Comprehensive Information About Impotence

History
Medical symptoms
Medical diagnosis
Clinical tests used to diagnose ED
Nocturnal penile tumescence (NPT)
Penile nerves function
Duplex ultrasound
Pathophysiology
Penile biothesiometry
Treatment
PT-141
PDE5 Inhibitors
Enzyte
Ginseng

Impotence

also known as Erectile dysfunction, is the failure to grow or maintain an erection of the penis that is suitable for sexual intercourse in spite of the ability to ejaculation. There may be a number of underlying causes, mostly of which are medically reversible.
Due to the personal nature, the this subject it has been unmentionable for such a long period of time, and is the stuff of many urban legends. Since the 1930s, folk cures have been presented broadly for this condition. The prologue of sildenafil (Viagra®) in the 1990s has caused a second wave of public attention, driven in part by profound advertising.
The Latin term, impotentia coeundi, describes simple incapability to insert the penis into the vagina. It has been replaced by more accurate terms.

Medical symptoms:

Impotence is described by ones incapability to maintain erection. An erection during ones sleep and in the early morning is usually cause by psychogenic, while loss of these types of erections may signify an fundamental medical condition, that usually stems to cardiovascular problems. Other causes of erectile dysfunction could be diabetes mellitus (causing neuropathy) or hypogonadism (declines testosterone levels due to the medical condition upsetting the testicles or the pituitary gland).

Medical diagnosis:

No formal tests are available to determine erectile dysfunction. Although some blood may be drawn to tests for and exclude any underlying diseases, such as diabetes, hypogonadism and prolactinoma.

Clinical tests used to diagnose ED:

Nocturnal penile tumescence (NPT):

A man normally has five to six erections during his sleeping hours, especially during rapid eye movement (REM). The absence of an erection during the sleeping hours may indicate a problem with nerve function or the blood supply in the penis. Two methods are available for measuring changes in the penile rigidity and circumference during nocturnal erection: snap gauge and strain gauge.

Penile nerves function:

Testing for sufficient nerve sensation in the penis is conducted with a test such as the bulbocavernosus reflex test. This test is preformed by the doctor squeezing the glans (head) of the penis, which should immediately cause the anus to contract if nerve function is normal. A doctor than measures the latency between squeezes and contractions by observing the anal sphincter or by feeling it with a gloved finger that is inserted past the anus. Patients with nerve damage due to diabetes or nerve disease are most likely to have specially detailed testing done.

Duplex ultrasound:

Duplex ultrasound is a test that is used to evaluate the blood flow, venous leaking, signs of atherosclerosis, and scarring or calcification of erectile tissue. By injecting prostaglandin, which is a hormone-like stimulator that the body produces, inducing an erection. An ultrasound is then preformed allowing the doctor to see thevascular dilation and to measure the penile blood pressure. These measurements are than compared to those taken when the penis is flaccid.

Pathophysiology:

A penile erection is controlled by two diverse mechanisms. The first mechanism is the reflex erection, which is accomplished by the touching of penile shaft directly. The second mechanism is the psychogenic erection, which is accomplished by erotic stimuli. The previous mechanism uses the peripheral nerves and the lower parts of the spinal cord, whereas the latter mechanism uses the limbic structure of the brain. In both circumstances an undamaged neural system is necessary for one to have a successful and complete erection. Stimulation of penile shaft by the nervous system than leads to the secretion of nitric oxide (NO) that causes the relaxation of the main erectile tissue of penis, which is also known as smooth muscles of corpora cavernosa, and followed by a penile erection. Sufficient levels of testosterone that is produced by the testes and the undamaged pituitary gland, are all necessary and important parts of a healthy male erectile system. Erectile dysfunction may develop if there is a hormonal deficiency, disarray of the neural system, decrease in penile blood supply or an underlining psychological problem.
Erectile dysfunction may also be triggered by iatrogenic (medically caused). A variety of antihypertensives (prescription medications are use to control high blood pressure) and some medications are used to modify the central nervous system response that may hold back an erection by denying ample blood supply or by changing the nerve activity. Impotence can be triggered by some medications such as antidepressants, especially SSRIs. Sometimes the impotence brought on by the use of SSRIs is permanent and does not go away after the discontinuance of the medication. During surgery if the removal of any anatomical structure, nerve damage or blood supply was harmed in any way the end result may be impotence. In studies conducted, men are at a greater risk of impotence when the circumcision has been preformed (Palmer). These studies have also been verified in China.

Penile biothesiometry:

The penile biothesiometry is an electromagnetic test using vibration to estimate the sensitivity and nerve function in the glands and shaft of the penis. A lack of sensitivity to vibration may be a sign of nerve damage in the pelvic area that can lead to impotence.

Treatment:

The treatment of impotence often depends on the cause. A testosterone supplement may be recommended for cases associated with hormonal deficiency. However, usually the cause of impotence is lack of ample penile blood supply as the result of age-dependent damage of inner walls of blood vessels. Apomorphine, which is a medical substance, is directly injected into the erectile tissue of the penile shaft to treat erectile dysfunction. In some cases of impotency a penile implant (penile prosthesis) is advised for medical treatment. A more conservative technique is the discovery of orally active agents that intensifies the effectiveness of NO that dilates the blood vessels of the corpora cavernosa.

PT-141:

PT-141 is an experimental medication that does not act on the vascular system like the previous compounds but do strengthen sexual desire and the drive in male as well as female. This medication is dispensed as a nasal spray PT-141 and works by the launching of melanocortin receptors in the brain. PT-141 is now awaiting approval of the FDA.

PDE5 Inhibitors:

PDE5 is a prescription inhibitors sildenafil (Viagra®), vardenafil (Levitra®) and tadalafil (Cialis®) are prescription medication that are taken by mouth. These medications work by blocking the action of PDE5 that causes cGMP to degrade. cGMP that affects the smooth muscle of the arteries in the penis to relax, allowing the flow of blood to the corpus cavernosum.

Enzyte:

Enzyte has been an advertised product by the infiltration coverage on television channels such as Court-TV. Complaints have been filed with the Federal Trade Commission (FTC) against this medication for it's deceptive advertising. Berkeley Nutritionals are the manufacturers of this medication and is about to be the subject of an investigation by the Attorney General of Ohio and the defendant in this class-action lawsuit.
Enzyte is a medical supplement that claims to amplify the frequency of an erection of the male penis or libido. Advertisements for Enzyte are regularly shown on TV commercials. These advertisements feature a smiling man that goes by the name. He claims to have taken Enzyte and his happiness shows the improvement of his sex organs and life. The advertisements are loaded with imaginative figurations such as golf clubs, a astonishingly tall glass of iced tea and a hose spraying barely a trickle reflecting a person that does not know about the drug Enzyte.
Enzyte is being disputed for its effectiveness. Some medical doctors are actually advising patients against taking Enzyte, claiming that it could head to damage. The Center for Science in the Public Interest have pleaded the Federal Trade Commission to forbid the viewing of further TV commercials for Enzyte due to a lack of proper testing and studies sustaining these claims. Manufacturers of Enzyte, Berkeley Premium Nutraceuticals, Inc., are presently under a class action lawsuit for false advertising.
The medication Enzyte claims to include: Tribulus terrestris; Yohimbe Extract; Niacin; Epimedium; Avena sativa; Zinc Oxide; Maca; Muira Pauma; Ginkgo biloba; L-Arginine; Saw Palmetto. Other ingredients: gelatin, rice bran, oat fiber, magnesium stearate, silicon dioxide.

Ginseng:

A double-blinded study has shown evidence that medications including ginseng over a placebo seemed to be better. agra ordering needs.