Sierra Acai Company
Sierra Acai Company
Open 7 Days a Week
MonaVie Independent Distributor
Distributor Training
Shop Online
Enroll Now
Buy Wholesale and maintain an Active status for 2 months and we will refund your $39 Distributor Fee
Friends
Buy Wholesale and maintain an Active status for 2 months and we will refund your $39 Distributor Fee
07-SEPTEMBER-2008 03:17:44 - Erectile dysfunction Semi-protected Erectile dysfunction Classification and external resources ICD-10 F52.2, N48.4 ICD-9 302.72, 607.84 DiseasesDB 21555 eMedicine med/3023 MeSH D007172 Erectile dysfunction ED or male impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis. There are various underlying causes, such as cardiovascular leakage and diabetes, many of which are medically treatable. Nerve trauma from prostatectomy surgery can cause chronic erectile dysfunction. The causes of erectile dysfunction may be physiological or psychological. Physiologically, erection is a hydraulic mechanism based upon blood entering and being retained in the penis, and there are various ways in which this can be impeded, most of which are amenable to treatment. Psychological impotence is where erection or penetration fails due to thoughts or feelings psychological reasons rather than physical impossibility; this can often be helped. Notably in psychological impotence, there is a very strong placebo effect. Erectile dysfunction, tied closely as it is to cultural notions of potency, success and masculinity, can have devastating psychological consequences, including feelings of shame, loss or inadequacy; often unnecessary since in most cases the matter can be helped. There is a strong culture of silence and inability to discuss the matter. In fact, around 1 in 10 men will experience recurring impotence problems at some point in their lives.1 Folk remedies have long been advocated, with some being advertised widely since the 1930s. The introduction of the first pharmacologically-approved remedy for impotence, sildenafil trade name Viagra, in the 1990s caused a wave of public attention, propelled in part by heavy advertising. The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina. It is now mostly replaced by more precise terms. The study of erectile dysfunction within medicine is covered by andrology, a sub-field within urology. Contents 1 Overview and symptoms 2 Pathophysiology 3 Causes 4 Diagnosis 4.1 Medical diagnosis 4.2 Clinical Tests Used to Diagnose ED 5 Treatment 5.1 Uncontroversial treatments 5.2 Controversial and unapproved treatments 5.3 Other treatment methods 5.3.1 Zinc 6 History 7 References 8 External links Overview and symptoms Erectile dysfunction is characterized by the regular or repeated inability to obtain or maintain an erection. There are several ways that erectile dysfunction is analyzed: Obtaining full erections at some times, such as when asleep when the mind and psychological issues, if any, are less present, tends to suggest the physical structures are functionally working. However, the opposite case, a lack of nocturnal erections, does not imply the opposite, since a significant proportion of sexually functional men do not routinely get nocturnal erections or wet dreams. Obtaining erections which are either not rigid or full lazy erection, or are lost more rapidly than would be expected often before or during penetration, can be a sign of a failure of the mechanism which keeps blood held in the penis, and may signify an underlying clinical condition, often cardiovascular in origin. Other factors leading to erectile dysfunction are diabetes mellitus causing neuropathy or hypogonadism decreased testosterone levels due to disease affecting the testicles or the pituitary gland. Erection problems are very common. The Sexual Dysfunction Association estimates that 1 in 10 men in the UK have recurring problems with their erections at some point in their life.1 Pathophysiology Penile erection is managed by two different mechanisms. The first one is the reflex erection, which is achieved by directly touching the penile shaft. The second is the psychogenic erection, which is achieved by erotic or emotional stimuli. The former uses the peripheral nerves and the lower parts of the spinal cord, whereas the latter uses the limbic system of the brain. In both conditions, an intact neural system is required for a successful and complete erection. Stimulation of penile shaft by the nervous system leads to the secretion of nitric oxide NO, which causes the relaxation of smooth muscles of corpora cavernosa the main erectile tissue of penis, and subsequently penile erection. Additionally, adequate levels of testosterone produced by the testes and an intact pituitary gland are required for the development of a healthy erectile system. As can be understood from the mechanisms of a normal erection, impotence may develop due to hormonal deficiency, disorders of the neural system, lack of adequate penile blood supply or psychological problems. Restriction of blood flow can arise from impaired endothelial function due to the usual causes associated with coronary artery disease, but can also be caused by prolonged exposure to bright light. Causes Neurogenic Disorders spinal cord and brain injuries, nerve disorders such as Parkinson's disease, Alzheimer's disease, multiple sclerosis, and stroke.2 Hormonal Disorders pituitary gland tumor; low level of the hormone testosterone. Arterial Disorders peripheral vascular disease, hypertension; reduced blood flow to the penis. Cavernosal Disorders Peyronie's disease.3 Nonphysical causes: Mental disorders clinical depression, schizophrenia, substance abuse, panic disorder, generalized anxiety disorder, personality disorders or traits.4, psychological problems, negative feelings.5 Surgery radiation therapy, surgery of the colon, prostate, bladder, or rectum may damage the nerves and blood vessels involved in erection. Prostate and bladder cancer surgery often require removing tissue and nerves surrounding a tumor, which increases the risk for impotence.6 Aging. Lifestyle: alcohol and drugs, obesity, cigarette smoking Incidence of impotence is approximately 85 percent higher in male smokers compared to non-smokers7. Smoking is a key cause of erectile dysfunction.89 Smoking causes impotence because it promotes arterial narrowing.10 See also Tobacco and health. Other disorders. A few causes of impotence may be iatrogenic medically caused. Various antihypertensives medications intended to control high blood pressure and some drugs that modify central nervous system response may inhibit erection by denying blood supply or by altering nerve activity. Surgical intervention for a number of different conditions may remove anatomical structures necessary to erection, damage nerves, or impair blood supply. Complete removal of the prostate gland or external beam radiotherapy of the gland are common causes of impotence; both are treatments for prostate cancer. Some studies have shown that male circumcision may result in an increased risk of impotence,1112 while others have found no such effect,131415 and another found the opposite.16 Excessive alcohol use has long been recognised as one cause of impotence, leading to the euphemism brewer's droop, or whiskey dick; Shakespeare made light of this phenomenon in Macbeth. A study in 2002 found that ED can also be associated with bicycling. The number of hours on a bike and/or the pressure on the penis from the saddle of an upright bicycle is directly related to erectile dysfunction.17 Diagnosis Medical diagnosis There are no formal tests to diagnose erectile dysfunction. Some blood tests are generally done to exclude underlying disease, such as diabetes, hypogonadism and prolactinoma. Impotence is also related to generally poor physical health, poor dietary habits, obesity, and most specifically cardiovascular disease such as coronary artery disease and peripheral vascular disease. A useful and simple way to distinguish between physiological and psychological impotence is to determine whether the patient ever has an erection. If never, the problem is likely to be physiological; if sometimes however rarely, it could be physiological or psychological. The current diagnostic and statistical manual of mental diseases DSM-IV has included a listing for impotence. Clinical Tests Used to Diagnose ED Duplex ultrasound Duplex ultrasound is used to evaluate blood flow, venous leak, signs of atherosclerosis, and scarring or calcification of erectile tissue. Injecting prostaglandin, a hormone-like stimulator produced in the body, induces erection. Ultrasound is then used to see vascular dilation and measure penile blood pressure. Measurements are compared to those taken when the penis is flaccid. Penile nerves function Tests such as the bulbocavernosus reflex test are used to determine if there is sufficient nerve sensation in the penis. The physician squeezes the glans head of the penis, which immediately causes the anus to contract if nerve function is normal. A physician measures the latency between squeeze and contraction by observing the anal sphincter or by feeling it with a gloved finger inserted past the anus. Specific nerve tests are used in patients with suspected nerve damage as a result of diabetes or nerve disease. Nocturnal penile tumescence NPT 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. It should be noted that 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. Penile biothesiometry This test uses electromagnetic vibration to evaluate sensitivity and nerve function in the glans and shaft of the penis. A decreased perception of vibration may indicate nerve damage in the pelvic area, which can lead to impotence. Penile Angiogram Invasive test - allows visualization of the circulation in the penis and is used during the repair of a priapism. Dynamic Infusion Cavernosometry Abbreviated DICC technique in which fluid is pumped into the penis at a known rate and pressure. It gives a measurement of the vascular pressure in the corpus cavernosum during an erection. To do this test, a vasodilator like prostaglandin E-1 is injected to measure the rate of infusion required to get a rigid erection and to help find how severe the venous leak is. Corpus Cavernosometry Cavernosography measurement of the vascular pressure in the corpus cavernosum. Saline is infused under pressure into the corpus cavernosum with a butterfly needle, and the flow rate needed to maintain an erection indicates the degree of venous leakage. The leaking veins responsible may be visualised by infusing a mixture of saline and x ray contrast medium and performing a cavernosogram. 18 Digital Subtraction Angiography In DSA, the images are acquired digitally. The computer creates a mask from lower-contrast x-rays of the same area and digitally isolates the blood vessels this is done manually through darkroom masking with traditional angiography. Magnetic resonance angiography MRA This is similar to magnetic resonance imaging. Magnetic resonance angiography uses magnetic fields and radio waves to provide detailed images of the blood vessels. Doctors may inject a contrast agent into the patient's bloodstream that causes vascular tissues to stand out against other tissues. The contrast agent provides for enhanced information regarding blood supply and vascular anomalies. Aside from the IV used to introduce the contrast material into the bloodstream, magnetic resonance angiography is noninvasive and painless. Treatment Treatment depends on the cause. Testosterone supplements may be used for cases due to hormonal deficiency. However, the cause is more usually lack of adequate penile blood supply as a result of damage to inner walls of blood vessels. This damage is more frequent in older men, and often associated with disease, in particular diabetes. Treatments with the exception of testosterone supplementation, where effective work on a temporary basis: they enable an erection to be attained and maintained long enough for intercourse, but do not permanently improve the underlying condition. There are different treatments available:19 Oral treatment 3 different tablets are currently available from the doctor and these work when there is sexual stimulation. Depending on the treatment, it will need to be taken 20 minutes to 1 hour before sex and the period of time over which it works can vary between 3 hours and up to 36 hours. Alprostadil This can be injected into the penis or inserted using a special applicator - usually just before sexual intercourse. Alprostadil has also bcome available in some countries as a topical cream under the brand name Befar,20 and preliminary studies have shown a clinical efficacy of up to 83%.21 It has an onset of action of 10-15 minutes and its effects can last over 4 hours.citation needed Vacuum device Please see main article penis pump These work by placing the penis in a vacuum cylinder device. 22 The device helps draw blood into the penis. A ring at the base of the penis help maintain the erection.22 This type of device is sometimes referred to as penis pump and may be used just prior to sexual intercourse. Hormone treatment It is rare, but some men receive hormones for their erection problem. This does depend on the cause of the problem as well as other factors. Surgery Often, as a last resort if other treatments have failed, the most common procedure is prosthetic implants which involves the insertion of artificial rods into the penis.23 Counselling Counselling is often a consideration, both where a psychological cause is suspected or must be ruled out, or to assist in management of any distress. ED can in many cases be treated by drugs taken orally, injected, or as penile suppositories. These drugs increase the efficacy of NO, which dilates the blood vessels of corpora cavernosa. When oral drugs or suppositories fail, injections into the erectile tissue of the penile shaft are extremely effective but occasionally cause priapism. When pharmacological methods fail, a purpose-designed external vacuum pump can be used to attain erection, with a separate compression ring fitted to the penis to maintain it. These pumps should be distinguished from other penis pumps supplied without compression rings which, rather than being used for temporary treatment of impotence, are claimed to increase penis length if used frequently, or vibrate as an aid to masturbation. More drastically, inflatable or rigid penile implants may be fitted surgically. Implants are irreversible and costly. All these mechanical methods are based on simple principles of hydraulics and mechanics and are quite reliable, but have their disadvantages. In a few cases there is a vascular problem which can be treated surgically. Uncontroversial treatments PDE5 Inhibitors The cyclic nucleotide phosphodiesterases constitute a group of enzymes that catalyse the hydrolysis of the cyclic nucleotides cyclic AMP and cyclic GMP. They exist in different molecular forms and are unevenly distributed throughout the body. These multiple forms or subtypes of phosphodiesterase were initially isolated from rat brain by Uzunov and Weiss in 197224 and were soon afterwards shown to be selectively inhibited by a variety of drugs in brain and other tissues.2526 The potential for selective phosphodisterase inhibitors to be used as therapeutic agents was predicted as early as 1977 by Weiss and Hait.27 This prediction has now come to pass in a variety of fields, one of which is in the pharmacological treatment of erectile dysfunction. One of the forms of phophodiesterase is termed PDE5. The prescription PDE5 inhibitors sildenafil Viagra, vardenafil Levitra and tadalafil Cialis are prescription drugs which are taken orally. They work by blocking the action of PDE5, which causes cGMP to degrade. CGMP specific phosphodiesterase type 5 causes the smooth muscle of the arteries in the penis to relax, allowing the corpus cavernosum to fill with blood. Specific devices are mentioned for information only; mention should not be taken as endorsement. Dopamine Receptor Agonist Inflatable implant Rigid implant Surgical treatment of certain cases Controversial and unapproved treatments Naltrexone Drug used for treating drug addicts can have some success in patients with inhibited sexual desire. Bremelanotide The experimental drug bremelanotide formerly PT-141 does not act on the vascular system like the former compounds but allegedly increases sexual desire and drive in males as well as females. It is applied as a nasal spray. Bremelanotide allegedly works by activating melanocortin receptors in the brain. It is currently in Phase IIb trials. Melanotan II Like bremelanotide the experimental drug Melanotan II does not act on the vascular system either but increases libido. Melanotan II works by activating melanocortin receptors in the brain. hMaxi-K hMaxi-K is a form of gene therapy using a plasmid vector that expresses the hSlo gene, that encodes the alpha-subunit of the Maxi-K channel. It has undergone phase I safety trials.28 Ginseng A double-blind study appears to show evidence that ginseng is better than placebo:29 see the ginseng article for more details. Enzyte Enzyte is a product that has been advertised by saturation coverage on television channels such as CourtTV. However, the Center for Science in the Public Interest CSPI has filed a complaint with the Federal Trade Commission FTC about Enzyte for deceptive advertising. It is manufactured by Berkeley Nutritionals, which is alleged to be the subject of an investigation by the Attorney General of Ohio and the defendant in class-action lawsuits. Enzyte is a supplement that claims to increase the male libido or frequency of erections of the penis. Commercials for Enzyte are shown regularly on television. These commercials feature a man named Bob who never stops smiling, apparently because he had taken Enzyte and improved the size of his sex organs. The commercials are riddled with symbolic phallic imagery, e.g. golf clubs, remarkably tall glasses of iced tea, and a hose spraying barely a trickle of water carried by someone who doesn't use Enzyte. The effectiveness of Enzyte is in dispute. Some medical professionals in fact advise against taking Enzyte, saying that it can lead to damage. The Center for Science in the Public Interest have urged the Federal Trade Commission to disallow further television advertising for Enzyte due to a lack of proper studies supporting claims. Enzyte maker Berkeley Premium Nutraceuticals, Inc., is currently under a class action lawsuit for false advertising. Enzyte is said to contain: 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. Herbal and other alternative treatments These are generally ineffective when tested blind, but may be useful for their psychological placebo effect: if a good result is expected, any highly praised, and often expensive, treatment can be effective. Reputable drugs can also benefit from the same effect. This is especially useful if blindfolded, as it helps to clear the mind of anxiety issues. Prelox Prelox is a Proprietary mix/combination of naturally occurring ingredients, L-arginine aspartate and Pycnogenol. In double blind tests carried out by Dr. Steven Lamm at New York University School of Medicine, 81.1% of men overall judged Prelox to be effective in improving their ability to engage in sexual activity. 30 Whilst the supplements should be taken daily, the manufacturers claim that it brings the spontaneity back into ones' love life; unlike other products which must be remembered to be taken a fixed time before sexual activity. Other treatment methods Zinc Zinc is known to help prevent the conversion of testosterone to estradiol, and testosterone is essential for proper erectile function and the synthesis of sperm testosterone deficiency is a primary contributor in many cases of erectile dysfunction.3132333435 Moreover, zinc levels have been found to be significantly reduced in both chronic bacterial prostatitis CBP and non-bacterial prostatitis NBP. Many doctors and nutritionalists recommend zinc for prostate or erectile problems.363738 Zinc is best taken in lozenge form, as in tablet form, zinc is difficult to absorb, and can irritate the stomach lining.39 History The earliest attempts at treating erectile dysfunction date back to Muslim physicians and pharmacists in the medieval Islamic world. They were the first to prescribe medication for the treatment of this problem, and they developed several methods of therapy for this issue, including a single-drug therapy method where a drug was prescribed and a combination method of either a drug or food. Most of these drugs were oral medication, though a few patients were also treated through topical and transurethral means. Erectile dysfunctions were being treated with tested drugs in the Islamic world since the 9th century until the 16th century by a number of Muslim physicians and pharmacists, including Muhammad ibn ZakarÄ«ya RÄ?zi, Thabit bin Qurra, Ibn Al-Jazzar, Avicenna The Canon of Medicine, Averroes, Ibn al-Baitar, and Ibn al-Nafis The Comprehensive Book on Medicine.40 Dr. John R. Brinkley initiated a boom in male impotence cures in the US in the 1920s and 1930s. His radio programs recommended expensive goat gland implants and mercurochrome injections as the path to restored male virility, including operations by surgeon Serge Voronoff. After the Kansas State Medical Board revoked his medical license and the Federal Radio Commission refused to renew his radio license both in 1930, Brinkley moved his operations just over the Texas border to Mexico where he opened a medical clinic and broadcast advertisements into the US from a border blaster radio station. Surgeons began providing patients with inflatable penile implants in the 1970s. Modern drug therapy for ED made a significant advance in 1983 when British physiologist Giles Brindley, Ph.D. dropped his trousers and demonstrated to a shocked American Urological Association audience his phentolamine-induced erection. The drug Brindley injected into his penis was a non-specific vasodilator, an alpha-blocking agent, and the mechanism of action was clearly corporal smooth muscle relaxation. The effect that Brindley discovered established the fundamentals for the later development of specific, safe, orally-effective drug therapies.41 Reference: Helgason Ã?R, Adolfsson J, Dickman P, et al 1996. Sexual desire, erection, orgasm and ejaculatory functions and their importance to elderly Swedish men: a population-based study. Age Ageing 25 4: 285-91. PMID 8831873. References ^ a b 1 in 10 men estimate, see for example: NHS Direct - Health encyclopaedia -Erectile dysfunction ^ Erectile Dysfunction causes. Erection Problems Erectile Dysfunction. Healthwise 2006. Retrieved on 2007-10-07. ^ Male Sexual Dysfunction Epidemiology. Erectile dysfunction. Armenian Health Network, Health.am 2006. Retrieved on 2007-10-07. ^ Causes of Erectile Dysfunction. Erectile dysfunction. Armenian Health Network, Health.am 2006. Retrieved on 2007-10-07. ^ Erectile dysfunction. Erectile dysfunction. Mayo Clinic 2006. Retrieved on 2007-10-07. ^ Erectile Dysfunction Causes. Erectile Dysfunction. Healthcommunities.com 1998. Retrieved on 2007-10-07. ^ The Tobacco Reference Guide. Retrieved on 2006-07-15. ^ Peate I 2005. The effects of smoking on the reproductive health of men. Br J Nurs 14 7: 362-6. PMID 15924009. ^ Korenman SG 2004. Epidemiology of erectile dysfunction. Endocrine 23 2-3: 87-91. doi:10.1385/ENDO:23:2-3:087. PMID 15146084. ^ Kendirci M, Nowfar S, Hellstrom WJ. 2005. The impact of vascular risk factors on erectile function. Drugs Today Barc 41 1: 65-74. doi:10.1358/dot.2005.41.1.875779. PMID 15753970. ^ Palmer J, Link D 1979. Impotence following anesthesia for elective circumcision. JAMA 241 24: 2635-6. doi:10.1001/jama.241.24.2635. PMID 439362. - Reproduced at www.cirp.org Circumcision Information and Resource Pages ^ Shen Z, Chen S, Zhu C, Wan Q, Chen Z 2004. Erectile function evaluation after adult circumcision. Zhonghua Nan Ke Xue 10 1: 18-9. PMID 14979200. ^ Senkul T, IÅŸerI C, ÅŸen B, KarademIr K, SaraçoÄŸlu F, Erden D 2004. Circumcision in adults: effect on sexual function. Urology 63 1: 155-8. doi:10.1016/j.urology.2003.08.035. PMID 14751371. - Reproduced at www.cirp.org Circumcision Information and Resource Pages ^ Collins S, Upshaw J, Rutchik S, Ohannessian C, Ortenberg J, Albertsen P 2002. Effects of circumcision on male sexual function: debunking a myth?. J Urol 167 5: 2111-2. doi:10.1016/S0022-53470565097-5. PMID 11956452. - Reproduced at www.cirp.org Circumcision Information and Resource Pages ^ Masood S, Patel H, Himpson R, Palmer J, Mufti G, Sheriff M 2005. Penile sensitivity and sexual satisfaction after circumcision: are we informing men correctly?. Urol Int 75 1: 62-6. doi:10.1159/000085930. PMID 16037710. ^ Laumann E, Masi C, Zuckerman E 1997. Circumcision in the United States. Prevalence, prophylactic effects, and sexual practice. JAMA 277 13: 1052-7. doi:10.1001/jama.277.13.1052. PMID 9091693. - Reproduced at www.cirp.org Circumcision Information and Resource Pages ^ Schrader S, Breitenstein M, Clark J, Lowe B, Turner T Nov-Dec 2002. Nocturnal penile tumescence and rigidity testing in bicycling patrol officers. J Androl 23 6: 927-34. PMID 12399541. ^ Dawson C, Whitfield H April 1996. ABC of urology. Subfertility and male sexual dysfunction. BMJ 312 7035: 902-5. PMID 8611887. PMC:2350600. ^ Welcome to LoveLifeMatters - guide to partner's erectile dysfunction ^ Beyond Viagra, worldhealth.net, August 12, 2003 ^ Goldstein I, Payton TR, Schechter PJ 2001. A double-blind, placebo-controlled, efficacy and safety study of topical gel formulation of 1% alprostadil Topiglan for the in-office treatment of erectile dysfunction. Urology 57 2: 301-5. PMID 11182341. ^ a b You don't have to live with Erectile Dysfunction ED. The Canadian Male Sexual Health Council CMSHC. Educational Flyer. note: This information may also be available online at http://www.cmshc.org. ^ Penile prostheses implants Chris Steidle, MD, SeekWellness.com ^ Uzunov P, Weiss B 1972. Separation of multiple molecular forms of cyclic adenosine-3',5'-monophosphate phosphodiesterase in rat cerebellum by polyacrylamide gel electrophoresis. Biochim. Biophys. Acta 284 1: 220-6. PMID 4342220. ^ Weiss B 1975. Differential activation and inhibition of the multiple forms of cyclic nucleotide phosphodiesterase. Adv Cyclic Nucleotide Res 5: 195-211. PMID 165666. ^ Fertel R, Weiss B July 1976. Properties and drug responsiveness of cyclic nucleotide phosphodiesterases of rat lung. Mol. Pharmacol. 12 4: 678-87. PMID 183099. ^ Weiss B, Hait WN 1977. Selective cyclic nucleotide phosphodiesterase inhibitors as potential therapeutic agents. Annu. Rev. Pharmacol. Toxicol. 17: 441-77. doi:10.1146/annurev.pa.17.040177.002301. PMID 17360. ^ Melman A, Bar-Chama N, McCullough A, Davies K, Christ G 2005. The first human trial for gene transfer therapy for the treatment of erectile dysfunction: preliminary results. Eur Urol 48 2: 314-8. doi:10.1016/j.eururo.2005.05.005. PMID 15964135. ^ Hong B, Ji YH, Hong JH, Nam KY, Ahn TY 2002. A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report. J. Urol. 168 5: 2070-3. doi:10.1097/01.ju.0000034387.21441.87. PMID 12394711. ^ Prelox® for improvement of erectile function: A review European Bulletin of Drug Research, Volume 11, No. 3, 2003. Steven Lamm, Frank Schoenlau, Peter Rohdewald ^ Om AS, Chung KW 1996. Dietary zinc deficiency alters 5 alpha-reduction and aromatization of testosterone and androgen and estrogen receptors in rat liver. J. Nutr. 126 4: 842-8. PMID 8613886. ^ Schmidt M, Renner C, Löffler G 1998. Progesterone inhibits glucocorticoid-dependent aromatase induction in human adipose fibroblasts. J. Endocrinol. 158 3: 401-7. doi:10.1677/joe.0.1580401. PMID 9846169. ^ Mahajan SK, Abbasi AA, Prasad AS, Rabbani P, Briggs WA, McDonald FD 1982. Effect of oral zinc therapy on gonadal function in hemodialysis patients. A double-blind study. Ann. Intern. Med. 97 3: 357-61. PMID 7051913. ^ Pfeiffer, Carl C. Ph.D. MD. 1976. Mental Elemental Nutrients: a physicians guide to nutrition health care, Hardcover, Keats Pub. ISBN 978-0879831141. ^ Pfeiffer, Carl C. Ph.D. MD. 1978. Zinc Other Micro-Nutrients, Trade Paperback, Keats Publishing, Incorporated. ISBN 0879831693. ^ Kavanagh JP, Darby C, Costello CB 1982. The response of seven prostatic fluid components to prostatic disease. Int. J. Androl. 5 5: 487-96. doi:10.1111/j.1365-2605.1982.tb00280.x. PMID 7174128. ^ Marmar JL, Katz S, Praiss DE, DeBenedictis TJ 1975. Semen zinc levels in infertile and postvasectomy patients and patients with prostatitis. Fertil. Steril. 26 11: 1057-63. PMID 1183629. ^ Balch, Phyllis A., CNC; Balch, James F., M.D. 2000. Prescription for Nutritional Healing. Avery Press, p. 597. ISBN 1-58333-077-1. ^ Milwaukee Journal Sentinel, Feb 10, 2002, Think zinc as way to boost your immune system. ^ A. Al Dayela and N. al-Zuhair 2006, Single drug therapy in the treatment of male sexual/erectile dysfunction in Islamic medicine, Urology 68 1, p. 253-254. ^ Brindley G Oct 1983. Cavernosal alpha-blockade: a new technique for investigating and treating erectile impotence Abstract. Br J Psychiatry 143: 332-7. doi:10.1192/bjp.143.4.332 inactive 2008-06-25. PMID 6626852. External links Erectile dysfunction at the Open Directory Project v d e WHO ICD-10 mental and behavioral disorders F · 290-319 Neurological/symptomatic Dementia Alzheimer's disease, multi-infarct dementia, Pick's disease, Creutzfeldt-Jakob disease, Huntington's disease, Parkinson's disease, AIDS dementia complex, Frontotemporal dementia, Elopement, Sundowning, Wandering · Delirium · Post-concussion syndrome · Organic brain syndrome Psychoactive substance alcohol drunkenness, alcohol dependence, alcoholic hallucinosis, Alcohol withdrawal, delirium tremens, Korsakoff's syndrome, alcohol abuse · opioids opioid dependency · sedative/hypnotic benzodiazepine withdrawal · cocaine cocaine dependence · general Intoxication, Drug abuse, Physical dependence, Withdrawal Psychotic disorder Schizophrenia disorganized schizophrenia · Schizophreniform disorder · Schizotypal personality disorder · Delusional disorder · Folie à deux · Schizoaffective disorder Mood affective Mania · Bipolar disorder · Clinical depression · Cyclothymia · Dysthymia Neurotic, stress-related and somatoform Anxiety disorder Agoraphobia, Panic disorder, Panic attack, Generalized anxiety disorder, Social anxiety, Social phobia · OCD · Acute stress reaction · PTSD · Adjustment disorder · Conversion disorder Ganser syndrome · Somatoform disorder Somatization disorder, Body dysmorphic disorder, Hypochondriasis, Nosophobia, Da Costa's syndrome, Psychalgia · Neurasthenia Physiological/physical behavioral Eating disorder: Anorexia nervosa · Bulimia nervosa Sleep disorder: Dyssomnia Hypersomnia, Insomnia · Parasomnia REM behavior disorder, Night terror · Nightmare Sexual dysfunction: Erectile dysfunction · Premature ejaculation · Vaginismus · Dyspareunia · Hypersexuality · Female sexual arousal disorder Postpartum depression · Postnatal psychosis Adult personality and behavior Personality disorder · Passive-aggressive behavior · Kleptomania · Trichotillomania · Voyeurism · Factitious disorder · Munchausen syndrome · Ego-dystonic sexual orientation · Fetishism Mental retardation Mental retardation Psychological development developmental disorder Specific: speech and language expressive language disorder, aphasia, expressive aphasia, receptive aphasia, Landau-Kleffner syndrome, lisp · Scholastic skills dyslexia, dysgraphia, Gerstmann syndrome · Motor function developmental dyspraxia Pervasive: Autism · Rett syndrome · Asperger syndrome Behavioral and emotional, childhood and adolescence onset ADHD · Conduct disorder · Oppositional defiant disorder · Separation anxiety disorder · Selective mutism · Reactive attachment disorder · Tic disorder · Tourette syndrome · Speech stuttering · cluttering v d e Diseases of the pelvis and genitals N40-N99, 600-629 Female Adnexa Ovary Oophoritis · Ovarian cyst · Ovarian hyperstimulation syndrome · Anovulation · Mittelschmerz Fallopian tube Salpingitis · Hydrosalpinx · Hematosalpinx Parametrium Parametritis Uterus Endometrium: Endometriosis Adenomyosis · Endometrial polyp menstruation Amenorrhoea, Anovulation, Hypomenorrhea, Oligomenorrhea, Menorrhagia, Menometrorrhagia, Metrorrhagia, Dysmenorrhea Hematometra · Retroverted uterus · Asherman's syndrome Cervix Cervicitis - Cervical polyp - Nabothian cyst Vagina Vaginitis Bacterial vaginosis, Atrophic vaginitis · Leukorrhea · Hematocolpos/Hydrocolpos intercourse Dyspareunia, Vaginismus Prolapse Cystocele, Rectocele, Urethrocele · Fistulae Vesicovaginal, Rectovaginal Vulva Vulvitis · Bartholin's cyst Other/general Pelvic inflammatory disease · Female infertility Habitual abortion Male Testicular Orchitis · Hydrocele testis · Testicular torsion · Male infertility Azoospermia, Oligospermia Epididymis Epididymitis · Spermatocele · Hematocele Prostate Prostatitis · Benign prostatic hyperplasia Penis Balanoposthitis/Balanitis · Phimosis · Priapism · Sexual dysfunction Erectile dysfunction · Peyronie's disease Other Hematospermia · Retrograde ejaculation See also congenital, neoplasia v d e Sex History History of human sexuality · History of erotic depictions · Sexual revolution Sexual acts Sexual intercourse foreplay · positions · Oral sex · Anal sex · Anal-oral sex · Group sex · Sexual sublimation · Barebacking · Dirty talk · Facial · Fingering · Fisting · Masturbation · Handjob · Non-penetrative sex · Sumata · Quickie Physiological events Ejaculation · Erection · Insemination · Orgasm · Pregnancy · Sexual arousal Health and education Andrology · Birth control · Erectile dysfunction · Gynaecology · Hypersexuality · Safer sex · Sexual dysfunction · Sex education · Sexually transmitted disease · Urology Identity Sexual identity · Sexual orientation Law Age of consent · Obscenity · Public indecency · Rape · Sexual assault · Sexual abuse · Sexual harassment Relationships and society BDSM · Incest · Marriage · Paraphilia · Prostitution · Religion and sexuality · Romance · Sexual abstinence · Sexual attraction · Sexual ethics · Sexual objectification · Sex surrogate · Sex tourism · Abortion Sex industry Artificial vagina · Dildo · Erotica · Lubricant · Paddle · Pornography · Vibrator · Sex doll · Sex toys · Sex shop · Adult video game Human sexual behavior · Human sexuality · Sexology · Sexual slang · Animal sexual behavior Retrieved from http://en..org/wiki/Erectile_dysfunction Categories: Sexual and gender identity disorders | Urology | Sexual health | Non-sexuality | PenisHidden categories: Pages with DOIs broken since 2008 | Semi-protected | All articles with statements | Articles with statements since June 2008 Views Article Discussion View source History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Català Česky Dansk Deutsch Español Esperanto Français Bahasa Indonesia Italiano עברית Latina Lietuvių Bahasa Melayu Nederlands ‪Norsk bokmÃ¥l‬ 日本語 Polski Português РуÑ?Ñ?кий SlovenÅ¡Ä?ina СрпÑ?ки / Srpski Suomi Svenska Tiếng Việt ייִדיש ä¸æ–‡ This page was last modified on 17 August 2008, at 09:27
39 Reasons to Drink Acai Juice Every Day
What is MonaVie - Watch the 8-minute video
Discovering MonaVie Video
The Power of You Video
Effects of MonaVie Active on Antioxidant Capacity in Humans
Log into your Wholesale MonaVie Account
So many of us do not eat a balanced diet, get enough sleep, have too much stress, or are impacted with toxins and pollutants. Drinking 2 ounces of MonaVie twice a day will help your body detoxify as well as build your immune system. Its the smartest thing you can do for yourself, so start today. Buying MonaVie through our company guarantees you support 7 days a week and, if you would like to share MonaVie with your family and friends we will guide you from start to finish.
1. Click on Enroll Now (30 - 55% off retail price)
2. Pay $39 for your Wholesale ID number.
3. NO minimum order required.
4. MonaVie is delivered to your door in 3 to 5 days.