Though this subject used to be taboo, it is now a very widely discussed topic. Men have always suffered from erectile dysfunction, but in the past it was always viewed as a sign of weakness or impotence in all areas. Thankfully, through our evolving as a society this is now not the case. Today there are a plethora of options for men who suffer from erectile dysfunction as well as those who simply would like to have bigger, stronger, fuller erections. 

Step 1

Look into prescription medications or generic equivalents. Today’s medicine is well equipped to deal with the issues of erectile dysfunction. If you’ve been unable to achieve or maintain a solid erection during intercourse, there are many safe drugs that can help with your problem. Viagra is perhaps the most well known of all the drugs. It should be taken 30 minutes prior to sexual activity and will cause the penis to become erect for the duration of the sex. For those men who don’t want to feel like they have to plan all their sex, Cialis allows one to take a pill at least 30 minutes before sex, but lasts 72 hours leaving the patient feeling prepared and not having to worry about taking the pill so often. Please discuss all the options with your doctor to determine which is right for you.

Step 2

Try topical creams. If you don’t feel like going the prescription drug route, there are creams out there that can help you accomplish a sustainable erection. These creams can be bought online, or purchased at a novelty sex store in your area (assuming your area has such kinds of businesses). Working much in the same way as the prescription drugs, topical creams are simply applied to the penis and should work immediately. The major complaints by patients is the mess caused by the creams as well as making it obvious to the partner that some sort of extra help is needed to achieve an erection.

Step 3

Experiment with exercises. Sometimes the key to lasting longer and achieving an erection lies in simply strengthening the muscles in the penis.
Try the following exercise: the next time you urinate, squeeze the muscle in your penis that stops the flow of urine (without using your hand). This is the same muscle needed for stronger bigger erections. Work it in the same way you would work any other muscle by means of a series of progressive exercises. Try progressively contracting the muscle for longer and longer periods and repeat throughout the day. This will help allow blood to keep trapped in the penis and in turn allow bigger stronger erections tat last longer.

Step 4

Eat the right foods. Each culture around the world has found “natural aphrodisiacs” in different types of food. And, though there is little science to back it up, it could be the right mentality if thought about in reverse. Though there might not be foods that help achieve an erection, there could be foods that might eventually prevent an erection. Keep yourself on a healthy well balanced diet and improvements in energy should be seen immediately. As your general health improves, so will your sexual state. Blood flow is the essential element in having an erection. Therefore, it is best not to eat food that could clog arteries or veins, thus inhibiting blood flow throughout the body including the penis.

Step 5

Smoking causes of erectile dysfunction. There is no denying it. Nicotine plays a big role in constricting blood flow. Keeping nicotine out of the body and exercising often will you’re your body in the ideal conditions for being able to achieve high quality natural erections.

Testosterone replacement therapy is not only effective in inducing puberty in adolescent boys with hypogonadism but may also be helpful for some adult patients with the condition. Some experts believe testosterone replacement therapy also may be helpful for older men whose testosterone levels are deficient.

Other procedures and devices

Vacuum Devices: Vacuum devices, or external management systems, are effective, safe, and simple to use for all forms of impotence except when severe scarring has occurred from Peyronie’s disease.

Using the Device

*The plastic cylinder is put over the penis.
*In so doing a vacuum is created making blood to flow into the penis and creating an erection.
*To retain it a band is put onto the base of the penis and the cylinder is removed
*A three to five minutes interval is the average to achieving an erection

Drawback: Lack of spontaneity is this method’s only major drawback. The erection involves only part of the penis shaft, and the process will certainly seem peculiar in the beginning. When these psychological obstacles are overcome, many couples find the result highly satisfactory.

Success rate: Studies have found that success with the vacuum device is equal to other methods. Between 56% and 67% of men using it reported the device to be effective. In one study of men who had used the vacuum device for many years, almost 79% reported improvement in their relationships with their sexual partners, and 83.5% said they had intercourse whenever they chose. Nevertheless, drop out rates are high. In one 1999 study, for example, the overall drop out rate was 65%.

Side effects: include blocked ejaculation and some discomfort during pumping and from use of the band. Minor bruising may occur, although infrequently. It is very important to use a medically approved pump.

Venous Flow Controllers (Cock rings): Vacuum- less devices that trap blood within the penis are also available. They are called venous flow controllers or simple constricting devices. These devices are typically rubber or silicone rings or tubes that are placed at the base of the erect penis to trap the erection. They can be used by men who can achieve erections but lose them easily. Attention should be taken not to use them for more than 30 minutes or lack of oxygen can damage the penis.

Penile Implants

There are three types in use currently:

*A hydraulic implant consists of two cylinders placed within the erection chambers of the penis and a pump. The pump releases a saline solution into the chambers to cause an erection, and removes the solution to deflate the erection.
*A penile prosthesis is composed of two semi-rigid but bendable rods that are placed inside the erection chambers of the penis. The penis can then be manipulated to an erect or non-erect position.
*A third implant uses interlocking soft plastic blocks that can be inflated or deflated using a cable that passes through them.

Other alternative treatments

Many alternative agents are marketed for impotence. Very few have been studied and some can be harmful.

Yohimbine (Yocon, Yohimex) A folk medicine of many years it has been shown to improve blood flow. However studies have been not been done to a conclusion about its efficacy.

Aphrodisiacs: Aphrodisiacs are substances that are supposed to increase sexual drive, performance, or desire. Some examples include the following:

*Viramax is a well-marketed product that contains Yohimbine and three herbal aphrodisiacs: Catuaba, Muira puama, and Maca. However, no tests have been done to prove its efficiency as well as its interaction with other medications.
*Foods that some people claim have aphrodisiacal qualities include chilies, chocolate, licorice, lard, scallops, oysters, olives, and anchovies. No evidence exists for these claims and certainly no one would ever advocate eating large amounts of such foods, which in cases such as licorice and lard can be dangerous.
*Spanish fly, or cantharides, which is made from dried beetles, is the most widely-touted aphrodisiac and is particularly harmful. It irritates the urinary and genital tract and can cause infection, scarring, and burning of the mouth and throat. In some cases, it can be life threatening.

No one should try any aphrodisiac without consulting a physician.

Still other alternative remedies

Ginkgo: In one small study, 78% of men who had impotence due to poor circulation regained erections after taking ginkgo. More research is needed however.

Ginseng root is a traditional Asian remedy for stimulating sexual function, although no studies have been conducted on its effectiveness.

Diet: It s best to keep to a diet of fresh fruits and vegetables, whole grains, fibre rich foods and to avoid saturated fats and sodium or salt. Loo out of r diets suggested for heart health as ED is caused by poor circulation.

Exercise: A regular exercise program is extremely important. Studies have showed that older men that did 40 miles a week boosted their testosterone levels by 25% against sedentary ones. Also it has been shown that men that burn 200 calories a day reduced ED risk by half as compared to men who did not exercise.

Limit Alcohol and Quitting Smoking: Men should consume alcohol in moderation and consider quitting smoking is altogether.

Stay Sexually Active: An active sexual life is key to avoiding impotence. It may be helpful to note that erections are firmest during deep sleep right before waking up. Autumn is the time of the year when male hormone levels are highest and sexual activity is most frequent.

Kegel Exercises: Although most people know it as being beneficial to people with urinary incontinence and by pregnant women, kegel exercises, may also be helpful for men whose erectile dysfunction is caused by impaired blood circulation. The exercises consist of tightening and releasing the pelvic muscle that controls urination

Changing or Reducing Medications: If any medications you are using are the cause of ED then discuss with your doctor about changing them.

Psychotherapy and Behavioral Therapy: Interpersonal, supportive, or behavioral therapy can be of help to a patient during all phases of the decision-making process regarding possible methods of treatment. Therapy may also ease the adjustment period after the initiation or completion of treatment. It is beneficial to have the partner involved in this process. The value of sex therapy has not been proven beyond reasonable doubt. In one study, 12 out of 20 men whose impotence had a psychological basis and who were advised to enter a sex clinic resisted sex therapy out of embarrassment or because they felt it wouldn’t help. Only one achieved satisfactory sex of the eight who accepted to go for therapy.

Diabetes may contribute to as many as 40% of impotence cases. Between one third and one half of all diabetic men report some form of sexual difficulty.

High Blood Pressure: Erectile dysfunction is more common and more severe in men with hypertension than it is in the general population. In addition most of the drugs used to treat to treat hypertension are thought to cause impotence as a side effect; but which is reversible once the medication is stopped.

Parkinson’s disease: As a risk factor for impotence, Parkinson’s disease (PD) is an under-appreciated problem. It is estimated that about one-third of men with PD experience impotence.

Multiple Sclerosis affects the central nervous system, also leads to sexual dysfunction in as many as 78% of males suffering from MS.

Prostate Cancer and its Treatments: can damage nerves needed for normal erectile function.

Radiation: The side effects of radiation therapy include most of those of surgery, but it does not pose any significant risk for impotence and incontinence.

Medications: about a quarter of all cases of impotence can be attributed to medications. Many drugs pose a risk for erectile dysfunction. Among the drugs that are common causes of impotence are the following:

*chemotherapy drugs
*Many drugs taken for high blood pressure, particularly diuretics and beta blockers.
*Most drugs used for psychological disorders, including anti-anxiety drugs, anti-psychotic drugs, and antidepressants.

Physical Trauma, Stress or Injury

Injury: spinal cord injury and pelvic trauma, such as a pelvic fracture, can cause nerve damage that result in impotence.

Bicycling: Because regular bicycling can lead to reduced blood flow to the penis.

Vasectomy: does not in it self lead to erectile dysfunction. When impotence occurs after this procedure, it is often in men whose female partners were unable to accept the operation.

Hormonal Abnormalities: Hypogonadism in men is a deficiency in male hormones, usually due to an abnormality in the testicles, which secrete these hormones. It affects 4 to 5 million men in the United States.

Low Testosterone Levels: only about 5% of men who see a physician about erectile dysfunction have low levels of testosterone, the primary male hormone. In general, lower testosterone levels appear to reduce sexual interest, not cause impotence. A 1999 study, however, suggests that testosterone levels are not an accurate reflection of sexual drive.

Erection can occur throughout life, happening before birth and into the 90’s in healthy men. Nocturnal erections occur during all male dreams (regardless of what the dream is about), unless the man has physical problems (this is the easiest way to determine if impotence is physical or emotional in nature). The so called “morning erection” is the result of being wakened during, or just after a dream; and it can be a very persistent erection. While a morning erection is not a sign of arousal, its presence and the pleasurable sensations it can create may result in arousal.

Men have only very limited control over their erections. During puberty the young man is often embarrassed by erection in public settings, but he gradually becomes able to suppress erections when the stimulation is mild. Likewise, it is impossible to “will” an erection, although sexual thoughts can cause erection. During prolonged foreplay a man’s erection may go away; this is normal, and is not a sign of lessening interest.

General health and physical exhaustion can affect erection; when very tired, a man may be able to have only a partial erection, but still be able to climax. Erection is lost in two stages; the initial stage is very quick, but usually leaves the penis firm enough to continue intercourse. The second stage is somewhat slower and is effected by a variety of things including age (which tends to speed it), and arousal level before climax, with higher (or longer) pre-climax arousal generally resulting in slower lose of erection

Although the head (or glands) of the penis is very sensitive to touch, touch alone does not bring about an erection. The epicentre responsible for such essential arousal is actually within the brain. Only after the brain receives visual, audio or mentally stimulating input will it transmit (via the central nervous system) instructions to the smooth muscles along the penis to relax. Specifically the release of nitric oxide in the corpora cavernosa relaxes the smooth muscles. At the same time, the artery to the penis widen to twice its diameter, increasing the blood flow sixteen-fold, and the veins which carry blood away from the penis are blocked. As a result, the two spongy-tissue chambers in the shaft of the penis fill with blood and the penis becomes firm. The corpora cavernosa, acting like a sponge, fill with blood. In fact, the corpora absorb up to eight times more blood than when the penis is flaccid. As your penis swells and lengthens, the filled corpora cavernosa press against the veins. The veins surrounding the chambers are squeezed almost completely shut by this pressure. The veins are unable to drain blood out of the penis and so the penis stays rigid and erect. This condition normally keeps this erection firm enough for intercourse.

At this most basic level this function is considered to be normal if a man is able to maintain his erection sufficiently long to engage in satisfying intercourse and the subsequent ejaculation. The length of time a man might stay continuously erect can be on the average be about 30 - 45 minutes. Of course the duration of his erection vary greatly, in which case it may be a shorter or a great deal longer. After ejaculation or cessation of further stimulation to the penis itself or to the brain excess blood will be allowed to drain away, while the level of blood flow into the penis returns to normal. The penis once again becomes flaccid as it loses the built up pressure.

Erectile quality or intensity may depend on the kind of stimulation the brain receives. Acts as simple as kissing or “petting” are at times sufficiently arousing to bring about an erection. Viewing a sexually titillating movie or photographs will arouse most men to erection. Beyond this the particular nature of erotic images will have varying effects, as men tend to have a broad range of sexual tastes and desires. While some men may become highly aroused by simple stimulation, others thrive on fetishes.

The male libido reacts to a wide variety of stimulation. To consider a man sexually dysfunctional solely by measuring his arousal during intercourse, with a long term partner, is simply too limited as well as illogical. Certainly there are men who are not only fulfilled, but thrive in life-long monogamous relationships. There is really no size fits all when it comes to men’s sensibilities and needs. It would be a mistake however to insist that all men can achieve the same purpose, blissfully maintaining a long-term relationship, which is both sexually and emotionally satisfying.

What if things aren’t quite working that way? There are a number of conditions which may diminish or otherwise influence this process, these are known and considered less than one very general catch all term: Erectile Dysfunction, which is technically defined as “the inability to achieve or maintain an erection sufficient for sexual intercourse”. This is one of the most common sexual ailments in men. Although erectile dysfunction can be primarily psychological in origin, for most men it’s more likely a physical disorder, often with some psychological overlay. While some men assume that erectile failure is a natural part of the aging process and tolerate it; others find it devastating. Withdrawal from sexual intimacy because of fear of failure can damage relationships and have a profound effect on the overall well being of the couple.

The Massachusetts Male Aging Study measured several health related variables in 1290 men aged 40 to 70 years. Erectile dysfunction was very common. Fifty two per cent of the men reported some degree of impotence-mild in 17.1%, moderate in 25.2%, and complete in 9.6%. Complete impotence was reported by 5% of men at 40 years of age and 15% at 70 years of age.

Over the past decades, the medical perspective on the causes of impotence has shifted. It was easy to routinely attribute almost all cases of impotence to psychological factors. Now investigators estimate that between 70% and 80% of impotence cases are caused by medical problems. It is often difficult to determine if the cause of erectile dysfunction is physical or psychological, or even some combination. The following may be helpful in understanding the difference.

1) Psychological impotence tends to be abrupt and related to a recent situation. The individual may be able to have an erection in some circumstances but not in others. The inability to experience or maintain an erection upon waking up in the morning suggests that the problem is physical rather than psychological.
2) Physical impotence occurs gradually but continuously over a period of time. If impotence persists over a three-month period and is not due to a stressful event, drug use, alcohol, or medical conditions, the individual may needs to seek medical attention from a urologist specializing in impotence.

In virtually every case of impotence, there are emotional issues that can seriously affect the man’s self-esteem and relationships, and may even cause or perpetuate erectile dysfunction. Many men tend to fault themselves for their impotence even if it is clearly caused by physical problems over which they have little control.

Anxiety has both emotional and physical effects that can affect erectile function. It is among the most frequently cited contributors to psychological impotence. Anxiety over sexual performance is often referred to as performance anxiety and may provoke an intense fear of failure and self-doubt. It can sometimes set off a cycle of chronic impotence. In response to anxiety, the brain releases chemicals known as neurotransmitters that constrict the smooth muscles of the penis and its arteries. This constriction reduces the blood flow into and increases the blood flow out of the penis. Simple stress may even promote the release of brain chemicals that negatively affect potency in a similar way.

Depression is strongly associated with erectile dysfunction. In one study, 82% of men who reported moderate to severe erectile dysfunction also had symptoms of depression. Depression can certainly reduce sexual desire, but it is often not clear which condition came first.

Problems in Relationships often have a direct impact on sexual functioning. A lack of communication among the partners can lead to partners of men with erectile dysfunction feeling rejected and resentful. Both partners commonly experience guilt for what they each perceive as a personal failure. Tension and anger frequently arise between people who are unable to discuss sexual or emotional issues with each other. Such a situation makes it very difficult for the man to perform well.

Socioeconomic Issues like losing a job or having lower income or education increases the risk for impotence.

Smoking (particularly heavy) is frequently cited as a contributory factor in the development of impotence.

Alcohol has also been implicated in causing impotence. In small doses, alcohol releases inhibitions, but in doses larger than one drink, it can depress the central nervous system and impair sexual function.

Lack of Frequent Erections deprive the penis of oxygen-rich blood. Without daily erections, collagen production increases and eventually may form a tough tissue that interferes with blood flow. The spontaneous erection men experience while sleeping or awake may be a natural protection against this process.