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If you have had a bad nosebleed recently, think back over the last few days. Have you been taking Viagra? If so, it is worth mentioning it to your doctor, say surgeons writing in the August Journal of the Royal Society of Medicine. Lucy Hicklin and colleagues at St George’s Hospital in London describe two case histories where very severe nosebleeds followed Viagra-enhanced sexual activity, and suggest possible reasons why the two could be connected.


A six-hour nosebleed

The first case study that interested the authors was a man in his late fifties who had come to the A&E department after a six hour nosebleed that still would not stop and kept him in hospital for six days. He admitted that he had been having heavy nosebleeds ever since taking Viagra a few days earlier. Both he and another patient with the same problem also had a history of hypertension, a recognised risk factor for heavy nosebleeds, but neither man had needed to go to hospital with the problem before.

Why might Viagra affect noses?

Sildenafil citrate, the drug behind the brand name Viagra, works by acting on erectile tissue. This does not just affect the penis though: parts of the nose also contain erectile tissue. Cases of “honeymoon rhinitis”, where men and women experience nasal stuffiness during sex, have already been well documented, and it is listed as a side-effect of Viagra. Could the drug have engorged the veins in the nose and made heavy bleeding more likely to happen?

The authors emphasise that a link between Viagra and nosebleeds is still an unproven theory, and research has not yet been done in this specific area. They point out that the effect “might be under-reported” because patients often feel too embarrassed to bring up sexual matters, especially sexual dysfunction, unless they absolutely have to. Awareness of the theory may help some men feel they can tell their doctors about a possible connection with Viagra, or ask for more information if they need it.

Rosamund Snow | Quelle: alphagalileo
Weitere Informationen: www.rsm.ac.uk/press

Mick Hunter
Sunday April 9, 2006
The Observer

1 Any stories about ex-boyfriends, even ones told against the poor blokes. If your ex was a violent, brainless, tattooed ex-con, this will only make us feel boring and unmanly. And scared.
2 The phrase 'I'd say it's bang-on average, if not slightly bigger'. Best to steer clear of the size issue. Like us talking about your weight, it can only lead to misunderstanding and hurt.

3 Obsessive accounts of your diet and exercise regime. Men like skinny women, true. But they dislike being exposed to the borderline eating disorders and pathological obsessiveness that produce them. And curvy and sane always beats mad and thin. Eventually.

4 The accusing phrase, 'What's wrong with the blue dress, then?' after we have said we like the red one.

5 Any details of your day at work. Although men can find the most basic things endlessly fascinating - the number of buttons on their shirts, farting - they will suddenly develop ADD when it comes to your professional life. Unless you are a porn actress. No, actually, even then...

6 Any information about things you thought about buying. We are perfectly happy to admire actual purchases, but yearning for those phantom shoes/dress/bag exasperates us.

7 Stories about other men patronising you. This will give us an irresistible urge to ruffle your hair and say in a kids-TV voice, 'Awww, did dey? Did dey do dat to oo?' I know, sometimes we're asking for trouble.

8 The word 'Fine' as a stand-alone sentence. The scariest syllable in the female vocabulary.

9 The sound of weeping. It destroys us.

10 Any details of strife you may be having with your female friends. The endless round of hurt and rapprochement that constitutes girls' friendships mystifies us. If she's that much trouble just delete her from your bloody mobile.

11 The phrase, 'Hang on, I'll just reply to this text before we order'. We want first claim on your attention, woman.

12 The phrase, 'Can you turn over, you're snoring'. Great, that's both of us awake.

13 The words 'Am I special? Am I?' Especially if you are drawing a circle around our nipple with your finger at the time.

14 Anyone else's name, in your sleep.

15 Your dreams. Unless we're in them. And in a good light, too. If not, save 'em for the shrink.

People who have had more than five oral-sex partners in their lifetime are 250% more likely to have throat cancer than those who do not have oral sex, a new study suggests. The researchers believe this is because oral sex may transmit human papillomavirus (HPV), the virus implicated in the majority of cervical cancers. The new findings should encourage people to consistently use condoms during oral sex as this could protect against HPV, the team says. Other experts say that the results provide more reason for men to receive the new HPV vaccine. Maura Gillison at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, US, and colleagues collected blood and saliva samples from the throats of 100 patients diagnosed with cancers of the tonsils or back of the throat. The scientists also took samples from 200 healthy people for comparison. By combining the blood and saliva samples with antibody molecules, Gillison�s team could tell whether a person had ever had an HPV infection. Cancer traps All of the study participants provided information about their sexual history, including the number of people with whom they had engaged in oral sex. After controlling for other risk factors for throat cancer, such as drinking and smoking, the analysis revealed that people who had prior infection with HPV were 32 times as likely to have this cancer as those with no evidence of ever having the virus. And those who tested positive for a particularly aggressive strain of the virus, called HPV-16, were 58 times more likely to have throat cancer. By comparison, either smoking or drinking increases the risk of such cancer by about threefold. The throat cancers analysed in the new study mostly started in the �crypts� of the throat � the grooves at the base of the tonsils. This might be because the tonsil grooves trap infectious particles, suggests Mark Stoler of the University of Virginia in Charlottesville, US, who was not involved in the study. High risk levels The study also revealed a link between oral sex and throat cancer caused by HPV. People who had one to five oral-sex partners in their lifetime had approximately a doubled risk of throat cancer compared with those who never engaged in this activity - and those with more than five oral-sex partners had a 250% increased risk. There was an even stronger link between oral sex and throat cancers clearly caused by HPV-16 (those tumours that tested positive for the strain). People with more than five oral sex partners had a 750% increased risk of these HPV-16-caused cancers. �This study is important because it is putting all of the pieces together,� says Gillison. �We need to add oral HPV infection to the list of risks for oral cancer,� she adds. Virus vaccine A vaccine against several of the most aggressive strains of HPV linked to cervical cancer received approval from the US Food and Drug Administration in 2006. However the plan to vaccinate adolescent girls with this vaccine developed by Merck, called Gardasil, has received some criticism. There have been no studies investigating whether the vaccine can also protect against throat cancer, but the new evidence linking HPV to throat cancer could lead to broader vaccination with Gardasil. �We will see a push for vaccination in men,� says Stoler, who has been involved in the development of the vaccine. Tonsil and throat cancers affect about two in every 100,000 adults in the US. The new results could promote the development of spit tests for HPV infection to help identify people at high risk for these cancers, researchers say. Journal reference: New England Journal of Medicine (vol 356, p 1944)