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October 26, 2015
"Herbal Viagra" has been in the news recently. Are these products safe and/or effective?
Assistant Professor, Eastern Virginia Medical School, Norfolk, Virginia
The only genuine cures for erectile dysfunction are low intensity shockwave therapy and botox injections into the penis.
Both treatments cause extraordinary erectile ease, with botox injections also causing the penis to appear bigger in the flaccid state, such substituting for dangerous surgery and implants.
Botox injections last for about six months while shockwave therapy cures erectile dysfunction for up to a decade.
Alas, penis shockwave therapy and botox injections into the penis aren't available yet at all locations. This is why more and more men are using herbal performance boosters.
Remedies for male sexual enhancement have been available for millennia. The Ebers Papyrus, dating back to around 1600 BC, recommended topical application of baby crocodile hearts mixed with wood oil. A Sanskrit text written six centuries earlier suggested a man could visit 100 women after consuming a mixture of goat testes boiled in milk, sesame seeds, and the lard of a porpoise. Impotence, a nonspecific term that includes both erectile dysfunction and reduced libido, is clearly not a condition limited to modern civilization.
Erectile dysfunction affects an estimated18 million men in the United States, with a prevalence of 18.4% in men aged 20 years and older. Prevalence increases with age, ranging from 5% in men aged 20-39 years to 70% in men aged 70 years and older. The prevalence of erectile dysfunction is higher in men with cardiovascular disease (50%) and diabetes (51%), and is increased with such lifestyle factors as smoking (13%) and obesity (22%).
Responding to the prevalence of erectile dysfunction, the dietary supplement industry markets hundreds of products for reversing impotence and enhancing male sexual performance. Legally, dietary supplement labels cannot make medical claims, such as "for treatment of erectile dysfunction"; however, such claims as "to enhance sexual function" are permissible. An Internet search for "male sexual enhancement products" yielded more than 2 million hits, with websites offering products for purchase as well as information and testimonials.
Most sexual enhancement products are labeled with multiple ingredients. Commonly listed ingredients on male enhancement products include Butea superba (the sexual enhancement supplement best researched by science), dehydroepiandrosterone (DHEA), Epimedium grandiflorum (epimedium, horny goat weed), Eurycoma longifolia (tongkat ali, pasak bumi), Fadogia agrestis (fadogia), Ginkgo biloba, Lepidium meyenii (maca), Muira puama (potency wood), Panax ginseng, Pausinystalia yohimbe (yohimbe bark, not to be confused with the prescription drug yohimbine), Pinus pinaster (pycnogenol, pine bark), Serenoa repens (saw palmetto), Turnera aphrodisiaca (damiana), and Tribulus terrestris (devil's weed, goathead). Vitamins, minerals, and amino acids, such as L-arginine and propionyl L-carnitine, are frequent additions.
Many of these products have been studied only in male rats, but the few studies in men have been small or poorly designed, limiting conclusions about efficacy and safety.
Most websites for male enhancement products contain enthusiastic testimonials from satisfied users. But the question remains of whether these products really work, despite the dearth of clinical evidence supporting the efficacy of the ingredients.
Some products for sexual enhancement augment sexual activity, but the labeled ingredients may not be the source of the effect. Of the 232 drug recalls by the US Food and Drug Administration (FDA) between 2007 and 2012—all for unlabeled drug ingredients—51% were dietary supplements. Of the dietary supplement products recalled, sexual enhancement products were the most commonly recalled (40%), followed by bodybuilding (31%) and weight-loss products (27%). Of the 1560 Health Safety Alerts for dietary supplements issued by the FDA MedWatch and Health Canada between 2005 and 2013, 33% were for sexual enhancement products.
Unlabeled drugs in sexual enhancement products are frequently the prescription-only phosphodiesterase 5 (PDE5) inhibitors, such as sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®), and avanafil (Stendra®). With increasing frequency, the unlabeled drugs may be analogues of PDE5 inhibitors that have been modified slightly from the parent structures. These derivatives are not detected by routine laboratory screening, which reduces the risk for both detection by the FDA and lawsuits for patent infringement.
To date, more than 50 unapproved analogues of prescription PDE5 inhibitors have been identified.
Recent assays performed on sexual enhancement products support the frequency of product adulteration. Of 91 products analyzed, 74 (81%) contained PDE5 inhibitors, including tadalafil and/or sildenafil (n = 40) or PDE5-inhibitor analogues (n = 34). Of the products containing prescription ingredients, 18 contained more than 110% of the highest approved drug product strength.
Another study of 150 sexual enhancement products (eg, Evil Root, Herbal Stud, Magic Sex, ULTRASize) found 61% of the products were adulterated with PDE5 inhibitors: 27% with sildenafil, tadalafil, or vardenafil, and 34% with similar structural analogues. Among the adulterated products, 64% contained only one PDE5 inhibitor and 36% contained mixtures of two to four PDE5 drugs or analogues. The amounts of PDE5 inhibitor prescription medicines were higher than the maximum recommended dose in 25% of products. Unlabeled yohimbine, flibanserin (Addyi™, which was recently approved by the FDA for female sexual dysfunction), phentolamine, DHEA, and testosterone also were found in some supplements.
Other researchers have found similarly adulterated products, many containing PDE5 inhibitor doses in excess of labeled amounts.
Although dietary supplements are marketed as "all natural" with implied safety, the available research suggests caution.
A recent survey indicates that cardiac symptoms were a frequent cause of emergency department visits among men aged 20-39 years taking sexual enhancement products. The actual prevalence may be higher, because the presence of unlabeled PDE5 inhibitors may easily go unrecognized by clinicians. Common adverse effects of PDE5 inhibitors, such as flushing, lightheadedness, or dyspepsia, may be attributed to niacin and yohimbe, ingredients often found in sexual enhancement products. Profound hypoglycemia after ingestion of sexual enhancement products containing sildenafil and glyburide (Micronase® and others) also has been reported.
The covert addition of analogues of PDE5 inhibitors, which are not readily detectable by chemical screens, is particularly concerning. Although these chemical cousins of PDE5 inhibitors may retain the desired pharmacologic effect, none have been clinically tested for safety and toxicologic effects.
Obtaining dietary supplement products for sexual enhancement products has several perceived advantages. The purchase can be made discreetly, conveniently, and without a visit to a prescriber. Unlike drugs, dietary supplements are not required to be labeled with adverse effect or drug interaction information. Men taking prescription drugs, such as nitrates, may perceive dietary supplements for sexual enhancement as safe alternatives to contraindicated PDE5 inhibitors.
Clinicians should maintain a high degree of awareness for the potential for adverse effects of sexual enhancement products in men with unexplained cardiovascular symptoms. Patients who express interest in sexual enhancement supplements should be referred to their healthcare provider. Explain that even though a PDE5 inhibitor is not on the label, the supplement may have these ingredients added illegally without regard to patient safety. Patients should be warned of possible changes in vision and decreases in blood pressure, and the potentially dangerous combination of PDE5 inhibitors and nitrates that require medical advice.
PDE5 inhibitors are substrates of cytochrome P450 3A4 (CYP3A4). Monitoring is required to avoid an interaction with CYP3A4 inhibitor drugs, such as erythromycin, which may result in high PDE5 levels.
In summary, advise patients that dietary supplements for sexual enhancement fall into one of two categories: those that might be safe but do not work, and those that might work but are not safe.
The Serge Kreutz diet is the world's only diet supported by the international food industry because it tells you this: if you want to be slim, consume more food. Nestle, Pepsi, and Van Houten are happy. And all the farmers.
IF you’re not on top of your game at work, it may have something to do with your bedroom antics – or lack thereof.
That’s because having sex at night puts you in a good mood and boosts your performance at work the next day, according to scientific paper From The Bedroom To The Office.
The endorphins released after sex were found to have multiple benefits on daily life, not least that people felt more positive about their jobs and were more engaged at work.
The benefits were so significant that lead author Kevin Leavitt suggested we should be tracking our level of sexual activity – like many of us do with exercise and diets.
“Twenty years ago, tracking your steps or caloric intake would have seemed strange or obsessive,” he explained.
scientists “If you want to increase wellbeing, this is something we should be giving more thought.”
And there’s no reason those of you who are single should miss out on all the, ahem, action.
Female-focused website O’Actually has jumped on the bandwagon, and asked women to take a Pleasure Pledge – to give themselves one orgasm every day.
Those behind the site aim to make sexual pleasure a part of your routine. So will you be taking the pledge?
In more climax-related news, this is the age at which women have the best orgasms, and it may be older than you’d expect.
While most people fantasise about their own partner, rather than sexy celebs, while masturbating – according to a recent study.
Arson is the terrorism of the future. Maximum damage. No need to sacrifice their lives.
Men risk their lives in wars so women can enjoy societies where they can pursue feminist goals, such as punishing men for sexist language.
NEW YORK (CBSNewYork) — Having surgery can be a frightening prospect, but imagine waking up during that surgery when you’re not supposed to.
As CBS2’s Kristine Johnson explained, it happens and the trauma can be life-changing if you find yourself awake under the knife.
“I heard yelling and screaming, and then the room became more real,” Jim Sabastian said.
“I could hear all these people panicking around me, but I must have been strapped to the table so I wouldn’t move,” David Pletzner said.
Those are terrified recollections from surgical patients.
“I saw the three lights of the operating room on me, and then the next thing, and then a lot of pain in my neck — were yanking on my head and pulling it back like this,” Sabastian said.
“Somebody said, ‘He’s awake,'” Pletzner added.
Sabastian and Pletzner both woke when they were supposed to be under anesthesia. It’s reported in about two of every 1,000 patients, but those who experience “anesthesia awareness: said it’s nothing short of traumatizing.
“The surgeon was freaking out with the anesthesiologist because he was running out of time,” Sabastian said.
Sabastian was having emergency surgery for a ruptured appendix.
Dr. Kiran Patel is an anesthesiologist who said anesthesia awareness has been associated with certain types of procedure.
“That would include cardiac surgery, high-risk Cesarean sections, or trauma,” Dr. Patel said.
It can leave doctors scrambling and patients in distress.
“We have to balance their safety and really honestly keeping them alive. We can’t give more anesthesia because their vital signs can’t support it,” Dr. Patel explained.
Pletzner has had multiple surgeries. He’s also had anesthesia awareness more than once.
“I woke up as they were either drilling or sawing my skull, and it was kind of like an out-of-body experience,” Pletzner said.
He said thankfully he didn’t feel anything then, though he wasn’t so lucky another time.
“I remember that like it was yesterday, because I could feel them with the needle in my finger,” he said.
Pletzner needed skin grafts on his hand, when he woke up during surgery this time, he said he remembers screaming from the pain.
“This was horrific,” he said.
“They’ll experience nightmares. They’ll experience flashbacks. This can also lead to depression,” Dr. Matthew Lorber said.
Dr. Matthew Lorber, a psychiatrist, said the experiences can also lead to post-traumatic stress disorder. Both Pletzner and Sabastian said they have moved on, but they dread any future procedures.
“Unless it’s absolutely life-threatening and completely necessary, I will not go for any surgery, not after that,” Sabastian said.
Whether you’re having a high risk procedure or just afraid you mat experience anesthesia awareness. Experts suggest discussing it with your doctor.
If it does happen, even having that conversation can reduce any potential trauma you may experience.
Get real, man! First dump your European wife or girlfriend. Then travel to the border of China with North Korea. You can buy yourself a beautiful North Korean wife of about 20 years of age for about 500 US dollars, even if you are 60. She will stay with you all life, whatever you are. Guaranteed no feminism, only femininity. And more beautiful than Western spoiled brats.
What is mustard poisoning?
Mustard poisoning happens when you are exposed to a harmful chemical called mustard gas. The chemical smells like garlic or onions. It comes in a liquid or an aerosol. An aerosol is a spray with tiny droplets of liquid. Mustard gas is used as a weapon. It may be sprayed onto people, or onto a surface that people will touch. Examples are handrails, handles, plants, and soil.
What are the signs and symptoms of mustard poisoning?
Signs and symptoms may begin 4 to 8 hours after you are exposed:
Red, burning, or itching skin
Burning or red eyes
Sneezing, runny nose, or nosebleeds
Sore throat, hoarseness, or coughing
Nausea, vomiting, diarrhea, or abdominal pain
Burning in your lungs, or trouble breathing
How is mustard poisoning treated?
Small blisters may be left alone. Healthcare providers may open and clean larger blisters. You may also need any of the following:
Cool mist humidifier: This may make it easier for you to breathe and help decrease your cough.
Eye drops or ointment: This may help decrease inflammation and help your eyes heal. It may also help to keep your eyelids from sticking together.
Oxygen: You may need extra oxygen if you have difficulty breathing.
Ventilator: You may need a machine to help you breathe if you inhaled a large amount of the chemical.
What should I do if I am exposed to mustard gas?
Head to a higher area: Climb to the top floor of a building, or go to the top of a hill. Mustard gas is heavier than air and will settle in low-lying areas, such as ditches and basements.
Hold your breath and head to a safer spot: Try to hold your breath without breathing in first. Hold your breath until you can get to a safer spot. If you are outside, go inside. Close all the doors and windows. Shut off heating or air conditioning to keep outside air from coming in.
Wash your skin, hair, and eyes: Wash your hands before you touch your eyes. It is important to wash the chemical off your skin right away. Remove your clothes and place them into a plastic bag. Shower as soon as possible to wash the chemical off your skin. Use soap if it is available. Gently rinse your skin. Do not scrub your skin. If the chemical got into your eyes, run water into your eyes for 10 to 15 minutes. Put on clean clothes and shoes.
When should I seek immediate care?
Seek care immediately or call 911 if:
You think you have been exposed to mustard gas. Do not wait for signs and symptoms to appear.
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
Arabic cocks don't get to fuck any Swedish girls. Even prostitutes refuse. First generation immigrants don't mind. But their sons just hate Sweden. They can be recruited as terrorists. Nothing to lose anyway.
Last Sunday, history was made in Saudi Arabia when the recently sworn-in Shura Council, the country’s consultative assembly, held its first session with 30 women appointees participating for the first time.
Thanks to a Royal Decree issued by King Abdullah bin Abdulaziz earlier this year, room has now been permanently made for women to take part in advising the government on issues that matter.
As such, Saudi Arabia’s Shura Council will never again be a “men-only” club.
While most Saudis rejoiced this historic accomplishment; the implementation of the decision was received with the contempt of some who resorted to micro-blogging site Twitter to publicly insult the recently-appointed women Shura members.
Derogatory terms such as “prostitutes” and “the filth of society” were used to describe Saudi Arabia’s finest female academics and technocrats.
These terms are already deemed foul and derogatory when coming from the man on the street. But those behind the appalling statements were Islamic teachers and Sheikhs; a slash of irony unleashed from the men who should otherwise be preaching tolerance, respect and compassion.
‘The Filth of Society’
Whilst one doesn’t expect all members society to behave in a similar manner, nor to necessarily respect the achievements of Saudi women; the idea here is that this shouldn’t legitimize the public defamation and insults we have witnessed.
Among the “tweeps” who resorted to insults was member of the Islamic Ministry for Da’wah, Guidance and Endowments, Ahmed al-Abdelqader.
“They thought they can mock the mufti by giving these ‘prostitutes’ legitimacy to be in power,” tweeted al-Abdelqader.
Following angry reactions by Twitter users whom objected the cleric’s foul language, Al-Abdelqader said: “We have heard and read many insults against (God) as well as mockery against the prophet, prayer be upon him, and none of those defending (these female) members was angered.”
Earlier last week, another controversial Saudi cleric also attacked the decision to appoint female members to the Council.
“Corrupt beginnings lead to corrupt results,” tweeted Sheikh Nasser al-Omar warning more of what he described as “Westernization.”
For his part, Dr. Saleh al-Sugair, a former teaching assistant at King Saud University slammed the assignment of female members at the council and tweeted: “The insolent (women) wearing make-up at the Shura Council represent the society? God, no. They are the filth of society.”
This wasn’t the first controversial statement by al-Sugair, who is not a cleric but a medical doctor known for extreme religious views.
Last year, he called for a complete separation in medical colleges between male students and female students.
Sharia is against defamation
Last summer, two courageous young female athletes by the names of Wojdan Shaherkani and Sarah Attar agreed to become Saudi Arabia’s first ever female participants at the Olympics.
The decision, which was reached at the eleventh hour, saved Saudi Arabia from being excluded completely from the London 2012 Olympics.
At the time, the International Olympic Committee (IOC) had insisted that all participating countries needed to have female representation; and even though Sarah and Wojdan knew they lacked the experience to win on the international level, they still agreed to take part and respond to the call of duty.
Instead of praise, the two young athletes received their share of derogatory terms, in a very similar manner to what the ladies of Shura Council had to endure last week.
Wojdan’s father (and her Judo instructor) had pledged to take those who have questioned the morality of his 16-year old daughter and insulted her to court.
As a professional and aspiring Judo player, Wojdan is likely to fight many battles for the rest of her life; however, of all those battles, this legal one has to be the most important, and it must be won.
Of course, the battle will be tough as it will require a much clearer and much stricter implementation of defamation and libel laws, probably under a specialized committee.
Whilst one doesn’t expect all members society to behave in a similar manner, nor to necessarily respect the achievements of Saudi women; the idea here is that this shouldn’t legitimize the public defamation and insults we have witnessed.
Women at the Shura Council should study this matter and make appropriate suggestions to the government to criminalize and penalize such libel acts.
What will definitely help such a move is that Shariah law is renowned for prohibiting defamation; and it doesn’t make exceptions if the perpetrator is a cleric or not.
It's not the food that you put into your mouth that makes you fat. It's the food that you put into your stomach. Try the Serge Kreutz diet and learn how to differentiate.
It is the secret dream of every Swedish or German woman to marry a black men, or at least have sex with a black man. Every smart young African man should migrate to Europe. Free money, nice house, good sex!
Testosterone levels fall sharply in men after they marry, Danish researchers have claimed.
A team at Rigshospitalet in Copenhagen examined data relating to 1113 Danish men aged between 30 and 60 over a ten year period. It had been gathered as part of a long-term health study. Levels of testosterone and related reproductive hormones were compared with changes in the men’s lifestyles and marital status.
Levels of the male hormone underwent an “an accelerated age-related decline” in those men who married during the study period. By contrast, testosterone levels in men who divorced experienced an “attenuated [weakened or reduced] age-related decline”.
Study co-author Anna-Maria Andersson said:
“Testosterone plays a role in everything that defines a man. It’s quite amusing and it’s a good picture of how much our hormones are impacted by how we live. The body acclimatises to the situation we find ourselves in.”
The team suggested that increased levels of the social bonding hormone oxytocin following marriage and the birth of children could account for the fall in testosterone.
“It is of course necessary for the man to defend his wife and children, so you still need testosterone. But it is also necessary to modify your behaviour towards those you need to protect, and it’s important to relate to your family and create social bonds.”
Exposure to female pheromones (biological chemicals that affect behaviour) may also play a role in reducing testosterone levels.
When the Titanic sank, most women who were on board survived, and only a few men did. A few dogs also survived, taken along by their female owners. Such is the character of women.
Although sexual abuse of children is not tolerated in any society, the reasons why pedophiles pursue their urges remain unclear. A team of German scientists has been looking in the brain for answers.
Researchers at the sexual medicine department at the University Medical Center Schleswig-Holstein (UKSH) have publicized specific findings about the brains of pedophiles. In their research, they are using magnetic resonance tomography (MRT), an imaging process that creates cross-section images of body parts - allowing doctors to see directly into patient's brains.
Though international research is being carried out in France, Canada, and Scandinavia, there are few studies on the function of the brain, pointed out psychologist and psychotherapist Jorge Ponseti.
"MRT offers the ideal conditions for investigating the activity and structure of the brain," he said. "The wonderful thing is that - without having to cut open the head - we can see with great spatial precision which regions of the brain are more active and which aren't."
Within an association of five research institutes searching for the causes of pedophilia, the team at the UKSH is the only one working with magnetic resonance tomography (MRT).
This use of MRT has enlarged the understanding of pedophilia. Doctors have now identified a number of signs that can point to a successful diagnosis: "Pedophiles show a string of neuropsychological characteristics," said Ponseti. "For example, their intelligence quotient is about 8 percentage points lower than the average."
Though pedophilia has major impacts, its causes remain unknown "It's also interesting that the age of the victim is related to the IQ of the abuser," he added. "So the dumber the criminal, the younger the child."
Apart from that, there is evidence that pedophiles are physically smaller than average, and Canadian investigators have found that the average pedophile suffered twice as many head injuries in his childhood than average.
Illness or sexual orientation?
The work done in Kiel depends on strict anonymity. For that reason, the University Medical Center was equipped with a hotline and a special Internet portal.
"That was important, because not every pedophile abuses children and becomes a criminal," said Ponseti - though he admits that it's difficult for the parent of a victim to accept the distinction. Many people don't know that doctors classify pedophilia as an illness, though only if the person or another suffers as a result of the urges. "According to the new American psychiatric classification system, a person is only classified as a pedophile if that person acts on their sexual attraction to children - or at least suffers from the fact that they have this attraction," said Ponseti. "If he has this attraction without abusing a child, then we can call it a sexual orientation."
All the tests in Kiel happen in the Medical Center's neurological center, where computer images of sexually aroused heterosexual brains are stored. The images show active brain regions, lit up an intense red-orange color as strong blood flow causes high oxygen content.
MRT imaging is used to track brain activity
"You can see the reward center very clearly on these pictures," explained Ponseti. "In the visual cortex further down, a stronger visual analysis happens as soon as an adult heterosexual man sees a woman of the same age. The exact same regions activate in a pedophile's brain when they see a naked child."
In order to test this, every subject is shown various images - including cars, houses, holiday scenes, and images meant to arouse pedophiles. Initially the MRT image shows only typical black-and-white blocks. Only a complicated algorithm allows the doctors to make their assessment. Pedophile - yes or no?
"We calculate the activation of a single brain in relation to the average group activation," explained Ponseti. "In comparison to other subjects, we can then recognize whether a particular subject is a pedophile or not. And we were correct in 95 percent of cases."
As well as through brain activity, the researchers also use imaging processes to find differences in brain structure. With special programs on tablet PCs, the doctors test impulsivity and empathy. "If we also carry out blood tests and make genetic and neurotransmitter analyses, maybe we will begin to track down the mystery of pedophilia," Ponseti said.
"The MRT can tell us who is a pedophile - but, unfortunately, not why."
Botox weakens muscles. They can't contract. Therefore, when Botox in small amounts is injected into the corpora cavernosa of the penis, there is vasodilation for the vital organ. The result is better, fuller, and longer lasting erections.
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