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The ability to achieve and sustain erections requires a healthy nervous system that conducts nerve impulses in the brain, spinal column, and penis, healthy arteries in and near the corpora cavernosa, healthy smooth muscles and fibrous tissues within the corpora cavernosa, adequate levels of nitric oxide in the penis. generic viagra from canada online buy viagra
Erection begins with sexual stimulation. Sexual stimulation can be tactile (for example, by touching the penis) or mental (for example, by having sexual fantasies). Sexual stimulation or sexual arousal generates electrical impulses along the nerves going to the penis and causes the nerves to release nitric oxide, which in turn increases the production of cyclic GMP (cGMP) in the smooth muscle cells of the corpora cavernosa. The cGMP causes the smooth muscles of the corpora cavernosa to relax and allow rapid blood flow into the penis. The incoming blood fills the corpora cavernosa, making the penis expand. subaction showcomments cialis smile online buy cialis
Sexual Problems in Men: A sexual problem, or sexual dysfunction, refers to a problem during any phase of the sexual response cycle that prevents the man or couple from experiencing satisfaction from the activity. The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution. Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility; this is somewhat less frequent but often can be helped. Notably in psychological impotence, there is a strong response to placebo treatment. Erectile dysfunction, tied closely as it is about ideas of physical well being, can have severe psychological consequences. What about psychological therapy? Experts often treat psychologically based impotence using techniques that decrease anxiety associated with intercourse. The patient's partner can help apply the techniques, which include gradual development of intimacy and stimulation. Such techniques also can help relieve anxiety when physical impotence is being treated. If these simple behavioral methods at home are ineffective, referral to a sex counselor may be advised. viagra samples online buy viagra
viagra sale Prostaglandin E1 injection test is sometimes performed to determine the penile blood flow. Prostaglandin is directly injected into the corpora cavernosa in order to cause dilation of blood vessels and promote blood flow into the penis. If erection ensues, it confirms normal or adequate blood flow to the penis. This can also provide information about possible therapeutic options. Erectile dysfunction, heart disease and other vascular diseases: Certain risk factors increase the risk of more atheroma forming which can make atheroma-related conditions worse. These are discussed in more detail in another leaflet called 'Preventing Cardiovascular Diseases'. Briefly, risk factors that can be modified and may help to prevent atheroma-related conditions from getting worse are: Smoking. Smoking is one of the biggest risk factors for developing an atheroma-related condition. Smoking roughly doubles your chance of developing ED. Young smokers may not be aware that they have a much greater risk of developing ED by middle age compared with nonsmokers. If you smoke, make every effort to stop. High blood pressure. Make sure your blood pressure is checked at least once a year. If it is high, it can be treated. If you are overweight, losing some weight is advised. A high cholesterol. This can be treated if it is high. Inactivity. We should all aim to do some moderate physical activity on most days of the week for at least 30 minutes. For example, brisk walking, swimming, cycling, dancing, gardening, etc. Diet. Aim to eat a healthy diet. Details in a separate leaflet called 'Healthy Eating'. Alcohol excess. Diabetes. If you have diabetes, good control of the blood sugar level and blood pressure can help to minimise the impact of diabetes on the blood vessels.