Get the treatment for your erection problem by clicking here!

It's absolutely astonishing how common direction problems actually are. Indeed, it is probably no exaggeration to say that there is not a man alive who was not at some time lost his erection during sex. Loss of erection can occur under many different circumstances, the most common of which would be when a man is attempting to engage in sexual activity and experiences anxiety due to perhaps the fact that he feels he is being observed, or that he has performance anxiety, or that he fears his partner will in some way criticize his sexual performance -- or indeed a number of other possible reasons.

In most cases erection problems go away fairly quickly. It's only when a man experiences erectile failure on several consecutive occasions that he may begin to develop such a persistent level of anxiety that he becomes truly impotent. (And, having said that, it is also true that many men lose their erection every time they attempt to have sex with a condom.) If an erection problem is ongoing and it certainly can damage a man's sexual self-esteem and sexual self-confidence - not to mention disrupting the fabric of his relationship with his partner who may regard this problem as in some way reflecting his opinion of her desirability, or her ability to arouse him.

As a rule of thumb any man who has a problem keeping an erection from more than one occasion in four when he engages in sexual activity can be said to have a problem with erectile dysfunction which is worthy of medical attention.

Even when there are obvious physical causes, the psychological contribution of a man's mind is profound. It isn't just about circumstances in the relationship, nor is it just about stress or anxiety. It's a combination of deep rooted feeling of sexual inadequacy (which may stem from a genuine physical problem such as diabetes, multiple sclerosis, hyperlipidemia and so on) and  a physical problem in the body. It is identifying the problem in the body that is often the easy part of the solution and treatment for erectile dysfunction.

It is not true to say that in most men erectile failure is independent of sex drive. That may well be true of men up to the age of, say, 40 -- but after that age one has to suspect that a process equivalent to the female menopause may be at work In that men do go through a decline in testosterone levels as they age (and some go through this drop in testosterone much more rapidly than others) and this drop in testosterone is directly related to a man's level of sexual desire and libido, as well as his capacity to sustain erections during sexual activity.

We need hardly add, I am sure, that ejaculation problems such as premature ejaculation or delayed ejaculation have only a very limited connection with erectile dysfunction. For example, premature ejaculation is sometimes closely associated with erectile dysfunction, but the first is often contingent upon the second: the way it works is that a man realizes he's losing his erection so unconsciously speeds up his arrival at orgasm and ejaculation the fear of losing his ability to thrust and satisfy his partner during sexual intercourse.

Equally, we need hardly add that infertility has nothing whatsoever to do with impotence. A man may be very fertile but unable to sustain an erection; equally a man may be impotent but highly fertile and obviously therefore able to father a child.

As we've observed before, penile erection is a complicated process that requires the interaction of many different parts of the body, the nervous system, the circulatory system and the mind. Any interruption at any part of this rather complicated process (which is described in detail in other parts of this website) can lead to a significant difficulty during sexual activity.

We will list the causes of erection failure below:

• the first and most well-known condition that causes erectile failure is diabetes, but others conditions such as high blood pressure heart disease and neurological disorders can also be implicated. Parkinson's disease and multiple sclerosis in particular are significant causes of reptile failure.
• prescription medications including those issued for high BP - and in particular the beta-blockers -- mood altering drugs such as antidepressants, and commonly prescribed and over-the-counter medications available for high levels of stomach acid such as ranitidine, as was sleeping pills and some heart medications. When drugs that are issued to these conditions are implicated in erectile failure, you should speak to your doctor to see if alternative is available that will not cause your erections to fail.
• unfortunately for men who have prostate surgery, and for those who have pelvic injuries which required deep surgery, nerve damage during such surgery is often followed by erectile failure.
• Smoking, drinking alcohol, and the use of illegal drugs such as cocaine
• on the emotional side of things, poor communication within a relationship, lack of desire to your partner, emotional resentment, anger, depression, anxiety and a host of other stressful emotions and situations can cause erectile failure. Indeed it's been said that the first thing that goes in a relationship when the relationship is under pressure is the sexual interaction between the partners, and there is a lot of truth in this.
• when bad feelings are repeatedly expressed within a relationship, as measured by the proportion of negative talk between partners compared to the proportion of positive and reinforcing talk between partners, the disharmony and emotional stress this produces can accentuate erectile problems
• I'm sure we need hardly add that spinal cord injury is a major cause of erectile failure although an involuntary erection may still be possible for a man who is paraplegic
• in simple terms the emotions that cause erectile failure are anxiety stress anger and depression. Also, sexual guilt is a major contributor to a reptile failure as exemplified by the man who betrays his partner sexually or by the man who was brought up in a repressed sexual environment as a child and who now finds either sex itself, or women in general, all the female sex organs in particular to be an unpleasant or aversive experience
• and finally for those men who have high sexual performance standards, or whose view of sex is governed by the view that the man must perform, give the woman orgasm, satisfy the woman at all times, and only then take pleasure, the anxiety about being good enough lover can often produce erection difficulties.

It is true that erection problems become more common as a man gets older. However, as we have observed direction problems can strike a man at any age: the physically-based problems are more common in older men, and the emotional/psychologically-based problems or more common in younger men.

If you are a man who is experiencing erectile failure or complete ED then the first thing to do is to check out your lifestyle. For example are you consuming large quantities of alcohol, are you smoking, or are you taking illegal drugs? Any of these issues will inhibit your ability to sustain a hard penis during extended sexual activity. Equally taking large quantities of food and little exercise are not calculated to give you a sense of sexual competence - quite the opposite in fact.

It's worth mentioning at this point that good communication between the partners in an committed relationship is absolutely essential that just to maintain sexual desire and interest in each other but also to avoid problems of anorgasmia or erectile failure. you have several alternatives that you can take up here one is counseling or therapy preferably from a qualified sexual therapist, and the other is to take advantage of the self-help program described on this website.

And he occasions when you may need to call a doctor to deal with your ED include occasions when you fail to deal with the problem yourself using self-help techniques, or where the problem begins after some kind of pelvic injury or prostate surgery, or where there are any other symptoms that are unusual or different to your usual state of health - this would include for example symptoms like low back pain abdominal pain or any change in your urine function.

Although every website on the subject lists various medications which can cause erectile failure, it is actually often quite difficult in practice if you taking the medication is to make the connection between the fact you cannot perform in  bed and the drugs you are taking. The best course of action is not to stop taking the medication but to consult your doctor and ask an alternative prescription which will not cause erectile failure.

The men who have had heart problems, the thought of resuming sexual activity can seem very threatening. Indeed, this is often the cause of erectile failure amongst patients. The good news is that sexual intercourse is safe (of course you should get the agreement of your healthcare provider), and anxiety resulting from the fear of having a heart attack whilst engaged in vigorous sex is usually unjustified.

In general the doctor will perform several examinations which include checks on blood circulation, the penile examination some kind of nervous function tests, and possibly of prostate examination. He should also run tests for hormone levels and cholesterol levels in your blood to ensure that there is not a circulatory issue affecting your penis. In addition he will ask questions about your erectile failure which might include, for example: have you been able to achieve erections in the past? How long has the difficulty been present? Do you experience nocturnal erections or emissions? what are your energy levels? Are you afraid of sexual activity because of your erectile failure? have there been any recent changes in your relationship, sexual activity, life changes, health, energy levels, stress levels? Have you recently had surgery, any treatments for your circulation system, your heart, your kidneys or any other aspect of your well-being? Do you have other symptoms? Do you have problems urinating?

You may find that the doctor orders a series of tests which will include blood tests, hormone profiles, cholesterol profiles, prostate specific antigen (PSA), erection rigidity monitoring, stress tests and so on.....

The treatment of erection problems

This all depends on the cause. If your difficulty is caused by some kind of hormonal imbalance, then whatever underlying endocrine disorder exists must be treated first. If you have an abnormality of the penis such as Peyronie's disease, then then this may need treating first. It goes without saying that if you're a heavy smoker, drinker, or eat excessively, then you need to make some lifestyle changes before you start addressing the issue of your ED.

The treatment of ED in recent times has been revolutionized by the advent of new treatment options. Viagra and its associated compounds aha are highly effective treatments which work for a large percentage of men with a reptile failure. Those with whom these drugs do not work may wish to consider addressing the emotional/psychological aspects of their relationship and the issues that may be causing them difficulty in achieving and sustaining erection. there are of course side-effects with each  sort of treatment. We'll just mention these briefly:

Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) these drugs are prescribed for men in all categories who have ED. This includes men with physical issues, psychological issues, and even an advanced deterioration of the blood vessels of the penis. They are phosphodiesterase-5 inhibitors, a name which refers to the enzyme on which they act to prevent loss of erection during sexual activity. They are not aphrodisiacal - that is to say they do not promote sexual desire, they only work well as pre-existing libido to increase rigidity of the penis. They do have side effects which can be disturbing if you are not aware of them in advance: these include flushing of the face, a blueish tinged with a vision, muscular pain, and they need to be avoided if you are taking certain types of heart medication. For example when taken with nitroglycerin they can lead to a dangerous fall in blood pressure.

The contraindications for PDE5 use include any of the following medical conditions (Subject to medical advice):

• stroke
• moderate to severe heart disease including unstable angina, cardiac arrhythmia or a recent heart attack
• heart failure
• hypertension (high blood pressure)
• diabetes
• low blood pressure (hypotension)

One of the best combinations of medication for ED is testosterone replacement therapy and Viagra -- at least to those men who are experiencing a drop in Ormond levels due to the middle life andropause.

Viagra has pretty much superseded the old system of introducing a pelletted form of the drug alprostodil into the urinary tract, as as it has also replaced the system of injecting papaverine into the erectile chambers of the penis; nevertheless these drugs may still be useful to some men who do not respond to Viagra. For some patients, a vacuum pump or penile implant may also be recommended or needed.

Viagra for Treatment of Erectile Dysfunction

What is Viagra?

Viagra (sildenafil citrate) is a drug of Pfizer Pharmaceuticals - it was the first drug approved for any treatment of erectile dysfunction other than surgery that does not have to be inserted into the urethra or or injected into the body of the penis. It was approved for sale only by prescription in March 1998, so it has been around forever 10 years and its safety record is pretty good.

It was developed by Pfizer as a drug which was designed to help men experiencing chest pain, but its development was aborted in 1992 because it did not show any promising signs of effectiveness as a heart medication. However, ancedotal information about the effects of sildenafil citrate caused Pfizer researchers to consider it as a treatment for erectile dysfunction. When re-evaluated as a treatment for erectile dysfunction it showed considerable promise: studies on more than 3500 men aged between 19 and 87 years have demonstrated that Viagra works effectively in a number of conditions associated with ED including

• diabetes
• injury to the spinal cord
• prostate surgery
• unknown cause
• hypertension and coronary artery disease

Viagra was so effective that the FDA approved the drug only six months after submission, because there were no issues of any significance, including adverse side-effects associated with it. (Although it has subsequently merged that Viagra must not be taken with various heart medications with which it can interact adversely.)

When taking Viagra

Doctors acknowledge that the data from the clinical trials and experience over ten years indicates that Viagra is a very effective treatment for ED: however, if you are considering using Viagra then it is important to emphasize that there are some men who do not respond to it, and it does not increase libido or sexual desire.  This is because it works on the physical response to never imposes produced by sexual arousal in mind or body.

General precautions before taking Viagra should be observed as follows:

• anyone taking nitrates, such as nitroglycerin, must not use Viagra. These compounds in combination can lower blood pressure too far.
• Viagra is only suitable for use by adult men.
• the use of Viagra shows be preceded by a complete medical examination.
• any man at risk of priapism or sustained erection (for example men with conditions such as sickle cell anemia, leukemia or multiple myeloma), or a man who has any penile abnormality should not take Viagra.
• you need to be aware that medications can interact with Viagra and therefore should consult your doctor about any existing prescriptions that you are using.
• Viagra Should not be used in combination with any other form of treatment for ED.

What are the side effects of Viagra?

Viagra has been found to have the following side effects in the clinical studies referred to above:

• headache - 16 percent
• flushing - 10 percent
• indigestion - 7 percent
• nasal congestion - 3 percent
• urinary tract infection - 3 percent
• less than three percent:
• mild and temporary visual changes (blue/green color perception changes and/or blurred vision), with possibly increased sensitivity to light
• diarrhea
• dizziness
• rash
• other side-effects included respiratory tract infection, back pain, flu and joint pain

Side effects that occurred less than 2 percent included respiratory tract infection, back pain, flu syndrome, and arthralgia (joint pain).

The mechanism of Viagra

As we have referred to above, the erectile mechanism of the penis involves nitric oxide (NO) being released - this compound is released in response to sexual stimulation in the corpora cavernosa.

• Nitric oxide is responsible for activating guanylate cyclase, which results in an increase in the tissue levels of cyclic guanosine monophosphate (cGMP).
• This increase induces smooth-muscle relaxation in the corpora cavernosa and this in turn allows the inflow of blood.
• Viagra (sildenafil citrate ) does not cause a direct relaxation of the human corpora cavernosa.
• Viagra enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PDE5).
• PDE5 is responsible for causing the degradation of cGMP in the corpora cavernosa - this makes the penis become flaccid, or relaxed, as blood flow out of the penis increases. 
• Sexual stimulation induces local release of NO, while Viagra inhibits PDE5, which causes an increase in tissue levels of cGMP in the corpora cavernosa. This allows continuing smooth-muscle relaxation, which permits inflow of blood to the corpora cavernosa, and erection of the penis.
• Viagra does not work when sexual stimulation is absent.

Do NOT take Viagra

• if you are using medications that contain nitrates, such as nitroglycerin
• Viagra Was not studied in men who have any history of heart attack, heart attack, stroke, or recent irregular heart rhythm
• either low or high blood pressure
• condition of heart failure or chest pain
• eye disorders

Because Viagra can lower blood pressure is essential that your doctor carries a full medical examination before you take it. On rare occasions Viagra has also caused prolonged erection called priapism: any erection that lasts longer than three hours should be  regarded as dangerous and the man concerned should go to the emergency room.

Over nine months in 1998, the FDA investigated two hundred reported cases of adverse effects to Viagra involving death or serious illness. It appears that 77 men did indeed have heart attacks or heart failure, but there remains some doubt as to whether and not these events were associated with Viagra and the number is phenomenally small compared to the 6 million prescriptions that had been issued over the same time period. Since the concern over the use of Viagra has now died down it is reasonable to assume that given the cautions are advised to men with heart failure or heart disease it is a safe drug to take to treat ED. Changes were made to the labeling of Viagra to emphasize that there are some risks no matter how small - but in general library is regarded as a safe method (not to mention an effective method) of treating ED.