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Erectile dysfunction (ED) affects the lives of many middle-aged men and their partners. The term erectile dysfunction covers a range of disorders, but usually refers to the inability to obtain an adequate erection for satisfactory sexual activity. Although erectile dysfunction, formerly called impotence, is more common in men older than 65, it can occur at any age. An occasional episode of erectile dysfunction happens to most men and is normal. As men age, it's also normal to experience changes in erectile function. Erections may take longer to develop, may not be as rigid or may require more direct stimulation to be achieved. Men may also notice that orgasms are less intense, the volume of ejaculate is reduced and recovery time increases between erections. Erectile dysfunction may also be a sign of a physical or emotional problem that requires treatment.
Erectile dysfunction was once a taboo subject, but more men are seeking help. Doctors are gaining a better understanding of what causes erectile dysfunction and are finding new and better treatments.
What is Erectile Dysfunction?
Erectile dysfunction or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. There are various underlying causes, such as diabetes, many of which are medically reversible.
The causes may be physiological or psychological. Psychological impotence can often be helped by almost anything that the patient believes in; there is a very strong placebo effect.
Due to its embarrassing nature and the shame felt by sufferers, the subject was taboo for a long time, and is the subject of many urban legends. Folk remedies have long been advocated, with some being advertised widely since the 1930s. The introduction of perhaps the first pharmacologically effective remedy for impotence, sildenafil (trade name Viagra), in the 1990s caused a wave of public attention, propelled in part by the news-worthiness of stories about it and heavy advertising.
The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina. It is now mostly replaced by more precise terms.
Signs and symptoms:
Erectile dysfunction is characterized by the inability to maintain erection. Normal erections during sleep and in the early morning suggest a psychogenic cause, while loss of these erections may signify underlying disease, often cardiovascular in origin. Other things leading to erectile dysfunction are diabetes mellitus (causing neuropathy) or hypogonadism (decreased testosterone levels due to disease affecting the testicles or the pituitary gland).
Here are some causes of ED:
* Arousal: The first step is sexual arousal, which men obtain from the senses of sight, touch, hearing and smell, and from thoughts.
* Nervous system response : The brain communicates the sexual excitation to the body's nervous system, which activates increased blood flow to the penis.
* Blood vessel response:. A relaxing action occurs in the blood vessels that supply the penis, allowing more blood to flow into the shafts that produce the erection.
Physiology of normal erections:
Penile erections involve an integration of complex physiologic processes involving the CNS, peripheral nervous system, and hormonal and vascular systems. Any abnormality involving these systems, whether from medication or disease, has a significant impact on the ability to develop and sustain an erection, ejaculate, and experience orgasm. Tumescence, the vascular filling of the cavernous bodies, relies on neural and hormonal mechanisms operating at various levels of the neural axis. This is unique among visceral functions because it requires central neurological input.
Andersson et al summarized some of the information related to the pathways involved in erectile function. The degree of contraction of corpus cavernosal smooth muscle determines the functional state of the penis. The balance between contraction and relaxation is controlled by central and peripheral factors that involve many transmitters and transmitter systems. At the cellular level, smooth muscle relaxation occurs following the release of acetylcholine from the parasympathetic nerves.
Pathophysiology of erectile dysfunction :
ED is essentially a vascular disease. It is often associated with other vascular diseases and conditions such as diabetes, hypertension, and coronary artery disease. Other conditions associated with ED include neurologic disorders, endocrinopathies, benign prostatic hyperplasia, and depression. Conditions associated with reduced nerve and endothelium function, such as aging, hypertension, smoking, hypercholesterolemia, and diabetes, alter the balance between contraction and relaxation factors. These conditions cause circulatory and structural changes in penile tissues, resulting in arterial insufficiency and defective smooth muscle relaxation. In some patients, sexual dysfunction may be the presenting symptom of these disorders.
Treatment:
An alternative model is the patient goal-oriented approach as suggested by Tom Lue, MD, in which a minimum of testing is performed. The patient and his partner express a preference for reasonable and appropriate treatment options and work with the physician to implement this plan.
The availability of three phosphodiesterase-5 (PDE-5) inhibitors, ie, sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis), has permanently altered the medical management of ED. Many patients no longer expect or are willing to undergo a long evaluation and testing process to obtain a better understanding of their sexual problem, and they are less likely to involve their partner in a discussion of their sexual relationship with the physician.
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Whatever we do, performance does matters to make it successful. A good performance is a result of a positive morale and our sincere efforts. One gets great amount of personal satisfaction after employing such efforts. But the problem comes when we begin to think about results rather then concentrating on our efforts. This is a fact which is true irrespective of the task we are indulged in.
A bit strangely, this fact is true even with our performance on bed while having sexual intimacies with our partner. This is a psychological problem, sometimes men continues to think of their sexual performance and the extent to which they can satiate their partners. The fear of failure is one major factor leading to sexual dissatisfaction while intercourse. As a result more then often such people fails to get proper penis erection leading unsatisfied female partner.
Various sexual therapies are recommended to sexual efficiency and to overcome the problems pertaining to sex. Another sexual disorder which has been a nightmare for millions of men around the world is ED or erectile dysfunction. This generally occurs in old age or due to damage to nerves, arteries, muscle or tissue that are required for getting a hard and erect penis. Ailments like diabetes or neurological disease are mainly responsible for such damages.
But with treatment becoming readily available more and more people are opting for potency pills. Viagra, being one of the most reliable names under this category is a highly popular drug. Even after the emergence of new drugs, Viagra is still preferred by most people due to its affordable price and effectiveness. So if you want to get rid of your performance woes, don’t wait, go ahead and buy Viagra online from a trusted pharmacy. It can also be bought from a cheap Viagra pharmacy in your locality at unmatched prices.
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“How Body Image Affects Sex”
A person’s body image affects his or her entire life. Body image can affect a person’s outlook, their career, their relationships with others, and especially their sex life.
A person who has a poor body image will perceive him or herself as unattractive to other people. This unhealthy mental outlook will start to influence their personality and behavior to the point of projecting negative feelings.
This is a shame because people who have a good body image, who see themselves as attractive to others, usually are happier. They tend to advance in their career. They enjoy more productive relationships. And yes, they have more sex. (And better sex)
Body image has little to do with physical attributes, and more to do with self-confidence. People who have a poor body image might actually be physically attractive to others, while people who are just average looking may have a good body image and be exceptionally appealing to others.
Body Image Is Powerful
Due to many different factors, including upbringing and the modern media’s distortion of sex appeal, a man or a woman may develop a very poor body image and become outright embarrassed about their physical appearance. This can cause a person so much stress and worry, that they simply withdraw socially. They do not date or try to meet new people and so end up sexually starving themselves.
Whereas body image is known to affect more women than men (over 70% of women polled stated they were not happy with their bodies, compared to 33% of men), men also can develop a poor body image; whether late in life after physical changes take place or starting from puberty and on into adulthood. Common body areas in men that are brought into question when a poor body image develops are skin, hair, nose, body shape, eyes, penis size, chest and stomach.
Some of these worries could be media influenced just as it is in women. Top male movie stars, porn stars—or worse yet computer-generated action heroes?—may have perfect bodies and set too high a standard to reach. On the other hand, psychological problems, a hard upbringing, or any recent traumatic experiences could also account for a poor body image.
The Truth About Your Body
Are you happy with your body? Are you proud of who you are and do you feel sexy whenever you dress for the occasion? If your first reaction is no!, or just an uncomfortable cringe, then maybe you have a poor body image. If that’s the case, then we have good news and better news for you.
First the good news. Poor body image is just a condition of the mind. While most people who suffer from low self-esteem are worrying about their physical appearance, other people are noticing the features they do like. If a man doesn’t have a perfect waistline, then many women will find beauty in his eyes, his smile or sense of humor. Just because a woman frets over her voluptuous figure doesn’t mean many men don’t find her curves quite sexy. Ironically, in many relationships the one physical flaw a person thinks he or she has can be charming to the partner.
Looks aren’t everything. And for the most part, people actually look good. But remember that whatever you are feeling inside is what you will project. So don’t spell out with your body language that you’re unattractive and unlovable. Sexiness, attractiveness and an appealing presence is determined by your own level of confidence and understanding, not your physical imperfections. (Which by the way, everybody has. Even movie stars, off camera)
Now the better news. The better news is that if think you have a very poor body image (meaning you think you’re ugly in some way) and are afraid to start dating because of the way you look, then sex surrogacy can help you!
How Sex Surrogacy Can Help
Sex therapists and sex surrogates can help men or women with body image problems. They can restore a person’s confidence. They can teach clients the fundamentals of dating, and better yet, the importance of loving themselves. Anyone can be told “to love himself”; but few educators can teach another person how to go about doing this, how to put away their fears and come to a healthy readjustment of their attitude. Sex surrogacy can do this. Sex surrogates can teach you how to perceive your body image in a kind and gentle way. This education can be done in many ways including talking concerns through with a therapist, receiving reassurance and comfort, engaging in emotional and mental exercises, and learning physical and sexual touching. Surrogate therapy has proven successful for many people who were once lonely, but who are now enjoying a better life and healthy outlook on life. (And yeah, better sex)
Thousands of people every year would rather have cosmetic surgery done than simply come to a better understanding of themselves, their bodies and what society expects of them. There’s hope for you too and it’s not by going under the knife. If you have low self-esteem or a poor body image, then running away from social activity (or from all of society and reappearing with a brand new face) is not the answer.
Improving your body image is. And seeking solutions through sex surrogacy may be just what you need.
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Ladies, if you find yourself asking your male companion that killer trick question "do I look fat", then let’s be honest, you are doing so for one of four reasons: you are fat, you are feeling fat, you are vain, or you are in need of attention. And if you haven’t figured it out already, you should know that any man worth his salt has learned one thing: to answer certain female trick questions immediately, firmly, and with a clear, riveted gaze. It is all about the rudimentary, involuntary-reflex response, "No. You look perfect!" It is not an answer, but simply a male maneuver to buy another minute until one can figure out for which reason the question was asked in the first place.
And most men, even the most boorish, know the various permutations of the trick question too.
For instance, the indirect method:
"Do these jeans look too tight?"
"No. They fit perfect." Or the slick double-secret-probation approach:
"Do you still love me, even though I’ve gained weight?"
"Yes I do. And you look perfect." Or the subtle non-question question:
"I think I need to go on a diet."
"No you don’t. You look perfect."
There can be no hesitation, no darting eyes, no mincing of words when the response is given. If one does, one deserves to become the sorry sack of shittolla one is about to become. My theory is that men whose fathers or mothers did not prepare them falter exactly once. Depending on the female partner, the offender is either killed (the lightest sentence), or treated to a year of hard time, at the conclusion of which the guilty party either has learned all the correct rudimentary involuntary-reflex responses or has joined the gay ranks or has become a monk vowed to a life of silence.
Well no matter how one gets there, for guys in the know, the rudimentary involuntary-responses are the easy part, after all they are as routine as lifting up the toilet seat—another gem that was hopefully hammered into us in our formative years. The hard part is trying to figure out the real reason for the question and choosing what the appropriate follow-up response is.
To enlighten those males who have not advanced to this stage, let me help you, let me show you the logic, let me give you hope. Let’s walk through this together. There’ll be fanny pats at the end if you get it.
So the trick question is asked. We immediately regurgitate the appropriate robotic response. We have about a minute to figure out her reason for asking and if a follow-up is required. That moment of male mental gymnastics is more tension packed than the last episode of 24.
As daunting as it might seem, it’s not so bad if we break it down like any other business problem.
1. She actually is fat. Beware! She ISN’T interested in your confirmation. She probably just got a glimpse of herself in a mirror, is feeling really lousy about, but uninterested in doing anything about. If she were interested in doing something about it, trust me she wouldn’t be asking you for an opinion! Unless you want a situation, it’s best to leave this one alone and say nothing in follow-up. And just in the event that you are toying with the idea of saying something that even slightly acknowledges her extra pounds, take an honest look at yourself first. There is a good chance you aren’t winning any Mr. Olympia trophies soon. So grab a bag of cheese doodles and take your lard-ass to the couch, lest you say something you will regret.
2. She feels fat. This is a ticklish one at first but in the end is as simple as number 1 above. She may feel fat because she is fat in which case she may be coming to grips with her fatness. That might be a good thing. Let her be; say nothing after the usual required response. The other possibility is that she might just plain feel some of that there bloating issue women get around that pre-you-not-what-but-I’m-not-allowed-to-say-because-it’s-sexist-but-really-not-because-it’s-true time. If this is the case, a poorly timed darting glance down at her belly could be suicidal. Don’t do it no matter how temptingt! Even if she lifts her belly-shirt and points. Don’t look! Stay focused and reaffirm the rudimentary involuntary-reflex response by changing it up a bit, "Get outta here: "am I fat"! You look perfect! If anyone’s fat it’s me!" Then volunteer to fold her underwear. Do something. Get out of there lickitty split.
3. She is vain. This is a tough one for me personally. If she is thin as rail and is just vacuuming for loose compliments, I have a tendency to want to give her something to think about; really feed into her low self esteem that seems so willfully misplaced. Again, it’s best to fight the urge, shut your hole and be glad it’s not a real issue. There are two corollaries to this though.
If this trick question stuff is a recent development, one may want to nip it in the bud before one ends up with someone who is vain all the time—not a very good thing. The standard knee-jerk response may be rewarding bad behavior subconsciously. After your minute of thinking is up, you might want to follow-up with the direct approach, "You know, I sense a little vanity there. Are you becoming a little vain? Feeling pretty good about yourself aren’t you?" Give her a chance to react. She probably will flash a little devilish grin, the type that acknowledges she has been caught. You then close with, "Nothing wrong with feeling good about yourself and occasionally fishing for a compliment. And sweetie, I’d compliment you all day long, if I didn’t think that it would eventually swell that pretty head of yours up so big that it starts to clunk off the walls and furniture and stuff; breaking the family crystal and all. That would be terrible." Ah, the beauty of a little disarming humor.
In the other scenario, if you find yourself on the down-side of the relationship with the self-absorbed twit and looking to speed up the inevitable, you might say casually, "Yeah, I’ve noticed those little bulges in your lower back. But they’re not so bad. No one’s perfect anyway." Then see if you can walk out of the room without a ring bouncing off your balding skull. The beauty of this retort is that she can’t see what you playfully pointed out—short of setting up a room full of mirrors anyway. It’s effective, satisfying and guaranteed the desired results. Plus you’ll be able to hock the ring she threw at you for some cold poker cash.
4. She needs attention. This is the most prickly reason she might be asking and not easily recognized by "X & Y" humans. Chances are she isn’t overweight. Chances are you might deduce falsely "she feels fat" because it’s that time of you-know-what-because-I-can’t-say-month. Before you settle on that or any other conclusion for that matter, take a few seconds more. Could it be that she just wants to know she is attractive to you because you have been so self absorbed with work or football or your thinning hair that you haven’t in the past year at least once looked her in the eye and told her she is the most beautiful person in your world? If she has to demean herself this way to check in on your attention, the fat she is referring to is from the heavy tumor you have become on her self esteem. And if you have even the slightest pang that this might be true, that she may need attention, you better drop whatever lame thing it is that you are doing, praise her up and down and make a mental note not to allow her to sink to this lowly place again. She may ask only once or twice more before she decides you are malignant and opts for immediate, radical surgery to remove the cancerous growth you’ve become.
By the way, women don’t have a lock on trick questions. Men do the same thing, just about male stuff. For instance, a man might mumble within earshot after coming out of the shower, "I wish my penis were bigger." It may not be in the form of a question but this isn’t Jeopardy either. It sure as hell is a cry for a little simpleminded ego building. Something like, "honey, you could jack up an eighteen wheeler with that thing" would go a long way. I suppose lesbian and gay couples eventually dive down (so to speak) into the same sad depths with equally problematic maneuvers.
The truth is I really don’t know what the answer is to avoid the certainty of these trick questions. Honesty in communication feels right and is even noteworthy but it’s not always effective.
"Am I fat?"
"Honey, you get any fatter and we’ll have to pay resident taxes to two states!"
or
"I wish my penis were bigger."
"You and me both! It’s like reading Braille with my vagina."
I suppose a simple "yes you are" or nod of agreement would be a better way to be honest without the immediate blood shed; the key word being "immediate." But eventually honesty will require your blood to flow.
So what is it we can do differently from scripting our escape? I guess nothing. Maybe it is just a condition of human relationships. I just can’t help but think though there is a better way. In the meantime, I’ll continue to brush up responses to new and improved trick questions. There is no time to relaxing, letting our guard down.
"Is my butt sagging?"
"Sagging? Are you kidding me? You could crack walnuts with that thing."
Not bad!
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I want to have the best sex in my life! What should I do?
1. You should have the best woman, the woman from your dreams. But you do not even hope she would like to have sex with you. No, no, you are not right. Imagine you had an eight inch penis. 90% of women would mention this thing under your trousers for sure.
2. You want to give pleasure and to take pleasure. Penis size is important when you want to take pleasure from sex and want to give pleasure to your partner at the same time. Do not believe women who say Size Doesn't Matter. Size does matter to women.
3. Sperm volume during sex and at the end of it affects both your and her orgasm. The more sperm you splash out the more unforgettable orgasm you will experience.
4. You are afraid to fail in bed? Of course big penis does not mean you can take advantage of it. Watch porn, ask friends about their sexual experience and follow some online sexual guides.Follow these steps and will have the best sex in your and maybe in her life. Don't be uncertain with your penis size and with your man power! Good Luck!
