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Medicine is the branch of health science and the sector of public life concerned with maintaining or restoring human health through the study, diagnosis, treatment and possible prevention of disease and injury. It is both an area of knowledge – a science of body systems, their diseases and treatment – and the applied practice of that knowledge.

Stimulation of the penile shaft by the nervous system leads to the secretion of nitric oxide (NO), which causes the relaxation of smooth muscles of corpora cavernosa (the main erectile tissue of penis), and subsequently penile erection. It is estimated that between 50% and 60% of diabetic men are impotent. It is estimated to affect between 10 million and 15 million men in the United States alone. So, how do you distinguish between impotence caused by problems with your body and that caused by psychological factors? A simple stamp can help. Tribulus had been used as traditional medicine to treat sexual dysfunction and male infertility in Europe and Asia for many decades before improvement in scientific extraction techniques allowed identification of its active ingredient, protodioscin. Now it is also defined as the inability to maintain an erection or ejaculate. A note of caution: Although there are many Tribulus extracts available over the counter today, almost all of these have been found not to contain any significant amount of the active ingredient. In this case, the impotence lasts as long as you are taking the drugs. Although they are often dismissed as ineffective solutions to impotence, more and more clinical research studies have found that herbs can help impotent men. One of the most underestimated causes of impotence is cigarette smoking — as if you need yet another reason to quit. as Tribulus shows positive effects only after two to three months. Several types of FDA approved vacuum therapy devices are available with a doctor's prescription. If you use these recreational drugs, however, you have bigger health problems than just impotence. As testosterone and other male sex hormone levels start to drop after reaching middle age, low testosterone level is often the culprit in most intermittent impotence problems, especially in older men. Penile erection is managed by two mechanisms: the reflex erection, which is achieved by directly touching the penile shaft, and the psychogenic erection, which is achieved by erotic or emotional stimuli. A significant proportion of men who have no sexual dysfunction nonetheless do not have regular nocturnal erections. A vacuum device composed of a plastic cylinder, pump and elastic ring or band can be used to affect an erection. Men with primary impotence have never had sufficient erections for satisfactory intercourse.

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