Drinking and sex a bad mix

Question: I am a virile, sexually active, middle-aged male. Prior to engaging in sex, my partner and I enjoy imbibing alcoholic beverages to loosen up/set the mood. How is it that alcohol has a positive effect on achieving an erection? Would testosterone supplements help?

?Answer: Alcohol, in moderate quantities, helps to reduce anxiety, stress, and inhibition through its role as a central nervous suppressor. Psychological impotence and performance anxiety can be helped by a modest amount of alcohol before initiating sex. It can slow the heart rate and increase the activity of the parasympathetic nervous system - the nerves that regulate digestion, slow down the heart rate, and increase the flow of blood into the penis and clitoris. Too much alcohol will lead to reduced motor (muscle) control, reduced cognitive faculties, euphoria, sedation, and unconsciousness. That said, the experts who study alcohol and its long-term effects don't recommend alcohol use before or during sex - especially in older men. Alcohol consumed too much and too often may eventually have a negative effect on all organ systems of the body, including those that are involved with sexual function.

Testosterone supplementation is useful only when you have a low blood testosterone level with a decreased libido/stamina. Testosterone replacement isn't helpful when you have a healthy libido and an erectile dysfunction problem. For that, medications like Viagra, Levitra or Cialis are the recommended treatment.

?Q: A friend of ours has a form of leukemia called "AML." He's currently receiving chemotherapy, but not doing well. Do you know of any hospitals where they may be doing research to find a cure for this cancer?

?A: Acute Myelogenous Leukemia, also referred to as "AML," is a cancer of the blood in which immature, abnormal white blood cells grow rapidly and uncontrollably in the bone marrow and interfere with the bone marrow's ability to produce red blood cells, healthy white blood cells, and platelets. It's a fairly rare cancer, with more men affected than women. The average age of someone diagnosed with AML is 63. AML cell growth is very fast and aggressive, and it's fatal within weeks or months if not treated or diagnosed promptly.

Because AML cell growth crowds out normal blood cells, it typically causes anemia and the associated symptoms of fatigue and shortness of breath from a reduction in oxygen-carrying red blood cells; bruising or bleeding from a reduction in platelets (clot cells); and infection from a reduction in normal white blood cells.

The key to survival in AML is early diagnosis, chemotherapy to try to induce remission, and eventual stem-cell transplantation. There are several subtypes of AML, and treatment and prognosis varies among the subtypes. Five-year survival rates vary from 15 to 70 percent, and relapse rates vary from 33 to 78 percent, depending upon the subtype.

Exciting research from England's Institute of Cancer Research may have found a novel treatment for AML using tranylcypromine (Parnate), an old and rarely used antidepressant. All-Trans Retinoic Acid (a Vitamin A derivative) has worked to treat one particular form of leukemia by directing cancer cells to mature, age, and die naturally. AML seems to be resistant to All-Trans Retinoic Acid because the genes in the cancer cells that it normally targets are shut off. Researchers just discovered that if they block an enzyme using the antidepressant tranylcypromine, they can switch on the genes that make AML cancer cells vulnerable to All-Trans Retinoic Acid. Researchers at Johns Hopkins University and the Medical University of South Carolina are collaborating with researchers in England, Germany, and Canada.

Mitchell Hecht is a physician specializing in internal medicine.