When Viagra was introduced several years ago, the drug's manufacturer warned of a number of visual side effects, including possible nerve damage to the eyes. But a UC Irvine College of Medicine study rules out some of these risks - even when the drug is taken in high doses.

Thanks to : Penis Pills

The current issue of the Mayo Clinic Health Letter outlines other treatment options for erectile dysfunction and why treatment is important.

Erectile dysfunction is more common in men over age 65 but can occur at any age. Men with concerns about impotence should ask their doctor about treatment options which include;

• Oral medications: As well as Viagra, a second medication was approved by the FDA in 2003 and another is expected to be available by the end of the year.
• Injected drugs: Men can inject drugs into the penis to enhance blood flow.
• Self-administered intraurethral therapy: This involves using a small applicator to insert a tiny pellet of medicine into the urethra.
• Vacuum devices: These devices are a hollow plastic tube which is placed over the penis and pumped to create a vacuum that pulls blood into the penis.
• Surgical options: These are usually considered if other treatments aren't working. Semirigid rods or inflatable devices may be surgically implanted.

The Mayo Clinic Health Letter is an eight-page monthly newsletter of information on today's health and medical news. To subscribe, please call toll-free 800-333-9037, extension 9PR1.

Dr. Doumas and his colleagues studied men between the ages of 31 and 65 years who were evaluated for hypertension and then were asked to complete a questionnaire that evaluated their erectile dysfunction according to the International Index of Erectile Function (IIEF). "The IIEF is widely used considered an accurate test for defining sexual dysfunction," said Doumas. "Using the IIEF's 'inform-then-probe' technique of questioning, we were able to clearly demonstrate a strong link between high blood pressure and erectile dysfunction."

Overall, 35 percent of the patients exhibiting hypertension had some degree of erectile dysfunction, and 9 percent of these patients had severe erectile dysfunction. By contrast, only 14 percent of patients with normal blood pressure had some degree of the condition, and 2 percent of these patients had severe erectile dysfunction.

In the second study, Dr. Charalambos Vlachopoulos of Athens Medical School, examined the long term effects of sildenafil (the active constituent in Viagra and other impotence drugs) on aortic stiffness. "Sildenafil is widely-used for treatment of erectile dysfunction, but the condition is so prevalent and closely linked to risk factors for coronary artery disease that we wanted to explore the drug's potential beyond erectile dysfunction treatment," said Vlachopoulos. "We found that the drug has a beneficial long-term effect on aortic stiffness, a risk factor for heart attack, stroke and coronary artery disease."

"We have seen in previous studies that patients suffering from ED and those suffering from coronary artery disease both share a common defect, endothelial dysfunction," Dr. Vlachopoulos said. The endothelium is a thin cellular layer that covers the innermost surface of all blood vessels. Endothelial function involves the cells' secretion of important substances, such as nitric oxide, that help control vascular tone and the ability of the vessels to dilate. "Because sildenafil blocks the breakdown of vasodilating substances produced by the endothelium to aid sexual function, we hypothesized that the drug may help reduce aortic stiffness, which is partly dependent on endothelial function," he continued.

Vlachopoulos and colleagues tested men with erectile dysfunction by giving them either sildenafil or placebo, daily, over 2 weeks. The researchers concluded that arterial stiffness decreased for patients on sildenafil. The research team then used pulse wave velocity techniques to measure blood flow as the heart beats. Vlachopoulos said that while the implications of the study were promising, it was only the beginning and more in-depth research would be needed in the future. "We are on the cusp of discovering new beneficial effects that seem to extend beyond sildenafil's acute action," he concluded.

The findings, published in the journal BJU International, were based on a study of nearly 500 men who had the implants fitted. The men were aged between 21 and 78 with an average age of 52.

Drugs are not an option for some men suffering erectile dysfunction, according to the researchers. "Not all men are able to take medication to help them overcome erection problems" explained study author Andrea Minervini. "Implanting a penile prosthesis remains an effective treatment, particularly for patients with medical conditions that cause irreversible erectile dysfunction."

The key findings of the study were:

• The most common reasons for men choosing penile implants were diabetes (27 percent) and vascular disease (26 percent). Radical pelvic surgery and spinal cord injuries were some of the other reasons cited.
• The study found that patient satisfaction rates were high, with 81 percent of the men saying they were satisfied with the results.
• Over 70 percent of patients were satisfied with the actual operation. Dissatisfaction was most likely to be caused by having the prosthesis removed because of problems such as infection or mechanical failure.

• Nearly a quarter of the men experienced post-operative complications, including short-term urinary retention and superficial wound infections. Major complications included prosthesis infection and mechanical failure.

• The complication rates varied depending on the type of prosthesis fitted and the nature of the patient's health problem. Men who had suffered pelvic trauma experienced a higher than average rate of prosthesis infection.

  While the new anti-impotence drugs are an option for many men, penile implants won't disappear, concluded Minervini. "Penile prostheses still have an important role to play and continue to provide the 'gold standard' for patients with irreversible erectile dysfunction."

Thanks to : Penis Pills

The survey showed that around 13 percent of the men reported experiencing ED (defined as difficulty getting or keeping an erection), but more surprisingly, 25 percent reported ED occurring with condom use (EDwC). "Participants with EDwC were 4 times more likely to use condoms inconsistently, and 5 times more likely to have multiple sex partners in the last year, suggesting that EDwC may represent a barrier to safer sex and play a role in STI [sexually transmitted infection] transmission," said Robert Garofalo, of Children's Memorial Hospital.

Overall, 6 percent of the surveyed men had used erectile dysfunction medications. Of these, 29 percent used them to enhance sexual performance and 64 percent of users mixed the erectile medication with alcohol or illicit drugs. "Particularly concerning is mixing Viagra™ and other erectile dysfunction medications with alcohol and drugs, such as ecstasy or methamphetamine," said lead researcher Najah Musacchio. "Such drugs boost sex drive and reduce inhibitions, yet impair sexual performance. [Their] use may permit men in altered mental and physical states to engage in unsafe sexual behaviors, creating concern for unwanted pregnancy and sexually transmitted infections." Musacchio's concerns are reinforced by past studies of adult men who have sex with men, that found Viagra™ use to be associated with risky sexual practices.

Another concern was that the men in the survey usually didn't get the medication from their doctor. Most of the men got the medication from their friends, or other non-medical sources such as the Internet.

The researchers said that given the association between ED and negative health outcomes such as depression and sexual dissatisfaction, doctors should ask adolescent males about ED and counsel them on the potential health risks of erectile dysfunction medication and substance use. They added that doctors should specifically inquire about EDwC, stressing the importance of using condoms with all sexual encounters. "The topic must be addressed," Musacchio said. "Data indicates that ED and erectile dysfunction medication use is not uncommon in young males. It should be openly discussed, especially since it can lead to unsafe sex and other health risks."

I'm not a biking fundamentalist waging a jihad against cars, but when I'm zipping by a traffic jam of SUV's choking in their own exhaust I feel a warm glow of... smugness. Bicycles are a net-positive in this world. They speed you to your destination. They keep you in shape without destroying your shins and joints and except for the initial cost, they're free to run.

So it was with some dismay that I read recently that too much cycling (read anything more than 3 hours a week – I log at least double that) can result in permanent impotence. This isn't exactly a new issue. It's been bandied about the zeitgeist for a few years now and most serious cyclists are aware of the issue.

Sadly, dick limpness and saddle pressure have been associated for a very long time. Hippocrates, the ancient Greek physician described impotence among the rich inhabitants of Scythia and noted fewer cases among the poor and attributed it to the frequent horse riding by the rich.

More recently, the link was investigated in 1997 with the publication of a Norwegian study in the journal Acta Neurologica Scandinavica. Its authors, Anderson and Bovim, found immediate nerve damage in 22 percent of riders who participated in an annual touring race of 540 km (330 miles). The symptoms ranged from impotence (13 percent) to penile numbness. The study caught the attention of some urologists, and in 1999 another study entitled, "Nerve Injury Associated with Avid Bicycling" was published in the prestigious and widely read (amongst urologists anyway) Journal of Urology.

This was the study that caught the attention of the newswire services and wide-eyed "avid" cyclists everywhere. One of the authors of the study, Dr. Goldstein, has gone on to become the standard bearer for the bicycle = limp dick school of thought. Quoth Dr. Goldstein; "Men should never ride bicycles. Riding should be banned and outlawed. It is the most irrational form of exercise I could ever bring to discussion." Goldstein has estimated that 100,000 American men suffer erectile dysfunction as a result of bicycle riding. Considering that 100 million American's rode bicycles last year, this may not seem like very much, but if you're one of those 100,000 your perspective might be different.

Goldstein and others have come under considerable fire from biking advocates and the bicycling industry in general. While in many ways this is a rearguard action, some of the criticisms are valid. The statistical methodology in a number of studies has been questionable. Some of these studies have been conducted by urologists dealing with men who were already suffering from erectile dysfunction (ED). While a higher proportion of these men were serious cyclists than in the general population, it is methodologically suspect to extrapolate from these figures what the risk factor is for the general population.

Yet studies and statistical rehashings conducted by the biking industry that found (surprise, surprise) that biking makes you less likely to suffer ED are perhaps even more suspect. In reading scientific studies it helps to keep in mind Mark Twain's quote; "there are three kinds of lies: lies, damned lies and statistics."

As yet, no one has conducted the definitive study on the association between bike riding and ED. Perhaps the most respected is a 2002 study conducted by Steven M. Schrader amongst a group of biking police officers. Schrader found an inverse relationship between the degree of seat pressure and time spent in the saddle, and the quality of nighttime erections.

While there's still not enough data to determine what degree of risk is involved in peddling about, it's probably safe to say that something is going on. But what is it? How can something as seemingly innocuous as riding a bike cause you to suffer permanent erectile dysfunction?

The problem appears to be both vascular and neurological. In a typical banana seat (still the most common), most body weight is borne by an area called the perineum, the name given to the area located between the back of the balls and the anus. Through the perineum run both the common penile artery and the pudendal nerve. Any activity which compromises the function of either of these two systems puts the individual at risk of diminished erectile capacity.

The pudendal nerve bifurcates in this area into the two terminal nerves, the perineal which enervates the testicles, (hence, riders often complain of numb-nuts after a long ride) and the dorsal nerve which enervates the penis. As its name suggests, the common penile artery is the main branch of the blood supply leading to the penis. Downstream of the perineum it splits into the bulbourethral artery, the dorsal artery of the penis, and the cavernosal artery. All three are important in achieving a good, solid stiffy.

Either system can obviously be damaged by a sharp impact. It was thought that blood vessels in particular are resilient and elastic in response to non-traumatic stress but evidence is mounting that both nerves and blood vessels can be damaged by long-term wear-and-tear. How this happens is still debatable but it appears that given enough stress, the lining of the blood vessel begins to break down affecting arterial flow. If the stress continues past this point the damage can become permanent.

All this is very sobering to bike enthusiasts like me. Is Dr. Goldstein right? Should men just stop riding bicycles? The answer is clearly no. Moderate bike usage is considered by almost all urologists to be safe, and for those who still like to log a few hours a day in the saddle, there are bike seats that have been designed to minimize the perineal pressure. Of these, the best are apparently the "noseless" bike seats that redistribute the pressure back from the perineum. For cheapos like me who don't want to cough up the extra dough, try tilting your seat down.

Perhaps the best advice is to be aware of what your body is telling you. If you suffer from numb-nuts after a long ride, take this as a serious warning signal. Ditto, if your erections suffer after a long ride. A little bit of caution, it would seem, goes a long way.

By the turn of that century this much was known about the erection: 1) It was vascular. Blood went in yet somehow didn't come out until the erection subsided; 2) It was neurological; 3) It was hormonal. The defining male essence, testosterone wasn't isolated until 1934 but they knew something in the testicles was responsible; and 4) It was mental. In other words, they knew all the elements involved in a pocket rocket but had no idea how lift off actually occurred. They had no shortage of theories though.

One of the earliest approaches was also in many respects the most obvious. If a stiffy was produced by blood coming in and not going out, then it stood to reason that the lack of a stiffy was a function of blood draining too quickly. The solution: block the drains. While a handful of doctors attempted various forms of venal ligation with middling success, it was a urologist by the name of G. Frank Lydston who is most closely associated with the procedure. Lydston was something of a latter day Renaissance Man. He wrote several works of fiction and went on to become one of the leading lights of the eugenics movement, advocating sterilization of criminals and the castration of Negroes accused of raping white women.

Lydston eventually abandoned venal ligation in favor of testicle transplantation (you may remember Frank as the dude who transplanted a testicle into himself). While venal ligations were performed throughout most of the century, it had a low success rate (less than 30 percent) and there were some serious complications including penile necrosis. "We have good news and bad news. The good news: The surgery was a success, your dick can get hard again! The bad news: It's gonna fall off... sorry."

The second approach was hormonal. As we've seen, testicle transplants were de rigueur during the 1920s, as were testicular extracts. When testosterone was isolated in 1934 there was a brief flurry of excitement (Hitler reportedly received injections) until it became clear that, while it had many effects, (increased strength and aggression, acne, hair loss and little bitty balls) it didn't do much to cure erectile dysfunction. While extremely low levels of serum testosterone have been associated with erectile difficulty, erectile dysfunction is rarely the result of low testosterone.

The third therapeutic approach was psychiatric and this eventually became the dominant means of dealing with erectile dysfunction for most of the century. In fact, as recently as the early 1980s, impotence was understood be almost entirely psychological in origin. Despite the success of Viagra and other erectile medications, many psychologists still cling to this belief. The "it's all in the mind" point of view was an outgrowth of the Freudian revolution. Freud believed that impotence arose from anxiety stemming from unresolved Oedipal issues. The idea that a man can't get it up because he unconsciously wants to sleep with mother and fears castration from his father may seem laughable from a 21st century perspective, but one cannot dismiss the power that Freudianism had over modern thought. People really bought into this.

There developed something of a turf war between those that believed impotence to have a psychological etiology and those (mostly urologists) who insisted it was physiologic in origin. The gauntlet was thrown down in 1927 with the publication "Impotence in the Male" by Wilhelm Stekel. Stekel, a disciple of Freud, insisted that, except in the rarest of cases where there was genital damage or disease, there was no such thing as organic impotence. In Stekel's estimate, impotence was 95 percent psychological in origin. He had no epidemiological evidence to support this assertion but people, both scientists and laymen, accepted the figure as fact.

This may seem bewildering given that it was so obviously off the mark. Did no one ask themselves why, after humping happily for most of their adult lives, men would suddenly be seized by Oedipal conflict? Urologists did, of course. There was even a debate held in 1936 between urologist Max Huhner and the famous psychoanalyst, Karl Menninger. But science, then as now, is driven largely by fad and the prevailing winds of the zeitgeist. Sometimes baseless assertions stick. Witness the orthodoxy of behaviorism in the 1950s or the current assumption that all rape is about power. In the battle for therapeutic supremacy, the psychologists won out - for a time anyway.

This was largely because the urologists of the time had so little to offer. Max Huhner himself was still clinging to the 19th century notion that impotence was a function of too much stroking-off. Add to this the questionable surgeries that were being performed with little success and it's no surprise that the prevailing winds drifted away from the physical etiology of impotence to the mental.

As it turned out though, the only real success achieved in combating erectile dysfunction for much of the 20th century fell to engineers. Engineers didn't know what organic or psychological issues caused the phallic balloon to go flat and they didn't care. They just wanted to pump it up again.

The first bright idea came by way of an Austrian inventor/engineer by the name of Otto Ledever. Ledever reasoned that if erection was achieved by blood being drawn into the penis and staying there, the effect could be achieved by applying a negative pressure on the penis and pulling the blood in. In 1917, Ledever patented an airtight cylinder topped by a bulb that acted as a vacuum extractor. It was the world's first penis pump and it worked... after a fashion. A limp dick could indeed by converted to an impressive erection. The trick was to maintain it when the vacuum was released. This was achieved by means of a constriction band around the base of the penis. It didn't last long and it tended to be floppy (the root of the penis inside the body remained flaccid), but for those willing to go to the effort it permitted insertion and something a little like sexual intercourse. And, as any mathematician can tell you, even a little is infinitely more than none.

The second major innovation was the prosthetic implant. The first of these was fashioned by Nicolai Borgoras out of rib cartilage. Borgoras was inspired by the baculum or os penis found in many mammals. His experiment was not a success, as the cartilage was reabsorbed after a few months. But it did allow for insertion and once this effect was acknowledged it was only a matter of finding a rigid material that wouldn't be rejected by the body. The answer lay in plastics. In 1952, surgeons implanted acrylic splints between the corpora cavernosa in five patients. It worked but proved too uncomfortable and the approach was superseded in the 1960s by polyethylene prostheses that could be inserted into the corpora itself. The technique was improved further in the seventies with the introduction of sponge-filled silicone implants placed intracavernosally. The main problem was the penis was maintained in a state of constant erection. It could be folded up or down but it remained stiff. This problem was overcome with the development of the "Flexi-Rod" that could be bent as the owner required. It still left the patient with a permanently expanded penis but hey, that was a cross most recipients were willing to bear.

The real breakthrough came in 1973 when F. Brantley Scott developed the inflatable prosthesis. The Scott device consisted of two silicone reservoirs that were inflated by means of a subcutaneous pump, positioned in the scrotum. And for some years this was the gold standard in erectile therapy and it remains in use today. I remember reading about it wide-eyed when I was a teenager. The problem with the device is that it requires slicing open your dick and walking around with permanent hardware in your nether regions. It's an extreme measure for any man to take and many are understandably reticent about undergoing the procedure.

Then in 1983, the world of erectile dysfunction was turned upside down when an Englishman named Giles Brindley stood up in front of several thousand attendees at a urological convention and pulled down his pants. But that's a story I'll leave to another week.

When I started using the stretching techniques and pc flexes I was 7" hard and about 5.5" around. After about a month or so I began to notice a moderate change in girth, and after about 3 months I am sittin at a little over 8" long and right at 6" around. The girl that I am with right now loves it and I think that girth is the most important factor over length. Hope this is helpful to someone!
SK

Thanks to : Penis Stretcher

How does jelqing enlarge the penis?
Jelqing exercises work in two ways: rebuilding and expanding the spongy bodies in the penis known as the corpora cavernosa and the corpus spongiosum, and, lengthening the ligaments of the penis, the main one being the suspensory ligament. A good example of ligament stretching can be seen in the women that belong to the Padaung tribe of Myanmar. Referred to as "Giraffe Women", they are known for their extremely elongated necks. From an early age, these women wrap metal coils around their necks. Over time, as more coils are added, the necks are stretched ten inches or more in length.

What is the best jelqing exercise for increasing penis length?
In manual stretches, nothing beats the "Tension Stretch". Why? The penis is anchored to the pubic bone by several ligaments. In order to stretch these ligaments, it's necessary to perform a stretch that taxes all of the ligaments involved. By "rotating" the stretched penis, you are effectively stretching all the ligaments without cutting off circulation.

What about increasing penis girth?
The easiest and most common exercise for increasing girth would have to be the jelq. As a beginner's exercise, it's fine, but for more advanced enlargement, I believe the jelq to be highly overrated. My recommendation is "the squeeze" exercise. Many men, after jelqing for several months and doing hundreds of repetitions a day, report an even better result by doing the squeeze for just a few dozen repetitions. The squeeze will expand the the spongy tissues of the penis and stretch the tunica (the elastic-like casing of the penis). I’d like to make clear the distinction between the "uli" exercise and the squeeze exercise. The uli involves the use of only one hand squeezing the base of the penis. The squeeze however involves the use of both hands, one at each end.

How long before I see results from jelqing and other exercises?
Many men start seeing changes in penis size within a few weeks. Some men have added up to an inch or more in less than a month. This is uncommon but not impossible. How quickly you see results is entirely dependent on keeping up the exercises and following instructions closely.

How big can I make my penis?
Some advanced users stop making gains because they fall victim to the "more is better" mode of thinking. They say, "Hey, I did 50 repetitions of 'the squeeze', and my penis is a half inch bigger. If it only took 50 repetitions to add that half inch, then with 100 repetitions, I should be able to add a whole inch!" This a fallacy and men should ensure they follow the routines as instructed. The penis needs to be treated with care and good jelqing routines are designed to avoid discomfort and injury.

Do jelqing exercises take a long time to do?
For beginners, the exercises shouldn't take more than 30 minutes a day. For more advanced levels of penis enlargement, an hour or more is not uncommon. Taking some of the time you normally spend watching TV and using it for penis enlargement is a good way to start.

Who can I get jelqing help from?
Finding a good program is very important. Does the program offer consultation services? How is their support? How long do they take to answer emails? Is the info regularly updated? Are there various routines to choose from? Are the guidelines easy to follow? Good jelqing programs should also offer message boards and discussion forums for members to discuss routines and results.

Q. How do extenders work?
A. Well, the extenders work by applying a constant tension to the penis. The human body is a very adaptive piece of engineering, it can change and adapt under stress. You may have seen examples of this, but possibly the most apparent is that of lifting weights. Working-out is a good analogy with regard to many aspects of the extender, because in effect, you're working-out your penis. Just as when we lift weights that are heavier than what we're used to, our body adapts to this new workload and builds extra muscle to help us with the task. The extender works in exactly the same way. The penis will actually manufacture new cells to adapt to the extender's force exerted on the penis. This results in a longer, thicker penis. There is simply more tissue being added.

Q. What's the reason as to why extenders have suddenly become so popular?
A. As you know, they've been around for a few years, but only recently have they gained a lot of popularity. This phenomenon is much like the experience of music groups who finally get famous. Bands are often gigging around and performing for 5 or so years before they actually get popular. Who knows why this is? Possibly because it takes a while for the music to catch on and word to spread. People generally take a while to warm up to an idea, even if it's a good one, but when they do, it becomes popular very quickly.

Q. Where was the extender invented?
A. They were invented in Europe, Denmark I believe.

Q. Can you tell us the difference between using an extender and performing manual exercises?
A. They can both deliver good results, the differences are mainly in the effort required to achieve those results. The extender is very much less effort. If you've ever done penis exercises, you'll know they take a little bit of work and persistence. It may be a labor of love, but the extender makes the whole process easier and less taxing. Second, the extender applies a constant tension over the whole length of the penis instead of the varied tension of manual exercises which can sometimes be an issue.

Q. Can extenders be used in conjunction with manual exercises?
A. They certainly can. Much like working out, fitness experts prescribe doing different kinds of exercises for each body part. To best workout the chest, bench press, incline press, decline press, dips, etc. should all be used. The same goes for the penis, the more varied your "workouts" the better, and the quicker results can be seen.

Q. Your company offers extenders with special formulation pills, what's the idea behind that?
A. Our device is the only extender to also come with specially formulated pills. The ingredients of these pills will aid with the actual penis enlargement. Each of the 10 different herbal ingredients and amino acids are known for their remarkable effect on the reproductive system and sex organs. Increased blood flow, harder erections, higher libido, and increased testosterone levels are just a few of the benefits that accompany an increase in size. Combined, the pills and traction device offer a very powerful enlargement solution that is unique to our organisation.

Q. Would you say that there are any risks associated with extenders?
A. It's like anything, there are no risks if the extenders are used correctly. The device is classified as a Type 1 Medical Device, and holds European Health Certification (CE). We provide an extensive manual on the correct methods of use. No injuries have been reported but I suppose anything could hurt you if you use it incorrectly. Follow the instructions and there shouldn't be any problems and if there are issues then our support people should be able to rectify things promptly.

Q. What sort of enlargement results can be expected with using an extender?
A. If used correctly, all high quality extenders will deliver you the same results. Most research suggests you will gain between 0.5 and 1 centimeter per month. However, pairing the device with the enlargement pills and exercises of the Size Genetics system enable the user to surpass the results offered by other extender systems. We guarantee this.

Q. We've seen some extenders that cost nearly $1,000, what's the difference between your product and the more expensive ones?
A. The only difference is the markup. We have examined competitors devices and the Size Genetics extender is either the same or higher quality than others available. The device is composed of a plastic ring that fits against the penis, two high-grade extendable metal rods and a silicone ring that holds the glans of the penis. We even include supplemental pieces that each of our other competitors charge extra for. The extender is also kept in a beautiful wooden box. And remember, we bundle our system with our special formulation pills, making the Size Genetics system the best value extender system on the market by a long way.

Q. Can men be confident in the Size Genetics guarantee?
A. Absolutely. The device has a 100% money-back guarantee. All we ask is that our clients try the device for a full 6 month period, if after this time they don't see the results they expected, they can return the system for a full, no-questions-asked refund.

Q. Can you tell us about what sort of support you provide for extender users?
A. We are happy to answer any questions on operational matters our customers may have. We provide our customers with round-the-clock support.