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In this group testosterone levels are abnormality in sperm production) may be seen and the lower than in non-temporal epileptic patients following frequency of hypogonadism increases with age (Herzog temporal lobectomy erectile dysfunction at 21 buy cheap viagra sublingual 100 mg, in whom testosterone levels are nor- et al erectile dysfunction treatment in tampa discount 100mg viagra sublingual amex. Animal type Study duration Control group Effects Cohn (1982) Rat 3 months - Sperm quantity v impotence hypertension viagra sublingual 100mg fast delivery, Fertility v Walker (1990) Rat erectile dysfunction oil order 100mg viagra sublingual with mastercard, Dog 13 months - Spermatogenesis v, Testicular atrophy Synder (1995) Rat 8 weeks + Spermatogenesis v, Testicular development v Roste (2001) Rat 3 months + Testicular atrophy observed in men with seizures due to right temporolim- The effects of new generation antiepileptics (fel- bic focus than in men who experience seizures due to left bamate, gabapentin, levetiracetam, pregabalin, tiagab- temporolimbic focus (Herzog, 2008). Agents that cause enzyme induction, such sifying its effects on hormones and semen parameters. Hormone levels were assessed during the first and affects the negative feedback on gonadotropin production third month of treatment in a group of male patients (Herzog, 2008). Although previous research male reproductive functions began in the first month of has shown that changes in the endocrine system due to treatment and that they were stable or progressive. Differences in Semen Parameters and total testosterone levels were normal in both groups. No hormonal changes were observed in the healthy con- In a study that compared patients that used antiepi- trol group. Epileptic discharges that de- were compared regarding testicular measures, no signifi- velop in the structures of the medial temporal lobe af- cant differences were observed (Roste et al. As a result, changes emerge in In another study in which epileptic patients receiving gonadal and reproductive functions (Herzog, 2008). Changes in pituitary hor- of epilepsy for more than 10 years that were also un- monal levels may occur according to this effect (Herzog, dergoing infertility treatment had low sperm counts and 2002a). This increase decreases the release of pi- their wives got pregnant 15 months after the new treat- tuitary hormones via the negative feedback mechanism. In another case it Decreased release of pituitary hormones may manifest was suggested that, along with a decrease in sperm count as reproductive dysfunction (Rattya et al. It was observed that the drug Research regarding this issue has been mainly cross- affects sperm motility directly in in vitro studies (Iso- sectional in design; therefore, no definitive conclusions jarvi, 2008). Animal studies may provide a way to explore Numerous studies and case reports have shown that the illness and the effects of drugs independently of each changes in hormones and sperm parameters due to other. Prog Neuro-Psychopharmacol Biol Psychiatry; Hayashi T, Yoshida S, Yoshinaga A et al. A study of the effects of temporal lobectomy on sexual and enzyme-inducing antiepileptic drugs. Neurology; 62:247– the testis after long-term valproate treatment in male Wistar rats. Epilepsia; parameters in men with epilepsy treated with valproate or carbamazepine 38 (Suppl. Most patients wait for their healthcare provider to enquire about their sexual health. Between a third and half of these women describe their problem/s as distressing, causing a major impact on their quality of life and interpersonal relationships. Addressing sexual health issues with patients can enhance medical practice and improve patient well-being. This article provides healthcare providers with an approach to addressing female sexual dysfunction, along with an overview of diagnosis and treatment options. Provide information (official journal of the International Society of Sexual Medicine) and about anatomy, physiology, normal sexual response, sexual changes a personal archive of references. An online survey of 3 807 healthy volunteers indicated that 40% of women did not discuss sexual problems with their clinician. An examination is mandatory if there is lack of sexual interest due to endocrine changes, a combination of dysfunctions or sexual Pathophysiology pain. The examination includes careful inspection for changes or An integrative approach is required, with attention to the biological abnormalities (e. When associated distress was considered, reproductive hormones (luteinising hormone, and follicle-stimulating a survey found the prevalence of hypoactive sexual desire disorder hormone) to rule out metabolic or pituitary dysfunction may be to be 16%, sexual arousal disorder 7%, orgasmic disorder 8%, and required. Clinical assessm ent Definitions, diagnostic criteria and Detailed history treatm ent options By asking the patient open-ended questions, she should be The Diagnostic and Statistical Manual of Mental Disorders version 5 encouraged to describe her complaint in her own words. Biomedical factors include diseases, drugs and hormones, and should be assessed in detail to include a gynaecological and an Female sexual interest/arousal disorder obstetric history, contraception methods, a medical and surgical Female sexual interest/arousal disorder is defined as the lack of or history, and medication use (including over-the-counter medications, significantly reduced sexual interest/arousal with at least three of the alcohol and illicit drugs). Decreased androgen levels do tool, asks four questions regarding a patient’s satisfaction, sexual not correlate well with decreased desire. Seeking help for sexual function complaints: What gynecologists [27] need to know about the female patient’s experience. Management of female sexual problems: Perceived barriers, practice patterns, and confdence among primary care physicians and gynecologists. J Sex positioning with maximum glans clitoral stimulation during vaginal Med 2010;7:2499-2508. Help-seeking behaviour for sexual problems: Te global intercourse has been shown to be beneficial. Sexual problems: A study of the prevalence and need for health care in the general population. Psychological and interpersonal dimensions pelvic floor muscles during attempted vaginal penetration. What is the true prevalence of female sexual dysfunctions infections, dermatoses, hormonal, vascular, neurological, or and does the way we assess these conditions have an impact? Clinical evaluation and management strategy for sexual dysfunction in men and women. A standardized diagnostic interview for hypoactive sexual desire disorder Organic disorders (e. A mindfulness-based group psychoeducational intervention targeting steroids, antibiotics, surgical). Circulating androgen levels and self-reported sexual dysfunction depressants and topical lidocaine. Vestibulectomy is recommended as a for the treatment of hypoactive sexual desire disorder in surgically menopausal women: A last resort when distinct mucosal involvement occurs. Preventive hygiene measures for the treatment of female sexual dysfunction in naturally menopausal women: Results of a are encouraged (e. Te role of mechanical devices in treating female sexual dysfunction and enhancing the [33] female sexual response. While pain is present, avoidance of 0269-0] penetration during sexual activity may be advised to break the cycle 27. A brief mindfulness-based cognitive behavioural intervention improves sexual functioning versus wait-list control in women treated for gynaecological cancer. Sildenafl for women patients with antidepressant-induced If phobic avoidance of penetration is present, treatments targeting sexual dysfunction. Standard operating procedures for female genital should occur prior to treatment for sexual dysfunction. Terapist-aided exposure for women with life-long vaginismus: A replicated single-case design. Your relationship with a patient/couple is a critical factor in effecting change Jerome Frank describes the Healer-Sufferer relationship in his book, Persuasion and Healing 3. Creating an optimal environment for disclosure Highly recommended: sex-positive material to “break the ice” 8. Ideally, assessment takes place in a secluded space, no ambient noise, dim lights, carpeted, away from the “outside world” 5. Common ingredients of therapeutic change, classically described by Jerome Frank: a) Patient’s expectation s/he will be helped b) Therapeutic relationship c) Therapeutic rituals provide meaning for symptoms d) Active collaboration between Therapist/Patient as they execute the ritual Recent meta-analysis: common factors explain 45% of variability in treatment outcomes (Laska, Gurman & Wampold, 2014) Psychosexual Education Encompasses: 1. If a woman cannot have an orgasm quickly and easily, there is something wrong with her. Men are more likely to orgasm with vaginal intercourse; women are more likely to orgasm following a variety of sexual activities, including oral sex or vaginal intercourse. At their most recent sexual encounter… 85% of men reported their partner reached orgasm, 64% of women reported achieving orgasm. Directed Masturbation • Establish comfort with looking at and touching oneself -Mirror exercises: view genitals and entire body (notice reactions) -Self-stimulation exploration -Feeling sexy: what is necessary and sufficient? Keep diary of thoughts, feelings, outcomes Problematic Thoughts • All-Or-Nothing (experiences are only good or only bad): “It hurts every time. Generating lists of conditions or factors which positively & negatively affect arousal, such as: • Context (energy level, appropriateness, etc) • Positive mood (for oneself and one’s partner) • What kinds of emotional and sexual stimulation are needed?
Syndromes
- Pregnancy -- Up to half of women have glucose in their urine at some time during pregnancy. Glucose in the urine may mean that a woman has gestational diabetes.
- Gonorrhea
- Calcifications, which are caused by tiny deposits of calcium in your breast tissue. Most calcifications are not a sign of cancer.
- Menstrual cycle stops (in women)
- Name of product (as well as the ingredients and strength, if known)
- Infection (a slight risk any time the skin is broken)
- You had a sexual partner with gonorrhea, chlamydia, or other STI.
- Draining of cerebrospinal fluid to lower pressure in the brain
The overall objective aim to erectile dysfunction causes alcohol discount 100 mg viagra sublingual fast delivery move us towards a desired world in which: of the study was to causes of erectile dysfunction include buy discount viagra sublingual 100mg online build a better understanding of men’s life experiences and their use of violence · Violence against women is never acceptable and against women to impotence used in a sentence generic viagra sublingual 100mg without a prescription encourage more evidence-based women and men are equally valued hard pills erectile dysfunction discount viagra sublingual 100 mg without a prescription. Although · Healthy, non-violent and equitable ways of being the regional and national analysis conducted to for men are the most common and accepted date contributes to this overall objective, further forms of masculinity. Effective prevention and response to violence against · Social norms for healthy male sexuality include women and girls requires comprehensive strategies, consent, compassion and respect for women’s long-term commitment and coordination among choices and bodies, and these norms are nurtured actors from a wide range of sectors. Violence prevention plans should · Violence against women prevention policies and be integrated in to the larger social development, programmes are based on local data and respond gender-equality and human rights plans and to the specifc patterns and drivers of diferent frameworks. Zawacki sex workers in Karnataka State, South India: and gender in Papua New Guinea: Towards (2006). Cross-sectional predictors of Impact on health, and reductions in violence a research agenda. Asian Pacific Viewpoint, sexual assault perpetration in a commu- following an intervention program. Hofman Nusa Tenggara Barat, Indonesia: Married in Vientiane Capital and Subsequent Access and R. The Asia Pacific Prevalence and risk factors reported by Journal of Anthropology, vol. Bulletin W orld Health Organization, and paying partner violence against women vol. Violence Against Melbourne: Australian Institute of Family W omen in Latin America and the Caribbean: Studies. Breaking a Comparative Analysis of Population-Based the Silence: Sexual violence in Cambodia. Complexity of Violence: A Critical Analysis of Sexual Violence in the Democratic Republic Breines, I. Gender and Society, lings: Youth Attitudes Toward Gangs, Vio- attraction to sexual aggression in a com- vol. Indian men’s use of commercial in Asia: Globalization, Gender and Islam in tries: Exploring Variation in Individual and sex workers: prevalence, condom use, and the Maldives. Re- Against W omen in Cambodia: Findings from searching Violence Against W omen: a Practi- Diener, E. Watts prevalence of gender based violence among sexual activity and male-male sexual (2005). South African men in the rural Eastern multi-country study on women’s health Cape: prevalence, predictors, and asso- and domestic violence. Behind the silence of harmony: risk factors for physical and sexual violence Jewkes, R. Ethical and Safety Recom- and Masculinities in Papua New Guinea in W omen’s Health, vol. Child Abuse and of sexual coercion against women: testing Archives of Psychiatry and Clinical Neurosci- Neglect, vol. International Violence During the Khmer Rouge Regime: Journal of Epidemiology, vol. Walker and Practices Regarding Gender and Violence tion by young, rural South African men: (2008). Violence against women in Papua Against W omen in Bangladesh: Preliminary prevalence, patterns and risk factors. Prospective study of rape perpetration by young South Ma’a Fafne mo e Famili (2012). Declaration on the Elimination of ing resilience and reducing risk for involve- Carpenter and L. Kiribati Family Health and for perpetration of child sexual abuse: lence, risk factors and associated health Support Study Report. International Family Planning Ministry of Internal and Social Affairs and and Neglect, vol. Predicting coercive In Sex W ithout Consent: Young People in gender norms among young men in Brazil: sexual behaviour across the lifespan in Developing Countries, S. Gender Dimensions of Alcohol W omen: Taking Action and Generating Consumption and Alcohol-Related Prob- Sivakumaran, S. Putting W omen First: Ethical and Safety Recommendations for Research on Roberts, G. Masculinity, Mental Sonke Gender Justice Network and Domestic Violence Against W omen. Engaging Men and Boys in misuses of population attributable frac- Changing Gender-Based Inequity in Health: tions. In Engendering Violence in persons with harmful alcohol consumption United Nations Economic and Social Papua New Guinea, M. In other words, Childhood Trauma Events Scale: A series of 13 questions it aims to ascertain whether a group of questions included in the questionnaire to measure men’s (for example making up a scale) actually reflect and women’s exposure to physical, sexual, a single underlying concept. Probability proportional to size: A quantitative sampling technique which takes varying Cluster: a cluster is, in this case of multi-stage sample sizes in to account. This helps to sampling used in this study, a group of a relatively avoid underrepresenting one subgroup in similar number of households in a geographical a study and yields more accurate results. Confidence interval: Because the strength of Lifetime prevalence of perpetration: The proportion association between factors is only an estimate, of male respondents who reported having the confidence interval is the range of values perpetrated one or more acts of a particular type within which statisticians are 95 percent confident of violence against a woman or girl at any point in that the actual strength of association will lie. Masculinities: The narratives of any given society that relate to how to be a man (what society Cronbach’s alpha: Cronbach’s (alpha) is a statistical tells us about men and how to be one) and the measure of internal consistency. In this case it is ways these stores are practised, acted out and commonly used as an estimate of the reliability of embodied by individuals through relationships a psychometric test for a set of questions that make and in institutions. See the Conceptual Framework up a scale, for example the Childhood Trauma section for more information on how the term is Events Scale. Current prevalence of perpetration: The proportion Multivariate logistic regression: A statistical technique of male respondents who reported having to calculate the strength of association (odds ratio) perpetrated one or more acts of a particular type of of selected factors. It can be directly interpreted as how many words or gestures, controlling behaviour and the times more likely someone is to perpetrate violence destruction of possessions. Some odds ratios were adjusted Intimate partner violence: The physical, sexual, for other variables in which case they are called economic or emotional abuse by a current or adjusted odss ratios. It can occur within heterosexual P value: The probability that the strength of or homosexual relationships and does not require association between factors occurred by chance. Physical violence: Physical violence is the intentional use of physical force with the potential for causing Sex act: Contact between the penis and vulva or death, injury or harm. Physical violence includes the penis and the anus, involving penetration, but is not limited to: scratching, pushing, shoving, however slight; contact between the mouth and throwing, grabbing, biting, choking, shaking, the penis, vulva or anus; or penetration of the anal poking, hair pulling, slapping, punching, hitting, or genital opening of another person by a hand, burning, the use of restraints or one’s body size finger or other object. Sex work: The exchange of money for sexual services, either regularly or occasionally. It includes such situations, including within marriage, on dates, acts as the denial of funds, refusal to contribute at work, in school and in families (such as incest). General practice management of type 2 diabetes – 2014–15 Disclaimer The information set out in this publication is current at the date of first publication and is intended for use as a guide of a general nature only and may or may not be relevant to particular patients or circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular circumstances when so doing. Compliance with any recommendations cannot of itself guarantee discharge of the duty of care owed to patients and others coming in to contact with the health professional and the premises from which the health professional operates. While the text is directed to health professionals possessing appropriate qualifications and skills in ascertaining and discharging their professional (including legal) duties, it is not to be regarded as clinical advice and, in particular, is no substitute for a full examination and consideration of medical history in reaching a diagnosis and treatment based on accepted clinical practices. Accordingly, The Royal Australian College of General Practitioners and Diabetes Australia and their respective employees and agents have, to the extent permitted by law, no liability (including without limitation – liability by reason of negligence) to any users of the information contained in this publication for any loss or damage (consequential or otherwise), cost or expense incurred or arising by reason of any person using or relying on the information contained in this publication and whether caused by reason of any error, negligent act, omission or misrepresentation in the information. Melbourne: The Royal Australian College of General Practitioners and Diabetes Australia, 2014. Supporting the education programs of Diabetes Australia Type 2 diabetes: goals for optimum management The table on the fip side lists goals for optimum diabetes management that all people with diabetes should be encouraged to reach. This table has been specifcally designed as a card for you to pull out and place on your desk or nearby for easy reference. Type 2 diabetes: goals for optimum management Encourage all people with type 2 diabetes to approach/reach these goals Diet Normal healthy eating. Body mass index (kg/m2) Therapeutic goal is 5–10% loss for people overweight or obese with type 2 diabetes. Ongoing self-monitoring of blood glucose is recommended for people with diabetes using insulin, with hyperglycaemia arising from illness, with haemoglobinopathies, pregnancy or other conditions where data on glycaemic patterns is required.
Assessment of the sexual and overall relationship mechanism of action is awaiting to be discovered. Treatment should be etiology speciic and address the issue of infertility in men of a reproductive age. Men, who never achieve orgasm and ejaculation, are suffering from either a biogenic failure of emis-- sion and/or psychogenic inhibited ejaculation may require fairly extensive medical evaluation. Men who occasionally achieve orgasm and ejaculation are usually suffering from psychogenic inhibited ejaculation or penile hypoanaesthesia secondary to age related degeneration of the afferent penile nerves and may respond well to various cognitive- behavioral strategies that include education and sexual techniques designed to maximize arousal. Men/partners of reproductive age should preliminary research suggests that the patient has be informed of the risk of infertility due to anejacula-- much to gain from this more holistic approach. The pres-- providing opportunity for necessary patient educa-- ence of spermatozoa and fructose in centrifuged tion and counseling. Additionally, the integration of post-ejaculatory voided urine conirms the diagnosis. Furthermore, couples presenting mul-- of the testis or vas/vasa or acquired ejaculatory duct tiple sexual dysfunctions are likely to beneit from obstruction. Management involves investigation by a model incorporating additional sex therapy with ultrasonic or radiological imaging to identify the site pharmacotherapy. Lesions of the nucleus studies are needed in order to deine an appropriate paragigantocellularis alter ex copula penile relexes. A role for 5-hydroxytryptamine in pharmaceuticals will only reine such an algorithm descending inhibition of spinal sexual relexes. The evaluation of sexual disorders: the urologic J Physiol 1991: 26:1276 evaluation of ejaculatory disorders. The neurobiological approach to premature and the bulbospongiosus muscle identiied by transsynap-- ejaculation. The effects of post-chemotherapy retroperitoneal lymph node dissection intracranial administration of the dopamine agonist for advanced testicular cancer. The mechanism of ejaculation: the glans-vasal D1 and D2 receptors on genital relexes: implications for and urethromuscular relexes. Hollow and fenestrated penile prosthesis: a new dopamine in the medial preoptic area: implications for implant for treatment of impotence. Impaired sexual response central nervous system of the rat-cell bodies and terminals. Pharmacologicalanalysisofmaleratsexual ferential binding of [3H]5-hydroxytryptamine, [3H]lysergic behavior. Stimulation of the majority of men with lifelong premature ejaculation prefer dopamine autoreceptors elicits «premature ejaculation» in daily drug treatment: an observation study in a consecutive rats. Lack of opioid or dopaminergic effects on uncon-- ditioned sexual incentive motivation in male rats. Clomipramine in the treatment of rapid (prema-- erection and pelvic thrusting behavior in dogs. Premature ejaculation: clinical subgroups alpha-blocking agent (phenoxybenzamine) in the manage-- and etiology. Sexual dysfunction in and correlates identiied in the Global Study of Sexual At-- the United States: prevalence and predictors. Premature ejaculation and serotonergic antide-- logic unit for sexual dysfunctions. Premature and delayed ejaculation: genetic and environmental effects in a popula-- 111. Chronic prostatitis in prema-- nergic receptors, selective serotonin reuptake inhibitors and ture ejaculation: a cohort study in 153 men. Alcohol, drugs and sexual function: a comparison of the effects of different serotonin reuptake review. Sexological approach to and paroxetine differ in sexual inhibitory effects after ejaculatory dysfunction. In Sacchetti E, Spano E, Spano P 2005 Jun 22: 25:5984-7 eds, Advances in Preclinical and Clinical Psychiatry, Vol I: 120. The neuroanatomical basis for the Fluvoxamine: established and emerging roles in psychiatric protopathic sensibility of the human glans penis. Somatosensory and ejaculation: a double-blind, randomized, placebo- evoked potentials in patients with primary premature controlled, ixed-dose study with paroxetine, sertraline, ejaculation. Antidepressants Evoked sacral potentials in subjects with true premature and ejaculation: a double-blind, randomized, ixed- ejaculation. Thyroid-stimulating hormone assessments in a Dutch pudendal pathways in primary premature ejaculation. Sexual symptoms in endocrine diseases: psychosomat-- on serotonin levels and serotonergic receptor subtypes in ic perspectives. Thyroid hormones, 1997 Fall: 23:208-11 serotonin and mood: of synergy and signiicance in the adult brain. Oxytocin mediates the phodiesterase type 5 expression and functional activity in estrogen-dependent contractile activity of endothelin-1 in corpora cavernosa. Identiication and characterization of two Behavioral effects of pubertal anabolic androgenic steroid classes of receptors for oxytocin and vasopressin in exposure in male rats with low serotonin. A short clinical diagnostic self-rating scale emission, ejaculation, and orgasm in the male. Hypoprolac-- rabbit prostate smooth muscles in response to nerve tinemia: a new clinical syndrome in patients with sexual stimulation. Thyroid hormone and activity of the prostate at ejaculation: an electrophysiologic male gonadal function. Physiology of Erection and Management of prevalence of sexual symptoms in male hypo- and hyperthy-- Paraplegic Infertility. Nagai A, Watanabe M, Nasu y, Iguchi H, Kusumi N, Kumon correlates of rapid ejaculation in patients attending an H. Analysis of human ejaculation using color Doppler andrologic unit for sexual dysfunctions. Epidemiology of premature ejaculation: identiication of a urethrocavernosus relex. Prevalence of chronic prostatitis in men with Ejaculation: An observational Study of Men and Their premature ejaculation. Marital problems and sexual sexual dysfunction in chronic prostatitis/chronic pelvic dysfunction: how are they related? In Levine S, Risen C, Althof S eds, Handbook ejaculation in patients with premature ejaculation and of clinical sexuality for mental health professionals. Severity of erectile dysfunction at presentation: num, 1992 effect of premature ejaculation and low desire. Cognitive-behavioral strategies and 2008 Jan: 71:94-8 techniques in the treatment of early ejaculation. The role of anxiety in premature ejaculation: a of behaviour psychotherapy on patients with premature psychophysiologicalmodel. Assessment investigation of affective and cognitive response to erotic of as needed use of pharmacotherapy and the pause- stimulation in men before and after sex therapy. Premature ejaculation: Use of ethyl amino tive response to erotic stimulation in sexually functional and benzoate to prolong coitus. In S Lieblum, R Rosen (Eds), Sexual desire sexual function in men with premature ejaculation and disorders New York: Guilford, 1988,. Clomipramine in the treatment of premature assessment and treatment, New york:: Guilford, 1991 ejaculation. Integration of treatments for male erectile research on premature ejaculation: a critical evaluation of dysfunction. In Hawton K, Salkovskis sertraline hydrochloride: a single-blind placebo controlled P, Kirk J, Clark D eds, Cognitive Behavioral Therapy for crossover study. Boston: Little Brown, 1970 Paroxetine treatment of premature ejaculation: a double- 225. The new sex therapy, New York: Brunner/ blind, randomized, placebo-controlled study. An assessment of clomipramine (Anafranil) conceptual, etiological, and treatment issues.
Ginkgo inflow to erectile dysfunction massage techniques buy viagra sublingual 100 mg cheap arterial tissues albumen of the seed also contains neurotoxic 4’-O- biloba extract have been through arteries and methylpyridoxine (ginkgotoxin) erectile dysfunction treatments vacuum cheap viagra sublingual online mastercard, etc used in traditional Chinese veins without medicine to impotence quoad hoc meaning order viagra sublingual 100 mg line improve blood obstructing systemic circulation erectile dysfunction doctors buffalo ny best buy for viagra sublingual. This constituents have a thinning enhanced supply of effect on the blood besides blood to sex organs is helping to improve the crucial in maintaining muscle tone in the walls of strong erection the blood vessels 12 Hibiscus sabdariffa Malvaceae Zobo, Pharmacology of the It decreases the Several compounds have been isolated from different Carotenoids, [42, 43] L. Spectroscopic analysis off the aqueous 12 weeks showed in extract of H sabdariffa L (Hs) have yielded citric significant change in the acids, hydroxycitric acid, hibiscus acid, malic acid absolute and relative and tartaric acids; oxalic acid as minor compounds. Isolation and characterization of the flower extract have yielded flavonoids such as hibiscetin-3- glucoside, (hibiscitrin), sabdaritin, gossytrin, quercetin, luteolin, chlorogenic acid, protocatechuic acid; sterols such as ?-sitosterol and ergosterol have been isolated. In a separate presence of arginine amino acids study, 1500 mg/kg or 3000 which boosts nitric mg/kg p. M tenuiflora is also composed of significant differences yuremanine and two chalcones; kukulkan A (2. M and morphology among the tenuiflora is also composed of the steroids sheep with or without M campesterol-3-O-?-D-glucopyranosyl, stigmasterol- tenuiflora. The result 3-O-?-D-glucopyranosyl and ?-sitosterol-3-O-?-D- indicated that M tenuiflora glucopyranosyl. Saponins such as mimonoside A, does not influence negatively mimonoside B, mimonoside C have been isolated. Increase in blood Saponins, alkaloids, plantain paradisiaca root on testicular Bromine, rubidium, strontium, saponins, function parameters on male norepinephrine, dopamine, serotonin, vitamin B6, vitamins, [51, 52] rats at 25, 50 and 100 mg/kg Circulation vitamin a, c and D and natural glucose, fructose. Meyer produced significant and acetylcholine-induced alkenes, sterols, fatty acids, carbohydrates, hydrocarbons, sustains increase in sexual and transmural nerve flavonoids, organic acids and vitamin flavonoids and activity of normal male rats. Indole alkaloids such as Harman, harmine, activity harmalol, and harmaline have also been isolated from P. The arousal and reduction mitragynine, rauwolscine, spegatrine, reserpine, and result showed that yohimbine of psychological rescinnamine, as well as ?-yohimbine, ?-yohimbine, is superior to placebo in the conditions by easing Pseudoyohimbine, Alloyohimbine, Ajmaline, treatment of erectile stress, mild depression ajmalicine, 19-Dehydroyohimbine, dysfunction. The presence of a new ?- organs involved in carboline alkaloid characterized as I-thioformyl-8-?- reproductive functions D-glucopyranoside-bis-2,3-duhydro- without affecting the isopyridinopyrrol and four new flavonoids including metabolic functions 7-O-rhamnoside, 7-O-6’’-O-glucosyl-2’’-O-(3’’- acetylrhamnosyl) glucoside, 7-O-(2’’-O-rhamnosyl- 2’’-O-glucosylglucoside) and glycoflavone 2’’-O- rhamnosyl-2’’-O-glucosylcytisoside (Sharaf M et al. Spectroscopic analysis of the seeds extract have led to the iusolation of two new anthraquinones glycoside such as 3,6-dihydoxy-8-methoxy-2- methylanthraquinone (peganone 1) and 8-hydroxy-7- methoxy-2-methylanthraquinone (peganone 2) 24 Piper guineense Piperaceae West African In a study to determine the The extract enhanced The chemistry of P. Several compounds and tannins adult male Sprague Dawley and ano-genital have been isolated including piperine, elemicine, rats, the result showed an behaviour myristicin and safrole which have strong increase in body weight and antimicrobial properties. The isolated compounds guineense at 200mg/kg for 4 are; N-pyrrolidyl-I-acetylamide, N-piperidyl-I- weeks and 8 weeks aceytlamide, N-isobutyl-2,4-octadienamide respectively had a positive (Pellitorine), N-piperidyl-Isobutyl-3,4- impact on male fertility dimethyoxybenzoic acid amide, N-pyrrolidyl-3- parameters and showed no methoxycinnamoylamide, N-Isobutyl-2,4- deleterious effects on male tetradecadienamide, N-piperidyl-2,4- fertility. In a separate study, dodecadienamide, N-Isobutyl-5- (3,4- the effects of Afromomum methylenedioxyphenol)-2-pentenamide, N-isobutyl- Melegueta and P. In high doses of presence of ursolic acid, Asiatic acid, squalene, but 3000 mg/kg, all determined no caffeine, flavonoids such as isovitexin, vitexin and sexual parametrs were rutin, gallic acid, hydrolysed tannins, puncalagin inhibited. Punicalin, terflavin A aphrodiasiac properties at and B, tergallagin, tercatain, chebulagic, geranin, low dosage grana to B and covilagin. Flavonoids such as Dawely rats on sexual and nitric oxide release kaempferol, kaempferol glycosides, quercetin, and behaviour and intracavernous from nerve endings of Fatty acids such as palmitic, steatric, oleic, and pressure showed increase in corpus cavernous tissue Linoleic acid; Tannis; Potassium salts have all been mount intromission and reported ejaculation latency representing an improvement in sexual character. They help to regulate sexual energy levels and sexual strength by increasing the percentage of free available testosterone levels for men and they even affect pregnenolone, progesterone, and estrogen 28 Turnera diffusa Turneraceae Damiana T diffusa extract at 80 mg/kg These effects can be T diffusa is composed of numerous phytochemicals. Major constituents are its activity was lower than pressure, a reliable monoterpenes such as ?-phillandiene,(+)-c amphene, Pasakbumni at 140 mg/kg positive index of cineole, ciral and borneol. In another study to erectile dysfunction hydrocarbons like zingiberene, ?-bisboline, ?- determine the effects of the farnesene and ar-curcumene as well as extracts of ginger as an sesquiphillandiene and the sesquiterpene alcohol aphrodisiac, there was zingiberol and gingerol which is responsible for its significant increase in pungency. It is significant that issues surrounding poor sexual performance and virility are unraveled in various economies of the world. Several plants have proven useful in the management of sexual disorders throughout history, even herbs and spices have been used to enhanced sexual activities in various parts of the world. There is great need for substances that are used to treat sexual dysfunction in humans. The use of aphrodisiacs is prominent in many countries of the world including Nigeria. Aphrodisiacs can be used directly or indirectly in the management of sexual dysfunction and improvement of virility. Demand for natural aphrodisiacs require further studies to properly understand their effects on human and safety profile, uses of aphrodisiacs can be harmful due to unavailable data on safety, mechanism of action and knowledge to support their extensive use in procreation. Isolation and characterization of the active constituents of plants used in improvement of sexual performance and virility can cause a dynamic change in the world today. It is pertinent that the phytochemistry of all plant used to treat sexual dysfunction and which also plays a significant role in the improvement of virility is studied. The aim of the leaflet is to provide you with detailed information about the condition. To view the online version of this leaflet, type the text below in to your web browser: http://www. But most urologists suspect that it is under-reported, and may affect as many as 1 in 10 men (10%). This begins as a localised inflammation, which may then mature in to a hardened scar. The scar is inelastic (stiff) and stops the penis stretching with erections, leading to the development of a curvature on erection. There are two erectile cylinders (corpora cavernosa) running along the penis (pictured). If the penis is abnormally squeezed or bent, the area where the septum attaches to the elastic fibres may over-stretch. In older men, reduced elasticity, disease of the arteries and diabetes all increase the likelihood of scarring after an injury to the penis. In most patients, the injury heals within a year and the plaque does not advance beyond its early inflammatory phase. In more persistent cases, the plaque is replaced by tough, fibrous tissue and may even form hard, calcium deposits. Peyronie’s disease can affect the penis by causing: • Curvature of the penis The inelasticity (rigidity) of the plaque means it cannot stretch as the rest of the penis does when you get an erection. A plaque on the top of the penis causes the penis to bend upward; on the underside, it causes a downward bend. In some cases, the plaque develops centrally, leading to indentation and shortening. Pain, bending, and emotional distress may then limit sexual intercourse; and • Erectile dysfunction (impotence) This occurs due the effect of the plaque reducing blood flow in the penis, but can also a loss of sexual confidence because of the change in shape of the penis. While most treatments can limit the effect of the condition on the penis, nothing can take the penis back to how it was before. The disease generally goes through two stages: • A painful, inflammatory phase This usually lasts for three to six months. There is no way to tell when the acute phase has ended, but easing of the pain usually heralds it; and • A chronic or stable phase You are usually in this phase at least 6 months after the pain has stopped. Two out of 10 men (20%) get a re-activation of the inflammatory phase, leading to more plaque development, and worsening curvature. In the remaining one out of 10 (10%), there may be spontaneous improvement in curvature without treatment. Although the plaque itself does not normally disappear completely, a new plaque can develop on the opposite side to the original one, leading to the penis straightening out. Peyronie’s disease sufferers usually seek medical attention in the acute phase because of painful erections or difficulty with intercourse. Providing education about the disease, and its likely course, is often all that is required. Nothing has been shown conclusively to make plaques disappear, or to limit their growth. Some tablets can, however, limit the pain in the early inflammatory phase, or improve the quality of the erection if that is the main problem. Most clinicians favour one type of medical therapy over another, although the evidence for all is weak. Potassium para?aminobenzoate (Potaba®) tablets have the best available evidence for improving pain, but are not very well tolerated. Tablets such as sildenafil, vardenafil, tadalafil and avanafil can help by improving erectile dysfunction in Peyronie’s disease, and this may be all the treatment that is required. Traction devices Traction devices have been used during the painful, inflammatory phase to limit the development and impact of curvature. Using a vacuum erection assistance device twice a day for 10 minutes (or a penile extender traction device for six hours each day) can, over a period of three to six months, help correct some of the curvature.
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