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Active Living
Full Listing with story descriptions
A Healthy Balance
Ankle Sprains
Active Kids, Healthy Kids
Active Kids in Winter
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Children, Nutrition & Exercise
Beat the Heat!
Cold Weather Workouts
Concussions
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Exercise and Disabilities
Exercise and Menstrual Irregularities
Exercise in the Cold
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Exercise is Medicine
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FITT Prescription
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From Surviving to Thriving
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Get Moving!
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Jump Start Weight Loss
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Live Actively
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Prehistoric Workout
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7 Wonders of Walking
Adolescent Health
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Acne
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Chronic Diseases in Teens
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A Woman's Physical
Your First Job
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Childbirth
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Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
Building a Better Baby
Birthing Etiquette
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Birthing Procedure Trends
Bleeding in Pregnancy
Breastfeeding Benefits
Caesarean Section by Request
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Cord Blood Banking
Delaying Motherhood
Blue after Baby or Postpartum Depression
Diabetes in Pregnancy
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Evolving Ideas about Pregnancy and Birth
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Folic Acid in Pregnancy
High Blood Pressure in Pregnancy
Getting a latch on breastfeeding
Group B Streptococcus
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Low Birth Weight Babies
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Nausea & Vomiting in Pregnancy
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Prenatal Classes
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Planning a Pregnancy
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Prenatal Care Providers
Postpartum Repetitive Strain Injuries
RH Disease
Rupture of Membranes Before Labour
Sex During Pregnancy
Skin Changes in Pregnancy
Smoking and Pregnancy
Support During Labour
Travelling While Pregnant
Ultrasound for Fun & Photos
Natural Remedies in Pregnancy
Vaccinations During Pregnancy
Vacuum & Forceps for Delivery
Vaginal Birth After Caesarean
When Baby Comes Home
Childhood
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Children and Sports Injuries
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Not Just Baby Fat
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Safe Summer Fun
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When to go to the Doctor
Whooping Cough
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Yeast Infections in Children
Chronic Pain
Full Listing with story descriptions
Introduction
Managing Your Pain
Movement Matters
Moving Forward
Nutrition
Opioids
Pacing
Pain Medications
Prevention
Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
Full Listing with story descriptions
Antibiotics and Dental Surgery
Baby Bottle Tooth Decay
Baby Teeth
Bad Breath (Halitosis)
Children's Dental Injuries
Choosing a Dentist
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First Dental Visit
Headaches
A Healthy Mouth
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Laser Use in Dentistry
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Orthodontist First Visit
Painless Dentistry
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Root Canal
Seniors Oral Care
Sensitive Teeth
The Smile You Want
Sore Mouth, Aching Jaw
Snoring and Sleep Apnea
Smiling through the Senior Years
Teeth for Life
Temporomandibular Disorders (TMD)
Tobacco Risks to Oral Health
Tongue Piercing
Tooth Whitening
Travel Dentistry
Water Fluoridation
Wisdom Teeth
Your Healthy Smile
DIABETES
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10,000 Steps
A1C Test
Accurate Blood Glucose Testing
Alchohol and Diabetes
A Diabetes Success Story
ABCs of Diabetes Management
Alternate Site Testing
Artery Health
ASA Therapy
Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
Blood Glucose Myths
Blood Glucose Testing
Blood Glucose Testing Tips
Blood Sugar Lows
Blood Glucose Monitors
C-Peptide Testing
Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Celebrating Health
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Constipation
Continuous Blood Glucose Monitoring
Cutting Edge
Dangers of Uncontrolled High Blood Pressure
Debunking Diabetes Myths
Driving and Diabetes
Diabetes and Menopause
Diabetes and OTC Medications
Diabetes Care Team
Diabetes and Celiac
Diabetes and Depression
Diabetes Diet
Diabetes Distress
Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
Diabetes and Oral Health
Diabetes and Thyroid Disease
Diabetes and Your Mouth
Diabetes and Your Eyes
Diabetes in Cats
Diabetes in Dogs
Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
Diabetic Ketoacidosis
Diabetic Retinopathy
Diet Tips for South Asians
Dining Out
Drinking and Diabetes
The Discovery of Insulin
Eating Disorders
Easing the Strain of Stress
Eating to Protect Your Kidneys
Eating Well During Shift Work
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
Exercise Excuses
Why Fad Diets Fail
Fats
Fibre
Fill Your Day with Energy
Financial Support for Diabetes
Food Temptation
Foot Care
Footwear and Foot Health
Fruits and Veggies
Gastroparesis
Gestational Diabetes
Get Active
Get Physical
Gift Ideas
Glucose Meters
Glycemic Index and Glycemic Loads
The Glycemic Index
Going Green in the Kitchen
Grocery Shopping Tips
Guidelines for Diabetes Management
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
Healthy Beverage Choices
Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
Hypoglycemic Unawareness
Impaired Glucose Tolerance
Immunization & Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin
Insulin Handling
Insulin - the Key to Energy Management
Insulin Pumps
Insulin Pen Needles
Insulin Pump Infusion Sets
Insulin Pump Therapy
Immunization and Diabetes
Internet Health Sites
Islet Cell Transplantation
Insurance
Ketones
Kidney Disease - Reducing the Risk
Living with Diagnosis of Diabetes
Living Powerfully with Diabetes
Low Blood Glucose
Managing Diabetes
Managing Blood Glucose
Metformin
Nutrition Food Labels
Meal Planning
Your Medication Expert
Medication Research Studies
Metabolic Syndrome
Microalbuminuria
New Diabetes Technologies
Natural Medicines and Diabetes
No Need for Insulin?
Not Snoozing
Over-the-Counter Medications
Oral Health and Diabetes
Osteoporosis and Diabetes
Diabetes and OTC Medications
Pedicure Precautions
Peripheral Arterial Disease
Pet Diabetes
Planning for Pregnancy
Prebiotics and Probiotics
Preparing for Activity
Putting off Insulin
Reducing Stress of Surgery
Safe and Successful Travel
Schizophrenia and Diabetes
Sensible Snacking
Setting Health Goals
Setting Goals for Physical Activity
Sharps Disposal
Shorter Insulin Needles
Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
Snacking with Diabetes
Sodium
Social Media & Diabetes
Solving the Insurance Puzzle
Stress and Diabetes
Success in School
Supplements
Supporting Spouse with Diabetes
Sweeteners
Sugar, Carbs and Blood Glucose Control
Think Positive with Diabetes
Tiny Bites Equal Big Calories
Travelling with Diabetes
Tips for a Better You
Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
Type 2 Diabetes
Understanding Diabetes
Understanding Diabetes Medications
Understanding Ketones
Used Sharps
Urinary Incontinence
Vacationing with Diabetes
Vegetarian Eating for Diabetes
Vitamin D
Walking
Wise Choices About Natural Medicines
Wonderful Water
Natural Medicines & Diabetes
World Diabetes Day
Your Medicine Cupboard
Zimbabwe Hand Jive
Family Medicine
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ADHD in Children
Allergic Rhinitis
Allergies
Antibiotic Use
Arthritis
Aspirin Every Day?
Asthma
Back Pain
Back Pain Myths
Back Pain - Lower
Birth Control
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Check-Up
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Contact Lenses
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Cost of Doctor's Visit
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Do I Need a Bone Density Test?
Doctor Visit
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Does My Sore Knee Require an MRI?
Do I Need an Annual Physical?
Eczema
Electronic Medical Records
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Family Doctor
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Floaters and Flashes
Food Poisoning
5 Ways to Stay Healthy
Gallbladder
Get Active!
Glare
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Human Papilloma Virus
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High Blood Pressure Risks
How to Talk to Your Doctor
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Lazy Eye Blindness (Amblyopia)
Medical Digital Technology
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Opioid Myths
Primary Healthcare Reform
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Restore Your Core
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Stroke
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Vaccination Controversies (ask the doctor)
Win by Losing
Urinary Tract Infections
Vision Flickers
First Aid
Full Listing with story descriptions
Bites and Stings
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First Aid Travel Kit
Hypothermia and Frostbite
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Growing Older
Full Listing with story descriptions
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Can I see Well Enough to Drive?
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Eating Well
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Get Active!
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Have Health, Will Travel
Health Tips for Seniors
Hearing
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Living Longer With Diabetes
Macular Degeneration
Male Menopause (Andropause)
Maintaining Quality of Life as You Age
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New Corneal Treatments
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Seniors and Medications
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Skin Over 50
Solving Sleep Issues
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Travel Tips for Snowbirds
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Modern Living
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Abuse
Acupuncture
Adult ADHD
Aging and Memory
Alcohol and Your Health
Anger Management
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Barbecue Basics
Bathtub Safety
Binge Drinking
Bisphenol A
Canada's New Blood System
Caring for a Loved One Dying at Home
Carpal Tunnel Syndrome
Computer Stress
Coping With Change
Cosmetic Surgery
Cosmetic Pesticides
Depression
Diabetes Epidemic
Discipline
Diseases from Pets
Downsizing
Dying at Home
Erectile Dysfunction New Treatments
Exotic Travel
Fertility Issues
Fetal Alcohol Spectrum Disorder
Foodborne Illness
Flu Pandemic
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Healing Through Music
Healthy Computing
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Mature Student
Melamine in Food
Middle Age Health
Mind-Body Connection
Mom Time
Money Matters
Outdoor Workers and Sun Safety
Patient Safety in the Hospital
Pets and Health Benefits
Pet Therapy
Physiotherapy Visit
Planning for End of LIfe
Reproductive Freedom
Safe Drinking Water
Schizophrenia
Smokeless Tobacco
Sexually Transmitted Diseases
Soy
Stigma of Mental Illness
Street Drugs
Stressed or Depressed?
Stress in the Workplace
Stress Leave
Swim to Survive
Sunburn
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Travel Comfort Tips
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Whiplash
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Nutrition
Full Listing with story descriptions
5 Tips to Manage Weight
10 Ways to Cut Down on Fat
Battle the Bulge
Boost Your Bone Strength
Body Image
Breakfast is Important
Bowel Health
Building Your Bones
Celiac Disease
Challenging the Milk Myth
Diet Reality Check
Drink Up!
Eating Smarter & Cheaper
Energy Drinks
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Food for Active Kids
Fast Food
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Healthy Diet, Healthy Smile
Healthy Eating for Boomers and Zoomers
Healthy Eating for Seniors
Healthy Eating on Business Travel
Healthy Ethnic Meals
Fad Diets
Fruits & Veggies - 5-10 a Day
Fats
Fat Phobias
Fats & Cholesterol
Feeding Your Kids
Fibre
Food Chemistry 101
Food and Mood
Getting Kids to MOVE
Healthy Eating for Teens
Healthy Habits
Herbal Medicine and Nutrition
New Ingredients for Your Shopping Cart
Iron
Kid's Food
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Meal Planning with Planned Overs
Mercury Levels in Fish
Night Snacking
Night Shift Eating
Nutrition on the Net
Nutrition Myths Busted
Nutrition Questions Top 5
Nutrition for Menopause
Essential Omega-3
Preventing Cancer Through Nutrition
Picky Eaters
Power of Fruits & Veggies
Portion Control
Power Lunch
PMS and Nutrition
Preparing for Surgery
Probiotics
Reducing High Blood Pressure
Replacement Meals
Sensible Snacking
Sodium
Sodium and Blood Pressure
Sports-Minded Nutrition
Sugar Substitutes
Survive and Thrive
Teen Nutrition
Tips for a SuperDiet
Understanding Food Biotechnology
Vacation Eating
Vitamins D
Vitamins and Minerals
Vegetarian Diet
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Weight Wise Tips
Pharmacy Care
Full Listing with story descriptions
After a Heart Attack
Adverse Drug Reactions
Adult Vaccinations
Allergy Attack
Antibiotic Overuse
New Anticoagulant Medications
Inhaled Asthma medications
Arthritis Medications
Biologics
Biological Response Modifiers
Blood Pressure Monitoring
Blood Thinners
Calcium and Iron Supplements
Changing Role of the Pharmacist
Children's Cold Remedies
Child's Fever
Choosing Sunscreens
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Cold Sores
Constipation and Haemorrhoids
Diuretics and Potassium Supplements
Drug Recalls and Withdrawals
Drug Interactions
Emergency Contraception
Erectile Dysfunction
Expanding Role of Pharmacies
Eye Protection - Sunglasses
Feminine Hygiene
Generic or Name Brand?
Heartburn
Heart Health
Insomnia
Kids and Cold Medications
Medication Questions?
Metabolic Syndrome
Natural Medicines
New Blood Thinners
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Over-the-Counter Drugs and Pregnancy
OTC Pain Relief
Packing Medications for Travel
Pharmaceutical Studies
Preventing Summer Hazards
Research Studies
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Sports & Nutrition Supplements
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Taking Medication
Take as Directed
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Viagra
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Your Best Shot
Your Medicine Cupboard
Prevention
Full Listing with story descriptions
Accident Prevention
Alcohol
Antibiotic Resistance
Backpack Pain
Bacteria Fight Back
Bedbugs
Disaster Planning
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Caffeine
Cell Phones and Driving
Childhood Obesity
Cancer Prevention Tips
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Cold and Flu Season
Disaster Planning
Diseases from Pets
Distracted Driving
Farm Safety for City Kids
Foodborne Illness
Flu Pandemic
The Flu and You
Heading Home for a Visit
Health Tips for Snowbirds
Hearing Loss and Music Players
H1N1 Virus - Plan Ahead
Household Mould
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Live Actively!
Insect Repellant
Keys to Preventing Cancer
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Live Actively!
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Are Pesticides Safe?
Preventing Burns and Scalds
Preventing Cancer through Nutrition
Quit Smoking 101
Respiratory Infections
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Should You Immunize?
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Teens, Drugs and Driving
Travel Health Considerations
Travel Medicine 101
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Workplace Alcohol Abuse
Women's Health
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15 Great Reasons to Breastfeed
Anemia
Approaching Menopause
Birth Control
Breast Cancer Screening
Breast Cancer - Genetic Risks
Breast Cancer Self-Exam
Breast Cancer Screening Guidelines Changes
Breast Health
Breastfeeding Myths
Cervical Cancer Screening
Contraception
Contraception for Mature Women
Cosmetic Procedures
Cystitis
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Estrogen's Effect on the Brain
Fear of Fracture
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Hirsutism - Unwanted Hair
Hormone Replacement Therapy
The IUD
Menopause - What Men Should Know
Menstrual Bleeding - Abnormal
Menstrual Bleeding - Heavy
Menopause
Menstruation Myths
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Third Generation Birth Control Pills
Osteoporosis
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Oral Contraction (The Pill)
Pap Test
Premenstrual Syndrome
xx
Sexually Transmitted Infections
Urinary Incontinence
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Viagra for Women
Yeast Infections
Your Pelvic Floor
Family Health Online / Pharmacy at Safeway
Family Health Magazine - PHARMACY CARE

Erectile Dysfunction
Drug treatment choices for a common problem

Erectile dysfunction (ED) is a very common problem for men between the ages of 40 and 70. ED is the inability to achieve an adequate erection for sexual intercourse. Although it is a common condition, this is not a comfortable topic for many people. Fortunately, this attitude is changing as more research and studies are done to help treat ED.

To learn how ED treatments work, the medical condition itself must be understood. When a man is sexually aroused, increased blood flow to the penis makes it firm (an erection). Both physical and mental problems can interfere with this process. Blood vessel, nerve, hormonal or emotional problems, or a combination, can all cause ED. Certain medications (see Table 1) can also contribute to the problem.

Pre-existing conditions can also cause ED. Anxiety, Alzheimer disease, depression, diabetes, high blood pressure, or hypothyroidism (underactive thyroid) can all play a role. Problems with the prostate (the gland that sits at the base of a man's bladder) may bring on ED.

Lifestyle choices, such as smoking and drinking excessive amounts of alcohol, can damage blood vessels in the penis, causing ED.

Drug treatments

It is important that assistance for ED fits the specific need. It might include counselling for an emotional problem or surgery for certain physical problems. ED drug treatments may also help. Your doctor can help you decide if you are a candidate for medications that treat ED. Several ED medications are commonly used. Learning about the options can help you understand the choices available.

Table 1
Medications that
can cause ED

  • Tricyclic antidepressants
    (e.g. amitriptyline, desipramine, nortriptyline)
  • Anti-Parkinson's medications
  • Phenothiazines
  • Metoclopramide
  • Barbiturates
  • Narcotics
  • Benzodiazepines (e.g. lorazepam, oxazepam, temazepam)
  • Digoxin
  • Spironolactone
  • Ketoconazole
  • Cimetidine
  • Diuretics
  • Beta-blockers
  • Methyldopa
  • Clonidine

Phosphodiesterase type 5 (PDE5) inhibitors
Undoubtedly, the most common medication for ED is that little blue pill, Viagra.™ Its chemical name is sildenafil. Viagra™ belongs to a class of medications called PDE5 inhibitors. Other PDE5 inhibitors include Cialis™ (tadalafil) and Levitra™ (vardenafil). All three are only available from a pharmacy with a prescription from your doctor. PDE5 inhibitors work by blocking the action of PDE5 in the body. This indirectly causes the smooth muscles in the penis to relax and allows blood to flow into the penis. If the man is sexually aroused, increased blood flow will cause an erection. Although none of the PDE5 inhibitors are currently found to be effective or safe in women, scientists are still doing research on this topic.

The most common side effects for all three PDE5 inhibitors include headache, nasal congestion, indigestion, and flushing of the face. Viagra™ may also affect vision more than the other two medications. Visual side effects can include altered color perception and blurred vision. All of these side effects usually go away over time, or in some people, once medication has been stopped.

None of the three PDE5 inhibitors can be taken with any alpha-blockers or nitroglycerin products, such as nitrate sprays, patches or tablets. Combining PDE5 inhibitors with nitrates or alpha-blockers will make blood pressure drop significantly in a short period of time. This can be life-threatening.

However, it is difficult to avoid nitrates altogether because they are frequently used in emergency situations, such as in heart attacks. So, nitrates should not be given within 24 hours of taking Viagra™ or Levitra,™ and not within 48 hours after Cialis.™

If you are taking certain medications, the dose of PDE5 inhibitors should be decreased. Various antifungals, antibiotics, and other medications are part of this list. Feel free to talk with your doctor or pharmacist about whether any of your medications conflict with PDE5 inhibitors.

The following medications can interact with PDE5 inhibitors:

Viagra™ should be taken on an empty stomach. If it is taken after a high-fat meal, the medication would not absorb well into the body and would be less effective. High-fat meals affect Levitra™ the same way they affect Viagra™. However, Cialis™ is not affected by the presence of food or high fat meals at all. Medication should be taken about an hour before sexual activity.

Cialis™ is marketed as the longest-acting, with effects lasting up to 36 hours after taking it. Viagra™ and Levitra™ are effective for up to six to eight hours. Again, it should be stressed that an erection will only occur in these time frames if the man is sexually stimulated. PDE5 inhibitors should also not be taken more than once per day or more than the amount prescribed. Those with kidney or liver diseases may be prescribed lower doses.

It may be hard to tell which PDE5 inhibitor is best for you. The three have not yet been compared in a research study. As a result, there is no concrete scientific evidence pointing to the best PDE5 inhibitor for everyone. Different men have various successes with each one. Speak to your doctor or pharmacist about which you should try for the best results.

Alprostadil
Alprostadil is also known as prostaglandin E1. It increases production of another chemical in the smooth muscle of the penis. The smooth muscle then relaxes, allowing blood flow into the penis and an erection.
Alprostadil is available in two different forms. One is Muse,™ a pellet containing alprostadil inserted into the urethra (see illustration). (The urethra is the tube that carries urine from the bladder out of the body.) The other is Caverject,™ or alprostadil, which is injected into the corpora cavernosa of the penis. The injection has been found to be more effective than the insert.

Both methods of medication delivery have the side effect of pain in the penis with an erection. Both are effective within 15 minutes of application. Priapism (a long-lasting erection) can occur with both routes, too. If an erection lasts for four hours or more, medical attention should be sought. This is a medical emergency. The partner of a man using the insert may experience irritation of the vagina, such as itching, burning, or even pain.

Both the alprostadil injection and insert are highly effective. However, many people find them inconvenient and not spontaneous. Talk to your doctor or pharmacist first to decide if the injection or insert may be right for you.

Testosterone replacement therapies
Testosterone replacement therapies are prescribed for hypogonadism (when sex glands do not release enough or any hormones). Blood tests can confirm low levels of testosterone. Since low levels are linked to decreased sex drive (libido), this may cause ED in some men. Testosterone replacement products help correct the hormone imbalance. If low testosterone levels are causing ED, this will correct the problem

Testosterone replacement therapies are available orally as tablets or capsules, by intra-muscular injection, or as topical gels or patches that are applied to the skin. The injection is the most effective and least expensive version. Though oral forms may cause liver toxicity, this is not a problem with the injection. Still, many people do not choose this method since injections are invasive and painful. Testosterone gels and patches are the most expensive form. However, many people find these products comfortable and easy to use.

Testosterone products can cause side effects, including gynecomastia (breast tissue growth in men), retaining of sodium, acne, and increased LDL (bad) cholesterol with decreased HDL (good) cholesterol. Worsened prostate cancer or benign prostatic hyperplasia (where the prostate has grown larger) can also result. As previously mentioned, oral testosterone can also be toxic to the liver.

Testosterone replacement products are not right for everyone. Proper blood tests and diagnosis by your doctor are necessary when considering these medications. If you think that they might help you, talk with your doctor.

ED is a serious problem for many men and can make relationships difficult. If you have the courage to face this medical condition, you can treat and possibly overcome ED. Take advantage of the resources around you, and talk to your doctor and pharmacist about what can be done for you.

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FAMILY HEALTH is written with the assistance of
College of Family Physicans of Canada
Alberta College of Family Physicians
FAMILY HEALTH is written
with the assistance of
The College of Family Physicans of Canada
Alberta College of Family Physicians
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