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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. free exercise tip for penis enlargment where to buy vig rx do penile enlargement pills work penis enlagement system penis elargement herb penis enlargment operation homemade penis enlarement com enlargement pennis pennis pump

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Generic Viagra? When men become sexually aroused, the arteries within the penis relax and open allowing blood to flow into the penis. This increased level of blood causes the penis to harden, resulting in an erection. Generic Viagra aids the process by not only helping but also increasing the flow of blood to the penis and helping the muscles to fully relax. This combination can help men who suffer from erectile dysfunction overcome the problem and return their lives to normal. Erectile dysfunction is a continued inability to get or keep an erection and there are many known causes of this disease. It not only makes sex impossible, but it also has a detrimental effect on self-esteem and confidence. However, erectile function has previously been a taboo subject that many men have been unwilling to discuss with anyone and certainly not with a stranger but recent advances in possible treatments for erectile dysfunction have seen many more men willing to discuss their problems with a view to finding a cure. In 1998 Viagra, or sildenafil citrate to give it its proper name, was first introduced. The generic Viagra, Cialis and others came soon after. This miracle drug brought hope to the lives of every man who suffers or who has suffered from erectile dysfunction. Previously, the only known treatments tended to involve painful procedures carried out by a urologist but generic Viagra is available in tablet form from your physician. The drug acts with natural sexual stimulation to give men the erection they want and keep it for longer periods of time. A quarter of men aged 65 or over suffers from erectile dysfunction and while its exact causes can be difficult to pinpoint exactly it is more often than not caused by illness or tissue damage. Potentially any disease that damages nerves or decreases the flow of blood to the penis can cause erectile dysfunction. It is also possible that you may be taking certain prescription drugs that decrease penile function, thus causing erectile dysfunction. Regardless of its cause, though, generic Viagra has the capability to cure it quickly and effectively. Obviously cutting down on prescription drugs known to cause erectile dysfunction and even cutting down on the amount of fat in your diet may help, but in some cases it isn’t feasible to stop taking prescription drugs. In these cases, buying generic Viagra online could be the solution for you. Do remember that, as with all drugs, Viagra is not suitable for absolutely everyone. Consult your physician initially or have an online consultation to discuss any prescription drugs you may already be taking. If it is ok for you to take Viagra then you can quickly and easily purchase generic Viagra online. The drug takes approximately 15 minutes to work, and will work as long as the patient becomes sexually aroused. There must be some stimulation, whether physical or mental, in order for the drug to work but either or both of these are present then there will not be a problem. Since Viagra was introduced in 1998 prices have obviously dropped quite significantly and where it was once necessary to receive a prescription from your doctor, it is now possible to get generic Viagra online. Buying generic Viagra online enables you to purchase drugs that are equally as effective as Viagra but for a fraction of the cost. These drugs have been tested and satisfy all medical and scientific factors. The only difference really is the price that you will have to pay. Erectile dysfunction is usually caused by physical illness or disease although it can be caused by prescription drugs, an unhealthy lifestyle or emotional problems. Regardless of the reason for erectile dysfunction it is vital that you remember you are by no means alone. Up to 30 million American men are treated with erectile dysfunction every single year and the vast majority of these men find that generic Viagra has the key to their problem. Read more at www.discountcanadiandrugstore.org penile enlargment procedure free penile enlargement video cheap vig rx pill penis enlargment device penile enlargment review vigrx scam vimax best penis enlargement surgery free natural penis enhancement penis enlargement tool

More than 50 percent of diabetic men suffer from impotence, and almost all complain bitterly that it has destroyed something that is very important to them. Impotence caused by diabetes can be prevented or reversed in almost all men whose bodies can still make insulin. Diabetes causes horrendous nerve damage including blindness, deafness, burning foot syndrome, loss of feeling, loss of muscle control, pain and tingling and impotence. The penis is the only gland in the body that has its blood supply shut off all the time. Muscles surrounding the penile artery constrict the artery to prevent blood from flowing to the penis. When a man is excited, his brain sends messages along nerves that cause the nerves to secrete a chemical called nitric oxide theat relaxes the muscles around the arteries to open blood flow to the penis and the balloons in the penis fill with blood and the man has an erection. More than 90 percent of diabetics who can still make their own insulin can be controlled so that they do not suffer nerve damage. When you eat, your blood sugar level rises. If it rises too high, sugar sticks to cells and causes permanent nerve damage. Doctors can measure how much sugar is stuck on cells with a blood test called HBA1C. To get your HBA1C to a normal range below 6.1, you have to avoid foods that cause a high rise in blood sugar such as those with added sugar, those made from flour such as bakery products and pastas, and fruit juices. Most cases of nerve damage from diabetes can be reversed by good control of diabetes, but sometimes the damage is permanent. For example once person goes blind from diabetes, he will never get his vision back. However, impotence is often reversible with good control of diabetes. Men who are impotent from diabetes must be seen every month and each month, the doctor must draw a blood test called HBA1C which measures diabetic control for the last 12 weeks, or another blood test called fructosamine, which measures diabetic control over the last 2 weeks. Every time, the HBA1C is greater than 6.1, the doctor must change the patient's drugs and the patient must change his diet. All diabetics should get a blood test called C-peptide to tell if their bodies can make insulin. If their C peptide is greater than 1, they should not be placed on insulin and should be started immediately on Glucophage and Actos or Avandia. These drugs lower high blood sugar levels, never cause low blood sugar, and also lower insulin to prevent obesity and heart attacks. Only if blood sugar levels cannot be controlled by diet and these insulin-lowering drugs should doctors prescribe drugs that raise insulin. pennis enlargement secret natural penis enlagement technique penis enlarement forum top penis enlagement pills penis enhancement operation online vig rx enlargment manhattan penis vigrx scam penis enlargement tool

Lose weight. Reduce stress. Lower your cholesterol level. Improve your circulation. Live longer. Stay younger. Sounds like an ad for a new wonder drug right? In fact it’s a partial list of the benefits of humanity’s oldest and most pleasurable pastime - sex. Most of us are aware of the feel-good benefits of sex while we’re engaged in it, but do you also know that there are benefits which carry on after the sweaty bodies have dried and the sweet talk has reverted to sports? For instance: Maintaining Ideal Body Weight There are 3500 calories in a pound of fat. For every 3500 calories you burn (that you do not replace with food!) you will lose one pound of fat. Sexual intercourse burns approximately 150 calories per half hour. Here’s how that stacks up against some other activities that may be part of your fitness regime: yoga 114 calories per half hour, dancing - rock 129, walking - 3mph 153, weight training 153, canoeing - 2mph 153, volleyball 174. According to one survey reported by the Ottawa Citizen, Canadians on average have sex 7.33 times per month, lasting approximately 24.4 minutes. That means that “Joe Canada” is burning off more than 10 thousand calories a year, or about 3 pounds, in a not particularly active sex life. Those who are more sexually active, into Tantra for instance where lovemaking lasts 4 hours, would burn up 600 calories a session. At once a week that’s 31,200 calories or 9 pounds per year. Considering that people put weight on gradually, slowly gaining 5-10 pounds per year until they are overweight, it’s not unrealistic to assume that regular sexual activity is one way to help maintain a healthy body weight. Increased Blood Flow Sex helps increase the blood flow to your brain and to all other organs of your body. Increased heart rate and deep breathing accounts for the improvement in circulation. As fresh blood supply arrives, your cells, organs and muscles are saturated with fresh oxygen and hormones, and as the used blood is removed, you also remove waste products that cause fatigue and even illness. Lower Cholesterol Lowering your cholesterol is another of the “sex as exercise” benefits. Sex helps lower the overall cholesterol level. Perhaps more importantly it tips the HDL/LDL (good/bad) cholesterol balance towards the healthier HDL side. Stress Reduction, Relaxation and Improved Sleep People having frequent sex often report that they handle stress better, so the normal stresses of living do not become distress. The profound relaxation that typically follows lovemaking, with orgasm for women and ejaculation and/or orgasm for men, may be one of the few times people actually allow themselves to completely let go, surrender and relax. Many indicate that they sleep more deeply and restfully after satisfying lovemaking. In the relaxing afterglow you may be able to let go of distracting thoughts. Being able to stop thinking has helped many to overcome insomnia. Sex as Pain Reliever Through the touch magic of sex the hormone oxytocin is secreted in your body which in turn causes the release of endorphins. Because of these natural opiates sex acts as a powerful analgesic, elevating the pain threshold and helping to relieve the aches of conditions like arthritis, whiplash and headaches. Now there’s a novel approach, sex as a remedy for headache rather than an excuse for abstaining! With arousal and orgasm oxytocin levels rise. They spike 3 to 5 times higher than usual just before orgasm. In fact it is oxytocin that triggers the orgasm. Measurements performed at the Masters and Johnson laboratories have shown that the uterine contractions brought about by orgasm (triggered by oxytocin) are just as powerful as those of child labor. Women can use this extraordinary orgasmic contraction and relaxation of the uterine muscle to relieve cramps during PMS and menstruation. Live Longer, Stay Younger A British study of 1,000 men found those who had at least two orgasms a week had half the death rate of their countrymen who indulge less than once a month. The hormone DHEA promotes sexual excitement and increases in response to it. Dr Theresa Crenshaw author of The Alchemy of Love and Lust says DHEA may be the most powerful chemical in our personal world. It helps balance the immune system, improves cognition, promotes bone growth, and maintains and repairs tissues, keeping your skin healthy and supple. It may also contribute to cardiovascular health and even function as antidepressant. Prostate and Genital Health Some doctors believe that more than 75% of men over 50 have a somewhat enlarged prostate, and that virtually all men will suffer from prostate enlargement if they live long enough. This condition, called benign prostate hypertrophy (BPH), is normal and usually not dangerous. Unfortunately, some of these men develop prostate cancer, one of the leading causes of death in older men. Regular sexual intercourse with frequent ejaculations will help to keep the prostate healthy. For those men who practice delaying ejaculation, for example in the practice of Tantra Sacred Sex, performing Kegel exercises (in which you contract the muscles around your genitals), will tone these muscles, just as exercising other muscles tones other areas of your body. More importantly, these exercises will help keep the prostate healthy, by moving the sexual energy up out of the prostate and circulating it throughout your body. The technique is very simple and you can perform hundreds of contractions per day for top sexual/physical fitness for both men and women. Imagine you are urinating, but want to stop the flow of urine, that’s all there is to it. Contracting your muscles in this way is one of the healthiest exercises you could add to your exercise regime. When 178 Belgian men with minor erection problems participated in a 4-month daily rehabilitation program which primarily focused on Kegel exercises, 74 percent showed improvement and 43 percent were cured. For women, Kegels strengthen the entire urogenital tract, aiding greatly in childbirth and preventing the onset of incontinence in later life. They also sensitize the genital tissues, helping women to become orgasmic and/or increase the intensity of their orgasms Boost Testosterone and Estrogen Regular sexual activity boosts testosterone and estrogen levels in both men and women. Besides boosting your libido testosterone fortifies bones and muscles. Some physicians suggest that testosterone keeps hearts healthy and good cholesterol high. Testosterone is what makes the sex drive in men and women more aggressive. It makes you want to have sex, pursue sex, initiate sex and perhaps dominate the lovemaking. Testosterone seems to motivate both men and women to strongly desire specific genital sex and release by orgasm. Because men have so much testosterone, they seem obsessed with genitals, intercourse and ejaculation, but appear to care less for romance and foreplay-touching, hugging, cuddling, eye gazing, etc. Sex increases women’s estrogen levels keeping vaginal tissues more supple and also protecting against heart disease. It is estrogen that makes a woman sexually receptive and responsive to a man’s approach. It is estrogen that makes her want to be touched and feel romantic, it is testosterone that makes her want to be penetrated. Estrogen makes a woman soft-breasts develop in response to estrogen. Estrogen is a powerful influence on how a woman smells. It influences the degree to which she projects softness, openness, and interest in sexual touching. Men’s bodies also produce estrogen. In fact testosterone can be converted into estrogen in the man’s body. Some estrogen helps a man to develop the softer, more nurturing feminine sides of their personalities. As men age, the testosterone/estrogen balance begins to shift, with testosterone decreasing and estrogen increasing, and this is one reason why so many men seem to mellow out as they get older. The Healing Power of Intimacy Sex is good for you, but sex with love is even better. According to Dr. Dean Ornish author of ‘Love and Survival: the Scientific Basis for the Healing Power of Intimacy’, “an open heart can lead to the most joyful and ecstatic sex”. His researches into intimacy and its effects on health have shown that “anything that promotes feelings of love and intimacy is healing”. If you have someone who really cares for you and for whom you care in return, someone you are intimately connected with in all ways - emotional, physical and more -- then you may be three to five times less likely at risk of premature death and disease from all causes. Part of this has to do with the positive effects of touch, what Dr. Crenshaw refers to as Vitamin T. The chemical composition of your body is changed by touch. Caressing, hugging, stroking, cuddling send a chain reaction of chemicals to signal your brain that this is pleasurable, nurturing, good. There is strong scientific evidence demonstrating the importance of touch to good health. In the 1930s, Dr. Rene Spitz, attending physician at a number of nurseries, noticed that the illness and mortality rates were quite a bit higher in some of the nurseries. His observations and experiments led to the finding that the children who were becoming ill and dying had nothing to do with hygiene or nutrition, but rather had to do with the amount of touching the infants received from the attending staff. He confirmed his findings by hiring “grandmothers” to come into the nurseries to hold, fondle, and cuddle the children. The illness and mortality rates declined rapidly. Researchers at Miami's Touch Research Institute (TRI) found that premature infants who received three massages a day over 10 days gained 47 percent more weight than preemies who weren't massaged. David Sebringsil, who writes regularly for The Society For Human Sexuality (one of the best online sources of excellent, sex-positive information), recommends Erotic Massage become a part of or alternative to regular lovemaking. It is one of the best ways to help someone achieve extended, multiple, or "whole body" orgasmic states. Through erotic massage partners learn to give and receive loving touch and extraordinary pleasure. It makes you healthier and happier. Healthy blood, healthy bones, healthy heart, healthy body and a peaceful mind - all thanks to the healing powers of sex. Next time you’re in the mood let her know you’ve got the doctor on your side! vimax medical penis enlargement penis enhancement drug vimax free penis enlargement tip penis enlarement surgery picture enlargement free penis pill sample herbal natural penis enlargment cheap penis enargement pills free penis enlargement exercise penis enlargement tool

Alan Pease, author of a book titled "Why Men Don't Listen and Women Can't Read Maps", believes that women are spatially-challenged compared to men. The British firm, Admiral Insurance, conducted a study of half a million claims. They found that "women were almost twice as likely as men to have a collision in a car park, 23 percent more likely to hit a stationary car, and 15 percent more likely to reverse into another vehicle" (Reuters). Yet gender "differences" are often the outcomes of bad scholarship. Consider Admiral insurance's data. As Britain's Automobile Association (AA) correctly pointed out - women drivers tend to make more short journeys around towns and shopping centers and these involve frequent parking. Hence their ubiquity in certain kinds of claims. Regarding women's alleged spatial deficiency, in Britain, girls have been outperforming boys in scholastic aptitude tests - including geometry and maths - since 1988. On the other wing of the divide, Anthony Clare, a British psychiatrist and author of "On Men" wrote: "At the beginning of the 21st century it is difficult to avoid the conclusion that men are in serious trouble. Throughout the world, developed and developing, antisocial behavior is essentially male. Violence, sexual abuse of children, illicit drug use, alcohol misuse, gambling, all are overwhelmingly male activities. The courts and prisons bulge with men. When it comes to aggression, delinquent behavior, risk taking and social mayhem, men win gold." Men also mature later, die earlier, are more susceptible to infections and most types of cancer, are more likely to be dyslexic, to suffer from a host of mental health disorders, such as Attention Deficit Hyperactivity Disorder (ADHD), and to commit suicide. In her book, "Stiffed: The Betrayal of the American Man", Susan Faludi describes a crisis of masculinity following the breakdown of manhood models and work and family structures in the last five decades. In the film "Boys don't Cry", a teenage girl binds her breasts and acts the male in a caricatural relish of stereotypes of virility. Being a man is merely a state of mind, the movie implies. But what does it really mean to be a "male" or a "female"? Are gender identity and sexual preferences genetically determined? Can they be reduced to one's sex? Or are they amalgams of biological, social, and psychological factors in constant interaction? Are they immutable lifelong features or dynamically evolving frames of self-reference? Certain traits attributed to one's sex are surely better accounted for by cultural factors, the process of socialization, gender roles, and what George Devereux called "ethnopsychiatry" in "Basic Problems of Ethnopsychiatry" (University of Chicago Press, 1980). He suggested to divide the unconscious into the id (the part that was always instinctual and unconscious) and the "ethnic unconscious" (repressed material that was once conscious). The latter is mostly molded by prevailing cultural mores and includes all our defense mechanisms and most of the superego. So, how can we tell whether our sexual role is mostly in our blood or in our brains? The scrutiny of borderline cases of human sexuality - notably the transgendered or intersexed - can yield clues as to the distribution and relative weights of biological, social, and psychological determinants of gender identity formation. The results of a study conducted by Uwe Hartmann, Hinnerk Becker, and Claudia Rueffer-Hesse in 1997 and titled "Self and Gender: Narcissistic Pathology and Personality Factors in Gender Dysphoric Patients", published in the "International Journal of Transgenderism", "indicate significant psychopathological aspects and narcissistic dysregulation in a substantial proportion of patients." Are these "psychopathological aspects" merely reactions to underlying physiological realities and changes? Could social ostracism and labeling have induced them in the "patients"? The authors conclude: "The cumulative evidence of our study ... is consistent with the view that gender dysphoria is a disorder of the sense of self as has been proposed by Beitel (1985) or Pfäfflin (1993). The central problem in our patients is about identity and the self in general and the transsexual wish seems to be an attempt at reassuring and stabilizing the self-coherence which in turn can lead to a further destabilization if the self is already too fragile. In this view the body is instrumentalized to create a sense of identity and the splitting symbolized in the hiatus between the rejected body-self and other parts of the self is more between good and bad objects than between masculine and feminine." Freud, Kraft-Ebbing, and Fliess suggested that we are all bisexual to a certain degree. As early as 1910, Dr. Magnus Hirschfeld argued, in Berlin, that absolute genders are "abstractions, invented extremes". The consensus today is that one's sexuality is, mostly, a psychological construct which reflects gender role orientation. Joanne Meyerowitz, a professor of history at Indiana University and the editor of The Journal of American History observes, in her recently published tome, "How Sex Changed: A History of Transsexuality in the United States", that the very meaning of masculinity and femininity is in constant flux. Transgender activists, says Meyerowitz, insist that gender and sexuality represent "distinct analytical categories". The New York Times wrote in its review of the book: "Some male-to-female transsexuals have sex with men and call themselves homosexuals. Some female-to-male transsexuals have sex with women and call themselves lesbians. Some transsexuals call themselves asexual." So, it is all in the mind, you see. This would be taking it too far. A large body of scientific evidence points to the genetic and biological underpinnings of sexual behavior and preferences. The German science magazine, "Geo", reported recently that the males of the fruit fly "drosophila melanogaster" switched from heterosexuality to homosexuality as the temperature in the lab was increased from 19 to 30 degrees Celsius. They reverted to chasing females as it was lowered. The brain structures of homosexual sheep are different to those of straight sheep, a study conducted recently by the Oregon Health & Science University and the U.S. Department of Agriculture Sheep Experiment Station in Dubois, Idaho, revealed. Similar differences were found between gay men and straight ones in 1995 in Holland and elsewhere. The preoptic area of the hypothalamus was larger in heterosexual men than in both homosexual men and straight women. According an article, titled "When Sexual Development Goes Awry", by Suzanne Miller, published in the September 2000 issue of the "World and I", various medical conditions give rise to sexual ambiguity. Congenital adrenal hyperplasia (CAH), involving excessive androgen production by the adrenal cortex, results in mixed genitalia. A person with the complete androgen insensitivity syndrome (AIS) has a vagina, external female genitalia and functioning, androgen-producing, testes - but no uterus or fallopian tubes. People with the rare 5-alpha reductase deficiency syndrome are born with ambiguous genitalia. They appear at first to be girls. At puberty, such a person develops testicles and his clitoris swells and becomes a penis. Hermaphrodites possess both ovaries and testicles (both, in most cases, rather undeveloped). Sometimes the ovaries and testicles are combined into a chimera called ovotestis. Most of these individuals have the chromosomal composition of a woman together with traces of the Y, male, chromosome. All hermaphrodites have a sizable penis, though rarely generate sperm. Some hermaphrodites develop breasts during puberty and menstruate. Very few even get pregnant and give birth. Anne Fausto-Sterling, a developmental geneticist, professor of medical science at Brown University, and author of "Sexing the Body", postulated, in 1993, a continuum of 5 sexes to supplant the current dimorphism: males, merms (male pseudohermaphrodites), herms (true hermaphrodites), ferms (female pseudohermaphrodites), and females. Intersexuality (hermpahroditism) is a natural human state. We are all conceived with the potential to develop into either sex. The embryonic developmental default is female. A series of triggers during the first weeks of pregnancy places the fetus on the path to maleness. In rare cases, some women have a male's genetic makeup (XY chromosomes) and vice versa. But, in the vast majority of cases, one of the sexes is clearly selected. Relics of the stifled sex remain, though. Women have the clitoris as a kind of symbolic penis. Men have breasts (mammary glands) and nipples. The Encyclopedia Britannica 2003 edition describes the formation of ovaries and testes thus: "In the young embryo a pair of gonads develop that are indifferent or neutral, showing no indication whether they are destined to develop into testes or ovaries. There are also two different duct systems, one of which can develop into the female system of oviducts and related apparatus and the other into the male sperm duct system. As development of the embryo proceeds, either the male or the female reproductive tissue differentiates in the originally neutral gonad of the mammal." Yet, sexual preferences, genitalia and even secondary sex characteristics, such as facial and pubic hair are first order phenomena. Can genetics and biology account for male and female behavior patterns and social interactions ("gender identity")? Can the multi-tiered complexity and richness of human masculinity and femininity arise from simpler, deterministic, building blocks? Sociobiologists would have us think so. For instance: the fact that we are mammals is astonishingly often overlooked. Most mammalian families are composed of mother and offspring. Males are peripatetic absentees. Arguably, high rates of divorce and birth out of wedlock coupled with rising promiscuity merely reinstate this natural "default mode", observes Lionel Tiger, a professor of anthropology at Rutgers University in New Jersey. That three quarters of all divorces are initiated by women tends to support this view. Furthermore, gender identity is determined during gestation, claim some scholars. Milton Diamond of the University of Hawaii and Dr. Keith Sigmundson, a practicing psychiatrist, studied the much-celebrated John/Joan case. An accidentally castrated normal male was surgically modified to look female, and raised as a girl but to no avail. He reverted to being a male at puberty. His gender identity seems to have been inborn (assuming he was not subjected to conflicting cues from his human environment). The case is extensively described in John Colapinto's tome "As Nature Made Him: The Boy Who Was Raised as a Girl". HealthScoutNews cited a study published in the November 2002 issue of "Child Development". The researchers, from City University of London, found that the level of maternal testosterone during pregnancy affects the behavior of neonatal girls and renders it more masculine. "High testosterone" girls "enjoy activities typically considered male behavior, like playing with trucks or guns". Boys' behavior remains unaltered, according to the study. Yet, other scholars, like John Money, insist that newborns are a "blank slate" as far as their gender identity is concerned. This is also the prevailing view. Gender and sex-role identities, we are taught, are fully formed in a process of socialization which ends by the third year of life. The Encyclopedia Britannica 2003 edition sums it up thus: "Like an individual's concept of his or her sex role, gender identity develops by means of parental example, social reinforcement, and language. Parents teach sex-appropriate behavior to their children from an early age, and this behavior is reinforced as the child grows older and enters a wider social world. As the child acquires language, he also learns very early the distinction between "he" and "she" and understands which pertains to him- or herself." So, which is it - nature or nurture? There is no disputing the fact that our sexual physiology and, in all probability, our sexual preferences are determined in the womb. Men and women are different - physiologically and, as a result, also psychologically. Society, through its agents - foremost amongst which are family, peers, and teachers - represses or encourages these genetic propensities. It does so by propagating "gender roles" - gender-specific lists of alleged traits, permissible behavior patterns, and prescriptive morals and norms. Our "gender identity" or "sex role" is shorthand for the way we make use of our natural genotypic-phenotypic endowments in conformity with social-cultural "gender roles". Inevitably as the composition and bias of these lists change, so does the meaning of being "male" or "female". Gender roles are constantly redefined by tectonic shifts in the definition and functioning of basic social units, such as the nuclear family and the workplace. The cross-fertilization of gender-related cultural memes renders "masculinity" and "femininity" fluid concepts. One's sex equals one's bodily equipment, an objective, finite, and, usually, immutable inventory. But our endowments can be put to many uses, in different cognitive and affective contexts, and subject to varying exegetic frameworks. As opposed to "sex" - "gender" is, therefore, a socio-cultural narrative. Both heterosexual and homosexual men ejaculate. Both straight and lesbian women climax. What distinguishes them from each other are subjective introjects of socio-cultural conventions, not objective, immutable "facts". In "The New Gender Wars", published in the November/December 2000 issue of "Psychology Today", Sarah Blustain sums up the "bio-social" model proposed by Mice Eagly, a professor of psychology at Northwestern University and a former student of his, Wendy Wood, now a professor at the Texas A&M University: "Like (the evolutionary psychologists), Eagly and Wood reject social constructionist notions that all gender differences are created by culture. But to the question of where they come from, they answer differently: not our genes but our roles in society. This narrative focuses on how societies respond to the basic biological differences - men's strength and women's reproductive capabilities - and how they encourage men and women to follow certain patterns. 'If you're spending a lot of time nursing your kid', explains Wood, 'then you don't have the opportunity to devote large amounts of time to developing specialized skills and engaging tasks outside of the home'. And, adds Eagly, 'if women are charged with caring for infants, what happens is that women are more nurturing. Societies have to make the adult system work [so] socialization of girls is arranged to give them experience in nurturing'. According to this interpretation, as the environment changes, so will the range and texture of gender differences. At a time in Western countries when female reproduction is extremely low, nursing is totally optional, childcare alternatives are many, and mechanization lessens the importance of male size and strength, women are no longer restricted as much by their smaller size and by child-bearing. That means, argue Eagly and Wood, that role structures for men and women will change and, not surprisingly, the way we socialize people in these new roles will change too. (Indeed, says Wood, 'sex differences seem to be reduced in societies where men and women have similar status,' she says. If you're looking to live in more gender-neutral environment, try Scandinavia.)"