Male and Female Erectile Dysfunction Cure
Sexual Performance
Medical Encyclopedia: Erection problems
www.nlm.nih.gov/medlineplus/ency/article/003164.htm
National Library of Medicine
Erectile dysfunction; Impotence; Sexual dysfunction - male
Definition
An erection problem is the inability to get or maintain an erection that is firm
enough for a man to have intercourse. You may be unable to get an erection at all,
or you may lose the erection during intercourse before you are ready. If the
condition persists, the medical term is erectile dysfunction.
Considerations
Erection problems are common in adult men. In fact, almost all men experience
occasional difficulty getting or maintaining an erection. In many cases, it is a
temporary condition that will go away with little or no treatment. In other cases, it
can be an ongoing problem that can damage a man's self esteem and harm his
relationship with his partner, and thus requires treatment.
If you have difficulty having or keeping an erection more than 25% of the time, it
is considered a problem.
In the past, erection problems were thought to be "all in the man's mind." Men
often were given unhelpful advice such as "don't worry" or "just relax and it will
take care of itself." Today, doctors believe that when the problem is not temporary
or does not go away on its own, physical factors are often the cause.
One way to know if the cause is physical or psychologic is to determine if you are
having nighttime erections. Normally, men have 3 to 5 erections per night,
In most men, erection difficulties do not affect their sex drive.
Premature ejaculation (when orgasm comes on too quickly) is not the same as
impotence. Together with your partner, you should seek counseling for this
problem, which is usually due to psychological factors.
Male infertility is also quite different from impotence. A man who is unable to
maintain an erection may be very capable of producing sperm that could fertilize
an egg. An infertile man is usually able to maintain an erection, but he may be
unable to father a child due to problems with sperm count or other factors.
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An erection requires the interaction of your brain, nerves, hormones, and blood
vessels. Anything that interferes with the normal process can become a problem.
Common causes
include:
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Diseases and conditions such as diabetes high blood pressure, heart or thyroid
conditions, poor circulation, low testosterone, depression, spinal cord injury,
nerve damage (for example, from prostate surgery, or neurologic disorders
(like multiple sclerosis or Parkinson's disease)
Certain medications such as blood pressure medication (especially
beta-blockers), heart medication (such as digoxin), some peptic ulcer
medications, sleeping pills, and antidepressants
Nicotine, alcohol, or cocaine
Stress, fear, anxiety, or anger
Unrealistic sexual expectations, which make sex a task rather than a pleasure
Poor communication with your partner
A "vicious cycle" of doubt, failure, or negative communication that reinforces
the erection problems
Erection problems tend to become more common as you age, but it can affect men
at any age and at any time in their lives. Physical causes are more common in
older men, while psychological causes are more common in younger men.
For many men, lifestyle changes can help:
ut down on smoking, alcohol, and illegal drugs.
 Get plenty of rest and take time to relax.
 Exercise and eat a healthy diet to maintain good circulation.
 Use safe sex practices, which reduces fear of HIV and STDs.
 Talk openly to your partner about sex and your relationship. If you are unable
to do this, counseling can help.
Couples who cannot talk to each other are not likely to be able to make love to
each other. Men who have trouble communicating their feelings may find it
difficult to share with their partner any anxieties about their sexual performance.
If you keep worries to yourself, you are more likely to lose erections. Men who
cannot express and resolve feelings of anger or frustration towards their partner
may hold back their erection as a weapon in the conflict. In these circumstances,
counseling can be very helpful for both you and your partner.
If erection problems seem to be caused by a medication you are taking for an
unrelated condition, consult your doctor. You may benefit from reducing the dose
of the drug or changing to another drug that has the same result but not the same
side effects. DO NOT adjust or discontinue medications without consulting your
doctor first.
Talk to your health care provider if your erection problems are related to fear of
recurring heart problems -- sexual intercourse is usually safe in these
circumstances.
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Call your doctor if:
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Self-care measures do not resolve the problem and you continue
having difficulty with erections. Effective treatments are available.
You suspect that a medication is causing the problem.
The problems begin after an injury or prostate surgery.
You have other symptoms like low back pain, abdominal pain, or change in
urination.
Call your doctor immediately or go to an emergency room if medication for
erection problems give you an unwanted erection that lasts more than an hour.
Permanent impotence or other lasting damage to your penis may result from this
condition.
What to expect at your health care provider's office:
Your doctor will perform a physical examination, which will likely include
checking your circulation, a rectal exam, a neurological exam, and an exam of
your penis.
To help diagnose the cause of the problem, your doctor will ask medical history
questions, such as:
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Have you been able to achieve and maintain erections in the past?
Is the difficulty in achieving erections or maintaining the erection?
Do you have erections during sleep?
How long have you had difficulty with erections?
What medications are you taking (including prescription medications, overthe-counter medications, recreational drugs)?
Do you smoke? How much each day?
Do you use alcohol? How much?
Have you recently had surgery?
Have you ever had vascular surgery or other treatments for your blood
vessels?
Are you depressed?
Are you afraid or worried about something?
Are you experiencing a lot of stress?
Has your energy level decreased?
Are you sleeping well each night?
Are you afraid of sexual activity because of physical problems?
Have there been any recent changes in your life?
What other symptoms do you have?
Have you noticed changes in sensations in your penis?
Do you have any problems with urination?
Tests that may be performed include:
Urine analysis
Blood tests, including metabolic panel hormone profile PSA
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Penile ultrasound (to evaluate for blood vessel or blood flow problems)
Nocturnal penile tuemscence (NPT) to test if you are having nighttime erections
and rigidity monitoring (Rigiscan)
 Neurological testing
 Psychometric testing
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TREATMENT
The treatment depends on the cause. For example, if the problem is caused by a
hormonal imbalance, medication to treat the underlying endocrine disorder will be
prescribed. Consult your health care provider for appropriate evaluation and
management.
There are many treatment options today. These include medicines taken by
mouth, injections into the penis, vacuum devices, and surgery. In order to treat
erectile dysfunction effectively, you must be aware of and comfortable with the
possible side-effects and complications that may occur with each therapy.
Sildenafil (Viagra), vardenafil (Levitra), and tadalafil are medicines prescribed for
mild-to-moderate erection difficulties caused by either physical or psychological
problems. Although these medicines have become extremely popular, they are not
"cure-alls," and they do not enhance erections if you are not impotent. And, they
DO have side effects. These pills should not be used with certain other
medications.
Men who take nitroglycerin for a heart condition (as either tablets, spray, or
patches) should NOT take these medications.  When taken with
nitroglycerin, these drugs can significantly lower blood pressure. Some men have
died from combining these drugs and nitroglycerin.
If pills do not work, other options are available. Testosterone may be prescribed
by either skin patch or injection, especially if the problem is related to age.
Alprostadil, injected at the penis or inserted as pellets, improves blood flow to the
penis. This technique is usually more effective than medications taken by mouth.
For some patients, a vacuum pump or penile prosthesis(implant) may also be
recommended or required. Consult your health care provider to see if one of these
treatments is right for you.
Kaiser DR, Billups K, Mason C, et.al. Impaired Brachial Artery EndotheliumDependent and Independent Vasodilation in Men With Erectile Dysfunction and
No Other Clinical Cardiovascular Disease. JACC. 2004:179,84
Glina S. Testosterone and erectile dysfunction. J Men's Health Gend 2004; 1(4):
407-412. Use of Sildenafil (Viagra) in Patients with Cardiovascular Disease:
Expert Consensus Document. J Am Coll Cardiol. 1999; 33: 273-82.
Update Date: 8/4/2005 Updated by: David R. Knowles M.D., Scottsdale Urologic
Surgeons, Scottsdale, AZ. Review provided by VeriMed Healthcare Network.The
Erection Blood Flow Process
Corpus cavernosum From Wikipedia, the free encyclopedia
A corpus cavernosum is one of a pair of a sponge-like regions of erectile tissue
which contain most of the blood in the male penis during erection. There are
corresponding structures and functions in the female clitoris. The term literally
means "cave-like body" (plural: corpora cavernosa).
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Male Anatomy
The corpus cavernosum and corpus spongiosum are three expandable erectile
tissues along the length of the penis which fill with blood during erection. The
two corpora cavernosa lie along the penis shaft, from the pubic bones to the head
of the penis, where they join. These formations are made of a sponge-like tissue
containing irregular blood-filled spaces lined by endothelium and separated by
connective tissue septa. The corpus spongiosum is one smaller region along the
bottom of the penis, which contains the urethra and forms the glans penis.
In some circumstances, release of nitric oxide precedes relaxation of muscles in
the corpora cavernosa and corpus spongiosum. The spongy tissue fills with blood,
from arteries down the length of the penis. A little blood enters the corpus
spongiosum; the remainder engorges the corpora cavernosa, which expand to hold
90% of the blood involved in an erection, increasing both in length and in
diameter.
Blood can leave the erectile tissue only through a drainage system of veins around
the outside wall of the corpus cavernosum. The expanding spongy tissue presses
against a surrounding dense tissue (tunica albuginea) constricting these veins,
preventing blood from leaving. The penis becomes rigid as a result. The glans
penis, the expanded cap of the corpus
spongiosum, remains
more malleable during erection because
its tunica albuginea is much thinner than
elsewhere in the penis.
Female Anatomy
The clitoris is homologus to the corpus
cavernosum in the male. The body of the
clitoris contains erectile tissue in a pair
of corpora cavernosa with a recognisably
similar structure.
In some circumstances, release of nitric
oxide precedes relaxation of the clitoral
cavernosal artery and nearby muscle, in a
process similar to male arousal. More
blood flows in through the clitoral
cavernosal artery, the pressure in the
clitoral corpora cavernosa rises, and the
clitoris is engorged with blood. This
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leads to extrusion of the glans clitoris and enhanced sensitivity to physical
contact.
The female anatomy has no corpus spongiosum, but instead two vestibular bulbs
beneath the skin of the labia minora (at the entrance to the vagina), which expand
at the same time as the glans clitoris to cap the ends of the corpora cavernosa.
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COMMENTS by Burton Linne
The same insulin caused degeneration of the endothelium smooth cells in arteries
that occurs in the kidneys, and toes for examples, occurs in the artery that supplies
the three layers of blood receiving penile tissues. The anatomy drawings above
that dissect the human penis show those three sections.
I knew about this from previous research, but finding the same characteristics in
the female was a surprise. The female clitoris is the structure that delivers
pleasurable signals from the friction and pressure of a rigid penis in the actions of
intercourse.
The same patching plaster and plaque building that occurs everywhere else in the
60,000 miles of blood vessels occurs in the arteries of both male and female sex
apparatus. Your penis and clitoris arteries are filling with calcium phosphate
around the clock along with your toes, feet and scalp.
As a young man, whatever problems you have in this department almost always
are not physical. As a 50 year and more older man, your psychological problems
are behind you, but your plaque mediated problems are operating. The same must
be said for the ladies.
Absent some mechanism for restoring your youthful circulation you are left with
only the highly potent vasodilators such as Viagra to open up the choked artery to
let in some blood to fill up the limp penis to force it into rigidity.
The ladies have no such chemical relief so far as I know. Viagra has little or no
effect on females. There are significant dangerous adverse side-effects to the
Viagra group of chemicals because their effect on arteries is not restricted to just
the penile Brachial artery.
More Technical Information
Comments
The following are copied verbatim from the published research material that
applies to the chemicals being sold for use by men to overcome the plaque
congestion that has built up in their blood system directly involved in the
complicated production of an erection.
It took years of Peripheral Vascular Disease development to reach the stage where
the little pipes are so plugged up they cannot do their work.
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The chemicals operate to block the removal of an enzyme (protein) that takes
apart another enzyme that produces a chemical to dilate the jammed pipes.
This intervention into a complicated chain of biomedical events was invented at
great expense because simply removing the calcium phosphate loaded plaque
(PVD) to restore the affected blood vessels to original condition is impossible
other than with the Rath/Pauling patented treatment which is what my therapy is
based on. This is slow because the removal cannot be done faster
than your liver and kidneys can process the debris. But it has no adverse side
effects. You keep on getting better by the day.
The dangerous chemicals perforce operate without precision because it is
impossible to predict the outcome of any one application. Ingesting these
powerful toxic agents means they are operating on your entire body. Because they
are unpredictable, random overshoot is highly probable. Overshoot means that
tiny capillaries will be ballooned and possibly broken.
Not overly dangerous in your fingers or toes, but if in your eyes, you are instantly
blind for life. And sure enough, that's what has been happening. That's a pretty
high price to pay for one roll in the hay.
I prefer to mix my distilled water cocktails in my kitchen to wash out my
accumulated plaque two or three times a day and keep my eyesight. It's a whole
lot cheaper, too. I don't need to pay a physician to write a prescription for highpriced poison that could blind or kill me. End of comments. Burton Linne
Medication Written by Pharmacists Reviewed by Doctors
Medical and Pharmacy Editor: Jay Marks, M.D.
GENERIC NAME: tadalafil
BRAND NAME: Cialis
DRUG CLASS AND MECHANISM: Tadalafil is an oral drug that is used for
treating impotence (the inability to attain or maintain a penile erection). It is in a
class of drugs called phosphodiesterase inhibitors that also includes sildenafil
(Viagra) and vardenafil (Levitra).
Erection of the penis is caused by the filling of the penis with blood. Filling
occurs because the blood vessels that bring blood to the penis increase in size and
deliver more blood to the penis, and, at the same time, the blood vessels that take
blood away from the penis decrease in size and remove less blood from the penis.
Sexual stimulation that leads to an erection causes the production and release of
nitric oxide in the penis. The nitric oxide causes an enzyme, guanylate cyclase, to
produce cyclic guanosine monophosphate (cGMP). It is the cGMP that is
primarily responsible for increasing and decreasing the size of the blood vessels
carrying blood to and from the penis, respectively, and causing the
erection. When the cGMP is destroyed by another enzyme, phosphodiesterase-5,
the blood vessels return to their normal size, blood leaves the penis, and the
erection ends. Tadalafil prevents phosphodiesterase-5 from destroying cGMP so
that cGMP stays around longer. The persistence of cGMP leads to a more
prolonged engorgement of the penis with blood.
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Phosphodiesterase inhibitor
From Wikipedia, the free encyclopedia
A phosphodiesterase inhibitor is a drug that blocks one or more of the five
subtypes of the enzyme phosphodiesterase (PDE), preventing the inactivation of
the intracellular second messengers, cyclic adenosine monophosphate (cAMP)
and cyclic guanosine monophosphate (cGMP).
Relatively non-selective phosphodiesterase inhibitors include the minor stimulant
caffeine and the bronchodilator theophylline.
PDE3-selective inhibitors, enoximone and milrinone, are useful for short-term
treatment of cardiac failure. Clinically these drugs mimic sympathetic stimulation
and increase cardiac output.
Sildenafil, Tadalafil and Vardenafil are selective inhibitors of type V
phosphodiesterase (PDE5), which is cGMP-specific and responsible for the
degradation of cGMP in the corpus cavernosum. These phosphodiesterase
inhibitors are used as remedies for erectile dysfunction.
Other PDE inhibitors that are currently mainly used as investigative tools in
pharmacological research include:
IBMX (3-isobutyl-1-methylxanthine): a non-selective PDE inhibitor,
rolipram: a PDE4-selective inhibitor
End
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