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

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Given the large variations in human penis sizes, discord and dissatisfaction with one's self are unavoidable. The longest erect penis recorded during the famous Kinsey surveys was a shocking ten inches. That is nothing compared to the 12" and 14" behemoths reported in "L'Ethnologie du Sens Genitale", and in Dr. David Reuben's "Everything You Always Wanted to Know About Sex", respectively. If that makes you want to cry, wait till you hear the good news - the shortest functioning erect penis measurement according to the Kinsey survey was 1 inch. There are, however, some reports in medical literature of penises that do not extend beyond 1 cm. when fully erect. Finally, just so you can know which side of the fence you are hanging from, a study by the Lifestyles Condom Co. indicated that the average erect length of a male sex organ is 5.877 inches. Women have often been reassuring towards their mates in this regard. "Size doesn't matter", they would say. Few men really believe that. In an online poll that asked if respondents felt that penis size makes a difference in a man's ability to sexually satisfy a partner, 46% of the respondents answered "Very much: Penis size makes a big difference in a man's ability to sexually satisfy a partner". Only 13% responded "Not at all: Penis size makes no difference in a man's ability to sexually satisfy a partner". The poll did not mention how many of the respondents were women and how many were men, but the fact is - men and women believe that size still does matter! In "The Beefcaking of America," (Psychology Today November/December 1994 issue) Jill Neimark reported the findings from a questionnaire completed by some 1500 male and female readers. The Neimark report suggests that a significant subset of women who are financially independent and rate themselves as physically attractive place a high value on male appearance. A small group unabashedly declared not only an rather unsurprising strong preference for better-looking men, they also indicated that they cared more about penis size, both width and length, than about the physical appearance of the man. Niemark's survey results also suggests that men believe their appearance has a larger impact on women than the majority of women actually acknowledge. Men indicated they feel their specific physical features, from hairline to penis size, strongly influence their personal acceptability by women. "Size does matter". Judging by the number of sites Google.com returns on a search for "penis enlargement", that seems to be a pretty popular opinion. As long as there are men out there running around with 14" monsters, the rest of the mortals will continue to judge themselves and pray at the altar of everything that grants bigger penises. The results of penis enlargement are not always pretty, considering the various methods that are purportedly effective. Claims range from the scientific to the outrageous, and some of them can be downright nasty. Unlike lizards, men do not have the power to regenerate lost appendages, so it is highly advisable to do a little research before fooling around with Mother Nature's precious gifts. The following is a list of some penis enlargement methods other than penis pills, followed by some general comments about each; Enlargement creams do nothing more than increase blood flow in the penis tissue. While this may definitely assist in erection firmness (Which will cause the penis to appear and feel larger), using creams cannot enlarge your penis. There is no known medical evidence too support the claim that topical preparations can do more than increase blood flow, unlike penis pills. Penis pumps create a vacuum and force blood to the penis tissue. According to Menstuff® Sexhealth columnist Dr. Williams, pumps are mainly used by men who suffer from chronic insulin dependent diabetes or circulatory disorders. They have such poor blood circulation overall that they cannot obtain proper blood flow in their penis area. By using a pump instead of penis pills, the skin and underlying tissues are stretched, allowing them to clamp off the blood flow and consequently trap it in the penis. With the clamp firmly in place, brief sexual encounters can occur. There is little medical evidence that penis pumps cause any actual permanent increase in the size of the penis. There is, however, bad news for "pumpers" out there - after using penis pumps over a period of time, some men claimed they were unable to get erections without the aid of a pump. This method of penis enlargement has been around for thousands of years. Weights are suspended from the penis to stretch it. With regular use, it can increase penis length - but at a price: It makes the penis thinner, and because of the stretched tissue, lessens the ability to achieve and maintain an erection. This method can also cause a decrease in blood circulation which can lead to serious problems including tissue damage. Penis enlargement surgery (or phalloplasty) is the Titanic of penis enlargement methods. It is huge, expensive and can end up being the worst disaster of your life. It can lead to serious complications like infection and scar tissue formation which can cause a misshapen penis. A well known horror story is that of Ron Nance, from Monterey, Calif., who claims that following his penis enlargement surgery he contracted a severe infection at the surgery site. He returned to his doctor, who re-sutured the incision. The complications persisted, and Nance claims he flew to Los Angeles a total of nine times for repairs before turning to other surgeons for help. Nearly two years later, with $20,000 invested in the operation and repairs, Nance states that he remains not only permanently scarred, but impotent. Other enlargement surgery patients have complained of disfigurement, shortening, loss of use of his penis, pain, swelling, excessive scarring, lumpiness, shrinkage, uneven surface with what appears to be cysts, and impotence. Many penis pills are nothing more than vitamin pills in disguise, and numerous men have been conned into popping them expecting more than what vitamins can deliver. Penis pill salesmen Michael A. Consoli, Vincent J. Passafiume, and several others have signed a consent agreement forfeiting approximately $35 million dollars in seized cash and property to settle charges that they had marketed penis enlargement pills with false claims. Operating as C.P. Direct, Inc., they claimed that their enlargement pill product "Longitude" would permanently enlarge the penis by 1-3 inches. They are not alone. So what penis enlargement supplements do work? The problem in discovering this lies in the fact that there are approximately 5 new "amazing" penis enlargement pills that appear on the market each month. Most of these products are nothing but Vitamins mixed with a few herbal ingredients to produce a penis pill. Users see NO gains, and this leads to unhappiness and loss of faith in all enlargement supplements. As with most things, the way to do properly choose a product is through systematic research. This will definitely take some time and effort, however if you obtain the results you desire, in the end it will definitely be worth your while. Some things to keep in mind: Stay away from any pill which contains Yohimbe. The FDA has placed this substance on its warning list - supplements containing this herb may cause side effects. A respectable supplement site will contain a list of the ingredients that their products contain. The ingredients only tell half the story, the actual blending and quality of the ingredients also counts. This is somewhat more difficult to determine, however. In general most penis pills are quite safe because their ingredients are non-prescriptive, consisting mostly of natural herbs. However, you should always read the ingredients and consult a doctor before purchasing or taking them. Some supplements have stated that men with diabetes or genital nerve damage should avoid taking enlargement pills. Penis enlargement pills can be expensive. They usually cost anywhere between $40-$80 per month. If the product indicates that you need to take "booster pills", it is usually a bad sign. If the product manufacturer claims you can have a penis so large it will make a stallion turn green with envy, you can most likely be sure they are selling you bottled scam instead of penis pills. If the promise sounds too good to be true, then you can assume it is. Sincere supplements will tell it like it is: Results may and will vary from one individual to another. These can include stronger erections, increased sexual stamina, more intense orgasms, improvement in urinary flow, increased blood circulation to genital area, higher sex drive, increased sperm production and overall improvement in sexual function. Most penis pill programs offer a set of free exercises with their product. These should not be cast aside - they are vital key to your enlargement process. Do them religiously along with your supplement taking and you will NOT be disappointed. The penis inferiority complex has been documented for quite some time, and has no doubt existed since men started bathing and showering in full view of each other. Most men seem to feel their penis is small and are envious of someone else's member. This concern and dissatisfaction appears to stem from the cultural belief that larger penises give greater pleasure to women, and that women prefer a man with a huge penises. So can you pump up with penis pills? My answer is yes. Daily exercises and supplements together can increase the size of your penis. But to do so, you have to be smart, be aware, dedicated, and PLEASE be careful. natural penile enlargment and lengthening vimax best penis enargement surgery pennis enlargement procedure compare penis enlargement pills vimax free penis enlargement exercise penis enlargement stretcher penis enlargment surgery picture cheap penile enlargement pills

Nearly every person feels at least a little bit insecure about certain aspects of himself or herself; it could be looks, height, skin color, and many other things. For many men, their penis size is one thing they wish they could change. There are theories about how this feeling of discontent probably started when they began comparing what they had with what other boys in the locker room had. Maybe some men blame an unsatisfactory sex life on what they think is an inadequate penis. Whatever the reason, many men believe that they fall short of the normal penis size and this affects how they think and feel about themselves in a lot of ways. The prevalent mindset is that bigger is better, and many women feel this way about their bodies, too. How many women have had breast implants done on them because they feel they will look more womanly and more attractive? For men, the perception is that the size of the penis is an indicator of masculinity -- if it’s bigger, he is more macho and someone who should command more respect. It doesn’t help that well-endowed men in porn movies are portrayed as having normal penis size. Also, no matter how much women deny that penis size is unimportant in lovemaking, men will still believe that they will be better lovers if they have big dicks. That’s why it is very important for men to know and understand the facts about normal penis size and to accept the fact that they are indeed normal. According to studies such as the Kinsey report, normal penis size in its flaccid state ranges from 2.5 to 4.5 inches and four to eight inches in the erect state. Interestingly, some penises grow to be much larger when erect, while others barely increase in size. Evidently, how big or small a flaccid penis is does not indicate how large it will be during erection. Another interesting factor that might influence how men see their penises is the viewing angle or perspective. Looking down at it might make it seem smaller than it actually is. That’s why when you compare the size of your dick with those of the other guys in the locker room, yours will usually seem to come up shorter. Insecurity about penis size is also prevalent among teenagers. This is understandable since a lot of adolescents feel the need to be looked up to or at least stand out. Getting laughed at for having a small dick during high school can be a humiliating experience. However, it is worth remembering that the body is still growing at that stage. Some men may reach normal penis size at an earlier age, while others are late bloomers and may attain their maximum growth at a later period. The average man usually has a normal penis size. However, wanting to look and feel better is not at all unusual. If you’re a man who wants to increase your penis size, there are several ways you can go about it. You can try various penis enlargement products that are out on the market, such as penis pumps, traction devices, penis enlargement surgery or phalloplasty, and dietary supplements. It would be wise to seek the advice of experts before you go for any major procedures. For some men, getting psychosexual advice from a psychologist or psychiatrist has helped resolve negative feelings about themselves. Wanting to look good and feel great is entirely normal, but obsessing over it is not. Accepting what nature endowed you with and knowing how to use it is key to self-acceptance -– you may be “normal,” but you are then in no way just “average.” herbal natural penile enlargment penile enlargement stretcher truth about penis enlarement pills penis enlargment before and after picture best penis enargement surgery penile enlargement drug free natural penis enlagement penis enargement surgeon cheap penile enlargement pills

Breast implants are medical devices that typically consist of a silicone elastomer shell filled with saline or silicone gel. The first silicone breast implants are developed by two plastic surgeons from Texas: Frank Gerow and Thomas Cronin. The implants are textured silicone bags and can be filled with saline, which is salt water, or silicone gel and they are smooth or textured silicone bags that can be round (dome shaped) or breast shaped (anatomic). Shaped breast implants are designed to reflect the slope of the breast. The breast implants are usually quite successful at making the breasts larger and fuller. And just about 80% of breast implants are for cosmetic reasons. If your doctor tells you that breast implants are proven safe, ask for a copy of any report that studied women with implants for at least 10 years. There is strong evidence that both saline and silicone breast implants can cause local complications including swelling and gel leakage. One study says silicone breast implants do not cause systemic illness. Like silicone breast implants, saline implants consist of a rubber like silicone shell. It should also be said that studies have shown that most women who get breast implants are happy with the results. Breast implants are considered by the FDA as medical devices and if the FDA approves silicone breast implants, many young women will get them. While this is not a final approval, it does mean that the FDA may soon allow silicone gel breast implants to return to the US. Silicone breast implants were removed from the market in 1992, and recently reintroduced. Health Canada has lifted restrictions on silicone breast implants, giving two manufacturers permission to market their products in Canada. The background is that silicone breast implants have been linked to a variety of illnesses, the most controversial of which are connective-tissue diseases and symptoms. One should also notice that there has been a great deal of controversy regarding the safety of silicone breast implants but they have been marketed in the United States since 1963. The Canadian government has now reversed a partial ban placed more than 14 years ago over health concerns linked to silicone breast implants. New research suggests that silicone breast implants could be replaced by tissue grown from a person´s own stem cells within a decade. What are the risks with these implants? Well, some studies indicate that women with cosmetic breast implants have a significantly increased risk of suicide. A long-term study suggests that cosmetic breast implants do not increase the overall risk of getting cancer. Although breast enlargement is a simpler form of surgery than other cosmetic breast procedures and complications can occur. The risk is about 1% but if it occurs the implants will have to be removed. There is a very slight risk that breast implants may rupture during a mammogram and the longer you have an implant, the greater the risk it will leak or rupture. As it now is the most commonly performed cosmetic operation not performed under local anaesthesia the results are very good. As with any surgery you should have a comprehensive, informative and understandable consultation with the doctor performing the surgery. That is crucial. truth about penis enlargement pill penis enargement before and after penis enlarement supplement top rated pennis enlargement pills homemade penile enlargement vimax male penis enlargement penis enlargement pump penile enlargment picture cheap penile enlargement pills

Cunnilingus if performed correctly has the potential to give women exceptional orgasms and many women actually prefer Cunnilingus to full intercourse in terms of satisfaction. To learn the art of cunnilingus takes a little practice and below we have outlined some tips to improve your technique below. The art of cunnilingus takes some practice but its practice both you and your partner will enjoy! Oral Techniques The Initial Lick As a start, try licking her from vaginal entrance up her clit and following the outer edges of her vagina covering both sides, going up and down and vice versa can be a great way to start your love making and will relax her and get her in the mood. Holding The Labial Hold the two parts together gently with your lips, run your tongue between the inner and outer labia one side at a time and repeat. Tongue Intercourse The majority of a woman’s nerve endings in her vagina are around the opening and within the first couple of inches inside. Hit them with your tongue when perorming Cunnilingus by inserting it into the vaginal opening, then licking gently in circular motions combined with flicks of the tongue. Flicking Spread her outer vaginal lips with your fingers. With your tongue pointed, gently lick and flick your tongue across the clitoris and into the vagina. When doing this make sure go gently and see the response before being harder with your tongue. Most women need to be extremely wet to enjoy this as it is quite an intense feeling for many women. Sucking Expose her clitoris by spreading her lips and gently pull back her hood. Suck the clitoris (be gentle) and then let it go and repeat again. This can be an incredible turn on and will be very frustrating, warming her up for the other Cunnilingus techniques that are outlined here. Holding The Clitoris Take the clitoris in your mouth and suck on it gently, at the same time flick your tongue around it. This can be done very lightly or aggressively or a combination of the two (find out what your women likes first) this is normally intensely arousing when done correctly. Its as simple as A-B-C Try using your tongue to spell the alphabet when performing cunnilingus. This is very arousing as your tongue is moving in lots of different directions. You can use any letters you wish, not just ABC! Listen to the ones that give her most pleasure and remember them! Other points to keep in mind to make cunnilingus pleasureable are 1. Share a shower or bath together before you start to make sure that you are both clean and add gels and lubricants to enhance taste and stimulation if you wish. 2. Ask your partner what she likes. She can give you directions such as harder, slower, faster, more circles etc 3. Fill your own mouth with as much saliva as you can before you begin and never touch or lick the clitoris when performing Cunnilingus with a dry finger or tongue. 4. Don't go for the clitoris make sure she is warmed up and aroused. Try gentle kissing and licking around the upper thighs and vulva area and work your way up to the clitoris. 5. Use a variety of ways to arouse her. If you repeat the same motion, your partner can become insensitive to it, keep in mind variety with Cunnilingus and keep her expectations up. 6. As she becomes more aroused, insert a finger or two into her vagina as well. 7. Continue to touch and hold her as she orgasms and after and make her feel wanted and loved. 8. The clitoris has more nerve endings than the entire head of the penis, so be very careful not to be to hard with it go gently and remember ask her all the time what she likes and doesn’t. Cunnilingus can enhance any relationship and most women love it and getting it right is all about communication. Following the above tips on cunnilingus will help you satisfy your partner and will enhance your relationship.