DEAR DR. ROACH: I read your column today about the senior lady who had burning pain in her hips and throbbing in her legs at night. I am a senior who has had those exact same symptoms for many months. I went to the doctor and had X-rays, etc., finally figuring it out myself — it turned out to be those “skinny jeans” that everyone is wearing that was causing the problem. As soon as I switched to a softer fabric in pants, my symptoms were gone for good! — T.
ANSWER: You are quite right. There is a syndrome that is increasingly recognized, sometimes called “skinny jeans neuropathy,” where the pants are so tight that they can compress the tibial, peroneal or lateral femoral cutaneous nerves, leading to pain and tingling in various locations. I found a case report of the muscle being damaged from too-tight jeans.
I appreciate your writing to help bring attention to this condition. Don’t be a fashion victim.
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DEAR DR. ROACH: When trying to get vitamin D from sunshine, is it beneficial to get the sunrays through window glass? — V.M.
A: No, the window glass absorbs the ultraviolet-B radiation necessary for efficient conversion of its precursor into the active form. The amount of time needed to synthesize vitamin D through the skin varies with skin color, latitude and time of year. For example, a light-skinned person in Miami in the summer needs only six minutes of direct sun exposure to get adequate (1,000 IU) vitamin D; it would take 15 minutes in winter.
In a Boston winter, it takes two hours for a brown-skinned person to make adequate vitamin D, and very dark-skinned people cannot make adequate vitamin D in winter in latitudes as far north as Boston. They must rely on food (such as salmon) or supplements to prevent low vitamin D levels.
DEAR DR. ROACH: I am a 57-year-old man, and I suffer from erectile dysfunction. I heard that Viagra causes you to lose your sexual desire, but Cialis restores it. I also want to know about an over-the-counter product that claims to improve not only erectile function but also size. Finally, why can’t medicines like Viagra be bought over the counter? They aren’t narcotics. — F.A.
A: It’s important to recognize that there is a difference between libido — the interest and desire for sexual contact — and erectile dysfunction, which is the inability to get a sufficient erection for sexual contact. The two are different, although certainly one can affect the other.
Both sildenafil (Viagra) and tadalafil (Cialis) work by inhibiting an enzyme called phosphodiesterase-5 (PDE5). They increase blood flow into and reduce blood flow out of the blood vessels of the penis. This allows for an erection in most men, as long as the other systems involved in sexual function — the hormonal and nervous systems, and especially the psychological function — are adequate.
Neither Viagra nor Cialis affects libido directly, but by improving confidence, either may have a significant effect. No over-the-counter drug is both safe and effective for improving sexual function. There is no medication that affects penile size in adults.
Finally, these medicines have the potential for serious harm, especially in combination with other medications, such as nitroglycerine-type drugs.
I have written before that ED is a condition that can be the first clue to serious neurological, circulatory, hormonal and psychological functioning. Although someday these medicines may be available over the counter, I feel a physician evaluation and education are mandatory.
Dr. Keith Roach is a physician at Weill Cornell Medical College and New York Presbyterian Hospital. Email him questions at ToYourGoodHealth@med.cornell.edu. Consult with your physician before making changes to your personal regimen.
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As a medical expert with a deep understanding of various health-related topics, I'd like to address the concepts mentioned in the article you provided. The article covers issues related to "skinny jeans neuropathy," vitamin D synthesis through sunlight exposure, and concerns about erectile dysfunction and medications like Viagra and Cialis. Let me break down the key points:
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"Skinny Jeans Neuropathy": The individual writing to Dr. Roach describes symptoms of burning pain in the hips and throbbing in the legs, which were attributed to wearing tight "skinny jeans." Dr. Roach validates this claim, mentioning a recognized syndrome known as "skinny jeans neuropathy." This condition occurs when excessively tight pants compress specific nerves, leading to pain and tingling in various areas. The case report mentioned in the article highlights the potential for muscle damage caused by overly tight jeans.
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Vitamin D Synthesis through Sunlight Exposure: Another query in the article pertains to obtaining vitamin D from sunlight exposure through window glass. Dr. Roach clarifies that the ultraviolet-B radiation necessary for efficient vitamin D conversion is absorbed by window glass. He explains the variations in the time needed for vitamin D synthesis based on factors such as skin color, latitude, and time of year. Additionally, he notes that certain individuals, particularly those with darker skin, may need to rely on food or supplements to maintain adequate vitamin D levels in the absence of sufficient sunlight exposure.
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Erectile Dysfunction and Medications: The article addresses a question related to erectile dysfunction (ED) and the use of medications like Viagra (sildenafil) and Cialis (tadalafil). Dr. Roach distinguishes between libido and erectile dysfunction, emphasizing that these medications work by increasing blood flow to the penis but do not directly affect libido. He dispels a misconception about Viagra causing a loss of sexual desire and Cialis restoring it. Furthermore, Dr. Roach warns against over-the-counter products claiming to enhance erectile function or size, emphasizing that no such safe and effective medications exist. He also highlights the potential for serious harm, especially when these medications are combined with other drugs, and stresses the importance of a physician's evaluation and education.
In summary, the article covers a range of health topics, including the impact of tight clothing on nerve compression, factors affecting vitamin D synthesis, and the distinction between libido and erectile dysfunction, along with cautions about medications for ED.
