DR MARTIN SCURR: I have erectile dysfunction but Viagra doesn't work for me. Is my sex life over?
Q: I have slow-進歩ing prostate 癌, 診断するd eight years ago, and have had several TURP 手続きs. For the past two to three years, I've been 苦しむing from erectile dysfunction. 非，不，無 of the pills (Viagra, Cialis etc.) have any 影響. My urologist says there's nothing else he can do. Is my sex life over? I'm 67 and still have 勧めるs and wish to make love to my wife. It is so painful knowing I can't. I don't want 注射s or pumps!
指名する and 演説（する）／住所 供給（する）d.
Dr ツバメ Scurr replies: I applaud your 開いていること／寛大 in 令状ing to me about an 問題／発行する that will 影響する／感情 many who will be too shy to 捜し出す help.
The loss of 性の 機能（する）／行事 is most likely to be the 遺産／遺物 of your prostate 治療. The low grade of the 癌 explains why your entire prostate （分泌する為の）腺 wasn't 除去するd.
Rather, you've undergone transurethral resection of the prostate (TURP) ― where sections of prostate tissue are 除去するd ーするために 持続する your urinary 機能（する）／行事 (a 危険 with 除去するing the （分泌する為の）腺 完全に).
Erectile dysfunction (ED) can be linked to 神経 損失 from 外科; 医薬, 含むing 血 圧力 pills and hormone suppressants used to 扱う／治療する prostate 癌; alcohol; cardiovascular 病気; high 血 圧力 and smoking
I 嫌疑者，容疑者／疑う you may be taking hormone suppressants to lower testosterone, which can 燃料 癌 growth. These can 影響する／感情 erectile 機能（する）／行事 (but it's 安心させるing your libido has not 苦しむd).
Other factors 含む anything that 影響する／感情s 血 供給（する） to the penis ― such as cardiovascular 病気, high 血 圧力 and smoking.
Erectile dysfunction (ED) can also be linked to 神経 損失 from 外科; 医薬, 含むing 血 圧力 pills and hormone suppressants used to 扱う／治療する prostate 癌; and alcohol.
You について言及する in your longer letter the adverts 申し込む／申し出ing to cure ED with this or that pill or drink. I'd not 支払う／賃金 any attention to these: I think it's just clever marketing 目的（とする）d at fleecing the 攻撃を受けやすい.
I would ask you to 再考する your 不本意 to try 注射s, as there's one 選択 that might 証明する successful. Trimix, which is 注入するd 直接／まっすぐに into the penis using an ultra-罰金 needle (so 原因（となる）ing 最小限 不快), 含む／封じ込めるs three 麻薬s, alprostadil, phentolamine, an d papaverine, which 上げる 血 flow to the penis and will produce a 早い erection. True, 麻薬s such as Viagra also 上げる 血 flow but they have to work their way around your whole 団体／死体 rather than working in situ as jabs do.
Another 選択 is Muse, a tiny pellet of alprostadil which you 挿入する into your urethra using a thin, 使い捨てできる applicator. This pellet 解散させるs and is 吸収するd in the 即座の area, producing an erection.
While you might not find these 戦略s 控訴，上告ing, they will be 効果的な and might enable you to 保持する an active sex life.
Q: My wife is 70 and active but her fingers are 徐々に becoming 新たな展開d, swollen and painful. Is there anything she can do, or take?
Ian H. Cross, Chichester.
Dr ツバメ Scurr replies: It sounds very much like she has osteoarthritis, a mostly 老年の-関係のある 条件 which can 原因（となる） swelling of the 共同のs, distorting them and 影響する／感情ing mobility. 治療 is 目的（とする）d at minimising 苦痛 ― the main 医薬s used are 非，不，無-steroidal anti-inflammatory 麻薬s (NSAIDs), a class of 麻薬s that 含むs aspirin and ibuprofen.
But because of the 危険 of 味方する-影響s, such as gastric bleeding, these should not be used long-称する，呼ぶ／期間／用語. 分かれて 研究 示唆するs that paracetamol is not much use for osteoarthritic 苦痛.
Many people turn to 'natural' 治療（薬）s, such as glucosamine, chondroitin, ビタミン D or fish oil 補足（する）s.
There is 現在／一般に a lot of 利益／興味 in curcumin (the active 成分 in turmeric) and Boswellia serrata ― 一般的に known as frankincense ― for arthritis 苦痛, and while the 証拠 is scant, I certainly wouldn't dissuade your wife from trying any of these.
Another 推論する／理由 to get that Covid jab
Long Covid continues to take a 激しい （死傷者）数 on Britain's health, as today's cover story 調査するs.
Many 報告（する）／憶測 memory problems, 同様に as difficulty in concentrating. Now その上の 確定／確認 of the 影響 on brain 機能（する）／行事 has 現れるd in intriguing 研究 from scientists at 皇室の College London, published in the New England 定期刊行物 of 薬／医学.
This 明らかにする／漏らすd that 患者s who 苦しむd 執拗な symptoms for 12 weeks or more experience a six-point loss in IQ ― nine points if the 初期の 感染 was so 厳しい they ended up in 集中的な care.
What's more, the 研究員s also 設立する that 早期に variants of the ウイルス 原因（となる）d more 厳しい cognitive impairment than later 緊張するs such as Omicron.
The question is, do these 消極的な 影響s 結局 解決する? What might their 衝撃 be long 称する，呼ぶ／期間／用語? There is much left to learn but our specialist teams are already making 進歩.
Another 肯定的な, I think, is that the 研究 also showed that those with long Covid who had two or more ワクチン接種s 苦しむd いっそう少なく brain 機能（する）／行事 impairment. This was even if they were 感染させるd by the ウイルス once again 実証するing the immunisation programme.
