By Sarah Mahoney

Youve Said It. Youve Heard It. How To Put That Excuse To
BedAnd Get Back In The Mood

Be honest. How many times have you turned down sex this month? Even the best
marriages have sexual cold fronts and everyday erectile dysfunction
a crushing work
deadline, a sick parent, or an acting-out teenthat can put the chill on
romance. But when sex evasion turns into a daily habit, marriage can become an
arctic zone. After all, there’s room for only so many nights of “Do we have
to? I’ve got a bad headache” before serious problems set in.

“It helps many couples to think of sex as a bank account,” says Lana
Holstein, M.D., author of Your Long Erotic Weekend . “If you just
got back from a vacation where you had lots of time alone, then saying I’m too
wiped out tonight’ isn’t a problem. But if you haven’t had much sex in the last
six months, then it took your husband some courage to ask. If you say no, that
can be damaging.”

And both partners, not just the avoider, are harmed. “The spouse with
more desire feels rejected, and the spouse with less desire feels coerced,”
says Barry McCarthy, Ph.D., author of Rekindling Desire: A Generic viagra in canada

Program to Help Low-Sex and No-Sex Marriages .

If you’re the avoider, try putting yourself in your husband’s shoes. Says
Dr. Holstein, who coaches clients at Miraval Resort in Tucson, AZ: “When a
wife turns down sex, what does she want her husband to do instead? Should he go
masturbate? My clients usually say, No, I don’t want him to do that!’ Nor do
they want him to spend an hour on a pornography Web site.”

Another reason to say yes when your husband makes a move: It’s good for your
health. “Sex, and the cuddling that comes with it, releases all kinds of
chemicals women need,” says Dr. Holstein, “including mood-boosting
hormones like dopamine, erectile dysfunction tablets
, and oxytocin.” What’s more, a study
from Wilkes University in Cialis soft uk, PA, found that couples who had sex
regularly had higher levels of disease-fighting antibodies than those who
didn’t.

So it’s time to outsmart your excuse-making self (don’t listen to hershe’s
probably just grouchy from wearing sweatpants too often). Here, six common
cop-outs, and what to say insteadto your husband and yourself:

“Didn’t we just do it last week?”

Mismatched desire is one of the most common complaints marriage counselors
hearbut experts say that the excuse is pure baloney. “Two different people
will never have exactly the same desire, drive, and timing,” says Rick
Warren, the founding pastor of Saddleback Church in Lake Forest, CA, and author
of the best-selling book The Purpose Driven Life . “Sometimes you
have to make love for the benefit of the other person, even though you may not
need it yourself at the moment.”

“There’s no such thing as the right level of desire. Normal is usually
whatever the desired frequency is for that couple,” adds Gerald R. Weeks,
Ph.D., chairman of the marriage and family therapy department at the University
of Nevada, Las Vegas. (In case you’re curious about what other couples consider
normal, here are stats from University of Chicago viagra vs cialis
: About 38 percent
of married women have sex a few times a week; 47 percent a few times a month;
and 15 percent a few times a year.)

What to say to yourself:

Remember your wedding day? When you said “I do,” you said “I
do” to sex too. “Even though you may not have promised to love, honor,
and have sex once a week,’ when you made a commitment to your relationship, it
was understood that sex would be part of the bargain,” say Patricia Love
and Steven Stosny, authors of How to Improve Your Marriage Without Talking
About It . And, yes, sometimes you have to be the instigator. When it
comes to different levels of desire, “the ball is in the court of the
person who wants it less,” says Pepper Schwartz, Ph.D., author of the
forthcoming Prime: Advice and Adventures from a Sexologist on Life and Love
in the Sensuous Years .

By Keith Ablow, M.D.

Rekindling Passion For The Husband You Still Love

People sometimes tell me they know a couple married 20 years whose sex life
is still as good as it ever was. Here’s what I tell them in return: “There
are only three ed meds
. One: This couple is lying. Two: They are telling
the truth, because they didn’t have good sex to begin with. Or three: Sex is
all they really have together. They never connected emotionally.”

I’ve drawn that erectile dysfunction medication
by listening to the many dozens of husbands and
wives I’ve counseled, almost all of whom have admitted that after 10 or 20
years of marriage, passion became elusive.

Sharing lives is different from sharing dinners and long walks and weekends
away. When you were dating the man you ultimately married, you were both acting
much of the time (consciously or not), putting your best feet forward in order
to be attractive to each other.

When you were sick or had a bad headache, you probably pretended it was no
big deal. So did he. Now when your stomach is upset, you feel free to tell him
you’re about to throw up.

When you had an argument with a close friend or your sister, you might have
told him, “It really wasn’t the best day, but it’s getting better now that
we’re together.” He might have smiled, taken your hand, and said, “Tell
me what happened. I want to know.” Now when he asks how your day was, you
might just say, “Fine,” and leave it at that. And he might be happy to
leave it at that too.

Nobody would write that kind of dialogue into a romantic ed medicine
it was
a sad or serious one. But that’s how married people generally talk because no
one can always act adoring or keep up an air of mystery while sharing the same
space with his or her spouse, year after year. Here are the truths about sex,
as I’ve learned from years of counseling, for most married couples:

Love is constant; passion needs recharging

No surprise: Everything in the universe eventually demagnetizes when left in
proximity to something of the opposite charge. Magnets do, and men and women do
too. Some people fall out of lust in seven days, never mind seven yearsor 17.
Basic animal attraction is a force of nature that seems designed to make us
matenot mate for life. Relaxing in our marriages and freeing ourselves from
the pressure of trying to impress our partners has a predictable outcome: Our
partners are not impressed. The magnetic spell we once cast on them begins to
lift.

Cozy is dysfunction erectile pill
, but not sexy

To the extent that men and women become real to each other, they cease to be
princes and princesses, gods and goddesses who inspire romantic fantasies or
amorous worship. Since couples lucky enough to be emotionally genuine with each
other share so many real moments, they need to pay special attention to
creating magical onesbecause great sex requires magic. I’d never suggest that
a couple trade their warm, safe home life for better sex. Why keep your
distance just so you can make love with abandon? I believe you can have a close
marriage and recapture a good sex lifebut only once you admit that reigniting
romance takes creativity and a commitment of time and energy.

Intimacy doesn’t equal sex

When a man and a woman reveal themselves to each other, it makes each person
feel more vulnerable. And, particularly for men, it’s hard to have amazing sex
while feeling emotionally exposed. Our earliest experiences with being close
come from our relationships with parents. And those relationships aren’t (in
any normal scenario) linked with sexual passion. That’s why some husbands and
wives are open about what pleases them sexually only when they have affairs.
They feel as if they have to be free of “family” to be free with their
amorous impulses.

Living with libido loco? For a growing number of women,
declining hormones, job stress, relationship issues, menopause, and other
problems are taking their toll in the bedroom.

Loss of sexual desire, known in medical terms as hypoactive
sexual desire disorder (HSDD), is the most common form of sexual dysfunction
among women of all ages. A recent study showed that nearly one-third of women
aged 18 to 59 suffer from a lost interest in sex, and it’s not all in their
heads.

Unlike men’s main sexual complaint, erectile dysfunction,
women’s biggest sexual problem is caused by a combination of both mental and
physical factors, which aren’t likely to be cured by merely popping a pill.

“Women’s sexuality tends to be multifaceted and fairly
complicated,” says sex erectile dysfunction answers
Sheryl Kingsberg, PhD. “Although we
would love to simplify it so we could have the one-two or even a one-punch
treatment, it doesn’t tend to work that way.”

But the introduction of anti-impotence treatments in the last
few years has spurred more research into the causes of sexual dysfunction among
both men and women, and effective therapies are available to help put the lust
back into women’s lives.

What Is Low Sexual Desire?

Contrary to popular belief, experts say frequency of sexual
intercourse has nothing to do with sexual desire or satisfaction.

“One of first things I do in speaking to women who come in
with sexual concerns is let them know that there is no normal frequency or set
of behaviors and things change with time,” says Jan Shifren, MD, an
assistant professor at Harvard Medical School. “If it’s working for them
and/or their partner, there is no problem.”

But when a woman experiences a significant decrease in interest
in sex that is having an effect on her life and is causing distress, then it’s
considered a problem of low sexual desire or HSDD.

Kingsberg says that sexual desire is more than just an issue of
low libido or sex drive. She says sexual drive is the biological component of
desire, which is reflected as spontaneous sexual interest including sexual
thoughts, erotic fantasies, and daydreams.

Kingsberg, who is an associate professor of pills

biology at the Case Western Reserve School of Medicine says, “It’s about
your body signaling that it wants to be sexual. Whether or not there is any
intention to act on it, we all have a certain level of drive.”

That sexual drive declines naturally with age based on
erectile dysfunction treatment
factors. But sexual desire also encompasses interpersonal and
psychological factors that create a willingness to be sexual.

“Above and beyond horniness, it is the sense of intimacy in
the relationship,” says Kingsberg. “If you are mad at your spouse, you
could be horny but you’re not going want to be sexual with that particular
person.”

Therefore, all of these aspects of sexual desire must be
examined in order to determine the root of the problem.

Common causes for a loss of sexual desire and drive in women
include:

• Interpersonal relationship issues. Partner performance problems,
  lack of emotional satisfaction with the relationship, the birth of a child, and
  becoming a caregiver for a loved one can decrease sexual desire.
• Generic soft tab cialis
  influences. Job stress, peer pressure, and media
  images of sexuality can negatively influence sexual desire.
• Low testosterone. Testosterone affects sexual drive in both men and
  women. Testosterone levels peak in women’s mid-20s and then steadily decline
  until menopause, when they drop dramatically.
• Medical problems: Mental illnesses such as depression, or medical
  conditions, such as endometriosis, fibroids, and thyroid disorders, impact a
  woman’s sexual drive both mentally and physically.
• Medications: Certain erectile pill
  (including the new generation
  of SSRIs), blood pressure lowering drugs, and oral contraceptives can lower
  sexual drive in many ways, such as decreasing available testosterone levels or
  affecting blood flow.
• Age. Blood levels of androgens fall continuously in women as they
  age.

diabetes,
high blood pressure, and low back pain, require fewer
medications if you can increase your activity level, lose weight, and improve
your diet. For some people who have type 2 diabetes, simple measures such as
eating a balanced diet that spreads
carbohydrate throughout the day and exercising
regularly can help keep your blood sugar level within a safe range without
insulin or other medications. Likewise, following a
particular eating plan and lowering your salt intake has been proven to lower
blood pressure.¹

How can I save money on prescriptions?

Generic medications are less expensive
copies of brand-name medications. Ask your doctor if you can take a
generic equivalent for the brand-name medication that
you take now. Generic equivalents are made according to the same strict U.S.
Food and Drug Erectile dysfunction drugs
(FDA) standards as brand-name drugs and therefore
have the same quality, strength, purity, and stability as their more expensive
counterparts.

Unfortunately, generic equivalents are not available for every
brand-name medication. If there is not an equivalent, ask your doctor if there
is a similar medication in the same class that may be less expensive or that
has a generic equivalent. For example, Flomax, which is used to treat an
enlarged prostate, is a relatively expensive medication that does not have a
generic equivalent. However, another medication that also is used for enlarged
prostate, Hytrin, does have a less expensive generic equivalent.

Always shop around for the best deal on
medications. The retail cost of medications can vary widely from pharmacy to
pharmacy. While finding a good deal is important, it’s also important that your
pharmacist (or pharmacists) knows your medical history, including all the
drugs-both prescription and erectile dysfunction pill, as well as dietary supplements and
herbs-you take, even if they are not dispensed at that particular pharmacy.
That way he or she can provide valuable advice about any potential for drug
interactions, side effects, or other problems.

Also, compare costs of buying medications online. Some large
drugstore chains have Web sites that offer savings. See a complete list of Web
sites on the National Association of Boards of Pharmacy (NABP) site at
http://www.nabp.net/vipps/consumer/search.asp. Look for Web sites that display
the NABP VIPPS (Verified Internet Pharmacy Practice Sites) seal, which means
they have met state and federal requirements.

The U.S. Medicare Web site, http://www.medicare.gov, has a useful
tool for comparing prices of hundreds of prescription drugs and generic
equivalents at pharmacies near you and also available by mail order. You can
access this information by answering “Yes” to the question “Do you have
Medicare?” and entering your Zip code. The Web site requires that you answer
several screens of questions and have some familiarity with computers. People
who have difficulty can call 1-800-MEDICARE (1-800-633-4227) to receive lists
of prices for the drugs they use.

Pill splitting is another strategy that
can help you save money without losing drug effectiveness or safety. Some
tablets are available at double the dose and at the same or almost the same
cost as lower doses. By splitting the larger dose, you can essentially get two
doses for the price of one. However, many medications are not suitable for pill
splitting, including timed-release pills and capsules. The chart below lists 10
commonly prescribed medications that researchers have determined can be split
safely and effectively with significant cost savings.²

Medications that can be split to save
money

Medication	Most commonly prescribed for:	Savings
Clonazepam (Klonopin)	Panic disorder, epilepsy	41%
Doxazosin (Cardura)	Hypertension	46%
Citalopram (Celexa)	Depression	46%
Atorvastatin (Lipitor)	High cholesterol	33%
Paroxetine (Paxil)	Depression	46%
Pravastatin (Pravachol)	High cholesterol	23%
Sildenafil (Viagra)	Erectile dysfunction	50%
Lisinopril (Zestril)	Heart failure, high blood pressure	38%
Sertraline (Zoloft)	Depression	46%
Olanzapine (Zyprexa)	Schizophrenia, bipolar disorder	31%

Ask your doctor or pharmacist if any of your prescription
medications are sold at higher dosages and if it’s possible to split them. Talk
to your pharmacist about how to split pills with an inexpensive, easy-to-use
pill
splitter.

Buying prescriptions in bulk can also
save you money. Ask your doctor to write a prescription for several months’
supply of medications that you take consistently. Mail-order services can often
save you money on large orders.

Are prescription medications always necessary?

There may be an ed pills
alternative for your
prescription medication. For example, nonprescription Aleve is a fraction of
the cost of the prescription equivalent Naprosyn. (Generic versions of
over-the-counter medications can save you even more money.) Often
nonprescription equivalents of prescription medications come in lower
strengths, so get instructions from your doctor on how to take them.

In the case of antibiotics, recent research has found that
antibiotics are not always necessary. For example, up to 80% of ear infections
get better without antibiotics.³ Your doctor might
recommend that you take a wait-and-see approach before buying expensive
antibiotics. Likewise, randomized trials show that 69% of people who had
citrate sildenafil ups sinus infection recovered without any antibiotics.⁴

Can I save money by purchasing prescription medications from Canada? Is it safe?

The answer to the first question is “Yes.” You can buy most
prescription medications, either over the Internet, by mail order, or in
person, for less money from Canadian pharmacies than from their U.S.
counterparts. Whether it is legal to do so remains controversial.

The FDA warns that the safety of drugs bought from other
countries cannot be ensured. However, many doctors acknowledge that Canada also
demands safety and efficacy for medications, and they would rather their
patients buy medications from Canada than have to skip doses because they can’t
afford their medications. U.S. citizens have been buying medications in Canada
for years, although officially federal law prohibits the practice. Currently,
the U.S. Customs Service allows Americans to bring a 90-day supply of
prescription drugs across the Canadian borders for personal use.⁵

Talk to your doctor if you decide to import your medications, and
be sure to buy only from licensed Canadian pharmacies and wholesalers.

How can my doctor help?

To enlist your doctor’s help, tell him or her that your
prescription medication bill is a financial burden. Ask for drugs that are less
expensive but just as effective. Often, several medications can be used to
treat the same condition, and your doctor may be able to prescribe the one that
is the most economical. For example, researchers have found that older, less
expensive antibiotics such as amoxicillin work better than newer antibiotics
for children who need treatment for middle ear inflammation.⁶

Often, drug companies give doctors medication samples free of
charge. You might ask your doctor if he or she has medication samples,
especially when you are trying out a new medication to see whether it will
work.

How can my insurance plan help save me money?

Take time to find out about how your medical insurance or
managed health care plan covers medication costs. Some insurance companies
cover only generic medications if they are available. With some insurance
plans, you may have to pay more for medications that are not on the plan’s list
of preferred medications. Some insurers cover medications that are bought only
at participating pharmacies. Your insurance company also may not pay for
certain medications such as weight-loss and hair-growth drugs. Ask the customer
service representative whether your medications are covered, whether you need
to buy at participating pharmacies, and about your copayment. Many insurance
companies also list this information on their Web sites.

If you have a choice between plans, check what your copayment for
prescription drugs will be, the maximum amount the plan will pay in a year, and
other particulars. Choose the plan that best suits your needs. When buying
medications, find out which payment option will be the least expensive. Some
factors to consider include whether there is a generic version of a preferred
medication, and whether an over-the-counter equivalent is cheaper than your
copayment. Remember, having the right information can save you time and
money.

What about the Medicare drug program?

Beginning in January 2006, a new Medicare drug program-the
Medicare Part D prescription drug benefit-will begin. For the most current
information about what the Medicare Part D Act means for you, go to
http://www.medicare.gov or call 1-800-MEDICARE. Your doctor, pharmacist, or
social worker may also be able to help you understand
your Medicare benefits.

What other resources are available?

See whether the pharmaceutical company that makes your
medication has a patient assistance program. Many pharmaceutical companies
offer free or discounted drugs for people who cannot afford them. These
companies often require that your doctor contact them first about your case. In
any case, your doctor will need to be involved, and the application process can
be complex. You may need to provide sildenafil citrate 100mg to verify your income. The
nonprofit organization RxAssist provides doctors and other health care
providers with the information they need to access these programs. You can find
out more at http://www.rxassist.org. This Web site
also lists state programs for seniors and disabled and low-income people.

If you have a rare disease, you may be eligible for the National
Organization for Rare Disorders (NORD) medication assistance program. This
program helps people with rare diseases whose income is too high to qualify for
Medicaid but too low to pay for their prescribed medications. For more
information, visit http://www.rarediseases.org/programs/medication.

Most veterans know that the Veterans Administration offers
prescription drug coverage for retired veterans. But many people don’t know
that the same service is available for their families and survivors. Call the
VA Health Benefits Service Center toll-free at 1-877-222-VETS (8387), or go to
http://www1.va.gov/health_benefits/.

Some organizations offer special discounts on prescription drugs
for their members. For example, members of AARP save 17% on brand drugs and at
least 50% on generic drugs. Also, many pharmacies offer some form of a discount
plan for seniors.

Diabetes is a very common cause of erectile dysfunction (ED). Clinical
experience and numerous studies suggest that at least 50% of diabetic patients
will experience difficulties with erections. When compared to nondiabetic men,
men with diabetes are up to 3 times more likely to have ED and appear to get it
earlier in life. The significance of ED increases with the severity and
duration of diabetes as well as with advanced age.

There is evidence that controlling blood sugars and cholesterol as well as
participating in a consistent exercise program may help in preventing the
development of ED and, in some cases, may even improve symptoms in those with
ED. If you are one of the many men with diabetes and ED, you have many
treatment options to consider, including:

Oral Drugs

The three oral medications available — Viagra, Cialis, and Levitra — to
treat ED have been used generic viagra pay with online check
in people with diabetes. In general,
however, the success rate of these medications is less than the reported
success rates in people without diabetes. These medications may help 50% to 60%
of men with diabetes.

Injection Treatment

When oral medications are ineffective, generic viagra overnight delivery injection therapy (the
injection of medication directly into the erection chamber of the penis) may be
helpful in facilitating intercourse. Among diabetic men, the success rates with
this method range from 60% to 80%. The medications used include:

• Alprostadil (brand names Caverject Impulse, Edex, and Prostin VR)
• Papaverine hydrochloride
• Phentolamine mesylate

In many cases, it may take a mixture of the three medications to produce an
adequate response. Although injections may be reasonably effective in diabetic
patients, about 50% of users stop after several years.

Vacuum Constriction Devices (VCD)

VCDs have been helpful in
facilitating intercourse among diabetic patients. They work in up to 80% of
users; however, like injection therapy, many people discontinue treatment after
several years.

This device consists of an acrylic cylinder that is placed over the penis. A
lubricant is used to create a good seal between the body and the cylinder. A
pump mechanism is used to create a vacuum inside the cylinder, allowing a
patient to achieve an adequate erection. If an adequate erection can be
achieved, a band or ring is then placed over the base of the penis (the part of
the penis closest to the body) and is used to help maintain the erection.

Learn more about vacuum constriction
devices.

Ed meds
Therapy

This treatment involves using an applicator to place a suppository or pellet
containing medicine into the urethra (canal in the penis that carries
urine).

Learn more about intraurethral
therapy.

Penile Implants

Clinical studies have shown a high degree of patient erectile dysfunction pills
with
penile implants when other therapies have not worked. Patients need to be
suitable surgical candidates and it is preferable that patients have reasonably
good diabetic control before surgery.

Learn more about penile
implants.

Get the facts about diabetes and
ED.

View the full table of contents
for the ED guide.

Reviewed by the doctors at the Glickman Urological
Institute at The Cleveland Clinic.

Doctors in primary care fields often hear their patients complain of night sweats. Night sweats refer to any excess sweating occurring during the night. However, if your bedroom is unusually hot or you are using too many bedclothes, you may begin to sweat during sleep–and this is normal. In order to distinguish night sweats that arise from medical causes from those that occur because ones surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment. In one study of 2267 patients visiting a primary care physician, 41% reported experiencing night sweats during the previous month, so the perception of excessive sweating at night is fairly common. It is important to note that flushing (a warmth and redness of the face or trunk) may also be hard to distinguish from true night sweats. There are many different causes of night sweats. To determine what is causing night sweats in a particular individual, a doctor must obtain a detailed medical history and order tests to decide if an underlying medical condition is responsible for the night sweats. Some of the known conditions that can cause night sweats are: Menopause The hot flashes that accompany the menopausal transition can occur at night and cause sweating. This is a very common cause of night sweats in perimenopausal women. Idiopathic hyperhidrosis Idiopathic hyperhidrosis is a condition in which the body chronically produces too much sweat without any ed meds medical cause. Infections Classically, tuberculosis is the infection most commonly associated with night sweats. However, bacterial infections, such as endocarditis (inflammation of the heart valves), osteomyelitis (inflammation within the bones), and abscesses all may result in night sweats. Night sweats are also a symptom of AIDS virus (HIV) infection. Cancers Night sweats are an early symptom of some cancers. The most common type of cancer associated with night sweats is lymphoma. However, people who have an undiagnosed cancer frequently have other symptoms as well, such as unexplained weight loss and fevers. Medications Taking certain medications can lead to night sweats. In cases without other physical symptoms or signs of tumor or infection, medications are often determined to be the cause of night sweats. Antidepressant medications are a common type of medication that can lead to night sweats. All types of antidepressants can cause night sweats as a side effect, with a range in incidence from 8 to 22% of persons taking antidepressant drugs. Other psychiatric drugs have also been associated with night sweats. Medicines taken to lower fever such as aspirin and acetaminophen can sometimes lead to sweating. Other types of drugs can cause flushing, which, as mentioned above, may be confused with night sweats. Some of the many drugs that can cause flushing include: niacin (taken in the higher doses used for lipid disorders), tamoxifen, hydralazine, nitroglycerine, and sildenafil (Viagra). Many other drugs not mentioned above, including cortisone medications such as prednisone and prednisolone, may also be associated with flushing or night sweats. Hypoglycemia Sometimes low blood glucose can cause sweating. People who are taking insulin or oral anti-diabetic medications may experience hypoglycemia at night that is accompanied by sweating. Hormone disorders - Sweating or flushing can be seen with several hormone disorders, including pheochromocytoma, carcinoid syndrome, and ed medicine . Neurologic conditions Uncommonly, neurologic conditions including autonomic dysreflexia, viagra for woman study syringomyelia, stroke, and autonomic neuropathy may cause increased sweating and possibly lead to night sweats.

multiple sclerosis (MS) may be used: During a relapse, to make the attack shorter and less severe. Over a long period of time, to alter the natural course of the disease (disease-modifying therapy). To control specific symptoms as they occur. Controlling a relapse Medications can shorten a sudden relapse and help you recover more quickly. Temporary treatment with medications called corticosteroids is the most common treatment used to control a relapse. These medications have not been shown to affect the long-term course of the disease or to prevent disability. Altering the course of MS using disease-modifying treatment Strong evidence suggests that MS is caused by the immune system causing inflammation and attacking the myelin-the coating surrounding the nerve and nerve fibers. Medications that change the activity of the immune system can reduce the number and severity of attacks that damage the protective myelin. Currently, interferon beta (Avonex and Rebif, and Betaseron), glatiramer acetate (Copaxone), and mitoxantrone (Novantrone) are the only medications that have been approved for this purpose. For people with free viagra order online MS, these medications can reduce the number and severity of relapses and can result in fewer brain lesions. They may also delay disability in some people. Betaseron and Novantrone may delay disease progression in some people with secondary progressive MS. Currently, there is no effective disease-modifying treatment for primary progressive MS. Relieving symptoms Treating specific symptoms can be effective, even if it does not stop the progression of the disease. Symptoms that can often be controlled or relieved with medication include: Fatigue. Medications to reduce fatigue or help you sleep better may include amantadine (Symmetrel), modafinil (Provigil), or fluoxetine (Prozac). Muscle stiffness (spasticity) and tremors. Medications that may reduce muscles spasms or stiffness include baclofen (Lioresal), tizanidine (Zanaflex), dantrolene (Dantrium), gabapentin (Neurontin), diazepam (Valium), or clonazepam (Klonopin). Sometimes a combination of these medications works best to reduce your muscle symptoms. Urinary problems and constipation. Medications used to reduce frequent urination may include propantheline (Pro-Banthine), oxybutynin (Ditropan), or tolterodine (Detrol). Medications sometimes used to relieve constipation include bulk agents such as psyllium (Metamucil) or daily use of laxatives. Pain and abnormal sensations. Depending on the severity of the pain, both prescription and treat erectile dysfunction the best medications may be tried. Prescription medications commonly used to reduce pain associated with MS include baclofen (Lioresal), carbamazepine (Tegretol), or gabapentin (Neurontin). Nonprescription medications may include acetaminophen, ibuprofen, or naproxen sodium. Depression. Antidepressant medications may be used to reduce depression that often occurs as a result of having MS. Antidepressants often tried include tricyclic buy generic online viagra as amitriptyline (Elavil), desipramine (Norpramin), or imipramine (Tofranil)-or selective serotonin reuptake inhibitors (SSRIs)-such as fluoxetine (Prozac) or sertraline (Zoloft) among others. Sexual difficulties. Medications used to relieve sexual difficulties that can be associated with MS include sildenafil (Viagra) for both men and women. Yohimbine and clomipramine may also be given to improve erectile dysfunction. MS can affect many parts of the nervous system and produce a wide range of symptoms. The choice of medications depends on your symptoms. Medication may be used only some of the time or regularly, depending on how severe or constant a particular symptom is. Changes in diet, schedule, exercise, and other habits can also help manage some of these symptoms. See the Home Treatment section of this topic. Medication Choices Symptom management Medications used to treat symptoms of an attack of multiple sclerosis (MS) and help you recover more quickly from a relapse include: Corticosteroids (such as methylprednisolone). ACTH (adrenocorticotropic hormone). Intravenous immunoglobulin (IVIG) or plasma exchange (neither is used frequently). Ed meds MS Medications used specifically for relapsing-remitting MS to reduce the number and severity of relapses and possibly delay disability include: Interferon beta (Avonex, Rebif, and Betaseron). Glatiramer acetate (Copaxone). Mitoxantrone (Novantrone) for relapsing-remitting MS that is rapidly getting worse. Secondary-progressive MS Medications used to treat and possibly delay the progression of secondary progressive MS that is also relapsing include: Interferon beta-1b (such as Betaseron). Mitoxantrone (Novantrone). Primary-progressive MS No medicines have been clearly proven to help, and none have been approved for primary-progressive MS. Some of the newer and experimental medications, such as immunosuppressants and other medications and biological chemicals (derived from or identical to substances produced by the body) are being tested for primary-progressive MS. Medications being studied A variety of immunosuppressants and other medications and biological chemicals (derived from or identical to substances produced by the body) have been tried as therapy for MS. While none have been clearly proven beneficial and none have been approved for treatment of MS, these medications may be used when standard therapy fails. Several medicines are currently being tested in clinical trials. People with MS who have not responded to standard therapy sometimes choose to participate in these trials. To learn more about clinical trials, talk to your doctor or contact the National Multiple Sclerosis Society at http://www.nationalmssociety.org. What To Think About Long-term treatment with interferon beta and glatiramer acetate can improve the quality of life for some people who have relapsing-remitting MS by making relapses less frequent and less severe. Some evidence suggests that these medications may also reduce or delay future disability caused by this form of the disease. The National Multiple Sclerosis Society recommends that treatment with interferon beta or glatiramer acetate be started as soon as it is clear that you have MS. Most neurologists support this recommendation and now agree that permanent damage to the nervous system may occur early on, even while symptoms are still quite mild. Early treatment may help prevent or delay some of this damage. In general, treatment is recommended until it no longer provides a clear benefit. Despite the recommendation, however, some people find it difficult to decide whether to begin disease-modifying therapy, especially when their symptoms have been fairly mild. Some may not want to bear the risks and flu-like side effects of interferon therapy when they are not sure they need it. Some may want to see whether their disease worsens before starting therapy. A small percentage of people diagnosed with MS may never have more than a few mild episodes and may never develop any disability, but the disease is unpredictable. For more information, see: Should I have disease-modifying therapy for MS? If you decide not to try disease-modifying therapy at this time, work with your doctor to monitor your health through regular checkups and periodic MRI scans to evaluate whether the disease is progressing. If new lesions are developing or existing lesions are growing, you may want to reconsider your decision and begin treatment. Treating symptoms and relapses The need and desire for medication vary. If your symptoms are mild, you may choose to manage them without any medication. If you have specific symptoms that are causing problems, certain medications may help you keep them under control. Or you may want to use medication only during a relapse. You may also want to consider: The possible side effects of using steroids or other medications to treat symptoms or control a relapse. Some people have only minor side effects, but others may have side effects that concern them more than their MS symptoms. The costs of treating symptoms and controlling relapses. In some cases, using medication to control symptoms and relapses may reduce the need for hospital stays. Other personal issues that you face at work or at home. Also keep in mind that it can be hard to tell whether medication is helping. Multiple sclerosis is a disease with spontaneous remissions, which means that your condition can improve on its own, without any treatment. Just because your symptoms improve after treatment does not mean that a treatment is working.