Frequently Asked Questions About Erectile Dysfunction

Featured Image Frequently Asked Questions About Erectile Dysfunction

Erectile dysfunction is a condition where a man cannot get a firm erection and cannot have sex. In short, ED interferes with the sexual performance of a man. There are many men out there going through these problems. They find it hard to get an erection and to stay firm enough to penetrate. It is declared a problem when a man's sexual performance has been unsatisfying to both the man and the woman. It is not easy for men to look for medical attention because they find it embarrassing.

Facts defining erectile dysfunction

  • Erectile dysfunction is the difficulty in achieving and maintaining an erection during sex.
  • Most causes of erectile dysfunction can be medical, psychological, or physical.
  • Organic causes of erectile dysfunction are caused by underlying health problems that affect blood vessels and nerves that supply blood in the penis.
  • Another major cause of erectile dysfunction is alcohol, smoking, recreational drugs, and prescription drugs.

It is worth seeing a physician because ED could be a result of a severe illness. Whatever the cause, a proper diagnosis will help address any medical issues or anything causing sexual difficulties. Some of the diseases that can cause erectile dysfunction include:

  • Heart diseases or narrowed blood vessels.
  • High blood pressure
  • Diabetes
  • Obesity
  • Parkinson's disease
  • High cholesterol
  • Prostate cancer

Other causes of erectile dysfunction include:

  • Hormonal changes
  • Penis anatomical disorder
  • Smoking, substance abuse, and alcoholism
  • Surgical complications
  • Radiotherapy

Common Treatment for Erectile Dysfunction

There are many prescription medications used to treat erectile dysfunction. Though some men buy them from local stores without a prescription, it advisable that one seeks medical advice from their doctor before using any of them. You cannot use these drugs if:

  • Using any drugs to control blood pressure.
  • Heart disease medications
  • Diuretics
  • Any drugs related to anything affecting the central nervous system, such as amphetamines and sleeping pills.
  • Anxiety drugs
  • Opioid painkillers
  • Antidepressants
  • Cancer drugs
  • Hormone drugs
  • Peptic ulcer treatment

Psychological issues causing Erectile Dysfunction

Psychological problems are the main reason most men fail to achieve an erection. The main causes of this are:

  • Depression
  • Guilt
  • Fear

Most ED cases are as a result of a problem in a man’s body. But persistent and new ED problems are likely to be physical. You find that mental illness is the major cause of ED as a secondary health issue. For example, a man who is overweight may have damaged vessels, but the main problem may be lack of self-confidence making his ED worsen due to psychological issues even before the physical problems can affect him.

What else can cause erectile dysfunction?

There has been a question regarding some physical activities such as cycling. According to previous research, riding a bike for many hours puts a man at risk of ED, prostate cancer and infertility. However, the latest study shows that ED and cycling are not related in any way. But there is increased risk of prostate cancer in men who ride for longer hours.

It goes without saying that injuries sustained in various sporting activities can cause ED.  Every man should seek medical treatment as soon possible if gets any injuries on the penile and pelvic area to prevent importance.

Frequently Asked Questions

Erectile dysfunction is a common problem among men. This refers to the inability to get and maintain an erection that is firm enough for sex. It becomes a big problem when the dysfunction doesn't go away. It affects sexual performance and causes mental stress, which affects a man's confidence and causes relationship problems.

 

Besides, impotence is a sign of an underlying health problem such as diabetes or heart disease. Male arousal is a long process that involves hormones, nerves, brain, blood vessels, and emotions. When any of these is affected, it can cause erectile dysfunction. Mental stress can accelerate or worsen erectile dysfunction.

 

Erectile dysfunction is a common problem because it may be caused by either psychological or physical issues or even both. For example, a minor physical issue can slow a man's sexual response and lead to anxiety, making maintaining an erection impossible. This is the common cause of impotence in men because once a man realizes his sexual performance is poor, he gets affected mentally.

There are several ways to cure erectile dysfunction without visiting the hospital. Instead of going to the hospital, you can use some home remedies to bring back your sexual performance. The best thing is that they are all-natural remedies and they include:

  • Maintaining a healthy weight and eating a balanced diet. This prevents obesity, which is one of the leading causes of erectile dysfunction disorders. A diet with minimal or fats and cholesterol is digested fast and doesn't encourage fat accumulation around the belly. You should also drink enough water to provide energy which regulates chemical processes. The diet is incomplete without vegetables and fruits to keep you healthy
  • Spare enough time to exercise. It boosts blood flow in the body and improves your muscles' strength awhile, ensuring that the cardiovascular system works efficiently.
  • Reduce stress at your workplace and home by solving any problems that may arise instead of holding bitterness and anger.
  • Quit smoking if you used to because too much consumption damages the lungs and the flow of blood through the veins is interrupted.
  • For how many hours do you sleep? Have enough sleep so that the body prepares for another day and also prevention of weight gain.

These are just a few of the home remedies for erectile dysfunction. Just make sure you talk to a doctor before you start using one. 

Causes of erectile dysfunction are many. But the best thing is that they can be avoided and others treated successfully. Common causes of this disorder include:

  • Taking some drugs, including both prescription and non-prescription.
  • Stress from home or jobs places a man emotionally and mentally, leading to the inability to get sexually excited.
  • Poor communication between two people can cause poor sexual performance in a man. A man who does not trust his partner will have problems in bed and cannot rise for the occasion adequately.
  • Underlying conditions such as kidney disorders, diabetes, hypertension, or cancer can cause ED. A man must undergo proper treatment and stick to the instructions given by their doctor if they want to perform sexually. While some of these conditions like diabetes are known to cause impotence, the right diet and medication consistency can prevent erectile dysfunction.
  • The use of tobacco restricts smooth blood flow to arteries and veins. With time, it also affects the blood flow in the penis leading to erectile dysfunction.

The doctor is always in abetter position to help you know what caused your ED. Visit one to under the required tests. 

According to a study, one person among the ten cannot have a solid erection. The best thing is that there are drugs for erectile dysfunction. Oral treatment is the first option that most patients get from their doctor. They do work but come with a few side effects. The safest drug is Sildenafil or Viagra. It reverses the impotence problem by increasing nitric levels in the body. This helps the penis muscles to relax, and blood flow increases, leading to a stiff and robust erection that can penetrate without any problems.

Sildenafil is not the only drug prescribed by doctors. It is common and usually taken on an empty stomach about one before a man can perform. Its effectiveness lasts up to five hours and works well in men with mild or moderate impotence.

Another drug that may be prescribed is Vardenafil, which can be taken with or without a meal. It also lasts up to five hours. Tadalafil or Cialis is taken on either a full or an empty stomach. It stays in the body for up to 36 hours. The dose to be taken depends on when it's needed. This ranges from the daily intake or large doses when needed.

None of the medications is 100% safe. But with proper use, these drugs are safe.

Vitamins boost immunity and help in repairing body tissues and heal wounds. They may no cure impotence but can help when combined with other forms of impotence treatments. Some of the vitamins that you can use to improve erectile dysfunction include:

Vitamin B9: This is also known as a folic acid supplement, which allows sufficient blood circulation and prevents hardening of the arteries. According to doctors, keeping the veins healthy, will enhance or help cure impotence.

Foods rich in vitamin B9:

  • Avocados
  • Legumes
  • Vegetables
  • Bananas
  • Broccoli
  • Cereals

 

Vitamin D: It improves testosterone levels in a man's body and also boosts a healthy immune system. Foods rich in vitamin D include:

  • Fatty fish
  • Egg yolks
  • Mushrooms
  •  

 

Vitamin B3: It is also known as Niacin which reduces hardening of the arteries to allow smooth circulation of blood around the whole body, including the penis. You should eat the following foods:

  • Liver
  • Turkey
  • Chicken breast
  • Green peas
  • Mushrooms

Start with lower intake of vitamins and increase with time.

Although herbs are difficult to identify and access, they are cheap and have fewer side effects. Most people are also not willing to eat herbs because they are not appealing. The taste behind them is very bitter, leaving an unpleasant taste in the mouth, and why most people do not want to take them. Before using any herbs, consult a medical physician to help you decide whether your health allows you to use them.

  • Panax ginseng is a Chinese Korean herb that is considered a safe treatment but should be used for a short-term period. This herb causes lack of sleep at night commonly and should therefore be used moderately.
  • Maca is a root vegetable rich in amino acids, iron, iodine, and magnesium. It is available in three types, including yellow, black and red. It helps men in sexual performance by keeping the body healthy and alleviating stress.
  • Men use horny goat weed to cure erectile dysfunction. Women also use it to reduce pain experienced during intercourse. This herb helps to enhances blood flow, which ensures a man gets a hard erection.

While herbs used for erectile dysfunction treatment are not 100% perfect, they come with less side effects compared to medical treatments. 

What is testosterone? This is the anabolic steroid and main sex hormone found in males. It helps the male reproductive organs to develop tissue in the reproductive area. Low testosterone reduces the ability to have a strong erection. Sex drive reduces in men as they grow older because levels of testosterone reduce.

When a man hits 40, their libido starts waning. Low levels of testosterone can also affect a man's mood, bone density, and increased fatigue. Besides, low testosterone, when combined with other health issues, leads to sexual performance decline. Signs of low testosterone include the following:

  • Loss of hair
  • The size of testicles reduce
  • Lack of sleep
  • Semen amount reduces
  • A sudden change of moods
  • Increased body fat

The best treatment for this is testosterone replacement therapy from a doctor. It helps to relieve symptoms. Any man with testosterone issues should talk to a doctor. It takes a blood test to check testosterone levels and start the treatment.

Most men do not have a problem to get sexually excited and maintain until he is ready to ejaculate. However, there are some signs that could signify an underlying problem that can lead to erectile dysfunction. Here are some signs to look out for:

 

  • Lack of frequent morning erection is one of the signs that a man's sexual strength is declining. It means something is wrong in the body, and therefore, blood cannot flow into the male organ properly even after a night's rest.
  • When exciting sexual thoughts are no longer as impressive as they used to be. This means a man stops thinking about sex a lot because of low testosterone levels in the body.
  • Increased blood pressure and cholesterol levels. They are a sign that you vessels could be damaged and likely to hinder blood flow in the body including in the penis.
  • Swollen gums that are painful or even bleed after brushing cause inflammation in the body. This eventually leads to blood vessels' damage, which translates to poor blood flow in the penis and hinders a good erection.

The signs of ED are not limited to this. Any man who feels their sexual drive is declining should seek medical attention as soon as possible.

Yes, an urologist can help with erectile dysfunction. Urologists treat patients with infections in the male reproductive organs and urinary tract. They carry out different tests to determine the cause of the impotence or infection before giving treatment. Here are some simple steps that an urologists will follow when treating erectile dysfunction in a patient for the first time:

  • The patients' medical history is required: A doctor checks for any underlying conditions or use of drugs likely cause ED malfunctioning.
  • A physical examination is performed: the level of blood pressure is checked because when higher than normal, it could indicate damaged arteries in the body. The penis is also examined for any visible injuries.
  • Blood and urine are tested to check the level of blood sugar and cholesterol and any infections.
  • Ultrasound for the penis: the doctor injects medicine that causes an erection to check through how the blood flows around.

With these tests, an urologist can tell where to start with erectile dysfunction treatment.

It is possible to stay erect longer without pills. Not every erectile dysfunction requires medical treatment. Some are caused by things that you can solve without taking any pills. Here is you can maintain your erection without the pills.

  • Avoid consuming processed food that contains a lot of fats and preservatives, which increase risks of damaged veins and eventually cause impotence
  • Eat more fruits rich in vitamins and fiber that improve blood sugar levels and control the body's amount of cholesterol.
  • Heavy alcohol intake should be avoided to reduce because it is the easiest way to take empty calories. This causes a big belly and bad fat in the body; both can cause erectile dysfunction.
  • Exercising can be done at home or in the office. If you have no time for the gym, just set aside time to work out alone. This will help tone muscles and enhance blood circulation in the body.
  • Maintain your body weight by checking on what you eat. Avoid eating too many carbs and greasy food despite craving for them because they cause obesity. Instead, go for healthy options such as fruits and vegetables and stay hydrated throughout the day.

There you go, identify what cause you low libido and apply the best solution without taking any pills.

A man who has been accused of infidelity can have erectile dysfunction due to guilt. The mental torture and failure to forgive himself will haunt him during foreplay and keep distracting him. Since a man cannot get sexually excited without a calm mind, he cannot get an erection as long as the guilt is on his mind.

Other men suffer from the guilt of not being able to satisfy their partners. If the issue is not solved with time, it contributes to the ED problem and worsens due to mental stress. A guilty man has no self-confidence. He is ashamed of himself and is likely to suffer depression as he feels worthless, which makes him sad and eventually leads to a severe depressive disorder.

The relationship between guilt and ED is complicated. But it does exist and brings many other mental problems such as anxiety and depression leading to impotence.

The male enhancement pills offer quick solution for men who have erectile dysfunction. It is easy because the pills are available in local drug stores without a doctor's prescription. However, despite giving the desired results, the male enhancement pills come with side effects that include:

  • Blood pressure drops suddenly, which can be fatal.
  • Difficulty in maintaining an erection without the help of the pills.
  • Pain experienced when passing urine due to damaged nerves around the penis.
  • The urethra can be damaged, leading to discomfort when releasing semen or passing urine.

Start on a low dosage, but be sure to talk to a doctor before taking any of the pills. If you experience symptoms showing a decline of sexual libido, look for help from a qualified doctor. Avoid rushing to the nearest drug store for male enhancement pills. Some of the ED problems can be cured using natural remedies that you can find at home to avoid these unpleasant side effects of male enhancement pills. .

Erectile Dysfunction can be cured using natural remedies. The best thing is that most of these natural ways of treating ED naturally give permanent results. Some of the trusted treatments include:

  • The use of natural herbs such as giseng and ginkgo can help cure ED. These herbs have been used for years and come with light side effects. However, it is always advisable to talk to your doctor before using any of these herbs.
  • Exercise daily, either in the morning or evening. Have a workout routine, and it will help you lose weight, enhance blood flow and relieve any mental stress. These benefits will eventually help cure ED.
  • Eat a healthy balanced meal to help maintain your body weight and avoid belly fat, which is the number one cause of ED.
  • Have enough sleep to allow the body to relax and gain more energy every day. Lack of sleep is a sign of an underlying problem such as stress, so get help if you have insomnia.

Food can keep the body healthy if you make the right choices. Erectile dysfunction can be treated with a healthy diet. Here are some foods you should consume regularly and enjoy to increase sexual libido.

  • Fresh spinach boosts testosterone levels because it contains folic acid, which helps prevent Erectile Dysfunction. It also contains magnesium known for maintaining healthy testosterone levels in the body.
  • Apple peels have ursolic acid that prevents prostate cancer. They keep the penis healthy and prevent ED.
  • Avocados: According to the Aztecs, an avocado tree is the "testicle tree." These fruits are sources of healthy fats, vitamins, and potassium, which are all essential to keeping the male organ healthy.
  • Chili peppers have capsaicin that triggers the release of the good hormone known as endorphins. They help to increase sexual libido in men.
  • Carrots are a superfood that improves the motility or moment of sperms and their numbers. The chemical in carrots known as carotenoids gives this vegetable the orange color and is the reason it helps to cure ED.

Millions of men are affected by erectile dysfunction across the world. They suffer from problems such as failure to achieve or maintain an erection. While some male enhancement pills have proven to work, such as Viagra, you can also take vitamins to help cure the ED problem.

Vitamin C, which is the Ascorbic acid, enables the body to release nitric oxide. You will find it in the following foods:

  • Berries
  • Citric fruits
  • Cabbage
  • Spinach
  • Broccoli

L- Arginine improves the circulation and flow of blood around the penis leading to a solid erection. You will find it in:

  • Watermelon
  • Nuts
  • Legumes
  • Meat

Vitamin D boosts the testosterone levels in the body while also improving immunity. You will find it in foods such as:

  • Egg yolks
  • Mushroom
  • Fish

The best thing about vitamins is that they are available in common foods. The taste of the food is great and so you don’t struggle to consume them.

Shock wave therapy is the latest treatment for erectile dysfunction and it has drawn much attention among men and medical practitioners. This treatment involves passing the sound wave along erectile tissue to improve blood functioning and allow new vessels to grow. There are other treatments used, which include:

  • Stem cell therapy where a stem cell is injected into the penis. Research shows that it is a safe process to treat ED in men. It is a form of therapy that is still under research, but it's quite promising.
  • Uprima is a tablet that dissolves under the tongue, stimulating the brain to increase sexual urge.
  • Gene therapy involves the replacement of body protein to correct the effects leading to ED.
  • Topiglan is in cream form applied around the penis, and sometimes it's used as an injection for quicker and safer results.

There are many latest forms of treatments for erectile dysfunction. But some are still being researched before approval.

Men mostly go for workouts to build their muscles and abs. However, they can engage in exercises that can help them with erectile dysfunction. Some of the exercises you can use to enhance your sexual libido include:

  • Kegel exercises or pelvic floor exercises are good for ED treatment. The exercises target the pubococcygeeus, muscle in the lower part of the pelvis. It also targets the pubic bone and the tailbone that support the organs in the pelvic area. Poor blood flow in the pelvis causes ED but can be improved through exercises.
  • Pilate exercises activate the pelvic muscles and help to increase strength around this area. This helps men overcome ED.

Using exercises to treat erectile dysfunction gives you lasting results. They are also more effective compared to other forms of treatments. The best thing about exercises is that they tackle stress, obesity, and many others and assure men positive results.

Apart from male enhancement pills, there are herbs that you can buy over the counter. They are sold in the form of pills but are made from natural ingredients. They include:

  • Yohimbe improves blood flow in the penis. It increases the production of norepinephrine, which is a neurotransmitter that helps a man get an erection. This herb also improves ejaculation and orgasmic function in men.
  • Ginseng pill is a strong aphrodisiac, and especially the Korean red ginseng has proven to be effective in ED treatment. It improves orgasmic function, overall sexual satisfaction and erectile function.
  • L-Arginine is an amino acid that improves blood around the penis and therefore comes in handy in ED treatment. It maintains the right levels of nitric oxide levels in the nerves and enables a man to maintain an erection.
  • Propionyl-L-carnitine occurs in the body naturally and is related to L-carnitine. It enhances blood flow and various issues that may interfere with the circulatory system. This makes it ideal for ED treatment.

Mental health problems can cause or worsen erectile dysfunction. In the past few years, ED was associated with older men. But currently, many young men are going through sexual-related problems due to mental health. Men as young as 20 years have impotence due to psychological issues. The worst thing is that once he notices that his sexual response is slow, a man worries a lot about getting and maintain an erection, which leads to anxiety and sometimes depression. What are the common mental problems which are likely to cause this?

  • Lack of trust is one of the leading causes of mental issues. Having secrets and lack of proper communication has seen many men suffer from ED. The anger builds up, and the stress increases and eventually leads to the occasion's inability to rise.
  • Stress and anxiety from home or job places make men lose interest in sex. To deal with such problems, a man should get busy with exercises and deal with issues causing stress. This will help them forget the negative vibes and become happy, eventually opening up for sexual excitement.
  • Depression is the worst place that a man can find himself as far as their mental is concerned. An individual starts hating on themselves wondering and feel worthless. Some men avoid visiting ladies or looking for a spouse because they think that he will not be appreciated for who he is. This lack of self-confidence ruins the sexual lives and causes them to fail terribly when attempting to have sex.

Erectile dysfunction may not be entirely 100% mental. But anything affecting many men mentally can cause or worsen erectile dysfunction.

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The EPOR modela human sexual response cycle model

Proposed a four-phase linear, sequential, and incremental model of the human sexual response cycle ( Fig 1). The phases were described as the excitation (E) phase (stimuli from somatogenic or psychogenic sources raise sexual tensions), the plateau ( P) phase (sexual tensions intensified), the orgasmic (O) phase (involuntary pleasurable climax), and finally the resolution (R) phase (dissipation of sexual tensions). The great success of this EPOR model was its wide compass it could characterize the sexual responses of women and men, both heterosexual and homosexual, ranging from simple petting to vaginal or anal coitus with orgasm. However, it had several weaknesses. Fig. 1 The development of the linear-sequence human sexual response model from (a) the original EPOR model of Masters and Johnson (2 9 through (b) the DEOR

Physiology Of Penile Erection

The physiology of penile erection involves an interplay of anatomical, hemodynamic, neurophysiological, and sex hormone interaction. Penile erection is the result of a complex interaction between the central nervous system and other local factors. This physical event also can be influenced by psychological factors. 5-Hydroxytryptamine (5-HT), dopamine, and nor-epinephrine play important roles as central neurotrans-mitters in the process of erection. Still other substances or hormones, such as endorphins, oxytocin, vasopressin, adrenocorticotropic hormone (ACTH) and related peptides, and prolactin, appear to participate in the complex and coordinated process of penile erection. Central nonadrenergic neurons also may influence male sexual behavior. Nitric oxide (NO) released during nonadrenergic, noncholinergic (NANC) neurotransmission and from the vascular endothelium is most likely the major neu-rotransmitter mediating penile erection.

SEXuAl Response Cycle

Two pioneering researchers, William Masters and Virginia Johnson, identified four stages of sexual response. These stages excitement, plateau, orgasm, and resolution are known as the human sexual response cycle. Two basic processes occur during sexual response vasocongestion and myotonia. Vasocongestion refers to the concentration of blood in the blood vessels and in the tissues of the genitals and breasts. In men, vasocongestion occurs when arterial blood flow to the penis increases and venous outflow decreases. Erection is a result of increased blood flow to the spongy tissue (corpora cavernosa) of the penis, causing these tissues to expand. In women, this inflow of blood causes the clitoris to enlarge, the labia to swell, and the vagina to lubricate. Myotonia, or neuromuscular tension, refers to the increase of energy in nerves and muscles. During sexual activity, myotonia takes place throughout the body, affecting both involuntary and skeletal muscles.

The Evolutionary Neurodevelopmental Perspective Atp

Finally, avoidants, dependents, compulsives, and negativists are all part of the so-called anxious cluster, personalities for whom anxiety is a prominent life concern. Avoidants and dependents are alike in sharing deep feelings of personal inadequacy but differ in their response to perceived inadequacy. When threatened with feelings of helplessness, dependents seek to bind others even closer to them by increasing their submis-siveness and attempting to please others all the more. In contrast, the avoidant is often very effective in nonsocial situations the dependent is not. Avoidants run away at the first sign of negative evaluation dependents stay and try to please. Both avoidants and compulsives share performance anxiety and a fear of evaluation, which they modulate with extraordinary self-control. Compulsives, however, are usually able to sublimate their anxiety into a preoccupation with rules, details, lists, and such avoidants are more likely to simply withdraw from social venues.

The Evolutionary Neurodevelopmental Perspective Ypr

The last personality with which the narcissist shares some resemblance is the sadistic. The passive exploitation of the narcissist is often mistaken for the active exploitation of the sadist. In the narcissist, however, exploitation is incidental to egocentricity. In contrast, the sadist dominates others self-consciously and deliberately constructs scenarios that demean others to force their inferior status to consciousness. The narcissist wants your worship the sadist wants to inflict impotence on others. Further, whereas the sadistic personality is characteristically destructive and cruel and enjoys watching others suffer, narcissists become rageful only when their sense of specialness is compromised. Otherwise, narcissists are content to go forth with benign insouciance, surveying their dominion and soaking up tributes and comforts owed to them by lesser others. If Leonardo returns to Spain, he will do so with just this mentality.

Antiparkinsonian Therapy And Hypersexuality

Sexual awareness or activity was reported in 3 to 4 instances. The authors noted that the 5 men in the 40 to 60 year age group, with a relatively mild form of parkinsonism and 1 to 2 year history of impotence, demonstrated improved motor function with therapy but did not report a change in sexual function. To assess the effect of L-dopa treatment on sexual behavior in 12 men and 7 women, treated for 3 to 15 months, semistructured interviews were conducted.14 The interviewers assigned numerical values to interview responses. Six men and one woman (37 ) reported activation of sexual behavior at some point during the therapy. There were strong negative trends between sexual activity and age of patient (r -.42) and duration of parkinsonism (r -.44). Three patterns of change in sexuality were described. In the first pattern, general improvement in overall function was accompanied by mild improvement in sexual function.

Drugs That Interfere With Norepinephrine Storage

Peripheral nervous system side effects are the result of a reserpine-induced reduction of sympathetic function and unopposed parasympathetic activity symptoms include nasal congestion, postural hypotension, diarrhea, bradycardia, increased gastric secretion, and occasionally impotence. Because of the increased gastric secretion, reserpine is contraindicated for patients

Paraphilia not otherwise specified

Zoophilia is an activity that involves becoming sexually aroused by repetitively carrying out sexual activities with animals. Zoophiles usually have other sexual outlets, but participate in zoophilia because of the ease of accessing animals for sexual purposes and the low risk of apprehension for such activity. Therapists frequently view zoophilia as a trivial problem that serves as a butt for jokes. In actuality, zoophilia is a more serious paraphilia than suspected because of the consequences of the learned behaviour.

Fascia and Ligaments of the Pelvic Floor

Pelvic Floor Ligament Suspension

Posterior to the rectum is the mesorectum, which contains both blood vessels and lymphatics that supply and drain the rectum. This is loosely bound down the front of the sacrum and coccyx by connective tissue known as the fascia propria. The lateral ligaments, which attach the rectum to the pelvic walls, are condensations of the fascia propria and contain loose areolar tissue, nerves, and small blood vessels. Thus, the mesorectum can be mobilized by dissection in the mesorectal plane leaving the mesorec-tum invested in this thin layer of fascia. The sacrum and coccyx are also covered in a thicker fascia, which extends downward and forward, just superficial to the anococ-cygeal ligament known as Waldeyer's fascia. Anteriorly the rectum is covered with a layer of visceral fascia that extends from the anterior peritoneal reflection to the urogenital diaphragm. This is Denonvilliers fascia and lies between the rectum and vagina (or prostate in men).

Primer on Sulbutiamine

Studies show it is an effective treatment for psychogenic erectile dysfunction. This means men who experience erectile dysfunction because of psychological issues such as depression, anxiety, or stress can get relief. While this may not sound like a big deal, compared to drugs prescribed to treat this condition, sulbutiamine is not only cheaper, but a much safer option.

Corticosteroid Levels May Deplete the Effects of Racetam Nootropics

Cortisol carries a lot of essential functions in the body however extended release can cause a lot of negative interactions. It is released during times of stress to limit less important functions such as immune function and energy metabolism. It also works to block insulin and reduce sexual function amongst many other negative consequences

5 Different Types Of Nootropic Stacks

Mucuna Pruriens and Panax Ginseng are the two herbal constituents of this stack. Mucuna works to increase dopamine levels and to a lesser extent, serotonin. Increasing both of these monoamine neurotransmitters may improve cognitive function. The dopamine neurotransmitter is related to focus, learning and motivation whilst, serotonin can help to improve mood, memory and promote calmness in some people. Panax Ginseng may work as a stimulant and could have other health benefits. The last components of this stack are two adaptogenic herbs Panax Ginseng and Rhodiola Rosea. Don't be fooled by these herbal components. These two spectacular herbs may boost energy levels and reduce stress hormones. Just be careful not to take these too close to bedtime as they may cause insomnia in some people.

Prostate Problems

Impotence is often a psychological problem more than a physical one. Drugs, tobacco, diabetes, and atherosclerosis can affect blood circulation which influences erectile ability. The herb yohimbe has been shown to improve erectile and ejaculatory activity. Hypnotherapy may also be beneficial. Ginseng and the Ayurvedic herb ash-waganda can enhance sexual energy.

Guanethidine

A common and troublesome side effect is postural hypotension. Sexual impotence does occur, and male patients may have difficulty ejaculating. Symptoms of unopposed parasympathetic activity include such gastrointestinal disturbances as diarrhea and increased gastric secretion.

Frotteurism

The frotteur rubs up against the buttocks, thighs, breasts, or vaginal area with his hand, his leg, his pelvic area, or with a newspaper or some other object. Despite being in a crowded public setting, while rubbing a complete stranger, he finds it easy to fantasize a close sexual relationship with the victim and can get an erection in seconds. Sometimes he will push his erect penis, underneath his clothes, up against the woman's thighs or buttocks.

Delayed ejaculation

Apfelbaum(77) criticizes the inhibition model, stating that increased intense stimulation is a demanding and coercive strategy that heightens performance anxiety. His treatment efforts are aimed at having the men acknowledge their lack of both desire to have intercourse and arousal during intercourse. His model mirrors the conventional therapy for female anorgasmia, focusing on decreasing demand and helping the patient focus on heightening erotic sensations. No outcome statistics on Apfelbaum's model have been presented.

Dysphagia

Improvement in esophageal dysphagia has been reported with apomorphine administration,108,109 although extensive testing has not been undertaken. It has been suggested that sildenafil might be of benefit in the treatment of spastic esophageal motor disorders110 because of its effect on nitric oxide, but there have been no published reports of its use for this purpose in PD. It is worth noting that transient esophageal obstruction has been attributed to levodopa, with resolution following drug discontinua-tion.111

Exhibitionism

Exhibitionists are characterized by recurrent compulsive urges to expose their genitals to another person, usually an adult (DSM-IV code 302.4 ICD-10 code F65.2).(34) Exhibitionists have strong sexual urges to expose themselves that become so intense that they find themselves sexually aroused and making concerted efforts to expose themselves to particular individuals. Although a few exhibitionists expose themselves to males, this is infrequent exhibitionism is generally perpetrated by males against females.