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Male sexual dysfunction is one of the most common health problems affecting men and is more common with increasing age. Chronic ED affects about 5% of men in their 40s and 15-25% of men by the age of 65. Transient ED and inadequate erection affect as many as 50% of men between the ages of 40 and 70. In around 95% of the cases, a suitable treatment can be found. Erectile dysfunction is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for erectile dysfunction. Viagra, Levitra and Cialis Currently, there are three oral medications approved by the Food and Drug Administration (FDA) for the treatment of erectile dysfunction: sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). All these agents block the enzyme phosphodiesterase type 5 (PDE-5) and belong to a class of drugs called phosphodiesterase (PDE) inhibitors. Viagra was the first and is probably the most famous of the three PDE-5 inhibitors used to treat erectile dysfunction. Viagra was approved as an effective agent for treating erectile dysfunction in March 27, 1998. Viagra is manufactured by Pfizer, Inc. Levitra was the second PDE-5 inhibitor to come to market in the United States, and it was approved by the FDA in August 19, 2003. Levitra is manufactured by Bayer Pharmaceuticals Corporation. Cialis was the third PDE-5 inhibitor to come to market and was approved by the FDA at the end of November 21, 2003. Cialis is manufactured by Lilly ICOS LLC. The major advantage of PDE-5 inhibitors is that they do not cause an erection at inappropriate times, because they act only in response to sexual stimulation. If there is no sexual stimulation drug remains in the background. All three are taken orally prior to planned sexual activity, acting to increase blood flow in the penis in response to sexual stimulation. However, there are important differences between the three, differences that could influence safety, specificity, duration of action, adverse effects, and ultimately, public acceptance within this class of drug. Mechanism of Action PDE-5 inhibitors do not directly cause an erection of the penis, but they alter the body's response to sexual stimulation by enhancing the effect of the nitric oxide, a chemical that is normally released during stimulation. Nitric oxide causes relaxation of the muscles in the penis, which allows for better blood flow to the penile area. Effectiveness of PDE-5 Inhibitors All 3 PDE-5 inhibitors have demonstrated excellent efficacy. Viagra, at 84%, is slightly more effective than Cialis at 81% and Levitra at 80%. Pharmaceutical Forms, Onset of Action and Duration of Effect Viagra and Levitra differ only minimally in terms of their structure, while Cialis differs markedly from Viagra and Levitra in terms of its molecular structure, which is also reflected in pharmacokinetic differences. Viagra: 25 mg, 50 mg 100 mg tablets Onset of action: 30 minutes (effect delayed if taken with food) Duration of action: 4 to 5 hours Levitra: 2.5 mg, 5 mg, 10 mg, 20 mg tablets Onset of action: 25 minutes (effect delayed by fatty meal) Duration of action: 4 to 5 hours Cialis: 5 mg, 10 mg, 20 mg tablets Onset of action: 16-45 minutes (effect NOT delayed by food) Duration of action: 36 hours All three drugs require sexual stimulation to be effective. Viagra should be taken on an empty stomach it works better if you do not eat a high-fat meal around the time you take it. Levitra may be slightly less effective if you eat a high-fat meal, but a moderate-fat meal does not reduce its effectiveness. Cialis works without regard to what you eat. Viagra and Levitra have similar half-lives, and onset and duration of action. Cialis has a slower onset of action and longer duration of action, which is attributed to its longer half-life. Patients who wish for spontaneity may opt for Cialis, which may allow for successful intercourse up to 36 hours postdose, even though it takes longer to reach peak effect. The considerably longer duration of effect for Cialis will likely allow less frequent dosing and greater impulsiveness between partners, but also could potentially prolong adverse effects. Dosage The recommended dose for Viagra is 50 mg, and the physician may adjust this dose to 100 mg or 25 mg, depending on the patient. The recommended dose for either Levitra or Cialis is 10 mg, and the physician may adjust this dose to 20 mg if 10 mg is insufficient. A lower dose of 5 mg is available for patients who take other medicines or have conditions that may decrease the body's ability to use the drug. Levitra is also available in a 2.5 mg dose. None of these PDE-5 inhibitors should be used more than once a day. Possible Side Effects Although all three drugs are generally well tolerated, side effects are still possible. Most common side effects: Viagra: facial flushing, headache, indigestion Levitra: facial flushing, headache Cialis: headache, indigestion Less Common Side Effects: Viagra: altered vision, dizziness, nasal, congestion Levitra: indigestion, nausea, dizziness, nasal congestion Cialis: back pain, muscle aches, nasal congestion, facial flushing, dizziness Precautions and Contraindications All PDE-5 inhibitors are absolutely contraindicated in persons who take organic nitrates. Alpha-blockers Viagra has precautionary labeling advising against taking 50 mg or 100 mg doses within four hours of taking a alpha-blocker. The 25 mg dose of Viagra has not been shown to significantly decrease blood pressure and in patients who take 25 mg of Viagra, use of any of the alpha-blockers is considered safe. Levitra is contraindicated in patients taking alpha-blockers. Cialis is contraindicated in patients taking alpha-blockers, except for tamsulosin (Flomax). Since both Viagra and Levitra have moderate vasodilatory and hypotensive effects, they should not be given in the presence of marked arterial or orthostatic hypotension, and should only be administered with caution in aortic stenosis or hypertrophic obstructive cardiomyopathy. Men who have had a heart attack or stroke within the past 6 months and those with certain medical conditions (e.g., uncontrolled high blood pressure, severe low blood pressure or liver disease, unstable angina) that make sexual activity inadvisable should not take Cialis. Dosages of the drug should be limited in patients with kidney or liver disorders. Conclusions The differences between the 3 drugs are not great. All appear to be effective and safe. Levitra has less side effects compared to Viagra and lasts about the same time as Viagra in the body. Cialis has few side effects and lasts longer in the body. This allows increased spontaneity and less frequent dosing than either Levitra or Viagra. However, the longer half-life of Cialis imposes increased risk for drug interactions. enlargement forum free matter penile size manual penis enhancement exercise penis enhancement pump herbal penile enlargment penis girth enlagement penis enlargment testimonials penis enlagement supplement penis enlarement technique

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Erectile Dysfunction or ED (also known as Impotence) is basically seen as a man’s inability to develop or maintain an erection (of his penis) long enough for sexual relations. However it can be a warning sign of other illnesses that can be killers. Let’s look at ED How to cure it and how serious it can be to your general health. The Causes of ED There are many causes, some are psychological and some are physiological. The psychological ones may be treated in a number of ways, but the physiological ones are indicative of some other body malfunction or condition which may be serious in nature, and need medical attention. The physiological causes may be understood if there are no normal erections during sleep. A man usually has about 6 erections per sleep session, and one in the early morning when testosterone levels are at their highest. However, if these erections are not present, it can indicate some cardiovascular problem, diabetes, or hypogonadism. Hypogonadism is unacceptably low levels of testosterone in the man’s system this will affect the testicles and naturally reduce or eliminate an erection. Tests to Determine Ed If you suspect you have ED, go to a doctor, he will begin with testing your blood for diabetes, hypogonadism and prolactinoma. The doctor will also test you for cardiovascular problems, like peripheral vascular disease or coronary artery disease. He will see if you lifestyle is correct, your weight, and verify your general state of health. Simplest Test The best way to determine if your ED is psychological or physiological is to determine if you never get an erection or you do (however rare). If you get an erection at all, the causes will be found being psychological in nature. If not, you have some other causes preventing erection and this will need immediate medical attention. Current Treatment of ED Current treatment of ED can usually start with testosterone if the doctor understands there is some hormone deficiency. If there was some disease, such as diabetes, there may have been damage to the penis blood vessels. Treatment of the diabetes is essential in any event, and some of the medications below are effective for intercourse, but not a cure. ED is now treated by drugs taken orally (such as Vigara, Cialis and Leventra), injected, or even as penile suppositories. All of above will increase the efficiency of Nitrous Oxide (NO). NO dilates the blood vessels of corpora cavernosa within the penis, and allows for engorgement, and subsequent erection. Other treatments include the injections apomorphine into the erectile tissue of the penile shaft. There is now oral apomorphine as well. You can also take a number of herbs that can help increase NO and circulation to allow more blood to flow into the penis and create an erection Natural herbs to cure ED The best three are: Ginseng and Ginkgo Balboa. These have been used for thousands of years by the Chinese to improve libido and are excellent all round body tonics. And finally L Argennine – Known as natures Viagra take 2,000 mgs per day. In tests it has been proved that 80% of men who did this saw an increase in sex drive and achieve better erections. Finally, there are treatments that require surgery, such as penile implants (both permanent and inflatable). There are special vacuum pumps that can be used, that will (with the aid of an elastic band) retain a semi-erection for about 30 minutes. It is highly recommended that if you think you have ED, see your doctor at once, as it really may be the symptom of something else. Get help and get sorted your life may depend on it. free penis enlargment technique penis enlargement pill penis elargement supplement truth about penis elargement pennis enlargement photo vimax penis enlargement patch vigrx penis enlargement pills penis elargement surgery penile enlargment drug

Impotence or erectile dysfunction in men is a condition signifying his inability to perform a sexual act. The term impotence may also be used to describe other sexual problems such as lack of sexual desire, premature ejaculation or orgasm. Using the term erectile dysfunction makes it clear that those other problems are not involved. Erectile dysfunction (E.D) is related to the hardening of penile arteries which restricts the flow of blood to the penis thus making it unable to achieve or maintain an erection. This sexual dysfunction in men attributes its reasons to various physical and psychological factors. Though initially it was thought to be psychological reasons as the predominant factor for impotence but recent studies show that 70% of E.D cases are as a result of physical complications in men’s health. Impotence has always been considered as an embarrassment factor by men but social awareness and medical advancement have helped in understanding that it is a disease and a medical condition which is treatable like any other disease. This attitude is strengthened by the advent of prescription drug Viagra, developed for the treatment of erectile dysfunction. Viagra, since its approval by the Food and Drug Administration in 1998 have been able to bring back the sexual ability in men using it. And this is mainly due to the presence of its active ingredient - Sildenafil citrate : Sildenafil citrate works by relaxing the penile muscles affected by arteriosclerosis and initiates free flow of blood thus facilitating erection. But it is always advisable to consult a doctor before using Viagra because Sildenafil citrate present in it might cause drug interactions with certain drugs especially nitrate medications like for chest pain or heart problems. Moreover, you can acquire Viagra information from online sources other than your doctor and the print media regarding dosage, precautions and possible side effects. The popularity and effectiveness of Viagra can be assessed from the increasing number of websites providing Viagra information and the also by the number of people logging in. Viagra can be your companion in making a stronger relationship with your partner. Because when Viagra is your aid, it can competently overcome impotence in a flash and make your love life as beautiful as ever. http://www.viagracures.com penile enlargement surgery photo cheap pennis enlargement pills vimax penis enlargement male penis enargement safe penile enlargment free penis enlagement tip best enhancement exercise penis pennis girth enlargement penile enlargment drug

One of the most effective contraception methods used today is vasectomy where the vasa deferentia are severed and sealed. With this, semen will be devoid of sperms so that women don’t get pregnant on ejaculation. However, as vasectomy is an irreversible procedure, its pros and cons have to be considered before opting for it. It is usually the man who has been married for a minimum of ten years that opts for vasectomies. It should be opted for if both the man and wife are content with the number of children they have, if the partner is unable to or cannot use any other birth control method or if the partner has a health problem where pregnancy is not advised. However, it is better to forget about vasectomy if you have an unstable relationship, is not certain of having any more children, single, divorced or separated or is doing it just to please the partner. Sometimes men opt for vasectomy due to stress like an illness, financial problems or a death. However as this stress is temporary, it is better to have some counseling before making the final decision. Always think deeply about the consequences of vasectomy with your partner before deciding on it. Some men worry that vasectomy may make him less of a man; this is not so as sterility has no effect on virility. There is no change on male characteristics, sex drive, the ability of getting an erection or the volume of an ejaculation with a vasectomy. It is not advised to take any aspirin, ibuprofen or ketoprofen two weeks after and before the operation as they thin the blood and cause bleeding. Acetaminophen is the preferred choice for pain relief. Vasectomy is basically an out patient procedure where the patient is awake during the surgery. Local anesthetic is injected into the scrotum wherein a slight sting is experienced before the area gets numb. No pain is experienced during the surgery, except for slight tugging and pulling. After the surgery, the incisions are bandaged and jock strap used for holding bandages in place and applying of pressure. An ice pack can be placed on the scrotum for relief from swelling. With the wearing off of the anesthetic, pain and cramping may be experienced which can be relieved with acetaminophen. The patient is advised rest after the operation. Stitches dissolve in about ten days’ time. It is not advised to bathe and swim for two days; no sports and heavy lifting for a week. However, if on a desk job, work can be resumed when the patient feels up to it. Remember, though it is possible to have sex about three days after vasectomy, it is still possible to father a child in this period as there may be sperms in ducts to the penis. It takes about 20 ejaculations to flush this sperms out. There may be some complications with vasectomy like bleeding in the scrotum, infection, scrotal pain or inflammation. The doctor should be approached if any of these symptoms develop. penis elargement pills review free penile enlargment technique top pnis enlargement pills enhancement forum free matter penis size penis enhancement without pills home penis enlarement enlagement manhattan penis surgeon vimax penis pillss in uk penile enlargment drug

The source of human sexual fantasy is usually genitalia and accompanied by explicit visual or imaginary images. These fantasies are normal and considered to be very helpful in getting a quick penile arousal. Medically, sexual fantasies are considered healthy and play a significant part in maintaining a healthy sexual act. But sometimes, sexual fantasies can become a trouble some affair. This happens when the desire to perform sex with someone else or with some other objects rather than your partner increases. In that case one can suffer from acute sexual dysfunction while performing the act with their partner. Sexual dysfunctions leads to sexual desire disorder, sexual arousal disorder or it may be orgasmic disorder. These disorders lead to failure of sexual activity with your partner. In many instances, it has been found that a problem of perfect penile erection is common. Males either cannot gain enough hard erection or cannot maintain a prolonged erection. At times this creates grave situations in one’s sexual life full of anxiety and depressions. This type of stigma creates problems in ones relationship. Levitra has been discovered to be a useful drug to combat such a case. Testosterone regulates various sex drives in human beings and maintains our interest in sex. They are responsible for a penile erection by improving the rate of blood flow into the penis. To have a satisfying sex for both the sexual partners, it is a must that the male partner should have an erection. Without it the act of sex is of no use. Levitra is one such drug that is prescribed basically for perfect penile erection. FDA trials have approved it for treating penile erection. Levitra increases the blood flow to human penis and improve an erection long enough for finishing a sex. It has been clinically proved that Men taking Levitra experienced harder erections and greater success during sex. Levitra is available in 2.5mg, 5mg, and 10mg and 20 mg tablets and is taken only according to doctor’s prescription. Generally a dose a day is enough to give the required result. It is taken about 60mins before performing sex for it takes time to stimulate our testosterones. If Levitra doesn’t work for the first time its better to talk to your doctor. Sometimes it could be a matter of adjusting the dose. But one thing one should always keep in mind that Levitra doesn’t cure sexual diseases. The stigma attached to what some feel are dirty thoughts, ideas and feelings that they should not have if they are “normal”, causes fear and anxiety. Many feel ashamed at these thoughts. The guilt that they generate can often cause problems in a relationship especially where the fantasy is seen as a betrayal of a lover or partner’s trust. As a result it becomes harder to concentrate on their partner which leads to impotency. In such situation Levitra is a boon for these persons Fantasy is quite normal. It is your private domain. Enjoy your imagination and do not feel guilty.