Over the last two decades in scientific laboratories of different countries there were developed numerous drugs to effectively combat the problem of erectile dysfunction.

At the moment on DrFrancais there are several types of drugs that can be divided into the following groups:

– PDE5 inhibitors – drugs that increase the potency;

– Inhibitors of reverse capture of serotonin – the extenders intercourse;

– Homeopathic medicines;

– Dietary supplements.

Brand drugs – is an innovative original drugs, which have undergone a full cycle of preclinical and clinical trials.

Inhibitors of PDE 5 –  the drugs increasing potency .

Viagra is a revolutionary drug for the treatment of impotency, has opened a new era in the fight against sexual dysfunction in men. The drug produces an American pharmaceutical company Pfizer. Viagra is available in tablets.

The active substance is citrate sildenafil. The basis of drug action is the inhibition of the enzyme FED-5, whereby the vessels of the cavernous corpus of the penis dilate, and an erection occurs. Duration – 4 hours.

Pros: Viagra works only with natural excitation and is not a stimulant. Buy generic Viagra in our pharmacy.

Cons: the tool dissonant with alcohol and fatty foods. In addition, in case some diseases, it is impossible to use it. These include cell anemia, severe liver disease and kidney, deformation of the penis, unstable arrhythmia, exacerbation of peptic ulcer disease, etc. the High price.

Unsafe combination of medicines with certain drugs: the donators of nitrogen oxide, erythromycin, ketoconazole, alpha-blockers. Possible side effects like facial flushing, headaches, nasal congestion.

Cialis has the longest effect among all means of all the drugs to increase potency. According to their parameters of safety and efficacy Cialis even exceed Viagra Manufacturer: Eli Lilly and Company (USA). The main active ingredient is Tadalafil. It is available in tablets. The mechanism of action is identical to Viagra

Advantages: rapid onset of effect (within 20-30 minutes), record of the duration of 36 hours. Diet and alcohol will not affect the effectiveness of the drug. The medication feature is a low likelihood of side effects.

Disadvantages: Cialis is contraindicated to the same group of patients as it is in Viagra and cannot be combined with the above drugs.

Levitra — the drug is 10 times more efficient than Cialis and Viagra and thus can be used even in the most severe cases. Manufacturer German pharmaceutical Corporation Bayer HealthCare AG. The main active substance is Vardenafil It is available in tablets. The duration is  8-12 hours.

Pros: very high efficacy of the drug in erectile dysfunction of any etiology, great compatibility with food and alcohol. Low percentage of side effects. It is approved for use by patients with diabetes, hypertension and high cholesterol in the blood.

Cons: same as Viagra and Cialis have.

Branded generics inhibitors FED, existing on the pharmaceutical market: Generic Viagra, Viagra Soft, Viagra Super active, Viagra Gel, Levitra (generic of 20 and 40 mg), Generic Cialis ( 20 and 40 mg), Cialis Super active, Cialis Soft, Cialis Gel, Tadagra (Cialis capsule), Sildigra. All of these products contain identical to the branded substance and have the same effects.

However, some of these products are presented in a more convenient dosage forms than brand drugs: for example, Viagra and Cialis Gel have a jelly-like consistency that accelerates the absorption in the oral cavity, and as a result, the effect is achieved faster. Soft pills (Viagra, Cialis) are chewable. They do not need to drink water, which makes them undoubtedly more convenient to use.

The rest (efficiency, side effects, contraindications) of these drugs doesn’t absolutely differ from the brand. The only but very important plus is the price, which is low in the generics.

Concomitant medications.

The pharmaceutical market also presented preparations, combining two active substances – to increase potency and prevent premature ejaculation.

Azoospermia – is the absence of spermatozoa in the semen. The disease may be one of the causes of male infertility. Azoospermia may be manifested in two forms. When it is a secretion form – there is disrupted formation of spermatozoa, so such a state makes it impossible to conception. The immature sperm contains the male sex cells, blood testosterone level is breached (too high a concentration or too low). Hypoplasia occurs of testicular and prostate cancer, there is an increased level of FSH.

These diseases may be caused as a consequence of changes in chromosomes – a hereditary, genetic pathology.

Another form of this disease is obstructive and often called aspermia. In this case, there is obstruction of the genital ducts due to the presence in them of any obstacles to the movement of spermatozoa, but the sperm production is not disrupted. Spermatogenesis can also be considered infertile, but such form that is treatable. This is generally surgical methods to restore potency.

Symptoms of aspermia:

• small amount of semen released during ejaculation;
• increased size and increased density of the epididymis;
• identification of the male gene hereditary disease cystic fibrosis;
• high content of sperm antibodies;
• disruption of the reproductive system infection or after undergoing an unsuccessful surgery.

If any symptoms are apparent, you should see a doctor for diagnosis. Before that, you need to go through several tests.

Necessary Studies

To obtain the information needed to establish the exact causes of azoospermia and subsequent selection of an effective method of treatment, patients need to pass the following tests:

1. Ultrasound examination of the scrotum organs, the prostate and seminal vesicles;
2. Determining the concentration in the blood of a number of hormones (testosterone, prolactin, estradiol, follicle stimulating hormone);
3. Establishing the presence in the semen of immature germ cells (semen);
4. Genetic studies (identification of a number of hereditary factors);
5. Determination of antibodies against the sperm;
6. Establishing the presence of infections, sexually transmitted infections (on the basis of biochemical and microbiological techniques);
7. Study of sample testicular tissue (biopsy).

If a man is diagnosed azoospermia of secretion form, in most cases – it is infertility, but there are a small percentage of cases, when using hormone therapy can be restored to normal sperm formation of mature sperm. In situations where the reason of vas obstruction deferens becomes intraprostatic cyst, then performed surgery – transurethral resection of the prostate gland cysts. Using this procedure, of the cyst through the wall of the urethra carried out the removal. Treatment using this method ensures the recovery of the ability to fertilize 25% of men operated.

Transurethral resection of the prostate gland cysts may have some complications:

• lack of sperm release during orgasm as a result of its contact with the bladder;
• throw urine into the prostate gland;
• inflammation of the epididymis.

While obstructive azoospermia, it is preferable to carry out microsurgical operation. If it does not bring the desired result, you should use assisted reproductive technologies. From this point of view, very often among men the following question arises: whether to do necessarily when azoospermia testicular biopsy, because it is usually prescribed this method of investigation. If indexes FGS and inhibin B are above the norm – it shows that spermatogenesis is broken and impossible to change this situation. The karyotype is examined to identify Klinefelter syndrome – a genetic inborn error.

Tips for maintaining an erection

Question:

Hi, I’m 19 years old, I have a girlfriend. We are virgins, but we want to try to get closer. We cannot have a sex. Every time I am doing a long prelude, she likes it. But when it comes to sex, my erection fails me. This is not the first time, although with the reaction all is normal. I liked her body, I was happy with everything, I loved her. But I feel bad when I cannot satisfy my girlfriend. She wants to satisfy me by oral sex, but I could not afford this. Give the advice, please.

Response:

Your erection is associated with your desire to satisfy the girl. Sometimes young guys worry too much, because this is the first time they will be in the close meet with their lovers. Intermittent erection is related with the unrest. You need to calm down, relax. If she offers you something new, agree, but be open to it. Psychological and emotional issues in this regard – this is normal. However, this does not mean that you should not take care of your health. It is necessary to undergo an annual examination, especially if you are just starting to have sexual intercourse. Also, special attention should be paid to innovations – new people, new occupations – all this is new for you, so stress and anxiety can occur in the most unexpected situations. If one just does not have something, do not dwell.

1. If you do foreplay before sex, think about whether you like it. If you do, because you have to – you will not get any pleasure. You will think, when it would be stopped, when to start the process. You are fixated on the result, and have to think about the process. Enjoy the moment, because the sexual act will be over, and for the second one you cannot wait immediately.

2. Surely every man uses condoms. It is a necessary and compulsory measure of cautions. Condoms protect you from sexually transmitted infections, a woman cannot get pregnant. Have you ever noticed that the condom can be uncomfortable? I’m not talking about the fact of his presence; I am trying to convey to you that the rubber agent squeezes you and the channels. From this there is a burning sensation. To find a way out of the situation, we should pay attention to the quality of the condom. It does not have to be expensive or cheap, it must be reliable and convenient. At the base of the condom should be a twisted rubber band, it should not be tight. During sex, the penis even slightly increases, the condom can be uncomfortable. Quality materials are also important – the usual condom can tear, that is not quite convenient and safe. Moved down will shrink the penis even more, by this all desire for sex may be compromised.

3. Try to turn a prelude to the game, do exercises that will capture the spirit. Before having sex, both partners should be excited, it must be controlled. It is impossible, so that one of them has to deliver positive emotions to another, but and that one in response to the other was lying still. If the erection disappears while entering the penis in the vagina, or while putting on a condom, try to caress partner in intimate places, when he would put on protection. At the time of entering the penis, partner must be active, to take care. If this is the first sex, the guy should kiss and caress the girl in order the relaxing to be continued without stopping.

4. If the process of the introduction the penis into the vagina is inconvenience, if girl has painful emotions, try to use a lubricant. It is made specially to improve penetration. She is nervous, the muscles are compressed, and she cannot relax, because the stress pattern is much higher than the desire to try the unknown. Lubricants can be applied to the genital organ of male or female. If you use condoms, the lubricant should be water-based, since it will not concentrate on the condom material. During the difficult penetration, the penis gets a load; she is clamped harder, so erection can disappear. If the grease is applied to the penis, it will be convenient to introduce it into the vagina.

5. Trying sex for the first time, you will feel the seriousness and responsibility. But this is only the first time, and it’s worth it. Then it will be easier, because it is a physical process. Over time, you will quickly learn to be excited, to undress, put on a condom. For each new case you need the experience, but it is recruited over time and with practice. This happens in sex – it takes time and persistence. Each time you’ll get more and more fun, you will learn how to be nimble and skillful. Try to relax every time, bring attention to the partner; do not focus only on your orgasm.

In addition to the tips I recommend you to read these books: Sexual men – problems and solutions. These editions will help you to understand not just women’s philosophy, but also better insight into the male body. Author of the book “Because it’s good – is a guide for women to obtain satisfaction” is a doctor of philosophy. These books will help you understand the problem deeply.