Penile prosthesis implant remains the most effective and permanent treatment for ED. Penile prosthesis implants can be broadly divided into malleable and inflatable prostheses (20). Malleable penile prosthesis, also known as semi-rigid prosthesis, does not allow for (physiological) flaccid state of the penis. The patient can bend the prosthesis upwards for sexual intercourse and downwards for concealment. Although the angle of prosthesis concealment has improved with recent devices, however due to the constant rigid state of the penis, they are still less comfortable compared to their inflatable counterparts, are more likely to cause social embarrassment and associated with higher risk of implant erosions (21). However, malleable prosthesis still has its place for the treatment of ED as these implants are easier to handle, easier to place and would benefit patients with impaired manual dexterity.
The penile roots are enveloped by two pelvic floor muscles, the bulbocavernosus (BC) and the ischiocavernosus (IC). The IC muscle is the “erector muscle” and the BC muscle the “ejaculator muscle.” The BC and IC muscles are responsible for the ability to lift one’s erect penis up and down (wag the penis) as they are contracted and relaxed. Although not muscles of glamour, they are certainly muscles of “amour.” Although unseen and behind-the-scenes, hidden from view, these often unrecognized and misunderstood muscles have vital functions in addition to erection and ejaculation. When the pelvic floor muscles are not functioning optimally, one loses the potential for full erectile rigidity. Like other skeletal muscles, they can undergo “disuse atrophy,” becoming thinner, flabbier and less functional with aging, weight gain, sedentary lifestyles, poor posture, chronic straining and other forms of trauma, including pelvic surgery (e.g., prostatectomy). Exercising them can enhance sexual health; maintain sexual health; help prevent the occurrence of ED in the future; and help manage ED. Specifically, pelvic floor exercises can be beneficial with respect to the following spectrum of issues: ED; ejaculation issues including premature ejaculation; urinary incontinence; overactive bladder; post-void dribbling; and bowel urgency and incontinence. One of the challenges of pelvic floor training is that most men do not know where their pelvic muscles are located, what they do, how to exercise them, and what benefits exercising them may confer. In fact, many men don’t even know that they have pelvic floor muscles. Because they are out of sight, they are often out of mind and not considered when it comes to exercise and fitness. However, although concealed from view, they deserve serious respect as they are responsible for vital functions that can be enhanced when intensified by training. Pelvic floor muscle training before and after prostate cancer surgery can facilitate the resumption of urinary control and sexual function after surgery. Pelvic floor training is also useful for men who suffer with stress urinary incontinence following prostatectomy. This is a spurt-like urinary leakage that occurs at times of increased abdominal pressure, such as with sports and other high impact activities. Pelvic floor contractions on demand are a technique in which the pelvic muscles are braced and briskly engaged at the time or just before any activity that triggers the stress incontinence. When practiced diligently, this can ultimately become an automatic behavior and the incontinence improved, if not resolved.

Peanuts contain a trove the amino acid L-arginine, which is one of the building blocks of nitric oxide, which aids your efforts under the covers. They also help reduce cholesterol levels. The less cholesterol you have in your system, the easier it is for blood to circulate throughout your body and down, which can help you maintain a firmer erection longer.

According to the Cleveland Clinic, “because erectile dysfunction is caused by a complex set of psychosocial, neurologic, and vascular factors, a specific cause in a patient may remain ambiguous.” The root causes are often related to a blockage or dysfunction of blood vessels. For example, ED can be due to conditions like atherosclerosis or diabetes, hormonal imbalances or problems related to mental health. It’s been found that common causes typically include one or more of the following factors: (2)


The Institute of Medicine recommends cumulative daily vitamin D intake of 600 international units (IU) for adults between 18 and 70 years of age , and 800 IU for those over 80. A 3oz serving of salmon contains about 450IU, while an 8oz. glass of milk only has about 100IU. Low vitamin D levels may be an independent, potentially modifiable risk for ED, so it’s worth taking Vitamin D supplements for your “D.” However, keep your daily vitamin D supplement intake below 4,000IU, as too much vitamin D can be toxic.


Many are quick to pull the trigger on the doctor’s prescribed solutions such as Viagra or Cialis rather than seeking out natural erection foods that can alleviate erectile problems, but the honest truth is that neither one of those will fix the underlying problems causing the weakened erections. Sure they work in most cases, but it’s always good to remember that they deliver a chemical erection which your body still cannot naturally produce.
There is no single cause for erectile dysfunction. Achieving an erection involves a complex series of physiological events; in order for an erection to occur, the body is required to coordinate nervous system responses with tactile sensations, emotional triggers, and signals from certain hormones. If any of these events are disrupted, impotence is likely to occur.
The phrase “use it before you lose it” can be applied when it comes to helping men with ED regain normal erectile function. Pelvic exercises, more commonly known as kegel exercises, are used to promote urinary continence and sexual health. They help to strengthen the bulbocavernosus muscle, which does three things: allows the penis to engorge with blood during erection, it pumps during ejaculation, and it helps empty the urethra after urination, according to Healthline.
Move a muscle, but we're not talking about your biceps. A strong pelvic floor enhances rigidity during erections and helps keep blood from leaving the penis by pressing on a key vein. In a British trial, three months of twice-daily sets of Kegel exercises (which strengthen these muscles), combined with biofeedback and advice on lifestyle changes — quitting smoking, losing weight, limiting alcohol — worked far better than just advice on lifestyle changes.

Feeling fatigued, very stressed, depressed or dealing with another mood-related issue that can lower libido. Sources of stress and diminished quality of life — such as “deteriorating economic position,” unhappiness with one’s job or other aspects that lower emotional health — are believed to be major causes for sexual dysfunction in both men and women


Peanuts contain a trove the amino acid L-arginine, which is one of the building blocks of nitric oxide, which aids your efforts under the covers. They also help reduce cholesterol levels. The less cholesterol you have in your system, the easier it is for blood to circulate throughout your body and down, which can help you maintain a firmer erection longer.
Issues relate to 'autoimmune type manifestations, joint pains, fatigue issues, rashes, sun-sensitivity, erectile dysfunction,libido issues, lack of energy and motivation, dry eye and sjogren's like symptoms, neuropathy for some, insomnia, etc. Any potential medications, therapies, or ways to approach these problems will be explored with great interest. Other questions involved 're-treatment' for relapsers, and issues around optimal dosing, and the role of Ribavirin.
Tufan herbal ED pills dilate blood vessels and make nerves and tissues of male genital region stronger. Dilated blood vessels supply more blood on arousal and which allows tissues to absorb blood and cause erections. Tufan herbal ED pills make tissues stronger so that these absorb more blood and grow more in size and get stiffer, stronger tissues provided by these best ED pills cause rock hard erections in a flash. These benefits provided by Tufan herbal ED pills resolve problem of slow, soft and weak erections and allow a male to gain quick, stronger and harder erections to provide natural ED treatment.
Ginseng is the most common ingredient among top-selling supplements for men’s sexual health (36). The English word ginseng derives from the Chinese term renshen. Ren means “person” and shen means “plant root”. This plant has been named in this manner as its roots resemble the lower limbs of a human, Traditionally, ginseng has been used to restore and enhance the normal well-being of the body. The effects are due to ginseng’s reactions with the central nervous system, metabolism, immune function and cardiovascular system. The principal active compounds are triterpene saponins known as ginsenosides. Animal studies have suggested that specific ginsenosides may be responsible for ginseng-mediated effects on copulatory behavior (37). Ginsenoside induces smooth muscle relaxation by hyperpolarizing the smooth muscle membrane via activation of large-conductance KCa channels (38).
A cold slice of watermelon can do more than just satisfy thirst and hunger during the warm summer months; it can help with bedroom satisfaction. Citrulline, the amino acid found in high concentrations of watermelon, is found to improve blood flow to the penis. A 2011 study revealed men who suffered from mild to moderate ED and took L-citrulline supplementation showed an improvement with their erectile function and were very satisfied. Natural watermelon juice, or “nature’s Viagra,” can also be easier on the stomach, since taking pills like Viagra can cause nausea and diarrhea.
This mineral is needed for a healthy sex life and a deficiency is linked to low testosterone levels which contributes to weaker erections. Zinc supplements can significantly improve matters in the bedroom. Food items loaded with Zinc can include oysters, shellfish, nuts and seeds. Erectile dysfunction and loss of interest in sex life can be caused by many physical and psychological reasons. Keep yourself healthy by consuming these vitamins and a healthy diet that is high in fibre and nutrients. Try to ignore OTC medicines like I-Arginine and other pills, and start including these fresh vegetables, apples, oats and whole grains in your daily life. 

ED is caused by vascular, hormonal, neurogenic, pharmacological, or psycho-genic factors. Performance anxiety where the person fears failing in a sexual scenario is a common psychogenic cause for ED.3 Neurogenic causes are related to diseases like Alzheimer's, Parkinson's, stroke or spinal cord injuries. Radical removal of the prostate (also called prostatectomy) is the cause of nerve-related ED as nerve injury is possible despite advances in surgical methods.4

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Impotence, or erectile dysfunction (ED), is the inability for a man to sustain an erection long enough for normal, satisfying sexual intercourse.  To understand the underlying causes of impotence, it helps to know the basics about how an erection develops, along with potential problems that get in the way. Erections begin in the brain with a thought related to sexual desire. Then a chemical message travels from the brain to the penis. Blood flow to the penis increases as blood vessels leading to the reproductive system relax and allow for increased circulation.

The definition of erectile dysfunction (ED) is the inability to obtain or maintain an erection firm enough for sexual intercourse. Historically, admitting to having ED was considered taboo and downright embarrassing until the advent of sildenafil citrate (Viagra) in 1998. Sildenafil liberated men from the stigma of having ED, and it opened a conversation about a problem that has existed for centuries. Up to 10% of men younger than forty suffer from ED and upwards of 60% by age 69.1
She is ‘a pile of mashed potatoes’, her breasts are a ‘tragedy’, she looks terrible in clothes but even worse when nude, wanted surgery for ‘a quick fix’ because she is too lazy to exercise, she has never looked worse, etc … and you are faking erectile dysfunction because you do not want to talk about the fact that you are still crying over a breast reduction that you didn’t want her to get.
How men can improve their sexual performance Many men want to know how to enhance their own and their partners’ sexual satisfaction. However, placing too much emphasis on performance can lead to anxiety. Certain lifestyle changes can help to reduce sexual anxiety, improve erectile dysfunction, and increase stamina. In this article, we describe 13 methods to try. Read now
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