Drug Administration (FDA)’s trials registry, more than 650 trials for PDE-5 inhibitors. Pharmaceutical Journal writes, “But with the first generation PDE-5 inhibitors off-patent since 2013, and limited interest from the pharmaceutical industry, there is no clear path to repurposing.”시알리스 구입 ReDO came into existence, in part, because of the problems in running clinical trials with off-patent drugs. “I became involved because my son had osteosarcoma, and he didn’t respond to standard treatments,” Pantziarka told Pharmaceutical Journal. “I found that there were people who were looking at non-cancer drugs which had some evidence of activity in cancer.” He went on to say, “Our intention is to find treatments we can get to patients quickly and repurposing really fits the bill very well. You can bypass the early stages of trials, so in theory the path should be clear to rapid adoption, should we have positive results.” Three of the cancer drugs that come to mind when thinking of repurposing drugs are Celgene’s Thalomid, Revlimid and Pomalyst. All are highly successful cancer drugs and all derive from thalidomide. Thalidomide was first marketed as an over-the-counter sedative in West Germany in the 1950s under the trade name Contergan. It was later marketed as an anti-nausea medication and to alleviate morning sickness in pregnant women, although in 1960, the FDA rejected it for morning sickness over concerns about side effects. It was also marketed in the UK, Australia and New Zealand as Distaval. Not long after approval in Germany, children began being born with phocomelia, a malformation of the arms and hands. Approximately 40 percent of those afflicted survived. Worldwide, about 10,000 cases were reported, with a global survival rate of 50 percent. The most common defects were “flipper-like hands” or even stumps. There were other deformities as well. After being pulled from the market, thalidomide was studied in a number of different diseases. Eventually, it was used to treat leprosy in other parts of the world. In 2005, Celgene received approval for its version of thalidomide, Revlimid, for mantle cell lymphoma, and a year later, for multiple myeloma. ReDO has created a database of about 270 drugs that have the potential to be repurposed for cancer therapies. Some are PDE-5 inhibitors. In cancer, they seem to have an immunological effect. One suggestion has been they could be used in cancer patients post-surgery to decrease the risk of cancer reoccurrence. They also appear to enhance patient response to chemotherapy. Paul Dent, with the Virginia Commonwealth University, told Pharmaceutical Journal, “PDE-5 inhibitors have really proven to be excellent drugs for repurposing in anti-cancer therapeutics. We were able to show that Viagra enhanced the lethality of breast cancer chemotherapy doxorubicin against prostate cancer cells.” The role of PDE-5 inhibitors in cancer appears to be broadly related to its improvements in cardiovascular blood flow, which allows the drugs faster access to tumors. More obviously, they would have benefits in cardiovascular disease, since they dilate arteries and improve blood flow. Pfizer also markets Revatio (sildenafil) and Eli Lilly and Company markets Adcirca (tadalafil) for pulmonary arterial hypertension. Lilly markets tadalafil as Cialis for erectile dysfunction. “But newer lines of evidence are saying that they’re actually having a direct effect on the [heart] tissues,” David Hutchings, honorary clinical lecturer in cardiovascular sciences at the University of Manchester, UK, told Pharmaceutical Journal. However, some PDE-5 inhibitors haven’t fared as well in cardiovascular clinical trials. There is other work involving PDE-5 inhibitors in neurological disorders, such as vascular cognitive impairment, a type of dementia caused by insufficient blood flow to deep brain areas. There has also been work at the use of these drugs to treat traumatic microvascular brain injury in American football players. And although not as obvious, PDE-5 inhibitors may have antiviral and antibiotic properties, although the work is yet unpublished. https://viagra-onlineshop.com/ The disincentive for developing these drugs, however, is that many have become generic and are manufactured by dozens of different companies. Companies are cautious to invest in clinical trials for drugs they don’t have major control of or for which there’s already potential competition. And, Pantziarka notes, in Europe, “if you want to license a drug for a new medical indication you need to be a manufacturer, you need to have the marketing authorization. So a not-for-profit organization can’t turn up at the European Medicines Agency (EMA) or the Medicines and Healthcare Products Regulatory Agency and say, look, we have got evidence that sildenafil is an anti-cancer drug.” 출처 : https://www.biospace.com/article/viagra-a-case-study-in-drug-repurposing/ Liz Meszaros, MDLinx | March 08, 2019비아그라 구입
Originally developed in 1989 by researchers at Pfizer to treat hypertension and angina pectoris, sildenafil—more commonly known as Viagra—may put the brakes on the actions of mTOR, a protein that plays a major role in many diseases, including heart failure, cancer, diabetes, and autoimmune disorders, according to researchers. ADVERTISEMENT Sildenafil could become an effective treatment for cardiac diseases in which mTORC1 is overly active, returning almost full circle to what it was originally intended for—the heart.시알리스 구입 During early clinical trials of sildenafil, however, it became evident that this drug was more effective at inducing erections than at treating angina. Thus, it became “the little blue pill” that changed everything for those battling erectile dysfunction. Sildenafil—a phosphodiesterase type 5 (PDE-5) inhibitor—is currently approved for the treatment of erectile dysfunction and pulmonary arterial hypertension. By selectively inhibiting PDE-5, sildenafil improves relaxation in smooth muscle tissue. However, it is sildenafil’s activity in blocking mTORC1—a complex formed by mTOR and other proteins—that is currently causing a fuss. In a recent study published in Nature, researchers discovered that turning on protein kinase G, the target of sildenafil, can block—rather than completely shut down—mTORC1, a protein complex that controls protein synthesis and plays a critical role in immune cell activation and memory. Excessive amounts of mTORC1 have been shown to have damaging effects on the heart. But completely blocking mTORC1 can also cause damage. “The problem with the few drugs that we have to manipulate mTORC1 is that they are essentially turning it off, which also shuts down its normal function in the cells,” said senior author David Kass, MD, the Abraham and Virginia Weiss Professor of Cardiology, and professor, Departments of Medicine, Pharmacology and Molecular Sciences, and Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD. “That means if you use it to, say, treat a tumor, you suppress the immune system as well, and might cause diabetes, or kidney and other organ damage by blocking mTORC1 in the other cells.”Dr. Kass and colleagues detailed their findings in a murine model of a molecular “switch” that may fine-tune mTORC1 activity instead of just turning it on or off. Specifically, they found that protein kinase G can alter tuberin—a cellular “antenna”—by adding phosphates to it. Thus, the tuberin, in essence, becomes a braking mechanism for mTORC1. They concluded that keeping the tuberin “turned down” triggered superactivity in mTORC1, and keeping tuberin “turned on” increased the braking action, keeping mTORC1 inactive in spite of stimulating hormones. “Instead of turning mTORC1 off, we had something that looked more like a car brake, that was effective only if the car (mTORC1) was on and active,” said lead author Mark J. Ranek, PhD, Division of Cardiology, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD. “The benefit is that the new way to control mTORC1 by altering tuberin didn’t prevent its normal roles, but could keep mTORC1 in check from being turned on to too high of a level,” he added.시알리스 구매 With these recent study results, these researchers have introduced the possibility that sildenafil could become an effective treatment for cardiac diseases in which mTORC1 is overly active, returning almost full circle to what it was originally intended for—the heart. “This is an important finding because it reveals a novel strategy that could be employed in future potential therapeutic efforts to protect the heart from damaging stress such as high blood pressure,” concluded Bishow Adhikari, PhD, a program officer for the study, and scientist, National Heart, Lung, and Blood Institute, part of the National Institutes of Health, Bethesda, MD. https://viagra-onlineshop.com/ 출처 : https://www.mdlinx.com/internal-medicine/article/3518 |
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