One problem for epidemiologists trying to quantify the extent and impact of erectile dysfunction is the frequent unwillingness of men to discuss the problem frankly. The accuracy of almost all data in this disease area is therefore impaired by the reluctance of many, particularly older, men to respond to what they regard as overly personal questions. However, with the development of simple questionnaires which can be self-administered, and the gradual breakdown of social taboos surrounding the open discussion of sexual issues, it is possible to anticipate higher-quality information in the future.

At this time, however, the best data available concerning the prevalence of erectile dysfunction are derived from the Massachusetts Male Aging Study. The findings of this study may be summarized as follows. A total of 1290 men aged 40–70 years were included in the study; erectile dysfunction was very common,

• with 52% of men reporting some degree of erectile dysfunction—mild in 17.1%,
• moderate in 25.2%
• complete in 9.6%.

Complete erectile dysfunction was reported by 5% of men at 40 years of age, rising to 15% at age 70 years. Loss of firm erections is often extremely bothersome to men. demonstrates the degree of worry, the loss of confidence, the negative feelings and the depression that can result.

Risk factors for erectile dysfunction
Risk factors for organic erectile dysfunction mainly stem from the fact that the erectile mechanism is a vasodilatory response dependent on smooth muscle function under neurogenic control. Aging, which has the strongest association with erectile dysfunction, probably exerts its effects mainly through impaired vasodilatory and venoocclusive mechanisms. Atheroma of the internal iliac arteries and their pudendal branches may be one factor, but age-related degeneration of intracorporeal smooth muscle mechanisms is probably more important. Venous leakage, another age-related phenomenon, may in itself be a manifestation of deterioration of intracorporeal smooth muscle function.

DIABETES MELLITUS
This disease is an important risk factor for erectile dysfunction. Damage to small blood vessels is the main etiology and, therefore, erectile dysfunction often occurs in association with diabetic retinopathy. Diabetic peripheral autonomic neuropathy is a further contributory factor. Erectile dysfunction may develop as a result of the progressive loss of small unmyelinated socalled C fibers secondary to diabetes. Several groups have reported that diabetes is associated with loss of NO synthase from NANC nerve endings and endothelial cells in the corpora. This may explain the pathophysiological basis of the erectile dysfunction that so commonly accompanies diabetes.

HYPERTENSION
This is frequently associated with erectile dysfunction. Approximately one-third of men beyond middle age have a diastolic blood pressure >90 mmHg. Hypertension causes damage to small blood vessels and this may adversely affect intracorporeal vasodilatory mechanisms. Moreover, many of the agents used to control hypertension, especially β-blockers and diuretics, are associated with the development of erectile dysfunction. It has been postulated that, because high intracorporeal pressures are required to produce penile rigidity, the reduction of blood pressure by any agent is likely to increase the incidence of erectile dysfunction. However, α-blockers, perhaps through the induction of intracorporeal vasodilatation, appear to enhance erection, while still lowering both systolic and diastolic blood pressures.

HYPERLIPIDEMIA
This disease often occurs in association with hypertension and is also a cause of damage to the peripheral vascular system. Hypercholesterolemia and elevated serum triglyceride levels are both also associated with erectile dysfunction.

SMOKING
Although there have been few epidemiological studies to confirm this, it appears likely that heavy smoking is associated with erectile dysfunction because of its deleterious effects on blood vessels and its action leading to an increase of platelet stickiness.

PEYRONIE’S DISEASE
Fibrosis developing in the corpora albuginea may result in permanent scarring and consequent deformity of erection. When the fibrosis is severe, penetrative intercourse may be impossible. As a result of the loss of tunica elasticity, Peyronie’s disease may also be associated with venous leak-induced erectile dysfunction.

PREVIOUS SURGERY
Various forms of pelvic surgery, particularly radical prostatectomy, cystoprostatectomy and abdominoperineal resection, are all strongly associated with subsequent erectile dysfunction.

DEPRESSION
Reactive or endogenous depression is strongly associated with erectile dysfunction: nearly 90% of severely depressed men report complete impotence. Treatment with antidepressants may sometimes improve the situation, although both monoamine oxidase inhibitors and tricyclic antidepressants may in themselves cause erectile dysfunction. Selective serotonin reuptake inhibitors, such as fluoxetine (Prozac®) may not only cause erectile dysfunction, but may also retard ejaculation.

Psychological Causes

There are actually psychological factors that can lead to erectile dysfunction; in fact, between 10-20% of erectile dysfunction cases actually are due to psychological factors, which sometimes work together with physical causes. Some of the main psychological causes of erectile dysfunction include stress, depression, low self esteem, and even anxiety. All of these things can contribute to the problem, and once erectile dysfunction occurs once, often it worsens these problems, making it occur again. However, Viagra can help some men who are dealing with ED due to these problems.

Physical Causes

Of course there are definitely some physical causes that can lead to erectile dysfunction as well. There are several physical problems that can cause problems getting an erection. These causes usually are related to damage or breakdown of the events that happen to cause an erection. This can include nerve impulses throughout the body, muscle responses, veins and arteries, and problems with the corpora cavernosa. There are a variety of different diseases that may cause these problems, leading to erectile dysfunction. Diabetes, Kidney disease, neurological disease, vascular disease, prostate cancer, surgery, injuries, drug use, alcohol and tobacco use, or even hormonal imbalances can all cause erectile dysfunction. However, even if you are suffering from any of these physical problems, usually you will find that drug therapies, such as Viagra, can actually help you to overcome the problems so that you can still experience a satisfactory erection in spite of these problems.

Medications

There are many medications out there that can cause erectile dysfunction too. So, if you are experiencing problems with impotence, consider taking a look at the medications you are taking. There are both over the counter medications and prescription medications that can cause problems with erectile dysfunction. Some of them can affect your circulation, hormones, or even your nerves, which can lead to erectile dysfunction. There are many drugs that can cause these problems, including antihypertensives, diuretics, antihistamines, antidepressants, antiepileptics, anti-anxiety drugs, antiarrythmics, NSAIDS, muscle relaxants, medications for Parkinson’s disease, chemotherapy medications, and even medications that are taken for prostate cancer. So, if you are dealing with erectile dysfunction that you think is a result of taking medications, consider speaking with your doctor about Viagra. Viagra can often be used safely with many of these medications and can help you deal with the problem.

How Viagra can Help

Viagra is a medication that is taken orally to help treat erectile dysfunction, and most men dealing with erectile dysfunction find that Viagra can really help to improve the erections that they have. Both getting an erection and maintaining an erection can be helped with Viagra and it can help you make sure that you have a sexual experience that is satisfying for you as well as your partner. Whether you are dealing with erectile dysfunction due to psychological issues, physical causes, or even medications, you will find that Viagra offers a safe way of help.

For more than 9 years now, Viagra has been helping men deal with ED safely. It works well for men of all different ages, for men who have various health issues, and even for men who only have difficulties some of the time. If you are wondering if Viagra may be right for helping you, then you may want to speak with your doctor. Your doctor can help you determine if you really have erectile dysfunction and can also help you figure out whether or not Viagra is a great choice for you. More than likely your doctor will recommend Viagra and you’ll be on your way to getting rid of those problems with erectile dysfunction.

It has been shown that naturally treating erectile dysfunctions is the best way to treat male impotence. Men who choose to incorporate natural health remedies into their treatment plan will also reap the benefit of…

1. Enjoying better overall health.

2. Increased sexual health.

3. Losing weight.

4. Having no side-effects.

Why Circulation Cures Impotence

Over 90% of erectile dysfunction problems stem from poor circulation levels. E.D. pills solve the problem be synthetically making the arteries relax or boosting the heart rate to increase the problem. However, erectile dysfunction pills can sometime cause more harm than good if the sufferer is not in good health. And if you are suffering from E.D., there could be a greater problem than impotence you should worry about.

Thousands of deaths and cardiovascular complications have been reported after taking the drug Viagra and other E.D. pills. Though it is uncommon, there are better ways to boost circulation levels than E.D. pills.

In fact, there are well over 10 natural ways to boost circulation levels downstairs. Here is a list of 4 ways that some doctors are now using before the pill is prescribed.

Natural Erectile Dysfunction Remedy Tips

For every problem, there is usually a remedy when it comes to the body. In the case of poor circulation, you can use your diet, vitamins, supplements, breathing techniques, herbs and even hydration to cure your problem. Here are some tips that prescription companies do NOT want you to know about!

1. Your Diet – My Erectile Dysfunction Remedy Report goes into great detail of how your diet has an impact on your circulation levels. But here is a short summary about how you should modify your diet. You should stay away from high fat and high cholesterol foods. Eat simple meals that are not processed or fried. Eat a bigger breakfast, normal lunch and a small dinner. Your stomach is about the size of your fist and you should eat accordingly.

Remember that if you eat before sex, the circulation you need downstairs will be also working in your digestive tract to digest the food. It is important to eat smaller at night and before sex.

2. Zinc – Most people suffer from a zinc deficiency, and if so, you will most likely suffer from a sexual dysfunction like erectile dysfunctions. You should take a supplement of 15 to 30 mg of zinc daily. It would also be suggested that you take 1 to 2 mg of copper with zinc because the mineral interferes with copper absorption. You could notice a change in weeks.

3. Lifestyle Habits – How you live also affects your sex life. Here are some secrets to live by: stop smoking cigarettes and cigars (plaque in arteries), moderate caffeine, eat complex carbohydrates, exercise to generate a sweat, and laugh. Though you might think these are too simple; they will work wonders for increasing circulation levels.

4. Vitamin Therapy - The average diet is no longer getting us the right vitamins. For instance, most erectile dysfunction sufferers are Vitamin A deficient. Take a trip to your local store and find a quality Vitamin A supplement. Take the recommended daily dosage and you are on your way.

A Guaranteed Cure for Erectile Dysfunctions…Side Effect Free

If you are finally ready to make a commitment to your health and to your sex life (she will thank you), then it is time you cured your erectile dysfunction for good! Please take a moment and visit our Natural Erectile Dysfunction Remedy website today.

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Mystification places definitions of “normal and healthy” sexual functioning in the hands of officially sanctioned experts rather than selfdefined enjoyment, more often reflecting these experts’ reality rather than women’s. When medical science alone defines the norms for sex, an objective reality is assumed, leading to a stance of moral neutrality in which “sex is no longer a human arena for negotiation, but an arena where there is an objective standard against which performance can be measured”. McCormick further identified the “nonconscious equation of sexual activity with reproductive potential” that influences clinicians to equate sexual dysfunction with “physical failures in the performance of intercourse”. In indhidualizniii sexuality and sexual problems, medicalization denies and obscures the effects of social contri-butions to people’s sexual complaints, including rigid sex roles, unrelenting standards of performance, relationships of unequal power, and histories of sexual victimization.

Tiefer recommended that feminist sex therapy include “corrective genital physiology education, assertiveness training, body image reclamation, and masturbation education.” McCormick also recommended that therapists treat individuals and couples for deficits in tenderness, poor communication, sexual selfishness, disinterest in oral sex, and unwillingness to cuddle, although she noted that deficits in these areas have not been assigned formal psychiatric diagnoses. A feminist approach to sex therapy uses existing scientific knowledge about biology, medical approaches, and empirically validated treatment techniques while adding the following ingredients:

1. Recognition of social and cultural gender inequality;
2. Recognition of the influence of this power differential in relationships, and a willingness to intervene at this level;
3. Valuing equally the subjective and affective aspects of sexuality, relative to physical performance;
4. Recognition of traditional sex roles as etiologic of many sexual problems, and a willingness to intervene at this level; and
5. Recognition of the unique experiences of men and women regarding sexual socialization, experiences of sexual coercion, sexual decision making, and the influence of relational factors in sexual dysfunction.

Injections are generally not the first-line means of TRT because of wide fluctuations in testosterone levels and injection site reactions. There are a number of gel formulations that are commonly prescribed including: Androgel; Testim; Axiron; Fortesta; additionally, many pharmacies will compound testosterone in gel or cream formulation at a fraction of the cost of the commercially available products. With the gels and creams, one needs to beware of skin-to-skin contact with the potential exposure of testosterone to others. There are scrotal patches: Testoderm and non-scrotal patches: Androderm, both of which can cause skin irritation. There is another formulation in the form of pellets that are injected into the fatty tissue of the buttocks: Testopel, advantageous in terms of its long-term efficacy (3-6 months) but disadvantageous in terms of the need for the minor procedure for implantation. There is a buccal formulation that is placed in the inner cheek or gum: Striant, a simple means of administration, but one that can cause gingivitis, interference with eating, drinking and dental hygiene.

Men on TRT need to be carefully followed to ensure that the testosterone is effective, adverse effects are minimal, and blood levels are in-range. Periodic digital rectal exams are important to check the prostate and in addition to testosterone levels, other blood tests are obtained including a complete blood count and PSA. Side effects of TRT may include the following:

• Oily skin; acne
• Sleep apnea
• Breast growth
• Increased red blood cell count
• Lipid profile changes
• Infertility—testosterone can be viewed as a male contraceptive
• Testes atrophy

The lion’s share of testosterone is manufactured in the testicles, although a small percentage is made by the adrenal glands. Healthy men produce 6-8 mg testosterone/day in circadian pattern with a peak in early morning hours and lag in the late afternoon. There is a gradual decline in T that occurs with the aging process—approximately a 1% decrease each year after age 30. The decline will occur in most men, but will not always be symptomatic. Symptoms of low T may include one or more of the following: fatigue, irritability, depression, decreased libido, erectile dysfunction, ejaculatory dysfunction, decreased energy and sense of wellbeing, loss of muscle and bone mass, increased body fat, abnormal lipid profiles. Essentially, low T can accelerate the aging process.

There is a strong relationship between low T and Metabolic Syndrome. Metabolic Syndrome is defined as having three or more of the following: high blood glucose levels; abdominal obesity; high fats (triglycerides); low levels of the “good” cholesterol (HDL); and high blood pressure.

Obesity can have a pivotal role in the process leading to low T. Fat is not just fat—it is a metabolically active endocrine organ that does not just protrude from our abdomens in an inert state. Fat produces pro-inflammatory factors, hormones and immune cells—including cytokines—which function to inhibit T production in the testicles and the release of hypothalamus and pituitary hormones that govern the release of T. Low T is present in about half of obese men. Fat has an abundance of the hormone aromatase, which functions to convert T to the female hormone estrogen (E). The consequence of too much conversion of T to E is the potential for gynecomastia, aka breast enlargement.

If a person has generalized atherosclerosis (fatty deposits narrowing the caliber of their arteries) as evidenced by angina, heart attacks, strokes, and/or claudication (leg and buttock pain that occurs with exercise and is indicative of poor blood flow), there is a great likelihood of penile arterial involvement as well. Diabetes, for example, is well known to give rise to atherosclerosis. Radiation therapy to the pelvis can cause scarring and damage to the penile circulation, thus resulting in vascular E.D. Because cigarettes contain nicotine (which functions to constrict blood vessels), E.D. commonly occurs on the basis of chronic cigarette use.

In many men, the arterial supply to the penis is intact, but because of venous leakage (a condition in which the otherwise rigid corpora cavernosa soften prematurely due to loss of blood through the veins), an erection cannot be sustained for long. The blood flow simply drains away from the corpora, resulting in flaccidity of the penis and the inability to maintain an erection. This is the underlying cause in about 70% of patients who suffer from ED. It is due to the loss of corporal smooth muscle such that sufficient relaxation to achieve obstruction of venous outflow cannot occur. The blood in the sinusoids leaks back into the venous system draining the penis. It is similar to essential hypertension, which is due to the loss of smooth muscle within the arterial walls that leads to stiff vessels in which relaxation is impaired.

Normal erectile function requires an intact brain, spinal cord, and peripheral nerve supply to the corpora cavernosa. Any interruption of the nervous system may result in E.D. since it is the nerve impulse to the cavernosal arteries that is the trigger for increased penile blood flow.  Generic Viagra Mexico

Diabetes, besides causing damage to penile circulation, causes a penile neuropathy (nerve damage) that commonly results in E.D. Alcohol abuse similarly may give rise to a neuropathy accounting for E.D. In fact, any neurological disease process (including multiple sclerosis, Parkinson’s disease, spina bifida, etc.) may result in E.D. Injury or trauma to the brain, spinal cord, or pelvis may cause E.D. on a neurogenic basis. A pelvic fracture may injure the nerve supply to the corpora cavernosa. Radiation therapy, besides causing damage to penile circulation, can damage the cavernosal nerve supply. Radical pelvic surgery (most commonly for bladder, prostate, or rectal cancers) may require removal of the cavernosal nerve supply, resulting in E.D.

Online Pharmacy India E.D. may be divided into organic (physical) causes and psychological causes. Clues to organic causes are the presence of a disease process or the use of a medication that is known to give rise to E.D., gradually deteriorating erections, or the loss of early morning and nocturnal erections. Clues to psychogenic causes are the presence of a psychological process (such as depression, stress, anxiety, breakup of a relationship, death of a loved one, etc.), sudden onset of erectile difficulty, intact early morning and nocturnal erections, and the ability to obtain an erection with masturbation although not with intercourse.

Many adults in the USA are beset with Civilization Syndrome, a cluster of health issues that have arisen as a direct result of our poor dietary choices and sedentary lifestyle. Civilization Syndrome can lead to obesity, high blood pressure, elevated cholesterol, and can result in such health problems as erectile dysfunction, diabetes, heart attack, stroke, cancer, and premature death. The diabetic situation in our nation—often referred to as “diabesity”— has become widely prevalent and it probably comes as no surprise that diabetes is one of the leading causes of sexual dysfunction in the United States.

There are four phases of the male sexual response including excitement, plateau, orgasm, and resolution.

In the excitement phase, penile erection occurs as a result of an arousing sexual situation. Accompanying erection is thickening of the scrotal skin and elevation of the testicles. In the plateau phase, there is increasing engorgement of the corpora and the glans, increasing size and elevation of the testicles, and a preejaculatory secretion that may occur at the tip of the penis as a result of discharge from the bulbo-urethral gland.

Orgasm actually consists of three phases: emission, in which seminal fluid and sperm from the epididymis, vas deferens, seminal vesicles and prostate is deposited into the urethra; ejaculation, which is the forcible expulsion of semen from the urethral opening, resulting from contractions of the peri-urethral and pelvic floor muscles combined with relaxation of the external sphincter and urogenital diaphragm; and orgasm, which is defined as the intense emotional excitement and climax that accompanies ejaculation, with considerable subjective variation.

Finally, in the resolution phase, there is loss of erection, the testicles decrease in size and drop down to the bottom position of the scrotum, and the scrotal skin regains its laxity.