17 Ways To Beat Erectile Dysfunction

ED Report 17 Ways to Beat Erectile Dysfunction This Report on Erectile Dysfunction (ED) presents an overview of the condition including • • • • •

What is ED? How to identify ED Conventional Treatments Alternative Treatments Preventing ED

17 Ways to Beat Erectile Dysfunction

Legal Statement 17 Ways to Beat Erectile Dysfunction, copyright © 2009 ImpotenceErectionTreatment.com This report is supplied for information purposes only and the material herein does not constitute professional advice. This report attempts to provide accurate and authoritative information with regard to the subject matter covered. It is provided with the understanding that the publisher is not engaged in rendering legal, medical, or other professional advice. If medical advice or other professional assistance is required, the services of a competent professional should be sought. The reader is advised to consult with an appropriately qualified professional before making any decisions regarding the subject matter of this guide. The author, publisher, and resellers do not accept any responsibility for any liabilities resulting from the decisions made by purchasers of this guide.

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DISCLAIMER: This is generalized information and should not to be substituted for personal -1advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

TABLE OF CONTENTS Legal Statement .............................................................................................................. 1 INTRODUCTION ............................................................................................................. 2 WHAT IS ERECTILE DYSFUNCTION? .......................................................................... 2 WHAT CAUSES ERECTILE DYSFUNCTION? ............................................................... 3 PHYSIOLOGICAL CAUSES OF ED................................................................................ 8 IS ERECTILE DYSFUNCTION COMMON? .................................................................... 9 DO I HAVE ERECTILE DYSFUNCTION? ....................................................................... 9 MEDICAL TESTS FOR ED............................................................................................ 10 CONVENTIONAL ED TREATMENTS ........................................................................... 12 ALTERNATIVE ED TREATMENTS............................................................................... 16 PREVENTING ED ......................................................................................................... 18 CONCLUSION............................................................................................................... 18 RESOURCES...................................................................Error! Bookmark not defined.

INTRODUCTION When it comes to the sensitive subject of impotence, also known as erectile dysfunction (ED), not many men are willing to discuss it. It is a subject that can quickly turn into a very embarrassing conversation and men with a problem such as this generally keep it to themselves. Of course, their partner will know that their man is having a problem, which for the men makes the matter worse. It is not something that men like to address but when more men begin to understand that this is a medical condition which can be treated; then they will start having better love lives. The lack of personal connection between a man and his wife can lead to a lot of different problems in the relationship. Failure to address a rather simple issue could lead to a lot bigger problems then that of the impotence itself. If neither the man nor woman fully understands what is happening, there may be a lot of confusion taking place. The woman may feel like she is not pretty enough or that her man is just not attracted to her and he can feel like he is not man enough for her and start to move away. The best thing to do is to seek medical attention and get the issue of impotence taken care of so everyone can move on with his or her life.

WHAT IS ERECTILE DYSFUNCTION? Impotence in men is often referred to by the medical term erectile dysfunction. Erectile dysfunction is a physical condition experienced by men who are unable to get or sustain an erection sufficient for intercourse. The medical definition of erectile dysfunction is that the male is unable to get an erection 25% of the time or more. A man may want to engage in sexual activities but despite the desire his body doesn’t respond. DISCLAIMER: This is generalized information and should not to be substituted for personal -2advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

In order for a man to be able to obtain and maintain an erection there has to be an increase of blood flow to the penis. An erection occurs as a hydraulic effect due to blood entering and being retained in sponge-like bodies within the penis. The process is most often initiated as a result of sexual arousal, when signals are transmitted from the brain to nerves in the pelvis. Failure for this to occur is the cause of erectile dysfunction. Many believe that erectile dysfunction occurs only with older men but there are also many cases of impotence in young men

WHAT CAUSES ERECTILE DYSFUNCTION? There are many different causes of impotence in men and most of these are related to diseases or conditions that the individual has or is prone to. Many diseases and conditions can affect the state of a man's penis. These conditions are heart disease, diabetes, alcoholism, neurological diseases, vascular diseases and kidney disease. There may be others but these are the most common. Other factors that can contribute to impotence in men are smoking, being overweight and lack of exercise or a sedentary lifestyle. Injuries to the area in and around the male reproductive organ can also be the cause of impotence in men. These injuries can affect the nerves or arteries that supply the necessary blood and sensation to the penis. Damage to nerves, pelvis, spinal cord, bladder and prostate can lead to erectile dysfunction. Damage to the nerves and arteries due to surgery can also be a cause of this condition in men. Medication can also cause impotence in men. There are several medicines that can have erectile dysfunction as a side effect. Among these medicines are antidepressants, appetite suppressants, antihistamines, medicines for blood pressure, tranquilizers and others. Studies have shown that most (but not all) of the medicines that can cause impotence in men only have a temporary effect. Psychological causes of impotence in men are also viable reasons which may affect a small part of the male population. Anxiety, stress, fear of failure, guilt and depression are just a few of the mental causes of erectile dysfunction. Impotence in men have many different causes and some difficult to prevent and avoid. •

Alcohol Use

Experts from around the world say that small amounts of alcohol is not a problem and will not result in alcohol cause impotence, but over consumption is what results in alcohol causing impotence. Therefore you need to be really careful with how much you are drinking and how often, because you just may be creating your impotence problem. Long term alcohol use is particularly bad, as the longer you drink, the more apt you are to suffer from not only impotence but various other health conditions as DISCLAIMER: This is generalized information and should not to be substituted for personal -3advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

well. Clinical studies have shown that prolonged alcohol abuse cases irreversible damage to the nerves in the penis, and this means that it is permanent. Long-term alcohol abuse affects the nervous system and damages the impulses between the brain's pituitary gland and the genitals. The nervous system is responsible for triggering the signals that dilate and relax the blood vessels in the penis that create an erection. Clinical studies have shown that prolonged alcohol abuse causes irreversible damage to the nerves in the penis, which results in alcohol impotence. Excessive drinking also results in behavioral changes that reduce sexual desire and inhibit sexual performance. Concentration and judgment become cloudy and physical activity and movement are affected. Alcoholism also disrupts hormone levels, in particular, testosterone and estrogen. Low levels of testosterone diminish sexual drive and function. • Recreational Drugs The use of so called recreational drugs is having a major impact on the bodies of those who abuse themselves in this way. One of the ways this abuse shows up is as erectile dysfunction. Whereas erectile dysfunction used to mainly show up in men over 50, now it is affecting young men including teenagers, largely due to substance abuse. Cocaine and cannabis are two of the leading causes but there are lots of other drugs that lead to or cause ED, or worse! •

Smoking

Numerous clinical studies have shown that smoking is actually identified as being the number one culprit in increasing the risk of impotence, which may be surprising to many people. Most people are aware that smoking can cause lung and heart diseases or even a stroke, but it is a fact that many men experience sexual dysfunction as a result of smoking cigarettes, cigars or pipes. In fact, even passive exposure to tobacco smoke can be enough to trigger impotence. A Chinese study of over 7000 smokers found that there was a significant statistical link between the number of cigarettes that men smoked and the likelihood they would experience erectile dysfunction, and the more cigarettes smoked, the greater the risk. The association between smoking and erectile dysfunction was even stronger in smokers with diabetes. Another study reported that men who smoke a pack of cigarettes a day are 40% more likely to be impotent than non-smokers. DISCLAIMER: This is generalized information and should not to be substituted for personal -4advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

There are several factors to be aware of when it comes to smoking and impotence. For one, in order for a man to be able to achieve and maintain an erection, there must be adequate blood flow to the penis, and smoking causes people to have abnormally low blood pressure. As a result this reduces the blood flow to the penis and in turn an erection is harder to achieve. As well, when there is excessive blood flowing out of the penis, erection is inhibited. When a healthy man experiences sexual stimulation the veins close off almost immediately in order to trap the blood, which is what results in the maintaining of the erection. However with a smoker, the venous chamber is encouraged to dilate and so they are often unable to maintain an erection, and this is just another way that smoking affects men physically and causes impotence.

• Diabetes Many common problems associated with diabetes collectively cause erectile dysfunction. Medical studies show that 50% of men with diabetes will be affected by erectile dysfunction. If you are experiencing difficulty getting erections, there may be a number of things happening in your body. When stimulated the body releases nitric oxide into the bloodstream which causes the smooth muscles and arteries in the penis to relax and let in blood. High blood sugar eventually causes blood vessel and nerve damage that affects many processes in the body, sexual response being one of them. Blood vessel damage restricts the release of nitric oxide. This lack of nitric oxide prevents key blood vessels from expanding and reduces blood flow to the penis. Also, according to the American Diabetes Association, 73% of adults with diabetes also have high blood pressure or take a blood pressure prescription medication. High blood pressure and diabetes combined increases the risk for blood vessel damage, which further reduces blood flow. • Hypertension – High Blood Pressure Recent analyses suggest that about 70% of men with hypertension have some degree of erectile dysfunction. With about 25 million men in the US with hypertension, substantial numbers of hypertension-related cases exist that tend to be of a more severe nature than in the general population. Men with ED are also more likely to experience hypertension. Hypertension can affect erections either through the changes it causes in the blood vessels, or by the medications used as treatment. High blood pressure causes the arteries to lose their elasticity, and they therefore cannot cope with the rush of blood needed for erection. High blood pressure may also affect the veins, DISCLAIMER: This is generalized information and should not to be substituted for personal -5advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

allowing the blood that does rush into the penis to leave just as quickly. The effects of hypertension on erectile function get steadily worse over time and may occur even before a man knows he has high blood pressure. • Bladder or Prostate Surgery Operations in or around the penis area can create significant troubles with your ability to obtain or maintain an erection. Your doctor may have explained this possibility to you before surgery, but when you’re told that the operation was a success it can still come as a shock. Although the operation may have been successful in most respects it can have unintended side effects. Nerve damage, or scar tissue that forms post-op for instance, can affect surrounding body parts and tissue. A loss of erection potency after surgery is a major side effect as the nerves responsible for erectile function running beside the prostate and urethra are notoriously difficult to locate. It takes up to a year to regain potency after surgery. • Prostate Cancer Prostate cancer on its own does not normally cause erectile dysfunction. However, some prostate cancer survivors who have had medical treatment like radiation or surgery do find themselves without the full sexual functionality that they had before. Sometimes this is a temporary problem, but it can also be a long term condition. Radiation therapy works by killing the cancer cells, but there are often side effects due to damaging of surrounding non-cancerous cells. • Liver Problems Untreated liver problems are associated with both loss of libido and erectile dysfunction. Once a man’s liver begins to loose function through medical problems, or as often happens naturally with ageing, he will start to experience hormonal changes. These changes result in the redistribution of fat and loss of muscular strength – and a reduction in virility. Testes and genitalia shrink and the person becomes less able to sustain erections. • Kidney Problems Kidney damage, kidney cancer, acute kidney failure, kidney infections, chronic kidney or renal failure, and acute nephritic syndrome are all different forms of kidney damage that can lead to erectile dysfunction. Experience shows that patients suffering from chronic renal failure frequently suffer from erectile dysfunction. Studies to evaluate the prevalence of erectile dysfunction in chronic renal failure (CRF) affected men have found that almost half of all men suffering from renal failure are experiencing erectile dysfunction. DISCLAIMER: This is generalized information and should not to be substituted for personal -6advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

• Cardiovascular Problems The most common cause of cardiovascular diseases in the world today is atherosclerosis, the narrowing and hardening of arteries in the body that causes a reduction in blood flow. Atherosclerosis typically affects arteries right throughout the body and is made worse by high blood pressure, high blood cholesterol levels, cigarette smoking, and diabetes. When coronary arteries (arteries that supply blood to the heart muscle) are narrowed by atherosclerosis, heart attacks and angina can occur. When cerebral arteries (arteries that supply blood to the brain) are narrowed by atherosclerosis, then strokes can occur. In the same way, if arteries to the penis and the pelvic organs are narrowed by atherosclerosis, then insufficient blood is delivered to the penis to achieve an erection. The severity of atherosclerosis in the coronary arteries and severity of erectile dysfunction are closely related. It is recommended that men who have just been diagnosed with erectile dysfunction should be evaluated for possible coronary artery diseases (advanced atherosclerosis that has not yet resulted in angina or heart attacks). • Peyronies Disease A small percentage of men suffer from Peyronie's disease, a bending of the penis during erection. The penis contains balloons that fill with blood to cause an erection. These balloons can develop a scar that prevents them from expanding normally during an erection, causing the penis to bend toward the scar. Normally Peyronie’s is a harmless condition that requires no treatment because the scar causing the problem usually disappears with no treatment within five years on average. Impotence associated with Peyronie's disease responds well to standard treatments for erectile dysfunction, such as injections, pellets and medications. Doctors will treat Peyronie's disease only when it hurts to have an erection or stops a man from making love. Surgery doesn’t normally help.

DISCLAIMER: This is generalized information and should not to be substituted for personal -7advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

PHYSIOLOGICAL CAUSES OF ED Psychological impotence is defined as the inability to maintain an erection or achieve penetration due to mental thoughts or feelings (psychological reasons) rather than a physical condition. Sexual activity requires that the mind and body work together. You may be one of many men out there, where your erectile dysfunction isn’t due to a specific physical health problem that can be helped by medication. Instead it is the end result of emotional or psychological problems that you are currently experiencing or have experienced in the past. With men over 40 the problem is more often due to physical causes, while with those under 40 it is more commonly psychological. In order for a man to get an erection, certain signals must be sent to the nerves from the brain. If the triggers for messages in the brain are confused and there is insufficient mental stimulation, then the end result will not be what you had in mind. Psychological triggers include: • • • • • • • • • • • • • •

clinical depression guilt schizophrenia post-traumatic stress disorder substance abuse low self esteem stress or anxiety panic disorder or fear personality disorders negative feelings work pressure financial concerns fear of getting old relationship problems

It may be necessary to talk to a therapist or a counselor who can help you to identify the various emotional and psychological problems that are causing the erectile dysfunction. It is often hard for males but a man needs to be very open to this type of assistance. He also needs to be patient because results may not occur immediately. Once you explore inner thoughts and feelings though it can be very rewarding in a number of useful ways. The understanding that emotional and psychological problems can be responsible for erectile dysfunction is very important when you are searching for solutions to your impotence. Check with your doctor first to rule out any physical problems that may be responsible before seeking therapy or professional counseling. The doctor’s assessment will help you to determine whether it is a mental issue that needs to be looked at. Following the advice of your therapist in this area can help you get your sex life as well as other elements of your life into a more positive position. DISCLAIMER: This is generalized information and should not to be substituted for personal -8advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

IS ERECTILE DYSFUNCTION COMMON? It is thought that nearly 30 million men around the world experience problems with impotence or erectile dysfunction (ED) as it is referred to medically. However, only about half of them take the time to have it properly diagnosed though. Many of the others find it too embarrassing to talk about with anyone so they hide it. They don’t want to discuss with their sexual partners or even with medical professionals. Statistics show that 1 in 10 men have had to deal with this problem at some time. May people believe that only older men experience erectile dysfunction and that it is due to ageing. However, ED can affect men of all age groups. It may be a surprise to most people that only 40% of those diagnosed with erectile dysfunction are aged 40 or older. While there is a higher risk of ED occurring as a man gets older it certainly isn’t the only cause of this condition. Erectile dysfunction may be an early warning sign that there is an underlying medical condition that needs treatment. The most common condition leading to ED is diabetes. Statistics show that 50% of men with diabetes also end up with erectile dysfunction. By immediately taking steps to get your diabetes under control you can significantly reduce the risk. Follow the directions of your doctor and make sure you ask any questions you may have. Smoking is another significant factor that has an impact on erectile dysfunction. Studies have shown that men who smoke one pack per day have twice the chance of experiencing ED. If they smoke more than one packet per day it triples their chances of experiencing erectile dysfunction. The risk of erectile dysfunction increases with each passing year for older men who smoke. In online surveys where their identity is kept secret, more men are willing to admit they have experienced a problem with erectile dysfunction. In those online ED studies up to 56% of the men in the survey admitted to having some level of problem. However, due to the online nature of the survey, the severity of the ED was unable to be assessed. It was obvious though that there is a significant need among men for some type of erectile dysfunction treatment.

DO I HAVE ERECTILE DYSFUNCTION? The only way to know for sure whether you are experiencing erectile dysfunction is by visiting your doctor and getting an accurate diagnosis. Your doctor has your medical history and knows what questions to ask, and what tests to order. However if you are overweight, a smoker, drink alcohol, take prescription drugs, smoke marijuana (cannabis), use cocaine, or are stressed then your chances of experiencing erectile dysfunction are very high. DISCLAIMER: This is generalized information and should not to be substituted for personal -9advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

Do not confuse premature ejaculation with impotence or erectile dysfunction. Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration. So to be clear - premature ejaculation is uncontrolled ejaculation, while erectile dysfunction is the inability to maintain an erection sufficient for intercourse.

MEDICAL TESTS FOR ED Repeated failure to achieve or maintain an erection sufficient for intercourse over a period of 3 months may lead to a diagnosis of erectile dysfunction. Despite the potential embarrassment it pays to be totally honest with the doctor interviewing you if you want the correct diagnosis. During patient interviews the doctor will try to determine answers to the following questions: 1. Is the patient suffering from erectile dysfunction or could it be a loss of libido or an ejaculation problem? 2. Is erectile dysfunction due to psychological or physical factors? 3. Are there physical causes for the erectile dysfunction?. 4. Is the patient taking medications that can cause erectile dysfunction? Physical examination A physical examination can reveal clues for physical causes of erectile dysfunction. For example, hypogonadism caused by low testosterone levels may be identified by physical characteristics and a reduced blood flow caused by atherosclerosis can sometimes be diagnosed by testing pulses in the legs or listening with a stethoscope. Laboratory tests Commonly used laboratory tests for evaluating erectile dysfunction include blood counts, urine analysis, lipid profiling, blood glucose levels, blood haemoglobin, serum creatinine, testosterone levels, and prostate specific antigen levels. Psychosocial examination A psychosocial examination consisting of an interview and questionnaire may indicate psychological factors contributing to erectile dysfunction. The sexual partner also may be interviewed as their expectations and perceptions are also important.

Clinical Tests Used to Diagnose ED Duplex ultrasound Duplex ultrasound is used to evaluate blood flow, venous leak, signs of atherosclerosis, and scarring or calcification of erectile tissue. Injecting DISCLAIMER: This is generalized information and should not to be substituted for personal - 10 advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

prostaglandin, a hormone-like stimulator produced in the body, induces erection. Ultrasound is then used to see vascular dilation and measure penile blood pressure. Measurements are compared to those taken when the penis is flaccid. Penile nerves function Tests such as the bulbocavernosus reflex test are used to determine if there is sufficient nerve sensation in the penis. The physician squeezes the glans (head) of the penis, which immediately causes the anus to contract if nerve function is normal. A physician measures the latency between squeeze and contraction by observing the anal sphincter or by feeling it with a gloved finger inserted past the anus. Specific nerve tests are used in patients with suspected nerve damage as a result of diabetes or nerve disease. Nocturnal penile tumescence (NPT) It is normal for a man to have five to six erections during sleep, especially during rapid eye movement (REM). Their absence may indicate a problem with nerve function or blood supply in the penis. There are two methods for measuring changes in penile rigidity and circumference during nocturnal erection: snap gauge and strain gauge. (It should be noted that a significant proportion of men who have no sexual dysfunction nonetheless do not have regular nocturnal erections. Thus presence of NPT tends to signify physically functional systems, but absence of NPT may be ambiguous and not rule out either cause.) Penile biothesiometry This test uses electromagnetic vibration to evaluate sensitivity and nerve function in the glans and shaft of the penis. A decreased perception of vibration may indicate nerve damage in the pelvic area, which can lead to impotence. Penile Angiogram Invasive test - allows visualization of the circulation in the penis and is used during the repair of a priapism. Dynamic Infusion Cavernosometry (Abbreviated DICC) technique in which fluid is pumped into the penis at a known rate and pressure. It gives a measurement of the vascular pressure in the corpus cavernosum during an erection. To do this test, a vasodilator like prostaglandin E1 is injected to measure the rate of infusion required to get a rigid erection and to help find how severe the venous leak is. Corpus Cavernosometry Cavernosography measurement of the vascular pressure in the corpus cavernosum. Saline is infused under pressure into the corpus cavernosum with a butterfly needle, and the flow rate needed to maintain an erection indicates the degree of venous leakage. The leaking veins responsible may be visualised by infusing a mixture of saline and x ray contrast medium and performing a cavernosogram. Digital Subtraction Angiography In DSA, the images are acquired digitally. The computer creates a mask from lower-contrast x-rays of the same area and digitally isolates the blood vessels (this is done manually through darkroom masking with traditional angiography). Magnetic resonance angiography (MRA) This is similar to magnetic resonance imaging. Magnetic resonance angiography uses magnetic fields and radio waves to provide detailed images of the blood vessels. Doctors may inject a "contrast agent" into the patient's bloodstream that causes vascular tissues to stand out against other tissues. The contrast agent DISCLAIMER: This is generalized information and should not to be substituted for personal - 11 advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

provides for enhanced information regarding blood supply and vascular anomalies. Aside from the IV used to introduce the contrast material into the bloodstream, magnetic resonance angiography is noninvasive and painless.

CONVENTIONAL ED TREATMENTS Work closely with your doctor to find something that works for you. Here are a few of the treatments that your doctor will consider. These are widely used and experience has shown that for many men they give the best chances of overcoming erectile dysfunction. The first line treatment of erectile dysfunction usually consists of a trial of PDE5 inhibitor drugs like Viagra, Cialis, and Levitra. • ED MEDICATIONS Viagra (sildenafil) One of the most commonly used impotence cure options is Viagra. This is the drug that we all hear of most being used for erectile dysfunction, and this is for good reason because it is one of most effective. This medication is taken orally and works by relaxing muscles and increases blood flow to particular areas of the body. As with most other medications there are certain side effects that are a possibility as a result of using Viagra, and which you need to be aware of before you start using it. Cialis (tadalafil) Another very popular impotence cure is Cialis. This is a newer drug than Viagra but one that has proven to be very popular as it is fast acting and remains effective for longer than most of its competition. It is also taken orally and is used to treat male sexual function problems by blocking a certain enzyme in the body, and in combination with sexual stimulation, it helps blood flow into the penis so that the man can achieve and maintain an erection. Levitra (vardenafil) Levitra is taken orally and works by blocking the enzyme called phosphodiesterase-5 or PDE5. By blocking this enzyme the muscles in the penis can relax which allows for more blood flow and with the proper sexual stimulation can lead to an erection. The manufacturers believe the fast action time will lead to more spontaneous and thus more enjoyable encounters for people requiring this type of treatment.

DISCLAIMER: This is generalized information and should not to be substituted for personal - 12 advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

Prostaglandin E (alprostadil) With injectable medications, Prostaglandin E1 has the best record, making it the current drug of choice. Despite its success rate many men give up using it for a variety of reasons. When improved formulations of Prostaglandin E such as a powder and a transurethral gel formulation as well as an effective oral medication which have been developed become available in the near future then no doubt this treatment will become more popular.

These are certainly not the only medications that are presently available to treat impotence, and what you need to do is speak to your doctor so that you can gather more information on this and learn about all the different drugs that you have to choose from. This way you will have the best chances of success, of finding a medication that works for you and which you can continue using for the long term. SIDE EFFECTS OF VIAGRA, CIALIS, LEVITRA: As with most other medications there are certain side effects that are a possibility as a result of using these medications, and which you need to be aware of. Side effects are similar for Viagra, Cialis and Levitra. Viagra is used in the example below. Possible side effects for Viagra include headache, flushing, stomach upset, heartburn, nasal stuffiness, diarrhea, dizziness, or lightheadedness may occur. Vision changes such as increased sensitivity to light, blurred vision, or impaired blue/green color discrimination may also occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Rarely, a sudden loss of eyesight in one or both eyes (NAION) may occur. This may or may not be due to the ED medication. If this serious problem occurs, seek immediate medical attention. You have a slightly greater chance of developing this serious eye problem if you have heart disease, diabetes, high cholesterol, certain eye problems ("crowded disk"), high blood pressure, are over 50 years of age, or if you smoke. Sexual activity may put extra strain on your heart, especially if you have heart problems. If you have heart problems and experience any of these serious side effects while having sex, stop and tell your doctor immediately of: severe dizziness, fainting, chest pain, nausea. For males, in the very unlikely event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and seek immediate medical attention, or permanent problems could occur. A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching, unusual swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or DISCLAIMER: This is generalized information and should not to be substituted for personal - 13 advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

pharmacist. PRECAUTIONS: Before taking an ED medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. Before using this medication, tell your doctor or pharmacist your medical history, especially of: penis conditions (e.g., angulation, fibrosis/scarring, Peyronie's disease), history of painful/prolonged erection (priapism), sickle cell anemia, blood system cancers (e.g., leukemia or myeloma), eye problems (e.g., retina diseases like retinitis pigmentosa), kidney disease, liver disease, bleeding disorders, active stomach ulcers, heart problems (e.g., recent heart attack or serious arrhythmia within past 6 months, heart failure, coronary artery disease with unstable angina, aortic stenosis, idiopathic hypertrophic subaortic stenosis), recent stroke within past 6 months, very high or low blood pressure. This drug may make you dizzy or cause vision changes; use caution engaging in activities requiring alertness such as driving or using machinery. Limit alcoholic beverages. To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position. Do not take this medication with any other product that contains sildenafil or other similar medications for erection problems (e.g., tadalafil, vardenafil). Caution is advised when using this drug in the elderly because they may be more sensitive to the side effects of the drug. This drug is not indicated for use in women or children. DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first. See also How To Use section for drug-food interactions. This drug should not be used with the following medications because very serious (possibly fatal) interactions may occur: nitrates (e.g., nitroglycerin, isosorbide), nitroprusside (or any "nitric oxide donor" drugs), recreational drugs called "poppers" containing amyl or butyl nitrite. If you are currently using any of these medications, tell your doctor or pharmacist before starting sildenafil. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription products you may use, especially of: alpha-blocker medication (e.g., doxazosin, prazosin, terazosin), other medications for impotence, azole antifungals (e.g., itraconazole, ketoconazole), bosentan, cimetidine, erythromycin, rifamycins (e.g., rifampin), high blood pressure medicines, delavirdine. If you are taking an HIV protease inhibitor (e.g., ritonavir, saquinavir), do not take more than a 25mg dose of sildenafil in a 48 hour period. If you are taking more than a 25mg dose of sildenafil and are also taking an alpha-blocker medication (e.g., doxazosin, prazosin, terazosin) for various conditions (e.g., enlarged prostate), separate the time between taking these medications by more than 4 hours.

DISCLAIMER: This is generalized information and should not to be substituted for personal - 14 advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

• PENIS PUMPS A penis pump is a cylinder that is fitted over the penis, with a manual or motorized pump to create suction. As the apparatus creates a vacuum around the penis, blood is drawn into the penis, helping it to become engorged. As vacuum increases, the difference between the inner blood-pressure and the pump pressure increases as well; excessive pressure causes vascular damage rather than a harder penis. Penis pumps, usually described in this context as vacuum pumps, have use in conventional treatment of impotence. The pump itself is essentially as described above, although often made to higher standards of quality with a much higher price, and arrangements for distribution by suppliers of medical equipment. Flexible compression rings, commonly called cock rings, can be added. Fitted on the open end of the cylinder, then an erection is created by pumping. Then the rings are pushed by hand onto the base of the erect penis before releasing the vacuum. This restricts blood flow, enabling the erection to be held even in the presence of problems of the vascular or nervous system which would otherwise lead to immediate loss of erection. In the best circumstances erections can be maintained for a considerable time, but manufacturers' literature recommends that, for safety, rings should be removed after no more than 30 minutes. Pumping must be done very carefully to avoid injury. Over-enthusiastic pumping can burst blood vessels and form blisters. • SURGERY Surgery is very rare and is normally only used to repair injuries. The other situation where surgery is used is penile implants. Penile Implants: This method replaces the two corpora cavernosa with inflatable penile implants. This is performed primarily as a therapeutic surgery for men suffering from complete impotence; an implanted pump in the groin or scrotum can be manipulated by hand to fill these cylinders from an implanted reservoir in order to achieve an erection. The replacement cylinders are normally sized to be direct replacements for the corpus cavernosa, but larger ones can be implanted. One advantage to this surgery is that an erection can be created whenever desired, for as long as is desired and as firm as desired. However, this surgical procedure can never be reversed.

DISCLAIMER: This is generalized information and should not to be substituted for personal - 15 advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

ALTERNATIVE ED TREATMENTS Herbs have been used for hundreds, if not thousands, of years to treat erectile dysfunction and other sexual problems. While there have been no major medical studies done on most of these natural products to determine how effective or safe they are, they do have centuries of safe use behind them. Treat herbal products with the same respect as prescription medication. Follow the directions on the packaging and you should not experience problems. By using a pure herbal formulation, a user is likely to be spared from experiencing side effects such as headache, blurred vision, dizziness, indigestion, and congestion. Medical experts claim that some of these herbal ingredients attend to and treat other body irregularities aside from sexual problems. • Gingko Improves blood flow, thus improving erections. Since its components assist in creating better circulation and oxygenation, Ginkgo Biloba helps treat other possible problems in the body, such as impotence among males. • Ginseng Asian Red Ginseng has been an oriental medication, supplement, and aphrodisiac since the ancient times. Ginseng is said to rejuvenate weak bodies and increase energy. While energizing the body, Ginseng's potent ingredient ginsenoside modifies the flow of blood to the penis and the brain, thus stopping early ejaculation and helping overcome impotence. • Tribulus Terrestris Tribulus Terrestris also strengthens erections and stimulates and increases libido. From being a European ancient sexual medication, Tribulus is now used by modern Europe and North America to medicate sexual dysfunctions and other general body weaknesses • L-arginine L-arginine has also been shown to act as a precursor in the body for the creation of nitric oxide. A gas molecule, nitric oxide has a number of possible effects on body cells, including the ability of relaxing arteries and small blood vessels. This can benefit sexual activity by maintaining blood flow to the penis for example • Epimedium Epimedium (locally called Horny Goat Weed), which originally came from China. This leaf extract claims to boost sexual libido because its prime ingredient, icariin, enhances DISCLAIMER: This is generalized information and should not to be substituted for personal - 16 advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

erection. Epimedium, also boosts blood flow through the penis, increasing sexual sensation. It is thought that Epimedium functions by affecting testosterone levels that improve sexual urge and vigor. • DHEA Low levels of the hormone dehydroepiandrosterone (DHEA) in the blood have been reported in some males with erectile dysfunction. In one medical study, 40 men with low DHEA levels and impotence were given 50mg DHEA per day for 6 months. Significant improvements in both erectile function and interest in sex occurred in the men taking DHEA but not in those assigned a placebo. • Maca Maca normalises steroid hormones like testosterone, progesterone and oestrogen. Therefore, it has the capacity to slow the hormonal changes of ageing. It acts on men to restore them to a healthy functional state in which they experience a more active libido. • Libidus Libidus is a product made from herbal ingredients. There have been some warnings out there that Libidus is linked to heart attacks. However, it has been decided that these men weren’t physically in a condition to perform sexually. They also had other existing heart conditions that they weren’t getting medical care for. That is why you should take the time to see your doctor about your erectile dysfunction. It could be a symptom of another health issue that you need to get assistance for. • Irexis Irexis is a herbal supplement that is commonly used for erectile dysfunction. The main ingredient found in Irexis is Yohimbe extract. It has been used for many centuries as a natural aphrodisiac for men. This ingredient is mainly grown in Africa. It also contains Tribulus Terrestris which is a plant found in many locations in the world. It naturally helps to increase a man’s sex drive.

Acupuncture Although Western Medicine still does not completely understand the reasons for the high success rate of Chinese acupuncture treatment for impotence, it is admitting that these treatments tend to treat not only the sexual dysfunction as well as chemical substances, but also the physical and psychological causes. It does this with a great deal less adverse side effects.

DISCLAIMER: This is generalized information and should not to be substituted for personal - 17 advice from a Registered Medical Practitioner

17 Ways to Beat Erectile Dysfunction

PREVENTING ED Prevention is all about avoiding those bad practices and habits that contribute to erectile dysfunction. First and foremost is to quit smoking and second is to reduce alcohol consumption to a glass per day. If you are overweight then shedding some of the excess has to become a priority. Diet and exercise will go a long way to overcoming ED if you are overweight. Cut down on whatever is causing stress or anxiety in your life. Too much work and not enough relaxation is a sure recipe for erectile dysfunction, especially if it’s combined with smoking, drugs, or alcohol. If you are using prescription drugs that have impotence as a side effect then talk to your doctor about possible alternatives, or whether you really need them. Recreational drugs like cocaine and marijuana lead to major health problems including impotence so it goes without saying that they should be avoided at all costs.

CONCLUSION There are a lot of potential causes for erectile dysfunction, many self inflicted, some not. There are also a lot of solutions to the problem. The hardest part may very well be, finding the best treatment for your personal situation. We hope this overview has put you in the picture and given you hope. Please make sure that your search for a solution is made under the care of a licensed medical practitioner, in order to protect your health, and to facilitate the correct solution.

Resource List The next Section is a List of Resources designed to give you a starting point in your search for products and services mentioned in this report.

DISCLAIMER: This is generalized information and should not to be substituted for personal - 18 advice from a Registered Medical Practitioner

RESOURCES Prescription Medications ED medications can be very expensive especially if you don't have health insurance. Your doctor can give you a prescription which you can present at your local drug store or pharmacy for supply. Alternatively you can buy online at an online pharmacy in the privacy of your own home. Online pharmacies generally have much lower prices than local stores and offer a fast discreet service. Edrugsonline.com – An online pharmacy in the US that has Viagra, Cialis, and Levitra at extremely good prices. Fast reliable and discreet. Accepts online and phone orders, and overseas customers. Viagra Data Sheet – A downloadable PDF data sheet containing technical details on Viagra. It includes information on clinical pharmacology, clinical studies, contraindications, precautions, dosages etc. Cialis Data Sheet – A downloadable PDF Data Sheet on Cialis. It includes information on clinical pharmacology, clinical studies, contraindications, precautions, dosages etc. Levitra Data Sheet – A downloadable PDF Data Sheet on Levitra. It includes information on clinical pharmacology, clinical studies, contraindications, precautions, dosages etc.

Herbal Treatments You can purchase individual herbs and mixtures from your local health food store or purchase more specialized products online. A couple of online stores with specialized products are VigRX Plus and Pro Solution. VigRX Plus – Market leading product containing Bioperine, Damiana, Tribulis Terrestris, Epimedium Leaf Extract, Cuscuta seed Extract, Ginkgo Biloba Leaf, Asian Red Ginseng, Saw Palmetto Berry, Muira Pauma Bark Extract, Catuaba Bark Extract, Hawthorn Berry ProSolution - ProSolution Pills contain a patented combination of the very best male potency ingredients including Drilizen, Zinc, Taj, and Momordica

Penis Pumps There are hundreds of different penis pumps in the market place but most of them are just toys. 99% of them are not safe for treating a medical condition like erectile dysfunction. A good medical grade penis pump comes with proper instructions, is made from high quality materials, and incorporates a pressure gauge to make sure it is operated within safe limits. Doctor Joel's Pump – A high quality vacuum pump especially designed for erectile dysfunction treatment.

Drug and Alcohol Help There are some excellent methods on how to recover from alcohol and drug addiction by people who have succeeded in overcoming these same addictions. There are also counselling and self help services available in most areas that can be found in your local telephone book. Drug Addiction Report – The Addiction Free Forever Program is guaranteed to show how to permanently end an alcohol or drug problem

Quit Smoking It’s not always easy but there are lots of different ways to quit smoking. Here’s one you might not have heard of. Quit Smoking – For smokers who are sick of trying to quit smoking by using patches, gum, sprays or pills.

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