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How is ED treated?

Most doctors suggest that treatments proceed from least to most invasive. Making a few healthy lifestyle changes may solve the problem. Quitting smoking, reducing alcohol consumption, losing excess weight, and increasing physical activity may help some men regain sexual function.

Cutting back on or replacing medicines that could be causing ED is considered next. For example, if a patient thinks a particular blood pressure medicine is causing problems with erection, he should tell his doctor and ask whether he can try a different class of blood pressure medicine.

Psychotherapy and behavior modifications in selected patients are considered next if indicated, followed by oral or locally injected drugs, vacuum devices, and surgically implanted devices. In rare cases, surgery involving veins or arteries may be considered.

Psychotherapy

Experts often treat psychologically based ED using techniques that decrease the anxiety associated with intercourse. The patient's partner can help with the techniques, which include gradual development of intimacy and stimulation. Such techniques also can help relieve anxiety during treatment for ED from physical causes.

Drug Therapy

Drugs for treating ED can be taken orally, injected directly into the penis, or inserted into the urethra at the tip of the penis.

Oral Medications
In March 1998, the U.S. Food and Drug Administration (FDA) approved sildenafil (Viagra), the first pill to treat ED. Since that time, vardenafil hydrochloride (Levitra) and tadalafil (Cialis) have also been approved. Additional oral medicines are being tested for safety and effectiveness.

Viagra, Levitra, and Cialis all belong to a class of drugs called phosphodiesterase (PDE) inhibitors. Taken an hour before sexual activity, these drugs work by enhancing the effects of nitric oxide, a chemical that relaxes smooth muscles in the penis during sexual stimulation and allows increased blood flow.

The recommended dose for Viagra is 50 milligrams (mg), and the doctor may adjust this dose to 100 mg or 25 mg, depending on the patient. The recommended dose for either Levitra or Cialis is 10 mg, and the doctor may adjust this dose to 20 mg if 10 mg is insufficient. Lower doses of 5 mg and 2.5 mg are available for patients who take other medicines or have conditions that may decrease the body's ability to use the drug. The 5 mg and 2.5 mg doses of Cialis are FDA-approved for daily use.

None of these PDE inhibitors should be used more than once a day. Men who take nitrate-based drugs such as nitroglycerin pills for heart problems should not use any of the three drugs because the combination can cause a sudden drop in blood pressure. Also, men should tell their doctor if they take any drugs called alpha-blockers, which are used to treat prostate enlargement or high blood pressure. The doctor may need to adjust the ED prescription. Taking a PDE inhibitor and an alpha-blocker within 4 hours of each other can cause a sudden drop in blood pressure. A small number of men have experienced vision or hearing loss after taking a PDE inhibitor. Men who experience vision or hearing loss should seek prompt medical attention.

Oral testosterone can reduce ED in some men with low levels of natural testosterone, but it is often ineffective and may cause liver damage. Patients also have claimed that other oral drugs-including yohimbine hydrochloride, dopamine and serotonin agonists, and trazodone-are effective, but the results of scientific studies to substantiate these claims have been inconsistent. Improvements observed following use of these drugs may be examples of the placebo effect-that is, a change that results simply from the patient’s belief that an improvement will occur.

Injectable Medications
While oral medicines improve the response to sexual stimulation, they do not trigger an automatic erection as injections do. Many men achieve stronger erections by injecting drugs into the penis, causing it to become engorged with blood. Drugs such as papaverine hydrochloride, phentolamine, and alprostadil widen blood vessels. The injectable form of alprostadil is marketed as Caverject. These drugs may create unwanted side effects, however, including scarring of the penis and persistent erection, known as priapism. Nitroglycerin ointment, a muscle relaxant, can sometimes enhance an erection when rubbed on the penis.

A system for inserting a pellet of alprostadil into the urethra uses a prefilled applicator to deliver the pellet about an inch into the urethra. The pellet form of alprostadil is marketed as MUSE. An erection will begin within 8 to 10 minutes and may last 30 to 60 minutes. The most common side effects are aching in the penis, testicles, and area between the penis and rectum; a warm or burning sensation in the urethra; redness from increased blood flow to the penis; and minor urethral bleeding or spotting.

Research on drugs for treating ED is expanding rapidly. Patients should ask their doctor about the latest advances.

Vacuum Devices

Mechanical vacuum devices cause an erection by creating a partial vacuum, which draws blood into the corpora cavernosa, engorging and expanding the penis. The devices have three components: a plastic cylinder, into which the penis is placed; a pump, which draws air out of the cylinder; and an elastic ring, which is moved from the end of the cylinder to the base of the penis as the cylinder is removed. The elastic ring maintains the erection during intercourse by preventing blood from flowing back into the body (see Figure 2). The elastic ring can remain in place up to 30 minutes. The ring should be removed after that time to restore normal circulation and to avoid skin irritation.

Couples may find that using a vacuum device requires some practice or adjustment. An erection achieved with a vacuum device may not feel like an erection achieved naturally. The penis may feel cold or numb and have a purple color. Bruising on the shaft of the penis may occur, but the bruises are usually painless and disappear in a few days. Ejaculation may be weakened because the elastic ring blocks some of the semen from traveling through the urethra, but the pleasure of orgasm is usually not affected.

Erotic Literature

Erotic literature comprises fictional and factual stories and accounts of human sexual relationships. These intend to arouse the reader sexually. The Internet and digital revolution in the history of erotic depictions, has blurred older forms of representing scenes of a sexual nature, although research indicates erotic literature was available among the poor and performed at public readings in 18th century Britain.

Online bookstores purvey a range of professional, commercial and non-commercial erotic writing. Whereas once access to online erotic fiction was largely restricted to membership or pay sites, in recent years a marked increase in the number of community based, not-for-profit or free access websites has led to an explosion in the level of popularity of this genre.

Increased interactivity and anonymity allows casual or hobby writers the opportunity not only to author their own stories, but also to share them with a worldwide audience.

Many authors adopt colorful pseudonyms and can develop cult followings within their genre, though a small number use their real names. Among transgendered or gender queer authors, it is a common practice to adopt a feminine or masculine alter ego, although it is not unheard of for a writer to use his or her own given name. Such erotica takes the form of novels, short stories, poetry, true-life memoirs, and sex manuals. Transgressive sexual fantasies are a common feature of the genre, on such themes as prostitution, orgies, homosexuality, sado-masochism, cross-dressing, incest and many other taboo subjects and fetishes. The stories may or may express in explicit language. Satire and social criticism are other common elements.

Auditions tv

Television auditions are very similar to Film and Theatre auditions. The main difference is time. Television is always under a time constraint. A script is written in a week, and the next week it must be cast in order to film the following week. Since there are a limited amount of recurring roles on television shows, most television auditions are for guest starring spots, under fives and extras. To get more information visit Television Auditions. The term auditions tv refers to television auditions. Television auditions are when actors audition for a part on a television show; some types of television show are: dramas, sit-coms (situation comedy) and soap operas.

For adults, the process of auditioning is much different than it is for babies. Adults are required to perform, as opposed to babies or infants, who basically will be cast by the way they look and their temperament. To learn more about what you can expect at a baby audition, go to baby auditions.

Aging changes in the Female Sexuality

 

As a woman ages, a number of changes take place in the female reproductive system. For women, the cessation of menses (menopause) is an obvious sign of aging. But, it is by no means the only change. A transition period, called the climacteric, lasts for many years before and after a woman's last menstrual period.

See also: Menopause
Information

For a woman, aging changes involve hormone levels, physical changes in the woman's entire reproductive tract, and psychological changes. Changes occur in the intricate relationship between the ovarian hormones and those produced by the pituitary gland (in the brain).

AGING CHANGES

Menopause is a normal part of a woman's aging process. The ovaries stop releasing eggs (ova), and menstrual periods stop. Most women experience menopause around age 50, although it occurs before age 40 in about 8% of women. Prior to menopause, menstrual cycles often become irregular.

The ovaries become less responsive to stimulation by follicle-stimulating hormone (FSH) and luteinizing hormone (LH). To try to compensate for the decreased response, the body produces more of these ovary-stimulating hormones for a time. The level of these hormones will eventually decrease.

The hormones produced by the ovaries include the different forms of estrogen (including estradiol), progesterone, and androgens (including testosterone). These hormones also decrease around menopause. The ovaries continue to produce small amounts of testosterone and some estrogen. The hormones produced by the pituitary gland are also decreased.

Because hormone levels fall, changes occur in the entire reproductive system. The vaginal walls become less elastic, thinner, and less rigid. The vagina becomes shorter. Secretions become scant and watery. The external genital tissue decreases and thins (atrophy of the labia).

In both men and women, reproductive system changes are closely related to changes in the urinary system.

EFFECT OF CHANGES

Prior to menopause, fertility varies depending on hormone levels. Menopause is said to have occurred when there has been one year without a menstrual period. With menopause, reproductive capacity is lost (the woman can no longer become pregnant).

Symptoms that accompany menopause vary in severity. Many of the symptoms are triggered by the hormone changes. Only about 20% to 30% of all women have symptoms that are severe enough that they seek medical attention.

Changes occur in the woman's breast tissue at the same time as other reproductive changes. A woman may experience changes in her sex drive (libido) and her sexual response may change, but aging does not prevent a woman from being able to have or enjoy sexual relationships. Most often, things such as availability of a partner, symptoms from vaginal dryness and thinning vaginal walls, and psychological and social factors affect a woman's sexual response more than direct aging changes.

COMMON PROBLEMS

The pubic muscles lose tone, and the vagina, uterus, or urinary bladder can fall out of position. This is called vaginal prolapse, bladder prolapse, or uterine prolapse, depending on which structure drops. A prolapse of any of these structures increases the risk of problems such as stress incontinence (urine leakage). Most prolapses can be treated.

Irritation of the external genitals can occur (pruritus vulvae). The vaginal walls become thinner and dryer and may become irritated (atrophic vaginitis). Sexual intercourse may become uncomfortable for some women (dyspareunia). There are changes in the levels of normal microorganisms in the vagina, and there is an increased risk of vaginal yeast infections.

Similar changes to the bladder and urethra may increase symptoms such as frequency and urgency of urination, and there is an increased risk of urinary tract infection after menopause.

Hot flashes, mood disturbances, headaches, and sleep disturbances are also common symptoms that occur during menopause. The causes of these changes are not well understood, but they are also related to the decreasing amount of estrogen produced by the ovaries.

Osteoporosis risk is greater in older women. This is caused, in part, by decreased estrogen levels.

PREVENTION and TREATMENT

Adequate lubrication (with a water-soluble lubricant) can help prevent painful sexual intercourse. A topical estrogen (applied inside the vagina) is sometimes recommended to help maintain the structure of the vaginal tissues. Sexual changes can also be related to factors other than simple aging.

Estrogen replacement (such as pills or patches) can prevent or reduce many of the symptoms associated with menopause, including vaginal atrophy and hot flashes. It also decreases the risk of complications such as osteoporosis.

However, hormone therapy (HT) may have side effects such as vaginal bleeding, and it has been associated with an increased risk of breast cancer, stroke, and heart disease, depending on when it is started and how long it is used. The risk and benefit of treatment is different for each person so women should discuss the pros and cons of estrogen treatment with her own health care provider.

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All Erotic Stories all
Baby By Sweatmeats - My insecurities turned me into a very loved baby. (FF, control, 1st-lesbian-expr) 5/19/2006
Back Room Wifebang By Anonymous - There is a lot of timing and luck involved in getting the chance to watch your normally reluctant wife suddenly turn it on for another man. But Brad, a 42-year-old professor, had that chance to see his 27-year-old wife perform at a convention last summer at an upscale hotel in Miami. (MMF, wife, voy) 5/14/2006
Backseat By Unknown BBS Author - A beautiful Aerobics instructor performs a special regimen in the backseat of one of her student's cars. (MF, affair) 6/12/1999
Backyard By Courtney - A girl home on vacation lies out in her parents backyard nude. Then finds that the neighbor man is peeking at her. (f-teen, solo, exh) 8/19/1997
Bad Boys By Cynthia - Cynthia does the Bi-sex scene with her boyfriend and his friend. (MMF, bi) 11/12/1997
Balls By Jilly - I'm a 22 year-old woman, and have always been fascinated with men's balls. I don't know about other women, but probably none of them have my particular fetish. I realize that I have a really kinky one, but all the guys I've known haven't seemed to mind. I like balls, and I've never heard of anyone liking men's balls as much as I do. (MF, size) 12/3/1999
Banana Split By Anonymous - She lies back, legs spread. I get out a banana, whipped cream, chocolate syrup and some cherries. The banana needs to be just barely ripe, almost still green, to be firm enough. (MF, rom, food) 4/10/2004
Barfly By Michael - A guy walks into a bar and gets the surprise of his life when a woman old enough to be his mother offers him an opportunity he can't pass up. (MF, public-sex, exh) 4/7/2002
Batgirl and Catwoman By Anon - She heard a voice, silky as a cat's purr but loud as a lion's roar and she knew she was in the right place. She had found Catwoman's Lair! And before Batman and Robin, too! She slipped something the size of a lipstick case from her utility belt, and then, wincing at the dirt on the glass, leapt through the skylight. (FF, catfight, movie-parody) 8/17/2003
Bath Time By Lori Helm - Two women and a guy take a bath together. (FFM, FF, oral, orgy) 10/2/1999
Bath Wrap By JOCA - Pat was home on vacation from College and yes she could get a little short tempered with her teenage brother and his friends. But did she really deserve what they did to her? At least the boys had fun, and well, maybe Pat did too, when all was said and done. (m+/F, teens, rp, gb) 1/18/2003
Becky Takes A Lover By B.J. - A married couple first fantasize about a threesome, then plan a way to make it really happen. They find that this new lifestyle is addictive in more than one way. (M+/F, wife, preg, intr) 2/4/2001
Beth's Party By Kristen - Beth's husband cheats with her best friend at Beth's party. They're in the pack yard alone in the swimming pool, at night. While the party goes on… (MF, cheat) 4/20/2000
Biker Girls By Melissa Keating - This is a story about my girl friend and lover, and myself one afternoon, with Frank, a guy among few, and how we fucked his brains out. Hope you'll like my story as much as I liked doing it. (FFM, bi) 9/1/2003
Billy & Jilly By Lisa & Sharon - Two children find their way on the path of sexual awakening. He's 15 and she's 13 and they're both virgins, that is until one fantastic afternoon while playing together they discover something wondrous. (mf-yteens, 1st) 10/5/2002
Bi-Sex with Byron By AB-2003 - Husband reluctantly acquiesces to his wife's desire to bring a black neighbor man into their bed. But soon he finds that there are lots of fringe benefits to the arrangement. (MMF, bi, intr, oral) 4/13/2003
Black Delivery By RMDragon - My mailman is fucking my wife. I can hardly believe it, because Sharon has never seemed very interested in sex. All that has changed now because a young black stud with a huge black cock found out exactly what turns her on. (MF, wife, intr, preg) 8/6/2001
Black Friday By Celia Garr - There was a period in my mid-twenties when I admit to having been fairly promiscuous. One Friday night when living in Monterey I went with some friends to a place called "Le Club." It was still fairly early and we were talking and drinking around a table, when they went off to dance or talk with someone else' and a black man approached me. I cannot remember his name. (Mdom/F, intr, huml) 6/18/2000
Black Neighbor By The BlackDude - A pretty young white wife falls hard for her big black viral neighbor. (MF, wife, intr, preg) 4/17/2005
Blindfolded Wife By Michael - I'd been married to my wife Laura for just about three years when I began to fantasize about having a threesome. (MMF, wife-sharing, inc) 10/4/2003
Blowjob For Daddy By Tattletale - Daughter comes home from college for summer vacation and catches her single dad masturbating in his bedroom. (MF, inc, oral) 2/17/2006
Blowjob Test By Horny Rick - College roommates who can't get any pussy decide to gratify their sexual needs with each other. (MMM, 1st-gay-expr, mast, oral, anal) 12/2/2006
Bobbi and the Frathouse By Bobbi Sue - Hi there it's Bobbi. For those of you who don't know me, I am a 5'1", 105 lb. athlete who has taken to showing off my body to liven up my sex life. I have shoulder length blond hair and blue eyes, and I like to think that my 34A-22-34 figure is firm and desirable. I am not beautiful, but I've been told by a lot of guys that I am. I would say that I am cute instead of gorgeous. My figure is firm because I work out at least eight hours a week, either cross country skiing, roller-blading, running, weight lifting, swimming, or biking. I've been told that my best feature is my firm ass, and I love to show it off. (F/M+, orgy) 8/21/1999
Bobbi Pulls a Train By Bobbi Sue - Based on "The Adventures of Bobbi" Bobbi Sue arranges to blow six guys then fuck them all -- at her friend Mary's house. She even gets a little pussy sucking done with Mary before hand. (M+/F, FF, oral, anal, orgy) 3/25/2000
Bobo By Vicki Eggie - Simply put, Virginia wanted to fuck. She didn't care who or where just as long as she got some hot male sausage to stuff into her aching pussy. "A girl can only go so long without riding the big shaft," she thought, "and I've gone about as far as I want to go." (F/dog, FF) 11/21/1999
Boyfriend, The By Caesar - Mom just hates Samantha's new boyfriend. She also hates that this no-good guy is bonking her sweet little daughter. Mom makes plans to get things back where they belong. (mf-teens, F/m-teen, nc?) 10/15/1997
Brandy and Kelly, Sisters By Sweet Irish - Sisters, one nineteen and the other eleven, encounter love and lust with two professional football players. Both were virgins and on a summer trip, allowed their lives to change. Norah, their mother, is also found to have enjoyed the fruits of love at an early age. The story contains others who are lucky in love and sex, in the end, father knows best or he gets the best. (Mf, ff, exh, inc) 4/22/2005
a target="_blank" href="../stories/brenda.htm">Brenda & Sarah By Comeman - Brenda and Sarah decide to put on a show for Brenda's boyfriend. And it all happens in the apartment Laundromat. (MF, FF, voy) 10/2/1997
Brenda's Education By Amy Davis - I remember when my Aunt Sherry came to spend a few days with my mother and me. My parents separated when I was 10 and my Aunt has been a great help to my mom. Aunt Sherry was five years younger then my mom and had never been married. She was always wearing sexy clothes and was a little on the wild side. (FF) 10/1/2001
Brother & Sister By Jennifer Conners - Sis moves in with her brother after she gets a divorce and takes up more than the duties of a wife. They actually go into the erotic video business after they decide that there are no boundaries to their relationship. (MF, inc) 5/28/1999
Buddy Fuck By Carl Smith - Andrea's on a business trip with two male associates when she decides that they're all good enough friends to buddy fuck. (MMF, work) 6/17/2006
Buddy Jerk-Off By AB-2003 - I still can't believe I let him do it. We'd been friends ever since 1st grade and nothing like this had ever happened before. (MM, mast, 1st-gay-exper) 4/19/2003
Bum Sex By AB-2006 - A young business woman succumbs to the urge to get down and dirty with homeless bums. (MF, unsafe-sex) 3/1/2006