The PDE-5 inhibitors

Penile erection is managed by two mechanisms: the reflex erection, which is achieved by directly touching the penile shaft, and the psychogenic erection, which is achieved by erotic or emotional stimuli. Impotence can be treated — sometimes even without drugs. To determine this, a man can simply wet and affix a small stamp on his flaccid penis before going to bed. Men with primary impotence have never had sufficient erections for satisfactory intercourse. Some of the most popular herbs available on the market today are Tribulus, yohimbe, ginkgo biloba, and others.

Tribulus had been used as traditional medicine to treat sexual dysfunction and male infertility in Europe and Asia for many decades before improvement in scientific extraction techniques allowed identification of its active ingredient, protodioscin. It is estimated that about 10% to 20% of impotence cases are the direct result of various psychological factors, such as low self-esteem, depression, and — especially — stress and anxiety (general and performance anxieties). The practice, which involved inspection of the complainants by court experts, was declared obscene in 1677.

A vacuum device composed of a plastic cylinder, pump and elastic ring or band can be used to affect an erection. The active ingredient of Tribulus acts as a natural precursor to these hormones and is converted into its final forms by the body's own natural enzymes. Although they are often dismissed as ineffective solutions to impotence, more and more clinical research studies have found that herbs can help impotent men. If never, the problem is likely to be physiological; if sometimes (however rarely), it could be physiological or psychological. Stimulation of the 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. No known side effects are linked with this herb. In this case, the impotence lasts as long as you are taking the drugs. in the 1920s and 1930s. 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.[17] 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.