How to improve your sexual performance without pills?

2018-04-29 / Health / Comments Off on How to improve your sexual performance without pills?Comments

Let’s face it, from some point any men may have some troubles with strong, long-lasting and frequent erection. Good news is that there are many time-tested and effective drugs for erectile dysfunction. Different doses, different pharmacological forms and variety of pricing options – all that is available not only in pharmacies next door, but also at online pharmacies with free shipping and discount programs.

sexual performance

Erectile dysfunction can be either temporary, occurring for a brief period, or permanent – when a man is not able to have erection at all or the erection is weak. If such a problem occurs, you should make an appointment with your doctor, any you can try to improve the situation on your own too. Synthetic drugs do increase libido, and have one significant advantage: they provide immediate result. For example, worldwide known Viagra starts working half an hour after taking a pill and the effect lasts for 5 hours or more.

But sexual life improvement includes a lot more than basic actions aimed at enhancing sexual function. It implies steady improvement of the whole body and helps to support self-confidence. Here are a few helpful tips on how to enhance sexual performance naturally. These methods are effective both alone and in combination with medical treatment. They can support to effect of pills and have few to no contraindications.

  1. Pay attention to your nutrition

It goes without saying that proper nutrition plays a primary role in the functioning of the whole organism. Food should contain all the necessary micro- and macronutrients for the body, especially vitamins and minerals necessary for libido, the main ones are zinc, selenium, vitamin E, C, B group vitamins. Every day you should fill the daily need for these substances. A clever idea is to get a blood test done: it will show, if you have any deficits in the abovementioned substances.

  1. Do special exercises

We are not talking about gym know. There are a few special exercises aimed at increasing the sexual performance by improving blood circulation in the pelvis and pelvic organs by training the special muscle group: the pubic-coccygeal muscles. There is a popular mistake that these exercises are beneficial for women only. But recent research shows that they are effective in men as well. They are not going to take a lot of time, but provide a noticeable result after first few weeks of regular training.

Besides the well-known Kegel exercise, you can perform pelvic rotation with your hands-on waist and legs shoulder-width apart. Complete at least 10 repetitions clockwise and then 10 counter-clockwise. Another great exercise is “parade step”: walk lifting your knees as high as you can. By squeezing your glutes with your knees bent you can also increase the amount of blood coming to your pelvic floor and genitals. You can perform a “glute bridge” exercise as well (lying on the floor on your back, the feet firmly stand on the ground, push your hips up squeezing your glutes and then lower them down).

  1. Check your testosterone levels

Sexual function and sexual desire have a lot to do with the level of the male sex hormone testosterone. A low level of testosterone in the male body is the cause of decreased sexual desire and performance. This is especially true for middle-aged and older men, whose testosterone level is gradually decreasing with time (by about 1-1.5% per year after 25 years). Check it in the laboratory to make sure your testosterone level is okay. If it is too low, there are several hormonal under-the-counter drugs as well as over-the-counter legal testosterone boosters – herbs and extracts that naturally boost the production of the male hormone.

  1. Control your weight

Excess weight in men is the worst enemy of good sexual performance. The fact is that being overweight leads to reduced testosterone production, and increases the level of estrogen – female sex hormone, the excess level of which leads to erectile dysfunction, but also to the deterioration of the overall health of men. In addition, excess weight leads to cardiovascular diseases and diabetes, which are also serious factors in decreased erection strength and many other health risks. To diagnose excess body weight, it is necessary to measure the waist – 94 cm (37 inches) or more indicates obesity.

  1. Give up unhealthy habits

By giving up alcohol, smoking and drugs you can significantly improve the sexual function. This fact is scientifically proven by doctors. If you don’t feel like giving them up completely, minimize consumption of these harmful substances.

  1. Stand up!

Prolonged sitting throughout the day decreases sexual performance. It is noticed that in white-collars and people, who spend a lot of time sitting on their butt, there is a clear tendency to have more problems with erection. This is related to reduced physical activity and impaired blood flow in the pelvis. Besides, this may lead to hemorrhoids. A great way to minimize risks is to organize a transforming working place, where you can stand up and work. If it is not possible, you can set a timer and stand up to go out of the room and make a few simple exercises for sufficient blood circulation. Another good tip is to have at least 2 hours of walk daily. In addition, you can use Kegel exercises. Kegels are aimed at training the pubic-coccygeal muscle will help to improve sexual life a lot. The major advantage of this exercise is that you do not have to leave your workplace to perform it.

  1. Check your mental balance

Quite often problems with erectile function arise from traumatic psychological experiences or chronic stress. This may be the consequences of unsuccessful sexual intercourse, uncertainty about one’s sexual abilities, problems in other spheres of life etc. In any case, you need to learn how to deal with these problems. If you don’t feel enough competence to do that yourself, then you can use medical help: seek help from a sex therapist or psychotherapist.

  1. Deal with depression

Prolonged depressions and treatment with antidepressants significantly decrease the sexual activity. When the body is a subject to any negative experience, the sexual function is suppressed. That’s how the nature works: the ancient mechanism of fertilization controls the births in case the conditions are not favorable for that.Besides, antidepressants have a popular side effect of decreasing sexual performance.

  1. Get enough sleep

That may sound banal, but if you spend at least seven hours a day sleeping, you will notice a lot of positive changes in your sexual life. Make sure you organize optimal conditions for sleeping: complete silence and darkness, as these factors provide good rest, even if the amount of sleep in less.

  1. Learn more about physiotherapy

Shockwave therapy is a promising approach in urology, based on the ability of acoustic waves to stimulate regenerative processes in living tissues. Shockwave treatment sessions promote formation of new vessels in the penis, so that even patients with impaired peripheral blood supply (which are often observed in cardiac patients and patients with diabetes), the erection can be restored within a few weeks. The method has practically no contraindications and allows the use of medications to achieve a long lasting result in patients of different ages.

We recommend that you visit this page where specialists from Canadian Health&Care Mall give you weekly insight full of new and useful tips on how to improve your sexual life and health in general!

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Canadian Pharmacy: Prostate-specific antigen

2015-07-29 / disease / 0 Comments


Serum PSA measurement has revolutionized the detection of prostate cancer in the general population, and has produced a significant downward stage migration in the epidemiology of the disease. Benign disease, however, can also elevate the PSA: 28% of men with histologically proven BPH have a PSA over 4.0 ng/ml. In fact, the similarity in the epidemiology of the two conditions and their frequent coexistence constitutes one of the greatest impediments to the specificity of PSA testing for prostate cancer. BPH confounds PSA screening via a number of mechanisms. Unfractionated PSA correlates with prostate volume in a log-linear fashion; the relationship between the two variables becomes stronger with advancing patient age30. Conversely, finasteride, a common treatment for BPH, reduces PSA levels by roughly 50% after 6 months of therapy. While ‘correcting’ the PSA by doubling the reported value has been suggested for men taking finasteride, the actual percentage change may range from −81 to +20%. (Of note, alpha blockers and saw palmetto33, two other commonly used medications among BPH patients, do not significantly affect PSA.) Urinary retention, a frequent complication of BPH, can produce further increases in PSA of up to six-fold; levels have been reported to drop by 50% within 48 h of relief of obstruction.
In the general screening population, unfractionated PSA has a sensitivity of 67.5–80% and specificity of 60–70%, given a threshold for normal of 4.0 ng/ml35. PSA levels above 4.0 ng/ml are found in approximately 8–13% of men with neither BPH nor prostate cancer, and in more than 30% of men with BPH but not prostate cancer.

Among patients

with PSA 4–10 ng/ml, only about 25% with normal DRE results in fact have prostate cancer. The specificity of PSA in men with PSA 4–10 ng/ml falls to as low as 50%, owing to the broad overlap in PSA levels between men with BPH and prostate cancer in this range. In particular, Monda and colleagues found that PSA could not reliably differentiate BPH from T1a prostate cancer. In the series of BPH patients of Lepor and colleagues, PSA and DRE screening had a sensitivity of 86.7 and 80.0%, specificity of 80.9 and 86.3%, and PPV of 25 and 30%, respectively.
Digital rectal examination still detects up to 25% of prostate cancers that present in the setting of PSA less than 4 ng/ml, and therefore remains an essential part of prostate cancer screening, in the context of BPH or otherwise. Certainly, however, the PPV of DRE goes up with increasing PSA, ranging from 4 to 11% in men with PSA 0–2.9 ng/ml, and from 33 to 83% in those with PSA 3–9.9 ng/ml. Owing to the inability of unfractionated PSA to discriminate reliably between prostate cancer and BPH, a number of modifications and refinements have been proposed over the past decade, and currently stand at various levels of development. This review focuses on those that have been specifically evaluated in the context of differentiating BPH from prostate cancer in a screening population. It should be noted that none of these tests has yet shown consistent enough benefit to win the endorsement of the American Urological Association’s PSA best practices policy

PSA density

Prostate-specific antigen density (PSAD), described by Benson and colleagues in 1992, refers to the serum PSA divided by the prostate volume as calculated from transrectal ultrasound (TRUS) measurements using the prolate ellipsoid formula. This measurement attempts to improve the specificity of PSA testing for prostate cancer by accounting for the PSA changes produced by BPH. The ratio of PSA-producing epithelium to stroma is relatively preserved in BPH, and the serum PSA is thought to rise at a relatively constant rate of roughly 0.3 ng/ml per gram of hyperplastic tissue. In prostate cancer, however, the concentration of epithelial cells in a given volume of prostate tissue increases; moreover, the ‘leaky’ nature of the neoplastic endothelium allows a greater amount of PSA to enter the bloodstream, producing an increase in PSA as great as 3.5 ng/ml per gram of tumor. A study by Furuya and co-workers of patients undergoing open or transurethral prostatectomy for BPH found that each gram of BPH tissue removed reduced the PSA by an average of 0.18 ng/ml, and that after surgical treatment for BPH, PSA should return to normal levels in a patient without concurrent prostate cancer.
Benson and colleagues analyzed a cohort of 595 men with PSA levels between 4.1 and 10 ng/ml, and found mean PSAD values of 0.297 and 0.208 among men with and without prostate cancer, respectively (p<0.0001). They constructed a PSAD-based nomogram that calculated prostate cancer risk estimates ranging from 3 to 100%41. An updated analysis of 733 patients found mean PSAD values of 0.285 and 0.199 among biopsy-positive and – negative patients, and 0.165 among those with no indication for biopsy. They concluded that a PSAD>0.15 corresponded to an 18% positive biopsy probability among those with an abnormal DRE or TRUS, and a 6% probability among those with no abnormality.
A Japanese study of 63 men with histologically confirmed BPH and 234 men with prostate cancer found PSA levels between 4 and 10 ng/ml in 36 and 25 men, respectively.
The BPH patients had a mean prostate volume (determined by transabdominal ultrasound) and PSA of 17.1±8.2 ml and 6.42±1.82 ng/ml, respectively, for a mean PSAD of 0.218±0.085. The prostate cancer patients, by contrast, had a mean volume and PSA of 33.4±14.1 ml and 7.8±2.15 ng/ml, for a PSAD of 0.572±0.363. The authors found that PSAD measurement yielded>90% sensitivity and 56% specificity for distinguishing BPH from prostate cancer. Other PSAD studies have been reviewed previously by Beduschi and Oesterling.
Drawbacks to PSAD measurement include the need to perform TRUS to obtain the measurement, the operator-dependent nature of TRUS estimation of prostate volume and the variable stromal-epithelial ratio among individuals. In a large, prospective, multicenter study of nearly 5000 men screened for prostate cancer with PSA and PSAD, Catalona and associates found that TRUS-measured volume correlated poorly (r=0.61) with pathological prostate weight, and that employing a PSAD cut-off of 0.15 to guide biopsy decisions would miss 47% of cancers among patients with PSA levels between 4 and 10 ng/ml.

Transition zone-adjusted PSA

BPH is almost exclusively restricted to the transition zone of the prostate, whereas prostate cancer most often affects the peripheral zone. Kalish and colleagues therefore proposed that adjusting the PSA for the transition zone volume rather than the total prostate volume would better reflect the relative contribution to PSA from BPH tissue, particularly in the PSA ‘gray zone’ of 4–10 ng/ml46. The transition zone-adjusted PSA (PSAT) does in fact appear to distinguish BPH from prostate cancer more accurately than PSAD. Kurita and associates performed TRUS-guided biopsies on 164 consecutive patients with elevated PSA and/or abnormal DRE. They found cancer in 27.2%, and calculated ROC areas of 0.667 for PSA, 0.663 for PSAD (not significant) and 0.826 for PSAT (p<0.01).
Zlotta and coworkers evaluated PSA density parameters for histologically proven BPH (n=74) and prostate cancer (n=88) patients, finding mean PSAD values of 0.12±0.07 and 0.22±0.12, respectively, and PSAT values of 0.21±0.13 and 1.02±0.70. They estimated that using PSAT with a threshold of 0.35 would miss 10% of cancers, versus 34% using PSAD with a threshold of 0.15. Again using a threshold of 0.35, they calculated sensitivity and specificity for PSAT of 90 and 93% for patients with total PSA 0.25–10 ng/ml, and 94 and 89% for patients with PSA 4–10 ng/ml48. In a separate study, Zlotta and co-workers also found that assessment of prostate volume by TRUS was more accurate for the transition zone (correlation with pathological weight r=0.95, variability −17 to +18%) than for the whole prostate (r=0.78, variability −21 to +30%), further supporting the concept of PSAT rather than PSAD measurement.

Article by Canadian Pharmacy Mall –

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The significance of fertility preservation

2014-09-10 / Health / 0 Comments

The importance of communication with professionals and others

Feeling embarrassed was a common and lasting reaction, but was eased where staff appeared comfortable, used humour, paid attention to privacy, showed kindness and compassion and were clear in their information sharing – and made more difficult where staff were clearly uncomfortable:

  • …she [nurse at the sperm bank] made us feel uncomfortable cos…she didn’t seem very happy… Like you’re not going to see them happy… She just like, this is going to happen…right here’s the cup, go in there…just like that. Not like normal talking. (16 at diagnosis)

Phrasing of questions around consent was significant, for example when sperm bank staff asked what to do with banked sperm in the event of their death (a legal requirement in the UK). For two, this was made positive when it was pointed out that the question assumed they could live to age 55 and beyond; for a third, it was presented less sensitively and led to lasting distress:

  • …it could have been put more kindly I think…if you were to die… I had just found out I was diagnosed with it and the question comes up if you were to die… (16 at diagnosis)

Where information was put over well, the directness of the professional in giving information was appreciated, even though it could also be rather daunting:

  • The doctors, they don’t beat about the bush, they just like, right this is it. Then they just like say it. Then you have to look to think if that is what they’ve said or if you’re just imagining it. (16 at diagnosis)

Some were able to manage this with great feeling:

  • When she [consultant] told me everything about it, it was quiet really, there was nobody else in the room and that’s the way I preferred it as well…private, there was nobody else there…cos she actually drew the curtains and everything when she came in so it was very private, so that was good…yes that’s what I preferred, anyway. I preferred being private without anybody listening in. (17 at diagnosis)

The consensus among both young men and parents was that the gender of the professional mattered less than the existence of a prior relationship or their general manner. Nevertheless, for some there was some uncertainty. Two young men said that they found it uncomfortable to talk with a woman about ‘men’s things’ but one of these also struggled in his contact with the male Sildenafil Canada Online nurse on the grounds that he did not know him.

One young man described his relief at talking to a fellow patient about their shared experiences in a late night conversation away at camp. Another felt similar relief when talking for the first time, more than two years later, to an adult who had banked. Just as poignantly, one had spoken with others on the ward at the time but, on realizing that they had all banked and he was not able to, did not feel able to discuss it again.

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