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Study investigates how gender, sexual orientation influences orgasms

New study by researchers from the Kinsey Institute for Research in Sex, Gender and Reproduction at Indiana University investigates how orgasm occurrence varies by gender and sexual orientation, and finds that single women are less likely to experience an orgasm than single men. But lesbian women are more likely to orgasm during sex than bisexual or heterosexual women.

According to the researchers, an orgasm is characterized by “subjective feelings of intense sensation and pleasure, including a sudden discharge of accumulated erotic tension at sexual climax and a temporarily altered state of consciousness.” Although past studies have led to a better understanding of the mechanisms that trigger an orgasm, the team notes that it is unclear as to whether an individual’s sexual orientation influences orgasm occurrence.

"Understanding the factors that influence variation in orgasm occurrence among sexual minority populations may assist in tailoring behavioral therapies for those of different sexual orientations," say the researchers. "Moreover, to the extent that lack of orgasm is seen as a common and unwanted problem, learning more about orgasm in same-sex relationships may inform treatment for men and women in both same-sex and mixed-sex relationships."

Woman have more varied orgasms, despite sexual orientation. From an online questionnaire, Garcia and colleagues obtained data of 6,151 single men and women aged 21 and over. Participants disclosed their gender, sexual orientation (heterosexual, gay/lesbian, bisexual) and the percentage of time they spent having an orgasm when with a familiar sexual partner. For their final analysis, they included the data of 1,497 men and 1,353 women who had engaged in sexual activity in the past 12 months. Results of the study revealed that when with a familiar sexual partner, men experienced orgasm 85% of the time, while women only experienced orgasm 63% of the time. The team also found that the likelihood of having an orgasm varied by sexual orientation. Lesbian women had the highest chance of experiencing an orgasm at 75%, while heterosexual women and bisexual women had a 62% and 58% chance of an orgasm, respectively.

The team explains that this particular finding may be because lesbian women are more “comfortable and familiar” with the female body, therefore they are better at inducing orgasm in their female partners. Likelihood of an orgasm did not vary between men of different sexual orientations. Furthermore, the researchers found that compared with men, women had less predictable and more varied orgasms, despite their sexual orientation. “This is consistent with literature suggesting that male orgasm is subject to less inconsistency, seemingly regardless of sexual orientation, perhaps due to both sex-specific physiology and culturally reinforced gender roles that endorse male sexual activity and pleasure,” say the study authors.

Commenting on their overall findings, the researchers say: “These data demonstrate the need for further investigations into the comparative sexual experiences and outcomes of sexual minorities, to understand the mechanisms by which sociodemographics, and, in particular, sexual orientation, affects sexual health outcomes including orgasm experiences.”

The team notes that their study is subject to limitations. For example, they point out that they did not look at orgasm occurrence among individuals who had sex with an unfamiliar partner and note that this is something they plan to investigate in future research.

In addition, they note that they did not know the gender of the participants’ partners. This is particularly important when it comes to bisexual individuals, as they were not able to determine whether the gender of their partner influenced the occurrence of orgasms.

Filed under sex gender sexual orientation orgasm research

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Bisexual women have most health problems

A new report on the lives of lesbians, gays and bisexuals shows that the situation in most areas is comparable to that of heterosexuals. Still a small group shows signs of marginalization and minority stress. “The similarities are greater than the differences regarding quality of life. That suggests that the world is moving forward,” said Kirsti Malterud. She is one of the researchers behind a new report on the lives of lesbians, gays and bisexuals.”The previous Norwegian report on quality of life from 1999 presented a dismal picture. We have been keen to provide more nuances,” said Malterud, a doctor and researcher at Uni Health in Uni Research.

The study of quality of life of lesbians, gays and bisexuals shows that the situation in most areas is comparable to that of heterosexuals. Yet not everything is rosy.

Worst for bisexual women “We see signs of marginalization and minority stress in a small group. This group has more mental health problems, poorer self-rated health, more sexually transmitted diseases, experiences loneliness and includes several suicide attempts. This applies to a minority, but it’s serious,” said Malterud. Within this minority, bisexual women have the most problems, according to the research report.

"There have been few previous studies of the quality of life of bisexuals in particular, and we did not know much about this in advance. We found differences in the life situation for some people in this group, especially for women. And that means that bisexuals deserve more attention; they’re struggling more," said Malterud. "Have we reached our tolerance limit?"

The lives of bisexual women are inferior with regard to self-rated health, chronic illness, mental health, suicide attempts, harmful alcohol use and loneliness.

The survey also shows that a great many bisexual men and women hide their sexual orientation at work (78 percent of bisexual men and 68 percent of bisexual women). The corresponding figures for gays and lesbians are 18 and 9 percent respectively. “The fact that some are struggling is related to the attitudes of those around them. Perhaps there’s little room in our culture for people who don’t want to call themselves heterosexuals, gays or lesbians. Have we reached our limit of tolerance by accepting gays and lesbians, but then that’s enough?” asked Malterud. Not just in or out of the closet.

She thinks a diversity policy is needed and that society must become even more inclusive. “It’s not the case that it’s up to the individual to come out, this is a responsibility we all share.”

The researchers also collected 274 stories about being “in the closet.” These have provided new insights into what it means to hide one’s sexual orientation. “The stories show that it’s wrong to talk about living in the closet. It’s not a question of either staying in or coming out, but it’s about the fact that lesbians, gays and bisexuals in a variety of social arenas are doing different things to hide their sexual orientation and considering the consequences of revealing it,” added Malterud.

Positive feedback

Malterud has written the report: “Our report is important because of our sound methodological procedures. There is a strong probability that we can make definitive statements about differences in quality of life. This is because we used a national sample to be as representative of the Norwegian population as possible, while we also recruited large numbers of lesbians, gays and bisexuals and we asked heterosexuals the same questions.” “We’ve had a lot of positive feedback and it pleases me when people describe the report as nuanced and objective.”

No surprise. The report shows that 16 percent of the men in the sample would move away from a gay man on the bus. This comes as no surprise to Malterud. ”I’ve been out as a lesbian since I was 28, and I’ve felt good about it. But I’m used to it being an issue, and that people form opinions when I talk about my girlfriends. The 16 percent who would move away is less than before, but still enough to make you unsure of people’s reactions if you come out. But we have to be pleased that there’s progress,” concluded researcher Kirsti Malterud.

Filed under Bisexual women health problem Bisexual

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What Are the Best Drugs for Pro-Sexual Effects?

Q: “Besides anabolic steroids, what drugs are the most useful for pro-sexual effect? If I could pick several, how could I stack them? I don’t have an actual problem but would like to be a real animal at times of my choice.”

A: When it comes to pro-sexual effects, in terms of popularity and fame only, there are the PDE5 inhibitors. The main examples are sildenafil (Viagra) and tadalafil (Cialis).

These drugs inhibit the breakdown of cGMP in blood vessels filling the penis, providing some increase in blood flow relative to when the drug is not used.

So, the user gets a somewhat more pro-sexual effect than what he would have had anyway without the drug. One way of putting it is that the quality of the erection may increase by about a letter grade. A “B” grade erection would likely improve to an “A,” or a “C” grade erection might improve to a “B” or even a “B+.”

PDE5 inhibitors provide no increase in libido. The body can adapt to them, so I would avoid frequent use.

The melanocortin agonists are much more interesting. The principal example is Melanotan II. This is injectable peptides that is available as research chemicals. Opposite to the PDE5 inibitors, Melanotan II do nothing directly at the penis, but act at the brain to activate the nervous system. Erections typically are much more readily produced, and desire can increase.

Pro-sexual effect generally begins at least several hours after injection. The delay may be as much as 8 hours after injection, as an estimate.

Melanotan II also promotes tanning, and in some can increase or darken moles. Effective dose is about 1-2 mg. Many users will tan much darker from even only 30 mg total of Melanotan II or less.

Where estradiol levels are too high, an aromatase inhibitor can have prosexual effect by correcting this. Where testosterone or estradiol is low, often HCG can provide correction, which again may improve sexual function.

(HCG increases estradiol only a small amount, via increasing testosterone, but the amount can be enough to increase estradiol levels from below-normal to low-normal.)
It could be more important to correct underlying problems in these areas than to seek the above drugs.

Filed under sexual effect drugs cialis Tadalafil

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Impotence & Loss of Libido


there are any side effects associated with steroid use that most individuals would like to avoid, it is that of impotence and loss of libido. While these are common side effects of anabolic steroids use, many who suffer from them choose to remain quite, rather than seek help and suffer the perceived embarrassment of admission. This is unfortunate, as this experience is not a mark of male deficiency, but that of a drug-induced hormonal imbalance. There are several potential causes responsible for the appearance of these symptoms, all of which need to be treated in their own way if a speedy recovery is desired. In this article we will cover all the basic causes and cures for diagnosing and treating sexual dysfunction in the steroid user.

The following are the 4 primary causes of sexual dysfunction in anabolic steroids users: Personal response to specific steroids, estrogen imbalance, testosterone deficiency, and 5-AR inhibitor use. Let’s look at the first of these, which is personal response. Of all the various steroids available to the BB’r, two in particular seem to cause this problem most frequently. These are Nandrolone and Trenbolone. Not everyone will respond the same to these drugs when it comes to their effect on sexual function. A number of individuals can take large doses of either of these drugs, sometimes even combined, yet experience no issues at all. Others may run into problems under certain circumstances, such as when their test to nandrolone/trenbolone ratio is off. Others are very sensitive to the effects of these drugs and will have problems no matter what they do, encountering full-blown sexual dysfunction, regardless of dose, within just a few weeks.

Typically, if an individual is prone to experiencing sexual dysfunction from these steroids, such side effects will generally begin to immerge within about 5-6 weeks of initiating use and will continue to present themselves as long as the offending compound(s) are employed. Often, these symptoms will begin to dissipate within 5-10 weeks after discontinuance of the offending compound. Tren ace and NPP are usually quicker to recover from, due to their much shorter active life in the body, while a drug like Deca, which maintains a very long active life in the body, can continue to produce symptoms for a significantly longer period of time (Note: Just because a user may experience issues with one of these drugs, it does not necessarily mean he will have the same problem with another).

When sexual dysfunction is brought on by either nandrolone or trenbolone usage, there are 3 options for treatment. One, the individual can discontinue the offending drug completely and wait for the symptoms to abate. Two, he can manipulate his testosterone to nandrolone/trenbolone ratio and see if this helps correct the issue (For example, the individual may experience sexual dysfunction when administering 400 mg of test and 800 mg of deca, yet a complete cessation of symptoms may take place when reversing that ratio to 800:400, in favor of testosterone). Lastly, if the individual’s symptoms are prolactin related, the addition of an anti-prolactin drug into one’s program may alleviate symptoms.

Some individuals wrongly assume that all Nandrolone and/or Trenbolone induced sexual dysfunction is prolactin related, as these drugs tend to elevate prolactin levels, but this is not the case. In many instances, those who suffer from nandrolone/ trenbolone induced sexual dysfunction find no relief from their symptoms, despite taking large doses of anti-prolactin drugs. Blood work has further confirmed this to be the case, with several of my clients’ personal blood work readings revealing normal to below normal levels of prolactin after treatment with anti-prolactin drugs, only to find that they’re still experiencing the same degree of symptoms as they were prior to treatment. These results are indicative of alternate causes of sexual dysfunction in users of nandrolone/trenbolone, which are likely directly attributed to the drugs themselves and not related metabolites.

Another cause of sexual dysfunction in steroid users is estrogen imbalance; either too little estrogen or too much can bring about the same problems. The use of aromatizable drugs can result in excess estrogen levels, particularly when administered in the absence of anti-aromatase drugs (A.I.’s). It is important to note that just like with nandrolone or trenbolone induced sexual dysfunction, not everyone will have the same response to excess or deficient levels of estrogen. Many individuals can seemingly administer grams of testosterone without making any attempt to manage systematic estrogen and experience no problems whatsoever. Others will not be so fortunate, with testosterone levels even slightly outside the normal physiological range being problematic.

The only surefire way to ensure that estrogen is properly controlled is through physician monitored blood work. Otherwise, one’s best guess is just that…a guess. The goal of the steroid user should be to keep estrogen in a normal male range. Contrary to popular belief, there is no medical evidence that suggests excess estrogen levels results in greater muscle growth in men. Still, estrogen does play several roles in the muscle growth process, both directly and indirectly, so unless future evidence contradicts the current position, maintaining levels within a normal range is considered ideal. Today we are fortunate enough to have several potent, prescription A.I.’s available for use, all of which are quite effective in the management of estrogen levels, regardless of the steroid type or dosage employed.

DHT is an essential male hormone, critical for the development and maintenance of normal male characteristics and physiology, including sexual function. Inadequate levels may precipitate a cascade of negative events, including erectile dysfunction and loss of libido. Under normal circumstances, the body produces its own DHT through converting a portion of freely circulating testosterone into the target hormone. However, since exogenous AAS suppress endogenous testosterone production, they’re also indirectly responsible for suppressing DHT production. Therefore, the inclusion of testosterone into one’s cycle is mandatory if the individual wishes to maintain sufficient DHT levels.

Cycles void of testosterone will usually begin to display the initial signs of sexual dysfunction around week 4 or later, as the body’s negative feedback system will immediately sense a rise in androgen blood levels and react accordingly by decreasing testosterone production. Since the amount of steroid hormone administered during a cycle will elevate one’s androgen blood level well into the supraphysiological range, testosterone production will continue to decrease until it is almost non-existent.

The preferred method of treatment for DHT deficiency is simple…use testosterone. In those who have been running cycles in the absence of this parent hormone and suffered the consequences, its subsequent inclusion will result in a speedy alleviation of symptoms. One does not necessarily have to use supraphysiological doses of testosterone in order to experience normalcy in the bedroom; more moderate doses are usually sufficient.

The last factor we are going to look at involves the use of 5-AR inhibitors. This class of drugs is used to prevent or slow the balding process, but is prone to causing all the same side effects associated with deficient DHT levels from other causes. The likelihood of experiencing sexual dysfunction when using a 5-ARinhibitor is highly dependent on the dosage employed. When deciding whether these drugs are right for you, make sure to weigh all your options before proceeding Often, 5-AR inhibitors can be avoided altogether simply by adjusting one’s cycle design, to incorporate drugs which are not known to cause androgenic alopecia ands by avoiding drugs (or minimizing the dosage) which commonly result in hair loss. The number of potential cycles is massive and one should not automatically dismiss an alternative approach just because it strays from the conventional format. So long as the cycle suits one’s goals and keep the BB’rs health in mind, that is all that matters.

Diagnosing the cause of sexual dysfunction in a BB’r is not always easy, especially when multiple potentially causative factors are present at one time. In cases like this, troubleshooting may be necessary in order to determine the true cause and eliminate it accordingly. There is merit to be found in trying one new PED at a time. By doing so, the individual will know exactly how the new drug is affecting him, without receiving mixed feedback from other new drugs at the same time and having no way of determining which drug is doing what. Sexual dysfunction may be one of the least enjoyable side effects of AAS use, but unlike many other side effects, it is avoidable in every case.

Filed under libido impotence anabolic steroids

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Sexual Dysfunction Study Reveals Poor Hormonal Health in Women and Men

Sexual dysfunction is reaching levels not seen since the Victorian period. But today’s difficulties stem not from the inhibiting power of social mores and taboos. Today’s sexual dysfunction is an alarming indicator of the hormonal status of women and men. A recent study found that 31 percent of men suffer from problems such as erectile dysfunction, premature ejaculation, delayed ejaculation and impotency. A whopping 43 percent of women reported problems such as loss of desire, decreased arousal, inability to have an orgasm and painful intercourse. Amazingly, only 12 percent of these women said they were concerned about their declining sexuality.

The study, led by researchers from Massachusetts General Hospital found this disheartening information by surveying 32,000 women across the U.S., age 18 to older than 100. The researchers asked the women standardized questions about their sexual health, and used a Female Sexual Distress Scale to quantify the women’s levels of concern about their diminishing sex lives. The scale was designed to assess feelings of unhappiness, anger, guilt, embarrassment, frustration, and worry.

43 percent of all the respondents reported some level of sexual dysfunction, 39 percent reported lack of desire, 26 percent reported arousal problems, and 21 percent had difficulty reaching orgasm. The study’s lead doctor reported belief that sexual problems are commonplace among women, while problems of personal distress related to the sexual dysfunction can affect a woman’s quality of life. He reported belief that a sexual concern is not a medical problem until it is associated with distress, an opinion that reflects the inability of traditional doctors to realize that sexual problems do not exist in a vacuum but are symptomatic of hormonal decline and imbalance and perhaps also poor overall general health.

Responses were often characterized by age differences. Older women had more sexual dysfunction but cared about it less. The most distress occurred in women age 45 to 65, the age of the midlife crisis or role adjustment period. During this time period women are experiencing menopause and may be also be in the midst of changing identify expectations, whether they want to be or not.

Although the researchers did not look at the specific reasons why older women had more problems but less distress about them, they speculated the reasons could include partner changes, medical conditions, or problems with their partner’s health. Women in the youngest group had the lowest number of sexual problems and distress.

These finding are consistent with those from a 1999 study that evaluated the prevalence of sexual dysfunction among American women. This study found that about 43 percent of women reported having sexual dysfunction. This doctor also regarded the study findings as important only to the extent that dysfunctional women were disturbed by their dysfunction.

According to the lead doctor from the Massachusetts study approximately one in eight women is sexually dysfunctional and distressed by her dysfunction. For these women he recommended relationship counseling, treatment of associated medical conditions, and sex therapy.

Counseling and sex therapy will have little effect on a woman who is sexually dysfunctional because her levels of sex hormones have declined and become unbalanced to the point where she can no longer feel sex. Grabbing onto such an easy, generic answer reflects a complete disregard for the root of the problem and for the person experiencing it.

A human’s sexuality is as essential to overall health as all the other body systems. If a person’s cardiovascular or detoxification systems stop working, it is taken seriously. But if it is the sexual system that no longer works it is considered a non event unless it is troubling to the person experiencing it. Then it is turned into a psychological issue that requires counseling. Is this totally clueless response an admission that women in the U.S. aren’t really supposed to be sexual beings at all, so when sexuality goes away it is just fine? Is it an expression of how much our puritanical roots remain? Will these doctors be worried when they lose their sexuality?

The women in the study with the greatest concern about their loss of sexuality were in the age group from 45 to 65. Women in this age group are in serious hormonal decline. Their issue is physiological, and they are worried because on some level they know what their sexual dysfunction really means. It is their calling card from a future of declining health status, degenerative disease, failing memory, brittle bones, and the nursing home. A woman with sexual dysfunction sends a powerful message to nature announcing that the possibility of reproduction has ended and she is no longer needed in the grand scheme of life.

Other symptoms that go along with loss of sexuality are bloating, hot flashes, anger, exhaustion and fatigue, body itches, weight gain, allergies, vertigo, and foggy thinking. Eyes dry up and so do all the other juices of the body. In addition to the inability to feel sex, sex is no longer pleasant because it has become painful from lack of natural lubrication. Vaginal tissue thins and loses its muscle tone. Body parts that were once so alive and responsive are now as if death has set in. Losing sexuality is like losing your arm. Life is never the same again without it.

Along with sexual dysfunction, the loss of hormones means the loss of protection against many of the diseases and disabilities that plague people in this age group. It is estrogen, progesterone and testosterone that protect women from breast cancer. Women rarely develop cancer until their hormone levels have declined dramatically. It is testosterone that protects the hearts of women. Testosterone is an anabolic steroid, a muscle builder and supporter. The heart is one of the muscles in the body and needs testosterone to keep it working at its prime. Women do not usually experience heart attacks until their hormone levels have fallen, and after that heart disease is listed as the number one killer of women, although the real killer is lack of hormones. Testosterone is also an integral part of the female sexual response. While estrogen lubricates the vagina, testosterone is the hormone of the orgasm. Sex hormones protect the skeleton and keep bones strong. They protect the brain. Alzheimer’s disease is not seen in women with a full complement of hormones.

The older group of women, those over the age of 65, who reported no concern over their sexual dysfunction have probably forgotten what it was like to be a sexual being. This is the group that has been without hormones for awhile, long enough for sexual memory to have faded or disappeared completely along with the ability to remember in general.

Women who are in the younger group and experiencing sexual dysfunction are most likely in the stage known as peri-menopause. In this stage estrogen is still there but has become out of balance usually because of a shortage of testosterone and progesterone. This is the group experiencing PMS, often the first signal that hormone levels are out of balance.

It does not have to be this way. Sexuality comes rushing back with hormonal balance. Many women report that regaining and balancing their hormones with the use of bioidentical hormone replacement allows them to experience a sex life like they have never experienced before. The period of life from age 45 upward is a time when many life tasks that once interfered with sexuality have been completed. It is a time when sexuality can reach a maturity that was not known at an earlier age.

It may take some work to get hormones in perfect amounts and balance, but it is well worth the effort. Hormone balancing with bioidenticals brings renewed sexuality and the ability to experience sex with a new appreciation. It also brings balance, energy and light to all the body organs and systems. It fills the body with energy and the mind with clarity and new thirst for knowledge. It brings muscle tone, balance and the desire for movement to the body. It brings shine to the hair, suppleness to the skin, and bounce to the step

Hormone balancing can be done on your own. Books written by doctors who have specialized in hormonal balance as part of their obstetrical/gynecological practice are available. These books give the precise directions, sources and amounts needed to restore the body to hormonal balance. However, much trial and error can be avoided by finding a doctor who specializes in anti-aging medicine or hormone balancing.

Start the quest for hormonal balance when the first signs of imbalance appear. Starting early will save many years of living at less than your full potential. If you have already begun to fall apart, it is not too late. Hormone balancing is appropriate at any stage of life and can add new quality to the remaining years. Women in their sixties and older may not be having hot flashes anymore, but they have joint pain, neck pain, arthritis, irritable bowel syndrome, cardiovascular disease, osteoporosis, brain fog and memory problems, cancer and dementia. All of these conditions can be improved by bioidentical hormone replacement at any age.

The erectile dysfunction, ejaculation timing issues and impotence reported by 31 percent of men are major signposts of hormonal decline. Production of the primary male sex hormone, testosterone, begins to decline from the age of 30 and continues. Falling levels of testosterone are responsible for men’s sexual dysfunction along with decreased muscle mass and bone density, insulin resistance, and depression. A recent study showed that low testosterone levels increased the risk of death in men from all causes by as much as 88 percent. Testosterone builds and strengthens bone and muscle. Optimal levels of testosterone are essential for preventing the heart attacks so frequent in men over 40.

Bioidentical replacement of testosterone allows men to regain their sexual functioning as well as the energy and joy for living that characterized their youth. When testosterone is replaced a signal is sent to nature that this man is still young and virile, the kind of guy that still has a place in the grand scheme of life.

Hormones cannot fully restore sexuality if the body if inflamed, stressed, or poorly nourished. The entire body needs to be functioning properly for a person to fully revive sexuality. Sexual health is part of general health and wellness. This includes good nutrition from a diet of whole foods, daily exercise, stress management, a full night’s sleep of eight hours or more, and having a purpose in life. It also means getting toxic chemicals out of the body, bathroom and kitchen.

Filed under sexual dysfunction men woman hormones

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Relationship stress may lead to early death

Family arguments and other relationship stresses could lead to premature death, a new study suggests.

This is the finding of a paper written by researchers at the University of Copenhagen, who analysed data relating to 9,875 Danish men aged 36 to 52 to examine the correlation between relationship stress and death in middle age.

The statistics had been collected for a previous project, entitled the Danish Longitudinal Study on Work, Unemployment and Health, which had taken place in 2000. Figures showed that people who were often worried or stressed due to demands and circumstances relating to their partners and children were between 50 and 100 % more likely to die prematurely.

In addition, the study found frequent arguing tended to increase a person’s mortality risk by two or three times, while men were more likely to be affected by high stress levels and early death rates if they were out of work, as this often increased pressure on home life.

Overall, men were the gender most affected, with their premature death rate being significantly higher than both women and that of healthy males.
This is thought to be due to increased levels of cortisol - a hormone released when a person is stressed - which can have a negative impact on health.

For example, previous research has shown that high levels of stress and anxiety can lead to high blood pressure, which in turn can result in cardiovascular disease and a potentially fatal heart attack.

The study states: ‘Men respond to stressors with increased levels of cortisol, which may increase their risk of adverse health outcomes.’
Other factors also played a part, such as an individual’s personality and their ability to cope with stress.

Lead author of the study Dr Rikke Lund suggests relationship counselling and other methods of intervention could help decrease this premature death risk among couples who often argue. She said: ‘Intervening in conflicts, particularly for those out of work, may help to curb premature deaths associated with social relationship stressors.’

Filed under stress death relationship

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Erectile Function and Fatigue

Most men find that their sexual desire increases after they start testosterone replacement. Sexual dreams and nighttime/morning erections may be more easily achievable, but in some cases testosterone alone does not make erections strong or lasting enough for successful intercourse.

For these men the use of prescription phosphodiesterase type 5 inhibitor (PD-5) medications like Viagra, Cialis, and Levitra - may be needed in combination with testosterone replacement. However, some men do not respond well to these oral agents or have side effects such as headaches, nasal congestion, flushing, gut problems, and, in the case of Cialis, back pain. Cialis may last longer than the others (36 hours compared to 4 hours for Viagra or Levitra), but so may its side effects. Some men take ibuprofen with these drugs to pre-treat nasal congestion and headaches, respectively. Cialis is also approved for daily use at 5 or 10 mg/day dose (regular dose is 20 mg/day). They are available by prescription but I have heard that some men are ordering them without a prescription from overseas websites to save money (overseas sources can be ten times cheaper than products in the United States). This book does not endorse the use of these drugs without a prescription, but it is my duty to mention facts about what is happening out in the real world.

Other options for men who need an extra erectile boost while using testosterone replacement:

Yohimbine - increases sex organ sensitivity. It can raise blood pressure and cause insomnia and anxiety, so talk to your doctor. A small study showed that men who used yohimbine with the amino acid arginine had better erections

Penile restriction rings—These rubber or leather restricting bands (commonly known as “cock rings”) can be very effective at maintaining erections after the penis fills up with blood. Be careful not to use it too tight. Neoprene and leather rings are the most common. They can be found online.

Other options are penile vacuum devices and penile implants. Due to the scope of this book, these two options will not be reviewed. Plenty of information can be found by Googling those terms.

Medications that could cause decreased sex drive or erectile dysfunction:

Medications can cause erectile dysfunction in some men. A great review of all studies of drugs that affect sexual function in men was provided by Dr Walter K.H. Krause. He was able to identify evidence from different studies (many uncontrolled and small) about the common classes of prescription medications that can cause erectile dysfunction. It is not known if testosterone replacement can counteract the effects of these medication classes.

Among the medications are:

  • Antidepressants: Selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, monoamine oxidase inhibitors
  • Blood pressure medications (antihypertensives): Alpha andregenergic antagonists, beta-blockers, diuretics, guanethidine, methyldopa
  • Narcotics and opiates
  • Barbiturates and benzodiazepines
  • Hormone related products: anabolic steroids, antiandrogens used in prostate cancer, estrogens, medroxyprogesterone, 5-alpha-reductase inhibitors
  • Anti-acids: Histamine 2 receptor antagonists, proton pump inhibitors
  • Cholesterol –lowering agents: Bile acid sequestrants, fenofibrates, statins


If no improvements in fatigue are observed after 6 weeks of testosterone replacement, factors beyond hypogonadism may be present. Thyroid and adrenal function should be checked to ensure that those two glands are working properly Sleep apnea can also be a factor involved in the failure to improve stamina. Depression may still need to be addressed with the proper medications and counseling.

Thyroid Function:

The thyroid is a butterfly-shaped endocrine gland located in the lower front of the neck. It produces thyroxine or T4, which is converted to tririodothyronine, or T3. T4 production is controlled by thyroid stimulating hormone or TSH, a hormone produced by the pituitary. Hypothyroidism, or low thyroid hormone, can cause sexual dysfunction as well as depression, fatigue, dry skin and hair, weight gain and increased sensitivity to the cold. Blood tests to measure TSH, T4 and T3 are readily available and widely used.

Adrenal Function:

The adrenal glands, located in the abdomen above the kidneys, regulate stress in the human body. When the body encounters an emergency situation, the adrenal glands release hormones, such as adrenaline, that enable the body to respond accordingly. You may have encountered this reaction, called the “fight or flight” response, if you have encountered danger, fear or shock. Adrenal fatigue is the controversial idea that the adrenal glands can become worn out, creating illness, if continually over stimulated. Proponents of the “adrenal fatigue” theory hold that the adrenal glands may be over worked in some individuals and therefore become “fatigued” and unable to produce sufficient hormones. When your adrenal glands become exhausted, your natural cortisol levels drop significantly. Cortisol is your naturally occurring stress hormone. In addition to low sex drive and infertility, symptoms of adrenal fatigue may include chronic fatigue, low blood pressure and low blood sugar, dizziness, headaches, anxiety or panic attacks, depression,and other equally debilitating reactions. Some doctors may prescribe low doses of corticoid steroids if your morning levels of cortisol (measure by blood, saliva or urine tests) are low. But be careful with corticoid steroids since they can increase fat mass and decrease bone density if given in doses that exceed what the healthy adrenals would produce.

The adrenal glands also produce dihydroepiandrosterone (DHEA), the most abundant hormone found in the blood stream. The body uses DHEA as the starting material for producing the sex hormones testosterone and estrogen in men. Studies have shown that it only increases testosterone in women. The production of DHEA diminishes in most people after age 40. In people aged 70 years, DHEA levels will be approximately 30 percent lower than what they were at age 25. Low blood levels of DHEA have been associated with many degenerative conditions. Some controversial and non-conclusive studies have shown that people with immune deficiencies and fatigue may benefit from supplementation with this hormone. It is still available over-the-counter in the United States. This may change soon due to a new bill passed by Congress that classifies it as a performance-enhancing steroid (no studies have shown that it has such effect). One study showed that women with the correct levels of DHEA can convert it into testosterone as their body needs while men do not benefit to the same degree. You need a blood test to know if you have low DHEA-S since most of the DHEA converts into this sulfated form. Common doses for women are 5to 30 mg a day, while men tend to benefit from 25-100 mg per day (to bring low levels of DHEA-S to normal) All the hormones mentioned can be tested with blood tests or by using the easy-do-it-at-home mail order saliva hormone tests that are permissible without a prescription.

Sleep Apnea:
Sleep apnea is a sleep disorder in which the patient briefly stops breathing or breathes shallowly many times during sleep and therefore does not get enough restful sleep; oxygen levels drop in the blood, starving the brain of oxygen. In addition to causing daytime fatigue, it can increase blood pressure and cardiovascular risks. Testosterone-replacement therapy has been associated with exacerbationof sleep apnea or with the development of sleep apnea,generally in men who use higher doses of testosterone orwho have other identifiable risk factors for sleep apnea (high body weight, thick necks, snoring, alcohol consumption, and others). Upper-airwaynarrowing does not seem to be caused by testosterone replacement therapy,suggesting that testosterone replacement contributes to sleep-disordered breathing by central mechanisms rather than by means of anatomicalchanges in the airway. If your spouse or partner complains that you snore loudly at night and you suffer from fatigue, tell your doctor. The only real way to find out if you have sleep apnea is to have your doctor refer you to a sleep lab for a sleep study. If you are diagnosed with sleep apnea, a Continuous Pressure Airway Pressure (CPAP) machine can be prescribed to help you open up your airways with a small air pump while you sleep. Some people love it while some hate wearing a mask while being hooked up to a machine at night.

PERSONAL COMMENTS: Because of terrible bouts with fatigue in the past, I was referred to a sleep lab and diagnosed with mild sleep apnea. I tried CPAP with different masks (they are smaller ones with “nose pillows” and many other designs, so don’t give up early without trying different styles). I could not get used to it. I have had my thyroid and adrenal functions checked without finding any problems.Unfortunately I get anxious if I use them for long periods, so I only use them as needed. What has made the most difference, besides keeping my testosterone in the upper side of the normal range, is going to bed around the same time at night and waking up also at the same time. Traveling and other factors can interfere with maintaining a normal sleep cycle, but the fact is I need to listen to my body’s needs. I can usually be tired enough to get better sleep by the time bedtime arrives if I avoid caffeine after 3 pm and don’t exercise too late at night.

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Spider venom shows promise for treating erectile dysfunction

A toxin synthesized from the venom of a spider may offer an alternative to today’s erectile dysfunction drugs, a new study suggests.

The toxin, unpoetically named PnTx2-6, comes from the bite of the Brazilian wandering spider (Phoneutria nigriventer). In humans, a bite from a wandering spider is very painful. What’s more, male victims may find themselves with priapism, or unrelenting and painful erection. It was this symptom, turning up in emergency rooms after spider bites in Brazil, that first alerted researchers to the potential of PnTx2-6 as an erectile dysfunction drug.

The toxin has been shown to improve erections in rats with hypertension and diabetes; now, researchers have tested it in aging mice and found that the toxin is effective in reversing age-related erectile dysfunction as well. ”It’s working in aging, which is a natural process,” study researcher Kenia Nunes, a physiologist at Georgia Health Sciences University, told  ”It’s not just in disease.”

Viagra, Levitra and other erectile dysfunction drugs on the market work by inhibiting an enzyme called PDE5. To get an erection, a man’s body must release nitric oxide, which relaxes the smooth muscle around the arteries of the penis, allowing for his blood vessels to dilate. The nitric oxide is a first step in a series of chemical reactions that allow this muscle relaxation to take place. One step in the series is cGMP, a signaling molecule that acts to keep the muscles relaxed. PDE5 degrades cGMP. That’s a good thing for ensuring that erections don’t last forever, but too much PDE5 can mean an erection doesn’t happen at all. By blocking the enzyme, PDE5 inhibitors solve the problem.

The spider toxin works differently. Instead of affecting PDE5, the compound seems to trigger nitric oxide release, acting directly to relax the smooth muscles. Because about 30 percent of patients don’t respond to PDE5 inhibitors, the toxin could provide an alternative to erectile dysfunction treatments currently on the market, Nunes said.
In the new study Nunes and her colleagues injected aging and young rats with the toxin extracted from the spider venom. They found that the toxin reversed age-related erectile dysfunction, offering hope that the toxin could eventually move out of animal testing and into human use. The toxin has not yet been tested in humans.

The researchers have since developed a synthetic version of the toxin. The next step, Nunes said, is to make sure that the compound doesn’t have any nasty effects beyond its intended purpose.

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Men with diet-induced erectile dysfunction may benefit from hitting the gym

Obesity continues to plague the U.S. and now extends to much of the rest of the world. One probable reason for this growing health problem is more people worldwide eating the so-called Western diet, which contains high levels of saturated fat, omega-6 polyunsaturated fatty acids (the type of fat found in vegetable oil), and added sugar. Researchers have long known that this pattern of consumption, as well as the weight gain it often causes, contributes to a wide range of other health problems including erectile dysfunction and heart disease. Other than changing eating patterns, researchers haven’t discovered an effective way to avoid these problems.

Searching for a solution, Christopher Wingard and his colleagues at East Carolina University used rats put on a “junk food” diet to test the effects of aerobic exercise. They found that exercise effectively improved both erectile dysfunction and the function of vessels that supply blood to the heart.


For 12 weeks, the researchers fed a group of rats chow that reflected the Western diet, high in sugar and with nearly half its calories from fat. Another group of rats ate a healthy standard rat chow instead. Half of the animals in each group exercised five days a week, running intervals on a treadmill.

At the end of the 12 weeks, anesthetized animals’ erectile function was assessed by electrically stimulating the cavernosal nerve, which causes an increase in penile blood flow and produces an erection. The researchers also examined the rats’ coronary arteries to see how they too responded to agents that would relax them and maintain blood flow to the heart, an indicator of heart health.


The findings showed that rats who ate the Western diet but stayed sedentary developed erectile dysfunction and poorly relaxing coronary arteries. However, those who ate the diet but exercised were able to stave off these problems.

Animals who ate the healthy chow were largely able to avoid both erectile dysfunction and coronary artery dysfunction.

Importance of the Findings

These findings may suggest that exercise could be a potent tool for fighting the adverse effects of the Western diet as long as the subjects remained very active over the course of consuming this type of diet, the authors say. Whether exercise would still be effective in reversing any vascular problems after a lifetime of consuming a Western diet is still unknown.

"The finding that exercise prevents Western diet-associated erectile dysfunction and coronary artery disease progression translates to an intensively active lifestyle throughout the duration of the ‘junk food’ diet," the authors say. "It remains to be seen if a moderately active lifestyle, or an active lifestyle initiated after a prolonged duration of a sedentary lifestyle combined with a ‘junk food’ diet is effective at reversing functional impairment."

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Tadalafil Succesfully Treated Erectile Dysfunction


A study of the investigational drug Tadalafil, an oral PDE5 inhibitor, found that it increased intercourse success in men with erectile dysfunction (ED) at up to 36 hours after dosing. The study was conducted by Dr. Hartmut Porstclinical investigator in private urological practice in Hamburg, Germany and the international tadalafil study group.

In the study, 348 men with mild to severe ED were given either Tadalafil 20-mg or placebo. Patients were asked to attempt intercourse on four separate occasions: once 24 hours after a dose, once again 24 hours after a dose, once 36 hours after a dose, and once again 36 hours after a dose.

Tadalafil significantly increased the percentage of successful intercourse attempts at 24 hours (57 percent) and 36 hours (60 percent) post dose compared with placebo (31 percent and 30 percent, respectively). Secondary measures of efficacy — penetration ability, hardness of erection, overall satisfaction - showed tadalafil to have greater efficacy than placebo at both 24 hours and 36 hours post dose.

Tadalafil was well tolerated; headache, flushing and dyspepsia (upset stomach) were the most common side effects, but most were mild to moderate in intensity. The extended duration of effectiveness did not appear to increase the rate of side effects or their severity, and very few patients receiving placebo or tadalafil discontinued due to side effects.

"We are very pleased to see that tadalafil allowed a majority of men in this trial to achieve normal sexual functioning at up to 36 hours after taking the drug," said Dr. Porst. "The extended duration of responsiveness may help eliminate the need for planning sexual intimacy and could potentially set new expectations in the treatment of ED."

Erectile dysfunction is the consistent inability to attain or sustain an erection adequate for satisfactory sexual intercourse. It is estimated to affect more than 30 million men in the United States.

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Bisexual men face unique challenges to their sexual health

Bisexual men have many unmet public health needs, which leave them vulnerable to sexually transmitted infections (STIs) and other health problems. This new study from the Centers for Disease Control and Prevention (CDC) illuminates the behavioral, interpersonal, and social realities of men who have sex with men and women (MSMW), and it explores possible interventions to better serve their needs.

MSMW represent a small portion of the population, with about 2% of sexually active males reporting sex with both men and women. Although low in numbers, the bisexual male population is disproportionally affected by HIV and STIs. According to study author William L. Jeffries IV, PhD, MPH, MA, factors that may affect the sexual health of MSMW include sex without condoms, early sexual debut, forced sexual encounters, increased numbers of sexual partners, substance use, exchange sex, risk behaviors of their male and female partners, and attitudes toward pregnancy. These factors shape MSMW’s vulnerability to HIV and STIs in ways that distinguish bisexual men from gay and heterosexual men. Negative attitudes toward bisexual individuals, economic barriers, masculinity norms, and the meanings associated with their sexual identities are among the social factors that may negatively influence their sexual partnerships and risks for HIV/STIs.

While HIV prevalence among MSMW is lower than among gay men, MSMW are more likely than heterosexual men to become infected with HIV. Also, MSMW are less likely than gay men to be tested for HIV, which can lead to undiagnosed HIV and transmission to partners. Along with HIV, other STIs are common among MSMW, with 21% of these men reporting STI treatment in the past year, compared to 12% for gay men and 2.3% of heterosexual men.

"MSMW’s increased likelihood of insertive sex without a condom, as well as commonly occurring oral sex with men and women, likely increase MSMW’s vulnerability to STIs readily acquired via penile-insertive and oral sex," writes Dr. Jeffries. "Moreover, receptive and insertive sex without a condom with men (no matter how common) makes MSMW more vulnerable to HIV than men who only have sex with women because HIV is more prevalent among men than women in the United States."
Dr. Jeffries also identifies other behavioral factors that may increase chances of acquiring HIV and STIs among MSMW, including early sexual experiences, multiple partners, illicit drug use, and attitudes towards pregnancy.

"MSMW’s attitudes toward pregnancy influence their sexual health. Qualitative data from black men suggest that desires to prevent pregnancy may prompt some MSMW to consistently use condoms with women," Dr. Jeffries explains in the paper. "Yet, MSMW may avoid condom use when their female partners use other contraceptives or when female partners perceive condom use as a sign of relationship infidelity. Further, MSMW’s desires to produce offspring biologically may prompt sex without a condom with female partners. In this regard, desires for fatherhood may indirectly increase these men’s vulnerability to HIV/STIs and transmission of these infections within their sexual networks."

In the current social climate, MSMW face several sociocultural obstacles including biphobia, or negative attitudes towards bisexuals.
"Biphobia can manifest in erroneous beliefs that MSMW are gay men who have not disclosed their sexual orientation and, particularly for black men, responsible for HIV transmission to women," Dr. Jeffries adds. "Experiencing these sentiments can contribute to MSMW’s social isolation and psychological distress, which in turn may promote HIV/STI risk through substance use, sexual risk behaviors, and the avoidance of prevention services."

This new research not only describes an understudied population, but also recommends interventions to better serve bisexual men. Dr. Jeffries suggests that some strategies for comprehensively promoting MSMW’s sexual health may be to:

  • Launch social marketing campaigns that use affirmative images of sexual minority men to counteract the biphobia and homophobia that MSMW experience 
  • Develop comprehensive sexuality education programs that provide invaluable HIV/STI prevention education to MSMW, including promoting school safety for MSMW 
  • Encourage social spaces that cultivate a sense of community to provide opportunities for social support and candid discussion of sexual health concerns 
  • Engage medical and health professionals in sensitivity trainings to lessen any hostility encountered by MSMW when they seek information about sexual health or HIV/STI testing

While more research and outreach is needed to better understand the particular health and other needs of bisexual men, this study sheds new light on the current situation.

"Sexual health promotion for MSMW should not be limited to HIV/STI prevention alone," concludes Dr. Jeffries. "Recognition of MSMW’s unique sexual and social experiences can lay the foundation necessary for ensuring that these men have healthy and fulfilling sexual experiences. Purposefully designed and tailored efforts for MSMW are indispensable for improving the sexual health of this vulnerable population.

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Headaches during sex likely more common than reported

About 1 % of adults report they have experienced headaches associated with sexual activity, and that such headaches can be severe. But the actual incidence is almost certainly higher, according to a Loyola University Medical Center neurologist and headache specialist.

"Many people who experience headaches during sexual activity are too embarrassed to tell their physicians, and doctors often don’t ask," said Dr. Jose Biller, who has treated dozens of patients for headaches associated with sexual activity (HAS). Biller is chair of Loyola’s Department of Neurology, and is certified in Headache Medicine by the United Council for Neurologic Subspecialties. Comedians have long joked about spouses avoiding sex by claiming to have a headache. But sex headaches are not a laughing matter, Biller said.

"Headaches associated with sexual activity can be extremely painful and scary," Biller said. "They also can be very frustrating, both to the individual suffering the headache and to the partner."

Headaches in general usually are caused by disorders such as migraines or tension-type headaches. But headaches also can be secondary to other conditions, and some of these conditions can be life-threatening.

The vast majority of headaches associated with sexual activity are benign. But in a small percentage of cases, these headaches can be due to a serious underlying condition, such as a hemorrhage, brain aneurysm, stroke, cervical artery dissection or subdural hematoma. “So we recommend that patients undergo a thorough neurological evaluation to rule out secondary causes, which can be life-threatening,” Biller said. “This is especially important when the headache is a first occurrence.”
Sexual activity is comparable to mild- to moderate-intensity exercise. The ancient Greek physician Hippocrates first noted the association between headaches and exercise and sexual activity. And in 2004, the International Headache Society classified HAS as a distinct form of primary headache.

Biller said men are three to four times more likely to get HSAs than women. There are three main types of sex headaches:

  • A dull ache in the head and neck that begins before orgasm, and gets worse as sexual arousal increases. It is similar to a tension headache.
  • An intensely painful headache that begins during orgasm and can last for hours. It’s called a thunderclap headache, because it grabs your attention like a clap of thunder. One of Biller’s patients, who asked to remain anonymous, described such a headache this way: “All of a sudden, there was a terrific pain in the back of my head. It like someone was hitting me with a hammer.”
  • A headache that occurs after sex and can range from mild to extremely painful. The headache gets worse when the patient stands, and lessens when the person lies back down. This headache is caused by an internal leak of spinal fluid, which extends down from the skull into the spine. When there’s a leak in the fluid, the brain sags downward when the patient stands, causing pain.

Depending on the type of headache, certain medications can help relieve the pain or even prevent the headache, Biller said.
Individuals can reduce their risk of sex headaches by exercising, avoiding excessive alcohol intake, keeping a healthy weight and counseling, Biller said.

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New insights into premature ejaculation could lead to better diagnosis

There are many misconceptions and unknowns about premature ejaculation in the medical community and the general population. Two studies provide much-needed answers that could lead to improved diagnosis and treatment for affected men.

Premature ejaculation can cause significant personal and interpersonal distress to a man and his partner. While it has been recognized as a syndrome for well over 100 years, the clinical definition of premature ejaculation has been vague, ambiguous, and lacking in objective and quantitative criteria. This has made it difficult for investigators to conduct clinical trials on experimental drugs and for doctors to effectively identify and treat affected patients. In 2008, the International Society for Sexual Medicine issued a definition of lifelong premature ejaculation, but a definition has been lacking for acquired premature ejaculation. “The lack of an evidence-based definition for acquired premature ejaculation promotes errors of classification, resulting in poorly defined study populations and less reliable and harder-to-interpret data that are difficult to generalize to patients,” said Ege Can Serefoglu, MD, FECSM, of the Bagcilar Training & Research Hospital, in Istanbul, Turkey.

By reviewing and evaluating the medical literature, Dr. Serefoglu and his colleagues on the Second International Society for Sexual Medicine Ad Hoc Committee now provide a unified definition of lifelong and acquired premature ejaculation. The committee proposed the definition to be a male sexual dysfunction characterized by

  • ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired);
  • the inability to delay ejaculation on all or nearly all vaginal penetrations; and
  • negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.

"The unified definition of lifelong and acquired premature ejaculation will reduce errors of diagnosis and classification by providing the clinician with a discriminating diagnostic tool," said Dr. Serefoglu. "It should form the basis for both the office diagnosis of premature ejaculation and the design of observational and interventional clinical trials," he added.
The committee also conducted and published a study to provide clearly worded, practical, evidenced-based recommendations for the diagnosis and treatment of premature ejaculation for family practice clinicians and sexual medicine experts. Led by Stanley Althof, PhD, of Case Western Reserve University School of Medicine in West Palm Beach, Florida, the experts reviewed previous guidelines for premature ejaculation and examined new findings. “There are many misconceptions about premature ejaculation. We sought to disseminate the most up-to-date information to non-sexual health specialists so that they can confidently treat patients suffering from this condition,” said Dr. Althof. “We also reveal the burden of this dysfunction on the patient and his partner and discuss, in depth, the multiple treatments available.” It also offers specific questions to ask patients during evaluations and detailed descriptions of various psychological, behavioral, educational, and pharmacological interventions.

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Men with erection problems are three times more likely to have inflamed gums

Men in their thirties who had inflamed gums caused by severe periodontal disease were three times more likely to suffer from erection problems, according to a study.

Turkish researchers compared 80 men aged 30 to 40 with erectile dysfunction with a control group of 82 men without erection problems. This showed that 53 per cent of the men with erectile dysfunction had inflamed gums compared with 23 per cent in the control group. When the results were adjusted for other factors, such as age, body mass index, household income and education level, the men with severe periodontal disease were 3.29 times more likely to suffer from erection problems than men with healthy gums.

"Erectile dysfunction is a major public health problem that affects the quality of life of some 150 million men, and their partners, worldwide," says lead author Dr. Faith Oguz from Inonu University in Malatya, Turkey. "Physical factors cause nearly two-thirds of cases, mainly because of problems with the blood vessels, with psychological issues like emotional stress and depression accounting for the remainder. "Chronic periodontitis (CP) is a group of infectious diseases caused predominantly by bacteria that most commonly occur with inflammation of the gums. "Many studies have reported that CP may induce systemic vascular diseases, such as coronary heart disease, which have been linked with erection problems."

The average age of the men in both groups was just under 36 and there were no significant differences when it came to body mass index, household income and education.
Their sexual function was assessed using the International Index of Erectile Function and their gum health using the plaque index, bleeding on probing, probing depth and clinical attachment level. “To our knowledge, erectile dysfunction and CP in humans are caused by similar risk factors, such as aging, smoking, diabetes mellitus and coronary artery disease,” says Dr. Oguz. “We therefore excluded men who had systemic disease and who were smokers from this study. “We particularly selected men aged between 30 and 40 to assess the impact of CP on erectile dysfunction without the results being influenced by the effects of aging. “The result of our study support the theory that CP is present more often in patients with erectile dysfunction than those without and should be considered as a factor by clinicians treating men with erection problems.”

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Viagra could prove useful in the fight against obesity

Researchers from the University of Bonn have treated mice with Viagra and discovered that the drug converts white fat cells (those unwanted denizens of the belly and similar swollen regions) into beige fat cells. Instead of storing excess energy, these recently discovered beige fat cells burn the energy from ingested food and convert it to heat. Viagra also appears (at least in mice) to decrease the risk of other complications caused by obesity.

Viagra (also known as sildenafil citrate) is used to treat erectile dysfunction, pulmonary arterial hypertension, and altitude sickness. It increases levels of the intracellular messenger cyclic guanosine mono-phosphate, which produces smooth muscle relaxation and thereby ensuring the blood supply for an erection.

Another effect of Viagra was noticed in a 2007 study. Mice dosed with Viagra for a 12 week period did not become fat when placed on a high-fat diet. The reason for the unexpectedly small gain of weight was not known at the time.

Following on from these earlier studies, Prof. Dr. Alexander Pfeifer, Director of the Institute for Pharmacology and Toxicology at the University of Bonn, and his colleagues studied the effect of Viagra on fat cells in mice. After giving the subjects the drug for seven days at about ten times the maximum approved dosage for human use, they discovered that a significant number of the white fat cells in the mice had been converted into the far healthier beige fat cells.

The study also establishes that larger levels of cyclic guanosine mono-phosphate prevent the remaining white fat cells from hypertrophy. When white fat cells store more energy, they become fatter rather than dividing into a larger set of cells. At least, they do this until they reach about four times their normal size, at which point they eventually divide.

Before this division happens, hypertrophy of the white fat cells causes them to release cytokines, which are immunomodulators – that is, they change the immune status of the body. In this case, they ramp up the action of the immune system, leading to chronic inflammation, which is at the base of most chronic health conditions, including cardiovascular disease, diabetes, arthritis, and even cancer. The white fat cytokines are particularly damaging to heart tissues.

The overall summary of the findings is that, at least in mice, Viagra can convert fat into calorie-burning beige fat, prevent white fat cells from overgrowing their bounds, and reduce the inflammatory response of the fat cells while reducing the amount of inflammatory cytokine messengers that are at least partly responsible for much of the chronic disease being fought by our medical systems. “It seems that sildenafil prevented the fat cells in these mice from getting onto that slippery slope,” says Prof. Pfeifer.

As always in medical studies, mice are not humans, and taking severe overdoses of Viagra to change the operation of your immune system, aside from being extremely expensive, is probably not an ideal course of action at this point. “We are currently in the basic research stage, and all the studies have been exclusively performed on mice,” stresses Prof. Pfeifer.

It may be some time before potentially suitable drugs for decreasing white fat cells in humans will be found, but perhaps this will eventually give users of Viagra another reason to be happy.

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