Pastor Ed Kok
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Pastor Ed Kok
Sex therapy is a short-term form of counseling, generally involving 5 to 20 sessions with a sex therapist. A typical session may be one hour every week or every other week. In addition, erectile dysfunction can cause men to feel inadequate in their roles. Men who are suffering from ED tend to isolate themselves from their relationships and withdraw from their partners. The use of oral therapy has long been preferred over invasive procedures such as injection therapy for erectile dysfunction. We review the pharmacology, efficacy and side effects of the newest agents available for oral therapy: the PDE-5 inhibitors sildenafil, vardenafil and tadalafil. The mean IIEF GS at Visit 1 was 25.7 (median 22, range 5 – 64), at Visit 3, 56.9 (median 62, range 7 – 73) and at Visit 4, 59.3 (median 60, range 18 – 73). The respective mean IIEF EDS was 8.2 (median 6, range 0 – 28), 23.5 (median 27, range 1 – 30) and 25.2 (median 25, range 6 – 30). There was no correlation between age and response to Viagra, although older men had relatively lower IIEF scores. ED is treatable at all ages. Of those who reported restless legs, more than half -- 53 percent - also reported trouble with their erections, compared to 40 percent of those who did not complain about restless legs. The recommended starting dose of tadalafil for most patients is 10 mg taken orally approximately 1 hour before sexual activity. The dose may be adjusted higher to 20 mg or lower to 5 mg depending on efficacy and tolerability. The maximum recommended dosing frequency is once per day, although for many patients tadalafil can be taken less frequently since the improvement in erectile function may last 36 hours. Tadalafil may be taken with or without food. 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. 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. For more information about the topic Orgasm, read the full article at Wikipedia.org, or see the following related articles: In some cases frequent use of a vacuum pump can eventually improve the degree of erection attainable without use of the pump. Claims of cheap "penis pumps" to permanently increase maximum penis size should be viewed with caution, however. Fig. 2: Cellular perspective of the erection pathway. The signal (nitric oxide) is released from nerve endings or from endothelial cells and activates a cascade reaction, which ultimately leads to an increased cellular concentration of cGMP (cyclic guanosine monophosphate). This second messenger molecule induces a series of events that lead to smooth-muscle relaxation through a reduction in the intracellular calcium ion concentration. The enzyme PDE-5 (phosphodiesterase type 5) reverses this effect by metabolizing the cGMP to GMP rapidly. The clinically important inhibitors of this enzyme (sildenafil, vardenafil and tadalafil) all act to promote smooth-muscle relaxation by their ability to allow cGMP to accumulate when nitric oxide is released, as is the case when sexual stimulation is present. Photo: Christine Kenney CONCLUSIONS: Sildenafil, vardenafil, and tadalafil are safe and effective PDE5 inhibitors for the treatment of ED. If there is a disadvantage to Befar®, it may be the fact that it is very temperature sensitive. It is strongly recommend that Befar® (and for that matter all alprostadil creams), remain refrigerated at a temperature of 2 to 8 degrees Celsius. The manufacturer claims that Befar® may be kept at up to 25 degrees Celsius for up to 14-days (8), but it is clear that any temperature in excess of that can damage the active ingredient within hours, perhaps even minutes. It would appear that when temperature damage occurs that the product takes on a clear look, rather than its normal strong white creamy appearance. Once damaged by heat, Befar® has no active ingredient and hence no action. How Do I Find a Sex Therapist? What are intracavernosal injections? Over time, high blood pressure damages your blood vessels, which can lead to erectile dysfunction. While it’s critical to get high blood pressure under control, ED is a side effect of some blood pressure control medications for some men. In vivo CTL assay. ?4 The ? subunit is found in a number of cell types and tissues in addition to the photoreceptors and probably should not be called a photoreceptor PDE subunit because it can also bind to other proteins. brand viagra online sale brand viagra sale Main Outcome Measures Self-reported ability to achieve and maintain an erection for sexual intercourse according to the International Index of Erectile Function and adverse events.