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Male sexual dysfunction is one of the most common health problems affecting men and is more common with increasing age. Chronic ED affects about 5% of men in their 40s and 15-25% of men by the age of 65. Transient ED and inadequate erection affect as many as 50% of men between the ages of 40 and 70. In around 95% of the cases, a suitable treatment can be found. Erectile dysfunction is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for erectile dysfunction. Viagra, Levitra and Cialis Currently, there are three oral medications approved by the Food and Drug Administration (FDA) for the treatment of erectile dysfunction: sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). All these agents block the enzyme phosphodiesterase type 5 (PDE-5) and belong to a class of drugs called phosphodiesterase (PDE) inhibitors. Viagra was the first and is probably the most famous of the three PDE-5 inhibitors used to treat erectile dysfunction. Viagra was approved as an effective agent for treating erectile dysfunction in March 27, 1998. Viagra is manufactured by Pfizer, Inc. Levitra was the second PDE-5 inhibitor to come to market in the United States, and it was approved by the FDA in August 19, 2003. Levitra is manufactured by Bayer Pharmaceuticals Corporation. Cialis was the third PDE-5 inhibitor to come to market and was approved by the FDA at the end of November 21, 2003. Cialis is manufactured by Lilly ICOS LLC. The major advantage of PDE-5 inhibitors is that they do not cause an erection at inappropriate times, because they act only in response to sexual stimulation. If there is no sexual stimulation drug remains in the background. All three are taken orally prior to planned sexual activity, acting to increase blood flow in the penis in response to sexual stimulation. However, there are important differences between the three, differences that could influence safety, specificity, duration of action, adverse effects, and ultimately, public acceptance within this class of drug. Mechanism of Action PDE-5 inhibitors do not directly cause an erection of the penis, but they alter the body's response to sexual stimulation by enhancing the effect of the nitric oxide, a chemical that is normally released during stimulation. Nitric oxide causes relaxation of the muscles in the penis, which allows for better blood flow to the penile area. Effectiveness of PDE-5 Inhibitors All 3 PDE-5 inhibitors have demonstrated excellent efficacy. Viagra, at 84%, is slightly more effective than Cialis at 81% and Levitra at 80%. Pharmaceutical Forms, Onset of Action and Duration of Effect Viagra and Levitra differ only minimally in terms of their structure, while Cialis differs markedly from Viagra and Levitra in terms of its molecular structure, which is also reflected in pharmacokinetic differences. Viagra: 25 mg, 50 mg 100 mg tablets Onset of action: 30 minutes (effect delayed if taken with food) Duration of action: 4 to 5 hours Levitra: 2.5 mg, 5 mg, 10 mg, 20 mg tablets Onset of action: 25 minutes (effect delayed by fatty meal) Duration of action: 4 to 5 hours Cialis: 5 mg, 10 mg, 20 mg tablets Onset of action: 16-45 minutes (effect NOT delayed by food) Duration of action: 36 hours All three drugs require sexual stimulation to be effective. Viagra should be taken on an empty stomach it works better if you do not eat a high-fat meal around the time you take it. Levitra may be slightly less effective if you eat a high-fat meal, but a moderate-fat meal does not reduce its effectiveness. Cialis works without regard to what you eat. Viagra and Levitra have similar half-lives, and onset and duration of action. Cialis has a slower onset of action and longer duration of action, which is attributed to its longer half-life. Patients who wish for spontaneity may opt for Cialis, which may allow for successful intercourse up to 36 hours postdose, even though it takes longer to reach peak effect. The considerably longer duration of effect for Cialis will likely allow less frequent dosing and greater impulsiveness between partners, but also could potentially prolong adverse effects. Dosage The recommended dose for Viagra is 50 mg, and the physician may adjust this dose to 100 mg or 25 mg, depending on the patient. The recommended dose for either Levitra or Cialis is 10 mg, and the physician may adjust this dose to 20 mg if 10 mg is insufficient. A lower dose of 5 mg is available for patients who take other medicines or have conditions that may decrease the body's ability to use the drug. Levitra is also available in a 2.5 mg dose. None of these PDE-5 inhibitors should be used more than once a day. Possible Side Effects Although all three drugs are generally well tolerated, side effects are still possible. Most common side effects: Viagra: facial flushing, headache, indigestion Levitra: facial flushing, headache Cialis: headache, indigestion Less Common Side Effects: Viagra: altered vision, dizziness, nasal, congestion Levitra: indigestion, nausea, dizziness, nasal congestion Cialis: back pain, muscle aches, nasal congestion, facial flushing, dizziness Precautions and Contraindications All PDE-5 inhibitors are absolutely contraindicated in persons who take organic nitrates. Alpha-blockers Viagra has precautionary labeling advising against taking 50 mg or 100 mg doses within four hours of taking a alpha-blocker. The 25 mg dose of Viagra has not been shown to significantly decrease blood pressure and in patients who take 25 mg of Viagra, use of any of the alpha-blockers is considered safe. Levitra is contraindicated in patients taking alpha-blockers. Cialis is contraindicated in patients taking alpha-blockers, except for tamsulosin (Flomax). Since both Viagra and Levitra have moderate vasodilatory and hypotensive effects, they should not be given in the presence of marked arterial or orthostatic hypotension, and should only be administered with caution in aortic stenosis or hypertrophic obstructive cardiomyopathy. Men who have had a heart attack or stroke within the past 6 months and those with certain medical conditions (e.g., uncontrolled high blood pressure, severe low blood pressure or liver disease, unstable angina) that make sexual activity inadvisable should not take Cialis. Dosages of the drug should be limited in patients with kidney or liver disorders. Conclusions The differences between the 3 drugs are not great. All appear to be effective and safe. Levitra has less side effects compared to Viagra and lasts about the same time as Viagra in the body. Cialis has few side effects and lasts longer in the body. This allows increased spontaneity and less frequent dosing than either Levitra or Viagra. However, the longer half-life of Cialis imposes increased risk for drug interactions. truth about penis enlarement penis enargement penis girth enlargement do penis enargement pills work herbal natural pnis enlargement pnis enlargement surgery pnis enlargement program prosolution penile enlargment pills

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Is there a link between penis size and body height? A 2002 study conducted by the British Journal of Urology gives some answers. Maybe this is one of the most popular myths about the size of the penis : while you could easily guess the shapes of a woman’s breast, legs and hips regardless of the clothes she is wearing, guessing a man penis size is notoriously a harder task without direct and real observation. Of course, some “happy few” can clearly boast – but this is rare – a big bulging organ behind their clothes. That’s also why many people still believe that the penis size could be related to factors like the size of the ears or nose, or the size of the hands or feet. Let’s go back to scientific facts : in 2002, a study conducted by the British Journal of Urology made clear there was no correlation between the size of the male foot and the penis size. It is also true that the study did not focus on body height to identify the penis size, but the result has of course every chance of applying to it. It must be understood that the penis is an appendage like the ears or the nose, and that it is not influenced by the body height. In fact, penis does not follow the same rules as bones or muscles which match the body height to simply sustain its weight and maintain its common erect posture. Study found that there is also no correlation between the limbs and the penis – even it is made clear that the development of the penis and the limbs inside the womb is controlled by the same genes. Remember that the overall human body development during childhood and puberty is controlled by genes and hormones in large numbers. And that is very unlikely that genes or hormones could control the size of two different parts or organs. This is why science has to do such myths justice or disapprove them forever, because there is no indication that they will ever vanish from the vast ocean of common ideas shared by mankind. penis enlarement pills product vimax surgical penis enlargement male penis enhancement vimax penis enlargement technique free pennis enlargement exercise penis enlargment review vimax penis enlargement review natural penis enargement exercise vimax penis enlargement surgery cost

Male genital has three major functions. The first function is urinating, which is rather self-explanatory, for reproduction -- that is, to carry on the human species and the last one is for sexual pleasure. The only penis function that gets a lot of publicity is sex, or the pleasure that can be obtained from sexual encounters. An erect penis is known to provide pleasure to both sexes. Nevertheless, there are three significant factors that contribute to attaining pleasure during sexual encounters and these factors are: libido or lust, healthy blood inflow and outflow, and a nerve supply that functions perfectly. Undeniably, their penis is the most frequently utilized part of the genitalia. And when it comes to this issue, the word “big” seems to be what everyone is looking for. Since a lot of men now are getting more conscious regarding their members’ size, more and more men are willing to try penis enlarger treatments or methods. On the World Wide Web, thousands of companies are engaging in this business, which makes the issues even more sensational. Since there are so many methods available, it is harder and harder to choose the one that would give the best result. No wonder some men tend to shift from one method to another while finding that nothing seems to suit their tastes. There is, however, a company that understands what men are looking for – a bigger and better penis. SizeGenetics is one of the best program available. Its program is different from other methods available in the market. It combines an enlargement traction device and a free penis exercises program to make sure you get that long and thick penis you and maybe your partner desire. It is the first and only program to blend all aspects of penis enlargement making it the most complex and effective penis enlargement program ever developed. The combination of these powerful tools has been thoroughly tested to guarantee you the best achievements in the shortest time possible. The easy to use traction device does not cause any pain and fits all penis sizes. It can be worn for many hours, but the ideal period is 2-8 hours each day. The effectiveness of the traction device is determined by the number of hours you had it on and not by the gap between usages. The traction device enables your penis tissues to increase the number of cells through stretching. This leads to permanent a size increase of 2-4 inches, increase in girth between 1 and 3 inches, 70% chances of penile disparity improvement and it does not impair orgasmic and erectile functions. Through Penis-Health program, you can access the penis enlargement exercises program that have been developed to work both on their own and together with the SizeGenetics device. This program consists of exercises and routines that only require a few minutes of your time everyday in order to obtain excellent results. herbal penis enhancement penis enlagement fact natural penis elargement pills penis elargement surgery cost penis elargement picture vig rx pic enlargment free penile pills sample free magna rx vimax penis enlargement surgery cost

There are a lot of men out there who need help with a very personal problem, but they are afraid to do anything about it. This is because the topic of erectile dysfunction is about as terrifying to face as an appointment with a divorce lawyer, so they try to avoid it altogether. Unfortunately, erectile dysfunction affects not only men, but it also affects their spouses as well, so this makes it impossible to avoid indefinitely. Sooner or later the topic of sex (or lack thereof) will come up at the dinner table, and then they must face the problem head on. That is usually when the name Viagra enters the conversation, and they better be ready to make an informed decision on whether or not to use it. Viagra was invented by a team of scientists in the late nineteen nineties, and it was approved for sale by the FDA (food and Drug Administration) on March 27, 1998. It was considered to be a breakthrough discovery in the medical and science worlds, and the inventors won the Nobel Prize for this invention. They had essentially discovered that when a man gets an erection a chain reaction occurs in the tissue of the penis which causes the levels of a substance called cyclic guanosine monophosphate (cGMP) to be elevated. When the level of this substance remains high, the penis remains erect. They also discovered that an enzyme called phosphodiesterase-5 (PDE5) breaks down cGMP. They found that the cGMP levels tended to breakdown rapidly in some men, and this was the cause of their sexual dysfunction problems. The key to sustaining an erection was to maintain high levels of cGMP for a long period of time, so they invented a drug that would inhibit the levels of the enzyme PDE5. This would allow the cGMP levels to remain high, which would sustain an erection for a long period of time. Before the invention of Viagra men with this kind of problem just had to suffer with their ailment. Many men were too ashamed to even talk about this problem. Beside the obvious issue of questioning their manhood, there just was not a whole lot they could do about it. There was no known cure, and that was a fact. They had to face this problem with very little help from the medical world. It was no wonder that most men kept this kind of thing to themselves. Many marriages were affected adversely due to this problem, and some even ended because of it. Viagra has been a Godsend to many men who were experiencing problems in bed. The scientific name for Viagra is Sildenafil and it basically acts as an inhibitor of the enzyme PDE5. This preserves the high levels of cGMP that are produced when a man is sexually aroused. Similar products like Cialis and Levitra work in the same way, thus, all three products are defined as PDE5 inhibitors. Viagra absorbs quite rapidly in the blood stream, usually within 30 to 120 minutes. It is a highly protein bound drug (96%) which means that is will absorb faster when taken with a high protein meal. Taking it with a high fat meal will reduce the absorption rate. Pfizer is the company who makes the only genuine Viagra, and any other company who claims to make it is a fake. There are many web sites on the internet who claim to be selling “real” Viagra, but most of them are frauds looking to make a quick buck. Only a U.S. licensed pharmacy can sell Pfizer’s Viagra product, so make sure you do a little investigating about the company you plan to buy from before you make your purchase. There are many reputable companies on the internet selling genuine Pfizer Viagra through completely safe and secure web sites. All you have to do is a little research and you will get the same product you would get at your local pharmacy, but without the potential embarrassment. You will even get a better price if you buy your Viagra online than you would if you bought it at your neighborhood pharmacist, for the pharmacist selling his products online does not have to pay overhead costs (employees, building leases, benefits, etc…). Viagra is metabolized in the liver by an enzyme that is known as CYP3A4. Any one with a liver condition (like cirrhosis) who is thinking about taking Viagra must consult their physician first to discuss a customized or reduced dosage. What used to be a problem without a cure is now a problem that can be cured with a little blue pill. Men who take a 50mg dose about an hour or two before sexual activity can regain the sexual vitality and stamina that they have been missing in their lives. They can now enter that dreaded conversation at the dinner table with their spouse (about erectile dysfunction) armed with the knowledge that they have a breakthrough drug on their side that was worthy of the Nobel Prize. They can even order it at a U.S. licensed online pharmacy and have their Viagra shipped overnight to their front door by a FEDEX courier who will hand over their order in a plain-wrapped box. © 2005 copyright. Michael P. Connelly vimax surgical penis enlargement penile enlargement tool penis enhancement surgeon easy elargement free penis surgery way herbal natural pennis enlargement free penis elargement technique penis enlargement tool penis enhancement cream vimax penis enlargement surgery cost

When thinking about my patients, I've noticed a pattern to the marital conflicts that they share. Here's my list of the top ten things that put your marriage at higher risk for break-up and the things you must do to strengthen it. 1) Putting-Down Spouse's Friends/Family Don't badmouth your spouse or her/his friends, family or associates. Spouses need to know you appreciate their world outside of you. Rather, compliment her friends and family. 2) Not Using Good Listening Skills This includes indulging pre-occupation, avoiding eye contact, looking somewhere else as the conversation unfolds etc. Rather, use good eye contact, wait 'til your spouse finishes talking and concentrate so much on what s/he is saying that you paraphrase it to demonstrate you REALLY listened. 3) Lack of Sexual Interplay This is a very ominous sign in marriage. If your partner has complaints that prevent him/her from wanting to engage you sexually, get help. Seek medical and/or psychological counseling, if necessary. Men, don't get hung-up on wanting SEX-SEXUAL INTERCOURSE all the time. Be able to frequently engage your partner slowly and tenderly in a SENSUAL fashion without SEX. Don't worry, your penis won't explode because of pent-up semen. Don't leave your partner clueless as to why you aren't interested in sex. 4) Always Having the Last Word or Need to be Right This includes lecturing, criticizing and over-correcting your partner. Narcissists are HARD to love! Occasionally, admit that you made a mistake, don't know or compliment your partner as having made a "good point" (and leave it at that). Please be concise. Don't answer every question with a lecture on the topic. 5) Not Following-Thru Actions do speak louder than words. Be reliable and trustworthy. When you commit yourself to doing something, do it. This builds the trust necessary to maintain a close relationship. Trust involves everyday things, not just fidelity. 6) Inconsiderate Teasing Believe your spouse if s/he says that your teasing was hurtful or a put down. Don't give a lecture about why that wasn't correct. Just stop it. Ask yourself what s/he would find complimentary and say that instead. If you just LISTEN to your spouse you can learn alot. 7) Deceit, Lies and Falsehoods Having lies and secrets creates distance and serious suspicions in your mate. This leads to lack of trust and robs your relationship of the fuel it needs to keep going. Swallow, bite the bullet, be considerate and be honest. 8) Being Juvenile When you know you are annoying and you continue to annoy, it's immature and VERY wearing on a spouse. Find better ways to get attention and use healthy communication techniques to communicate your gripes. 9) Explosive Anger You must handle conflict constructively EVEN if your spouse doesn't. Having angry outbursts always makes you the loser, even if you ARE right. That's called being "self-defeating." Copyright, Shery, 2006