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The Prostate: Part I – BNP What is situated below a body of water, has four zones and is commonly associated with venial pleasures. No it is not some romantic European city, but rather a walnut sized male organ that serves important procreative functions. It also happens to be an organ that plagues men as we age. This organ or gland is the prostate. This is the first of two articles on the male prostate. This article will focus on a disease process that affects older men, something we refer to as benign prostatic hyperplasia (BPH). BPH is a non-cancerous growth in the size of the prostate gland that impairs the flow of urine out of the bladder. The second article will focus of prostate cancer. But first a little about the small yet important male organ. The gland is located just below the bladder. It usually measures one inch by one-and-a-half inches (approximately the size of a walnut). It surrounds the urethra (the tube that takes urine out of the bladder). It is responsible for producing a fluid important in male sexual function. In the past the prostate was described as having “lobes”, but today we refer to it as having concentric zones. These zones are important both on an anatomical as well as histological level. We can separate pathology along these zones as well. For instance most all cancers occur in the peripheral zone while the benign process of enlargement occurs almost exclusively in the transitional zone (which only occupies about 5% of the total prostate volume). The prostate gland is also made up of different cell types. Cancer cells develop from the epithelial cells, but it is the interaction with stromal cells that is important in the behavior of the cancer. BPH develops from an interaction between these cells as well, but it is complex and poorly understood. Testosterone and other hormones and their interactions with this gland are hot topics of research in understanding prostate disease. The prostate gland produces most of what is found in the male ejaculate. The average volume is about 3 mL. This is less than a teaspoon and only 1% of it is sperm. The majority of the semen volume is made of products of the seminal vesicles and the prostate. The male ejaculate is very rich in potassium, zinc, citric acid and fructose. Along with these substances it also contains prostaglandins. There are many other unusual substances found in the semen. Not all is know about their function or purpose. This important male organ is a complex mix of anatomical structures and cell types that make it possible for human reproduction. However beyond the reproductive years of men, this organ becomes one of burden rather than usefulness. We will discuss the finer points of BPH and how to best avoid it and if plagued with it, treatment options. BPH typically affects men from their fourth to fifth decade of life and beyond. Several hormones come into play that have a drastic effect on the transitional zone (the zone that is most central and surrounding the urethra). Namely a metabolite of the male androgen Testosterone called Dihydrotestosterone (DHT) plays a big part on the enlargement of cells of the prostate and the encroachment on the urethra. There are several signs and symptoms that correlate with BPH and they are: slow urinary flow, the urge to urinate all the time, nighttime urination, enlargement and distension of the bladder with continuous urine leakage (incontinence) and urinary obstruction. Autopsies suggest that more than 90% of men older than 70 years have BPH. The average age for symptomatic development is about 65 years for white Americans and about 60 years for African-American men. Ways to prevent the effects of DHT on the prostate gland and the ensuing enlargement are via medications that block the enzyme 5-alpha-reductase, which converts Testosterone to DHT. Proscar is such a drug commercially available through a pharmaceutical company. Proscar works on blocking the effects of androgens on the epithelial cells and can actually shrink the size of the prostate making some of the symptoms of BPH resolve. Alternatively two FDA approved drugs that aid in symptoms of BPH (but act differently than Proscar) are Hytrin and Cardura. Both Hytrin and Cardura are drugs in the alpha1-blocker class. Originally researched as a centrally acting blood pressure reducer for patient with hypertension, it was discovered that this drug would actually relax the prostate tissue surrounding the urethra making symptoms of BPH resolve. Side effects generally include low blood pressure, dizziness, and nasal stuffiness. While neither of these two drugs will “cure” or reverse the process, they certainly do provide symptom relief for the patient plagued with BPH. Another way to treat this disease and a more natural approach is the use of herbs know for their anti-androgenic effects on the prostate. These include the well-studied Saw Palmetto herbal extract that blocks 5-alpha-reductase in the same manner as the prescription drug. Saw Palmetto taken in a standardized dose of 160mg twice daily has shown increased urine flow, with minimal side effects. Saw Palmetto is an herb indigenous to the Lowcountry of Georgia and South Carolina. Pygeum Africanum is shown to do the same yet it is not as effective and there is a fair degree of stomach symptoms. Pygeum is derived from an African evergreen tree. Stinging Nettles (Radix urticae) is another herb used widely in Europe for prostate health that has been shown to lower the residual urine volume in men with enlarged prostates. These phytotherapeutics (plant derived medicines), used and described by the Egyptians as far back as the 15 Century B.C., have a common compounds called phytosterols. The most effective phytosterol is beta sito sterol for BPH. None of the medications or herbs has been shown to prevent prostate cancer. These prescription medications and herbs are for the treatment, reduction in size or prevention of the benign process of enlargement of the prostate. Prostate cancer prevention and treatment is by other means and the subject of the next article. Besides the herbal and drug therapies there are a few surgical therapies worth mentioning. These include the most common transurethral resection of the prostate or TURP. This is where under the care of an urologist the constricted urethra within the prostate gland is “reamed out” thus mechanically or surgically widened the opening. A variant of this is the transurethral incision of the prostate (TUIP) where an incision rather than resection of the tissue is performed. A suitable procedure for patients with prostates 100 mL in volume. This involves an abdominal operation and removal of the whole prostate. Of course symptoms mentioned above for TURP are of greater frequency with this more radical procedure. There is also thermotherapy (a type of microwave treatment) that alleviates irritative symptoms, but not much is available in long-term results in the medical literature. And finally stent placement is an option. This can be used in selected cases of patients with a poor general condition and in the non-operative candidate. Symptoms of BPH include: Obstructive symptoms: Hesitancy in initiating voiding (trouble getting started) Weak urinary stream, prolonged voiding Post-voiding dribbling (mild incontinence) Sensation of incomplete emptying Nocturia (night time urination) Overflow incontinence Acute urinary retention (very painful condition) Irritative symptoms: Dysuria (discomfort in urination) Frequency Urgency Scoring BPH: The American Urological Association Symptom Index (AUASI) and International Prostate Symptom Score (IPSS) are now considered the gold standard measurement tools for the assessment of BPH symptoms and response to treatment. Both questionnaires can be used by a physician in a clinical practice to quantify the subjective symptoms of BPH and monitor therapies. Part II in this series will cover annual examination of the prostate, blood testing, prostate cancer. It will also cover prevention and treatment of prostate cancer. Reference: http://www.prostatehealth.com Lowe, FC. Et al, Phytotherapy in treatment of benign prostatic hyperplasia: a critical review. Urology 48:12-19, 1996 Dreikorn, K. et al, Stellenwert von Phytotherapeutica dei der Behandulng der benighnen Prostatahyperplasia. Urologe (A)34:119-129, 1995 Fitzpatrick, J.M. et al, Phytotherapeutic Agents in Management of Symptomatic Benign Prostatic Hyperplasia. Urological Clinics of North America. 22:407-412, 1995 Wilt T, Ishani A, Mac Donald R.. Serenoa repens for benign prostatic hyperplasia. The Cochrane Database of Systematic Reviews 2002, Issue 3. Art. No.: CD001423. DOI: 10.1002/14651858.CD001423. [Research by Sagalowski and Wilson, 1998] © 2005 enlargement manhattan pnis manual penis enlargement free magna rx pnis enlargement review free exercise tip for penis elargement penis enlagement review penis enlargment excersizes penile enlargement pump

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One of the most interesting approaches to corporate relocation incentives is the Quality of Working Life (QWL) program, which is a systems approach to job design and a promising development in the broad area of job enrichment. QWL has received tremendous support from a number of sources. Managers have regarded it as a promising means of dealing with stagnating productivity, especially in the United States. Workers and union representatives have also seen it as a means of improving working conditions and productivity and as a means of justifying higher pay. Research and analysis of motivation point to the importance of making jobs challenging and meaningful. Job enrichment includes factor such as challenge, achievement recognition and responsibility. Job enrichment should be distinguished from job enlargement. Job enlargement is about variegating a job to divert the boredom associated with performing repetitive operations. It means enlarging the scope of the job by adding similar tasks without enhancing responsibility. In job enrichment, the attempt is to build into jobs a higher sense of challenge and achievement. A job may be enriched by variety. But it also may be enriched by giving workers more freedom in deciding about such things as work methods, sequence and pace or the acceptance or rejection of materials. Also encourage participation of subordinates and interaction between workers. Give workers a feeling of personal responsibility for their tasks. Taking steps to make sure that worker can see how their tasks contribute to a finished product and the welfare of an enterprise. Finally, give people feedback on their job performance; preferably before their supervisors get it. But there are certain limitations as well of job enrichment. One of these is technology. With specialized machinery and assembly line techniques, it may not be possible to make all jobs very meaningful. Another limitation is cost. There is also some question as to whether workers really want job enrichment, especially of the kind that changes the basic content of their jobs. penile enlargment result herbal natural penis enlagement free penis enlagement pills penis enargement information safe penile enlargment vimax best penis enlargement surgery herbal natural penis enlagement vimax penis enlargment pennis enlargement information

It is estimated that over one million men are infected with genital warts at any given time in the United States. As you know sexually transmitted diseases are running rampant in the world. This article will give you the facts about male genital warts. Genital warts are a sexually transmitted disease which causes a person to become infected with a human papillomavirus or HPV. There are over 100 known HPV's of which a couple will cause visible male genital warts. They are spread by unprotected sexual or genital contact. Males with multiple partners or weakened immune systems are especially at risk. Even if have no visible symptoms, you can still spread the virus. Condoms offer protection but do not completely protect you during sexual or genital contact. The virus may lie dormant in your system for years. Typically genital warts appear within a few months of the infection. They usually appear on the shaft of the penis, the scrotum, the anal area,or in the groin area. Genital warts look like small puffy white blisters in a cauliflower like pattern. This link has genital wart pictures and other valuable information Click Here. The warts will typically disappear on their own within three weeks to three months. You will still have the virus, so you can still infect your partner. Unforetunately, even after the warts go away or are treated, they re appear in 20 to 50% of the cases. It is interesting to note the HPV's that cause genital warts, are not the same as, those that cause planter warts, flat warts, or other warts. You need to seek medical advice or attention if you present with any of the following symptoms. Discharge from the penis or burning while urinating are typical indications. Other indicators are rashes, bumps, or sores or blisters in the genital or anal areas. Your treatment options are dependent on several factors. The number and size of your genital warts. Where they are located, and if special equipment is needed. The cost of the treatment is also a factor. The following link provides treatment options. Click Here. There are several treatments available by prescription that you can apply at home. Treatment can be painful and you should be cautious when applying, so as to not damage surrounding skin. Stronger topical applications are available, but must be administered by a healthcare professional. The appearance of male genital warts is a traumatic experience. Especially when you find out the virus (HPV) will still be in your system, after the warts disappear. It is staggering to realize the infection multiplication factors, when you have multiple partners. Abstinence? This is an option. Whatever your sexual prediliction, protected sex is no longer an option. A more than passing knowledge of your partner is now becoming paramount. Males get genital warts and we must not infect anyone else! penis enhancement surgery penis enlagement result pennis enlargement pic penis enargement pump penis enhancement system penis enhancement procedure penile enlargement penile enlargement pump pennis enlargement information

Definition of a Phytoestrogen What exactly are phytoestrogens, and how can we use them to our benefit in the development of the breasts, as a hormonal balancer for menopausal symptoms, and as a healthy, preventative addition to our diet? Phytoestrogens are also quickly becoming the buzz as natural breast enlargement alternatives, and hormone replacement therapy for women going through menopause. The word "phytoestrogen" is derived from "phyto", meaning plant, and then "estrogen" is because of their ability to affect estrogenic activity in the body. It is important to know that although phytoestrogens may have some similar actions to estrogens, they are not the same as the true hormonal estrogens that our bodies produce. Phytoestrogens are actually a group of compounds found in plants that influence our own estrogen activity by mimicking it's effects in the female body. Categories of Phytoestrogens Phytoestrogens are categorized into four main groups and these are then further subdivided. The four groups of phytoestrogens are soy isoflavones, lignans, coumestans and resorcylic acid lactones, though the latter is not a true phytoestrogen.6, 7 The most chemically effective as a phytoestrogen (estrogen-mimicking supplement), and structurally similar to estrogen, are the soy isoflavones. Soy isoflavones are now being touted as a healthy supplement for menopausal and pre-menopausal women for their "healthy estrogen" enhancing abilities. Now, what about phytoestrogens as a breast enlarging or breast enhancing supplement? There are several products out there marketed as breast enlargement supplements using phytoestrogen technology combined with other natural herbs known for varying degrees of breast enhancing and hormone balancing qualities. The question is, do they work and are they healthy? The answer to that is two-fold. You should never stay on any supplement like this for more than nine months at a time, as this may become harmful to your health since it is unnatural to sustain higher estrogen activity for such a long period. However, under the correct usage and when used with proper diet, phytoestrogens can be used, and have been used, successfully to enlarge and enhance breasts, and even to alleviate symptoms of hormonal imbalance, decrease libido and other hormone-related issues common to women - especially premenopausal or menopausal women. The bottom line is, we are only beginning to understand the benefits that natural phytoestrogens and phytoestrogen-based supplements can have for women, be it for purposes of breast health, breast enhancement, menopause symptoms relief, and hormonal imbalances. One must be careful in choosing any phytoestrogen product, as they vary greatly in quality and purity standards. Examine the company you are buying from closely. Don't go on price alone - see if they have credible testimonials or a proven track record for success and quality. This way, you can be sure to reap the full health and beauty benefits of introducing phytoestrogens into your diet! permanent penile enlargement free penis elargement tip top penis enargement pills plastic surgery penis enhancement penis enhancement photo natural penis enlargment exercise vig rx penis enlargement pill best enlargement exercise penis pennis enlargement information

Penile Implants These are the most irreversible and drastic ways of achieving artificial erection. Only when all other measures have been exhausted with no longer-lasting effects are achieved is that penile implants are warranted. These are prosthetic devices made of inert silicone, which are surgically inserted into the penis. Normal erection cannot be achieved after that. There are two kinds of penile implants: Passive Implants: Two rods of silicone are inserted into the penis, which remains erect all the time. The silicone rods can be put in different angles, but this may be an embarrassment in public occasions such as swimming. Orgasm may be achieved unless there are hormonal or neural factors which impede it. Active Implants: These are inflatable silicone pouches which are also implanted into the penis. The penis remains in flaccid state until a proper manipulation of the prosthesis causes its inflation and consequent erection. One type of implant is activated by pressing the glans (the head of the penis) with one hand. Liquid is transferred from a reservoir to the main inflatable pouches. In another type, the liquid reservoir is implanted into the scrotal sac, and can be pumped by hand. Other Treatments Other surgical and non-surgical treatments for impotence are being tried in an experimental basis, and there may be a promising future for some of them. For instance, groups of physicians in Russia and Germany have been experimenting with electrical stimulation of the pelvic area using an external pad applied to the abdomen and back. There are already commercial devices using this principle, which seems to increase the blood flow in the genital area. Direct stimulation of pelvic nerves (leading to a nerve-induced erection) by using implanted electrodes and an electrical pacemaker-like device are also being considered. "Natural" or alternative methods do abound. They range from "natural" foods which have high testosterone or DHEA levels, such as green oats (marketed under the brand name of SEXATIVA) or saw palmetto; to yoga exercises to increase muscle tone and blood flow in the genital area. It is hard to say whether there are real effects or they are just the effect of suggestion or placebo phenomena. One thing has been scientifically determined, however. The blood levels of testosterone increase just after exercise, or by loosing excessive weight. Thus, a natural way of combating mild hypogonadism might be frequent exercising and keeping a normal weight. Controversial and unapproved treatments Controversial and unapproved treatments Bremelanotide The experimental drug Bremelanotide (formerly PT-141) does not act on the vascular system like the former compounds but increases sexual desire and drive in male as well as female. It is applied as a nasal spray. Bremelanotide works by activating melanocortin receptors in the brain. It is currently in Phase IIb trials. Ginseng A double-blind study appears to show evidence that ginseng is better than placebo: see the ginseng article for links and more details. Enzyte Enzyte is a product that has been advertised by saturation coverage on television channels such as Court-TV. However, the Center for Science in the Public Interest (CSPI) has filed a complaint with the Federal Trade Commission (FTC) about Enzyte for deceptive advertising. It is manufactured by Berkeley Nutritionals, which is alleged to be the subject of an investigation by the Attorney General of Ohio and the defendant in class-action lawsuits. Enzyte is a supplement that claims to increase the male libido or frequency of erections of the penis. Commercials for Enzyte are shown regularly on television. These commercials feature a man named Bob who never stops smiling, apparently because he had taken Enzyte and improved the size of his sex organs. The commercials are riddled with symbolic phallic imagery, e.g. golf clubs, remarkably tall glasses of iced tea, and a hose spraying barely a trickle of water (carried by someone who doesn't use Enzyte). The effectiveness of Enzyte is in dispute. Some medical professionals in fact advise against taking Enzyte, saying that it can lead to damage. The Center for Science in the Public Interest have urged the Federal Trade Commission to disallow further television advertising for Enzyte due to a lack of proper studies supporting claims. Enzyte maker Berkeley Premium Nutraceuticals, Inc., is currently under a class action lawsuit for false advertising. Enzyte is said to contain: Tribulus terrestris; Yohimbe Extract; Niacin; Epimedium; Avena sativa; Zinc Oxide; Maca; Muira Pauma; Ginkgo biloba; L-Arginine; Saw Palmetto. Other ingredients: gelatin, rice bran, oat fiber, magnesium stearate, silicon dioxide. Herbal and other alternative treatments These are generally ineffective when tested blind, but may be useful for their psychological (placebo) effect: if a good result is expected, any highly-praised, and often expensive, treatment can be effective. Reputable drugs can also benefit from the same effect. Uncontroversial treatments for erectile dysfunction PDE5 Inhibitors The prescription PDE5 inhibitors sildenafil (Viagra®), vardenafil (Levitra®) and tadalafil (Cialis®) are prescription drugs which are taken orally. They work by blocking the action of PDE5, which causes cGMP to degrade. cGMP causes the smooth muscle of the arteries in the penis to relax, allowing the corpus cavernosum to fill with blood. Vacuum pump An external vacuum pump will produce an engorged penis with success approaching 90%; a penis ring will maintain this state, although it should be removed after not more than 30 minutes. The erection is not as rigid or hard as a natural erection; drugs or injections, when they work, may be preferable. Various studies show the degree of satisfaction of users and their partners to be vary variable, even when drugs and injections do not work; in one study, about 20% of men who tried a (high-priced) pump decided to proceed to purchase one. Other studies show higher percentages of satisfied users. In some cases frequent use of a vacuum pump can eventually improve the degree of erection attainable without use of the pump. Claims of cheap "penis pumps" to permanently increase maximum penis size should be viewed with caution, however. Some vacuum pumps are sold at a higher price with 100% refund within 90 days to dissatisfied users, with a somewhat lower price with 50% refund guarantee (Osbon Erecaid, [7]). This pump is supported by medical insurance schemes, including the UK's NHS and US Medicare and private insurers. The better-known pumps sell for prices of around 200 GBP/400 USD (2006). There is at least one vacuum pump with rings which sells for around one-fifth of this price (Noogleberry, [8]). Specific devices are mentioned for information only; mention should not be taken as endorsement.