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Obesity (external fat) is associated with internal obesity and fatty matter clogging up the arteries of the body (including the pudendal artery which supplies blood to the penis). Additionally, obesity can have a negative effect on our sex hormone balance (the balance of testosterone and estrogens), further contributing to sexual dysfunction. The fatty tissue present in obese abdomens contains abundant amounts of the enzyme aromatase—functioning to convert testosterone to estrogen—literally emasculating us! High blood pressure will cause the heart to have to work harder to get the blood flowing through the increased resistance of the arteries. Blood pressure lowering medications will treat this, but as a result of the decreased pressure, there will be less blood flow through the pudendal arteries. Thus blood pressure medications, although very helpful to prevent the negative affects of hypertension—heart attacks, strokes, etc.—will contribute to sexual dysfunction. High cholesterol will cause fatty plaque buildup in our arteries, compromising blood flow and contributing to sexual dysfunction. Tobacco constricts blood vessels and impairs blood flow through our arteries. Stress causes a surge of adrenaline release from the adrenal glands. The effect of adrenaline is to constrict blood vessels and decrease sexual function. Thus is the physiologic explanation for the all-too-common occurrence of performance anxiety. Interestingly, men with priapism (a prolonged and painful erection) are often treated with penile injections of an adrenaline-like chemical to bring down the erection.

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.

Aging is one of the major risk factors for erectile dysfunction. Men in their 40’s have approximately a 40% chance of having some form of ED and this prevalence increases by about 10% in each succeeding decade. Generally speaking, diminished blood flow, most commonly on the basis of an accumulation of fatty plaque deposits within the walls of blood vessels, is often associated with the aging process. As we age, physiological and lifestyle factors combine to increase this plaque build-up, causing a significant narrowing of many of the body’s blood vessels. The resultant diminution in blood flow to our organs negatively affects the functioning of all of our systems, since every cell in our body is dependent upon the vascular system for delivery of vital oxygen and nutrients and removal of metabolic waste products. Pelvic atherosclerosis, the accumulation of fatty deposits within the walls of the blood vessels that bring blood to the penis, will diminish blood flow and incite sexual dysfunction. Ironically, too, any loss of sexual function can lead to further progression of the problem: unfortunately, deficiency in genital blood flow, which may initiate sexual dysfunction, produces a state of poor oxygen levels (hypoxia) in the genital tissues. This, in turn, induces tissue scarring (fibrosis), which further compounds sexual dysfunction.

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.