Is erectile dysfunction a problem with the veins?

A: Erectile dysfunction (ED) has many causes. Because male sexual arousal involves a complex coordination between the brain, peripheral nervous system, blood vessels (veins and arteries), muscles, hormones, as well as one's emotional state, anything that goes wrong with any of these components could contribute to ED. When it comes to blood vessels it's more common for arterial problems to cause ED, rather than venous problems. The most common arterial problem which contributes to ED is atherosclerosis – the hardening and narrowing of arteries due to plaques which build up inside them. Yes, this is the same atherosclerosis that can lead to heart disease. Atherosclerosis reduces the amount of blood that arteries can deliver to the heart and penis which, over time, can lead to heart disease and ED. As a matter of fact, because the arteries supplying the penis are much smaller than those supplying the heart, symptoms of atherosclerosis may first manifest as ED. Some even say that ED can be an early sign of heart disease. In this case, part of the treatment for ED is the same as for atherosclerotic heart disease – lifestyle changes, including weight loss, stopping smoking, and healthy dieting. More serious cases may warrant further investigation and treatment.

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Can Generic and Mail Order Drugs Save Us Billions?

The 2010 Drug Trend Report, a study on medication usage in the U.S., suggests that most patients prefer generic drugs and mail-order pharmacies. According to the report, sponsored by Express Scripts, 82% of patients who use brand name medications actually prefer generics. As well, 70% of patients who use retail pharmacies to fill medications for chronic conditions prefer to use a home delivery pharmacy because of discounts offered by their insurance companies. The study suggests that if physicians were to heed patient preferences in this manner, it could eliminate up to 33% of wasteful dollars spent on pharmacy-related costs annually. This amounts to a total of $134 billion dollars. Express Scripts is a publicly traded American company with a revenue of $25 billion and net income of over $800 million in 2009.