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The Geneva Investment Group have been using the services of SF Drainage for the past 10 years. We have used the company on many occasions during this time and have been very pleased with the prompt and efficient service that we have received. As one of the biggest private landlords in Brighton and Hove, we pride ourselves on a prompt service to tenants who report drainage issues to us. By using SF Drainage we are sure that our tenants will get a quick, reliable and efficient service and that we, as landlords, are charged a realistic amount for the work carried out. We would have no hesitation in recommending the services of Sean Frape at SF Drainage and are pleased to be associated with this company.
We at innBrighton Ltd have been using S.F. Drainage for all drainage work within our estate in the Brighton & Hove area for over three and a half years. During that time we have never been let down or disappointed with the service provided and all issues have been resolved quickly and professionally whenever we have called them. We have no hesitation in recommending their services as a competent and reliable partner to work with.
Dear Sean, I want to thank you for the brilliant job you did for me. With the help of the Brighton and Hove pest control office I had been dealing with a rat invasion for nearly 2 months. It was finally decided that they were coming up through the drains as, like many properties in Woodingdean I had no interceptor drain. Southern Water engineers came and advised a camera survey of the drains to check where the rats were gaining entry. I then phoned you and in two days you came to my rescue. I was literally desperate and in a right state. You were very professional but brought a sense of humour to a rather grim situation. You checked my drains, flushed out 5 dead rats from the pipes, plugged the sewage vent and advised me on how to seal the drain where the concrete had crumbled and allowed the rats to get into the cavity wall and up into the loft. All this at a very fair price. I followed your advice and four weeks on I have had another check from the pest control officer who found no trace of rat activity. I have not heard anything either. I would whole heartedly recommend you to anyone and wish you every success in your business. I think of you and your brother as among the good guys! Thank you, Jennifer Peli


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Training Courses and Bookings - Full Details
Primary Events
Secondary Events
Joint / Other
Click 'Book Now' to reserve your place.
Senior Leader Development Programme - Session 1
26th February 2019, 9:30am-3:00pm
Venue: St Patrick's RC High School
This course is suitable for people who are aspiring to senior leadership or have been recently appointed to senior leadership.
Tuesday 26th February
Monday 11th March
Thursday 21st March
Tuesday 2nd April
The sessions are from 9:30am-3:00pm.
Course Content:
Session 1 - Climate vs culture and the impact of senior leaders
Session 2 - Leading people and leading teams
Session 3 - Leading impact, use of data and leading teaching and learning at a whole school level
Session 4 - Evaluation and next steps
£550 per delegate


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Raylene Cravens, owner of Lash by Lash studio in Oklahoma City, was just named NovaLash's 2019 Lash Artist of the Year. Here, she shares her top five tips for lash success.
Oribe Director of Training & Content, Kien Hoang, embraced natural curl and used a variety of Oribe products to enhance each shape to create low-maintenance, downtown-girl styles for the Nicole Miller F/W collection. Learn more here.
The International Salon and Spa Expo (ISSE) brought the acclaimed North American Hairstyling Awards (NAHA) and Beacon to the event for the first-time ever.
At Sunday night's Screen Actor's Guild (SAG) Awards 2019, Emily Blunt was styled by Laini Reeves using products from Joico to keep her looking award-winning all night long.
The biggest night in beauty has wrapped up and the 2019 North American Hairstyling Awards winners have been announced at ISSE Long Beach in California!
Entries open February 1 for CosmoProf Beauty's Licensed to Create Awards, which will take place during Premiere Orlando, June 2, 2018.
Winners of the MUD Make-up Designory scholarship administered by Beauty Changes Lives will each receive a $2,500 tuition scholarship.
Paul Dykstra, CEO, talks about the value of attending and exhibiting at Americas Beauty Show and the many ways attendance translates into support for the professional beauty industry.
Farouk Systems, Inc. hosted its fourth bi-annual CHI Education Symposium for cosmetology instructors across the US. More than 80 instructors from CHI Partner Schools traveled to Houston for this three-day educational event.
Laura Chihaia and Mireya Villarreal share how they found success and during a recent workshop that covered bridal upstyling, makeup techniques and photo editing.
Allison McElroy of Clive and Co. in Addison Texas and Ashley Peters of Jewel Hair Design in Alexandria, Virginia will each receive an immersive week of learning in Chicago, courtesy of Pivot Point International along with tickets to America's Beauty Show and the Beauty Changes Lives Experience.
The Makeup Show is having a special two-day holiday Pop Up Shop on December 15th and 16th in NYC. David Maderich, NAHA's 2018 Makeup Artist of the Year, shares details and why he is going.
The NAHA texture category demonstrates texture skills with designs that complement the individuality of diverse hair textures. Hair texture may be natural or chemically treated, but entries must display wearable, cutting-edge textured hair styles.
The NAHA Salon Team category showcases a team's diversity, versatility, creativity and expertise in hair styling. Salon teams must consist of at least two members and be employed at the same salon to be eligible.
Upstyles to classic waves, the NAHA Styling & Finishing category shows off the best in styling/finishing design.


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Union Coop to float tenders for UAQ mixed-use project
Union Coop said it will be floating tenders in July for the 191,742-sq- ft Umm Al Quwain Coop Project, a mixed-use development coming up in the northern emirate that will boast several retail units, a hypermarket and 70 residential apartments.
Spain unveils Expo 2020 Dubai pavilion design
Spain has unveiled the design for its Expo 2020 Dubai pavilion, portraying sustainability as the central theme and putting the spotlight on efficiency, energy saving and resource management in its making besides the special Spanish flair.
Al Raid lays foundation stone for $290m Oman walkway
Al Raid Group, a specialist developer of shopping malls and leisure destinations, has laid the foundation stone for RO112 million ($290 million) The Al Araimi Walk, a major shopping, entertainment and touristic destination in Oman, said a report.
Damac opens new 2,000-sq-m community skatepark
Damac Properties, a leading UAE-based luxury developer, said it has officially opened the gates to the new 2,000-sq-m skatepark located within its premium residential community, Damac Hills, in Dubai, UAE.
Musanada inks partnership deal with Krypto Labs
Musanada, a key provider of integrated services to Abu Dhabi government in facility management and construction, has signed a deal with Krypto Labs, a global innovation hub, to collaborate on innovation initiatives through knowledge-sharing.
Jumeirah Group unveils new luxury desert resort in Abu Dhabi
Jumeirah Group, a global hotel company and a member of Dubai Holding, is expanding its portfolio in the UAE with the opening of a luxury desert resort in Abu Dhabi featuring Arabian style rooms, magnificent villas with private pools and a destination spa.
Veolia consortium preferred bidder for Jeddah ISTP project
A consortium comprising Paris-based Veolia, a global leader in resource management, and its Saudi partners - utility company Marafiq and equity group Amwal AlKhaleej - has been named as the preferred bidder for the Jeddah Airport 2 ISTP Project.
Major phase of Saudi dam purification plant kicks off
The Saudi government has announced the launch of Phase Two of a key water purification plant at Beesh dam in the Jazan region. Once the project gets completed, its capacity of purified water will hit a whopping 150,000 cu m per day.
Saudi King unveils $22bn infrastructure projects
Saudi Arabia has launched over 1,000 infrastructure development projects worth a total of SR82 billion ($22 billion) in capital Riyadh and the surrounding towns mainly focusing on key sectors such as transportation and housing, said a report.
Saudi Arabia seeks technical consultants for STP project
Saudi Water & Electricity Company (WEC) has issued a request for qualification for technical consultants to undertake a pre-feasibility study and assess project technologies related to sewage plants with capacity of upto 25,000 cu m per day.
Bee'ah launches waste permit portal in Sharjah
Bee'ah, a sustainability pioneer in the Middle East, has joined forces with the Hamriyah Free Zone Authority (HFZA), to launch the first phase of a state-of-the-art Waste Permit Portal, the first of its kind in Sharjah, a media report said.
Saudi group AKH opens new HQ in Dammam
Saudi-based Al Abdul Karim Holding (AKH) company has announced the opening of its new headquarters in the Dammam region of the kingdom. The 37-storey AKH Tower was designed and supervised by Dewan Architects + Engineers.


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We all know whole grains are good for us, but we've collected the best whole-grain recipes to make them a regular part of your cooking routine. The fiber and nutrients associated with whole grains make them an essential part of a healthy diet, but it's often difficult to work them into your everyday cooking. This collection of recipes uses whole grains—from brown rice to whole-wheat pasta—in a delicious variety of ways.
If you want to achieve a healthy lifestyle you must take steps to ensure you maintain a certain level of balance… spiritually, physically, emotionally, socially, mentally and financially. You need to balance work and family, and all the other areas of your life without spreading yourself too thin and having a guilt trip when you do one thing, but think you should be doing another. All of the key areas of our lives overlap and interlink, effecting each other. Unless we create for ourselves satisfaction in each and every part of our life, we can never truly be fulfilled, or live a contented, happy and healthy life.
Anyone who eats a vegetarian diet knows that one of the most common questions asked is "Where do you get your protein?" But this gallery of recipes is your answer. We rounded up our favorite meat-free meals that also pack a serious punch of protein. With over 20 grams of protein per serving, these dishes are anything but rabbit food. Our hearty meals will keep you full and nourished by using vegetarian protein sources like tofu, eggs, lentils, tempeh, cheese, and beans.
If you've made it this far, it's likely you've had enough of something in your life. Whether that something be the number on the scales, the fact your clothes no longer fit you, how you look in the mirror, comments people make about you, the way you feel, or something else altogether. This time, you're motivated to do something different in the hope of experiencing a different outcome.
Heart disease is the No. 1 killer of both men and women in the U.S., claiming one out of every four lives. And while you might think it won't happen to you (you've got great genes, right?), over time, poor eating habits—those venti flavored lattes, desk-side snacks and late-night pizza runs—can lead to high blood pressure, high cholesterol and inflammation, raising your risk for heart attack and stroke.


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Thursday, 29. June 2017
Delphi Blogs of the (Week) Month #53
Marco's Tech Blog – Embarcadero News Embarcadero Partners with CData to Offer Enterprise Connectors (press release at http://www.businesswire.com/news/home/20170621005319/en). You can read more on this blog post from Sarina, https://community.embarcadero.com/blogs/entry/new-enterprise-connectors-for-delphi-and-c ...
Wednesday, 28. June 2017
Bug: Initialisation of Delphi Record containing a dynamic array with 'Implicit' class operator – Stack Overflow
The Wiert Corner – Bug: Initialisation of Delphi Record containing a dynamic array with 'Implicit' class operator – Stack Overflow [WayBack] Filed as [RSP-16084] Compiler produces wrong code: Initialisation of Delphi Record containing a dynamic array with 'Implicit' class operator – ...
Brisbane Meeting – July 2017
Australian Delphi User Group Members – Wednesday July 5th at 5:30pm to 9pm. Eivind will present on how to use the Google APIs to do Push Notifications with Delphi and Android. The material will form the basis for an app that will be useful for ADUGers, and attendees will have the opportunity to influence the features of the planned ...
Monday, 26. June 2017
RAD Studio 10.2 Patch for Android Released
Marco's Tech Blog – As Sarina already mentioned in the community site, last week Embarcadero released a second patch for Delphi and C++Builder 10.2 Tokyo. The first patch was focused on tool chain issues, while this new one addresses several issues for Android platform support. Namely, some of the fixes relate ...
Saturday, 24. June 2017
Castle Game Engine 6.2 released
Pascal Game Development – We're proud to announce the release of Castle Game Engine 6.2! Castle Game Engine is an open-source 3D and 2D game engine, with a support for many game asset formats, portable (desktop, mobile), with a lot of graphic effects and components. Check out our features here, take a look at our ...
Thursday, 22. June 2017
RAD Server and Enterprise Connectors
Stephen Ball – Connected Systems Many years ago I was the lead developer for a software development company that was a market leader in the leisure industry. Back in the day, we were using Delphi 3 and then Delphi 5 to create the software. The software was a complete CRM that interfaced with access control ...
Celebrating 22 Exciting Years of Innovation with Delphi
Marco's Tech Blog – Delphi was released over 22 years ago in San Francisco. More than two decades later, the Delphi design philosophy remains steadfastly the same: continual innovation and increasing productivity for developers. Throughout its history, Delphi has been one of the most successful development ...
Wednesday, 21. June 2017
Oh Look, Another Book!
Glooscap Software – "The odd thing about people who had many books was how they always wanted more." -- Patricia A. McKillip Oh for crying out loud! I just got finished writing about two new Delphi books and someone else throws their hat in the ring. It's like you can't turn around without tripping over another one ...
When someone writes UTF-8 and UTF-16 strings to the same file in binary format without converting between them…
The Wiert Corner – A while ago, I had to fix some stuff in an application that would write – using a binary mechanism – UTF-8 and UTF-16 strings (part of it XML in various flavours) to the same byte stream without converting between the two encodings. Some links that helped me investigate what was wrong, ...
Testing is Not Dead: The Future of the Software Testing Role
blog.gurock.com – This is a guest posting by Justin Rohrman. Justin has been a professional software tester in various capacities since 2005. In his current role, Justin is a consulting software tester and writer working with Excelon Development. Outside of work, he is currently serving on the Association For ...
Tuesday, 20. June 2017
Storing objects in the Google Firebase cloud with TMS Cloud Pack
TMS Software Blog – Since the latest release of TMS Cloud Pack, there is now also built-in support to use Google Firebase for cloud data storage. The architecture of Google's Firebase is quite simple. It offers storage of JSON data in the cloud. The JSON data has a unique identifier in a table and via access with this ...
TMS WebGMaps brings submarkers and extra options to load POI files
TMS Software Blog – We're pleased to announce TMS WebGMaps v2.9 has been released today. TMS WebGMaps is our VCL component that exposes a myriad of geographical functions for integration in Delphi or C++Builder Windows applications. In this new version, we introduce submarkers. When at a given position, more than one ...
Movie #124 - IndexFieldNames Property on FireDAC DataSets
LearnDelphi.TV – In this video we take a look how we can use the IndexFieldNames property on any FireDAC TDataSet to enable sorting when clicking on a TDBGrid title. The nice thing about FireDAC is it also allows you to sort in reverse order.
Movie #123 - IndexFieldNames Property on FireDAC DataSets
LearnDelphi.TV – In this video we take a look how we can use the IndexFieldNames property on any FireDAC TDataSet to enable sorting when clicking on a TDBGrid title. The nice thing about FireDAC is it also allows you to sort in reverse order.
Monday, 19. June 2017
Pictures from Italian Delphi Day last week
Marco's Tech Blog – Last week I was at a large Italian conference (with almost 100 Delphi developers attending) in my city. I gave a keynote on the status and future of Delphi, and there were many other sessions given by Italian Delphi developers and some international experts (including Stefan, Dmitry, and Yuriy). See ...


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Miniature farm animals helping children and teenagers cope with autism
Miniature farm animals are being used to provide respite and support to children and teenagers with autism.
INKA respite farm stay at Lake Clifton, 110 kilometres south of Perth, is home to the fun-size animals including pigs, sheep, goats and horses.
Groups of children and teenagers with autism bunk at the homestead and work together to care for each other and the animals.
Max and Marlow stand at half the height of a standard goat. (ABC Radio Perth: Gian De Poloni)
The farm's manager, Jim Brownlie, said while the children might be intimidated by Knickers the giant steer who lives just 20 minutes up the road, his animals' small stature made them feel safe and comfortable.
"It's very calming for a lot of them," he said.
"It's a night-and-day difference for some of these guys who come here because other places can't cope with them, but here they're totally different.
"They've got the animals, they've got the freedom, and they've got the quietness away from the city."
Mr Brownlie said some of the guests were highly autistic and did not cope well in high-pressure environments.
"When we see signs [of difficulty], we try to get them outside, and as soon as we get them down beside the animals, it just seems to calm them down," he said.
"It's great therapy for them, they just love feeding the animals.
"It's the same faces all the time here that the guys see and they cope better with that."
A newborn mini-pig at INKA Respite in Lake Clifton, which are sold to make money for the centre. (ABC South West: Michael Black)
Mini pigs the star attraction
Mr Brownlie rears miniature piglets and sells them to raise money for the organisation.
He said there had been a high demand for the pigs as pets in recent years and saw them as a suitable alternative to a domestic dog or cat.
"They're intelligent, they have the IQ of a three-year-old, and they're very easy to train.
"They take a wee bit more work than a puppy to begin with, but they learn quicker than a puppy once you get over that initial first start because they're very wary of strangers.
"They're very much great fun, they love water, you can take them to the beach and they'll get in the sea — they're much like a dog."
Arnold and Olivia are two full-sized mini-pigs that are cared for at the farm. (ABC South West: Michael Black)
The only challenge is that miniature pigs are classified as farm animals by local councils, meaning special provisions are needed to keep them in urban areas.
"To me there's nothing different about them," Mr Brownlie said.
"They're an animal that needs care, just the same as a dog."
Countryside is relaxing for autistic kids
Twenty-year old Tom Lean is autistic and said the farm had become a second home.
"I love it because I'm out of the city," he said.
"My family has farms so I've always been a farm person — I feel more relaxed, I don't get annoyed as much.
"I do find it good to get away from everyday reality out here.
"I like helping make pens up, I like feeding the animals, looking after them."
Mr Lean said he saw it as his responsibility to help take care of some of the other children lodging at the farm.
"Some days it can be a bit full-on, but I feel like I am making a difference to them and they do enjoy it," he said.
"I believe I am doing a good job at it."
As for Mr Brownlie, he said he and his family would never eat bacon again after caring for the miniature pigs.
"My niece won't touch any pork products at all now because of the mini pigs — and she used to love it."
The miniature sheep at the farm are a Victorian breed known as Babydoll Southdown. (ABC Radio Perth: Gian De Poloni)


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Stoke Primary Academy is a values-led school I which staff model the respect for others, self and the school environment that we wish to promote.
With clear boundaries for behaviour through our 'Stoke Expectations' and consistent but fair consequences, children understand the parameters and feel safe in school. We nurture good behaviour through building relationships with pupils and engaging them in exciting learning experiences that respect individuals and build self-esteem.
Children at Stoke know that we expect:
Children take pride in their school and enjoy working hard to meet our school expectations.
To foster a greater understanding of how we learn, we also focus on developing our Learning Powers through everything that we do. Children know that they can achieve great things if they build these learning powers and think about how to improve on the areas that they find tricky.
Our Learning Powers are:
-Be curious
-Have a go!
-Be co-operative
-Use your imagination
-Don't give up!
-Enjoy learning
-Keep improving
For more information about our behaviour expectations at Stoke, please see our Behaviour Policy.


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EPE have been working with DTP Media to design a new website. It is currently under construction, so please bear with us. In the mean time, email us using
Event Power Engineering have recently been awarded the contract to install a brand new festoon lighting system running along 1000m of the streets in St Ives. The specification is to remove all parts of the previous installation, that is around 30 years old and has been declared as unsafe, and to replace with entirely new fixing points, catenary, electrical circuits, cabling and lamps. To make this...
We've recently found an article written on Cornwall Live detailing our recently acquired appointment. Thanks for the comments
We have just come across an article of the St Ives BID website. http://stivesbid.co.uk/portfolio/festoon-lights/
Working with and the , Event Power Engineering installed Winter Lights into Boscombe precinct. These consisted of custom designed ghost and pumpkin motifs, attractive, animated displays and boas across the street mixed with lamp columns decorated with lit bats and spiders webs.
Event lighting and Christmas lighting specialists, Event Power Engineering, were enlisted by Littlehampton Town Council to create an innovative Christmas lighting display in the town centre. The display ran throughout the festive period starting with the annual light switch on in November, right up until the 12th night of Christmas in January 2018.
Continue reading...


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Cambridge Cream Silk Stripe Fabric
Click for Product Details
Bold or Subtle, these stripes make a stament in your room. Like a beautiful suit they never go out of style. A variety of sheens and finishes are featured in this of designer silk collection. Woven from 100% silk fibers.SOLD PER YARD100% SilkDry Clean Only
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General Contractor
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Building your Business
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Free Consultation
Get a unique analysis of your needs and a jump start on your business expansion.Get my Free Consult »
What Our Customers Say:
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I have had the pleasure of working with Hoeft Builders on both the construction and subsequent renovation of our office in Eau Claire and the construction of our new office in Chippewa Falls in 2009.
I can recommend them highly and without reservation. They did whatever it took to get the job done as promised. The finished work attests to their commitment to quality. Again, I can recommend Hoeft Builders without reservation.
Hoeft Builders did a great job managing the original scope of work and all the unanticipated work that needed to be completed that was not in the original scope of work. Hoeft Builders did an excellent job coordinating the construction and meeting project deadlines. The communication, attention to detail and follow through has been superb. Hoeft Builders has made this Dunkin Donuts build-out a low maintenance experience for us.
We would like to thank you on an excellent job on the construction of our building located in Fort Atkinson, Wisconsin. As a franchisee of numerous fast food restaurants, I will say I have rarely had a building go up as smoothly and timely.
It was a pleasure working with you as our Construction Management firm and we will most definitely keep Hoeft Builders in mind for our next build.
We knew we needed an experienced General Contractor to build our new Mega Foods store. The precast, block and steel building was constructed just inches behind the existing store while keeping the original Mega East open for business every day during construction. Hoeft Builders did an excellent job from project planning through occupancy.
As our General Contractor, Hoeft Builders exceeded our expectations and our customers remark on a daily basis how great the new store is. Since the store has opened we have engaged in multiple other projects with Hoeft including a new Mega Holiday in Chippewa Falls and again our experience was great. The team at Hoeft Builders is top-notch and always there when we need them.
We had the pleasure of working with Hoeft Builders, as our Construction Management firm on the construction of our orthodontic office. We were impressed that Peter Hoeft personally made several on-site visits to discuss our vision. Chris Colle was very professional and personable, managing every step of our project extremely well and responding quickly to changes. Our office was completed on time, within budget, and with an exceptional result. We give Hoeft Builders our highest recommendation and look forward to working with them on our next project!
Peter – I just wanted to check in with you and let you know how thankful I am for Jay and Chris. They are both so organized, responsive and professional. In the past few weeks, they have helped to make everything clear and organized. They have been so willing to listen our ideas and help us to create the perfect space for our members. So, as I am sitting here at my desk trying to wrap my head around everything that is happening, I seriously am thinking that I'm not sure what I would do if they weren't involved. I just wanted you to know how much I appreciate everything you and your staff are doing for the Boys & Girls Club. Thank you!
Working with Hoeft Builders was stress free and dare we say, fun? Those are not words most people would use to describe their general contractor! This is a group of good hometown guys who bring world class service and experience. We never heard the words "no we can't." They were always happy to go leaps and bounds beyond what we expected during the busy and stressful time of building a new home for our practice. They never stopped at the brick and mortar, they helped us with every detail of the operation. We felt confident and comfortable that they would not only get the job done, they would get it done right.
Every single person we interacted with was professional and approachable. Peter Hoeft and his team effortlessly managed the building process before our eyes…from the plot of frozen ground to the beautiful final product for a functional building with classy details and personal touches. You can't help but like these guys…they went from builders to friends…we would do it all over again, but only with Hoeft Builders!
Thank you for your efforts in the build-out of our newest Erbert & Gerbert's location on Clairemont Avenue. This is the fourth store we've developed over the past fifteen years and it was by far the best experience ever.
The project was letter perfect from start to finish. I have said on more than one occasion that if we decide to build another location in or around Eau Claire, we won't even consider it without Hoeft Builders as our Construction Management firm. Thank you so much.
As a public entity, we typically work with a variety of General Contractors on many different types of building projects and Hoeft Builders has proven to be a quality General Contractor focused on delivering a quality product to their customers. From the owner to the project managers, they are very service oriented and are extremely professional, capable and easy to work with. The commitment and attitudes of everyone involved was second to none. Hoeft Builders is an excellent General Contractor.


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ED usually has a multifactorial etiology. Organic, physiologic, endocrine, and psychogenic factors are involved in the ability to obtain and maintain erections. In general, ED is divided into 2 broad categories, organic and psychogenic. Although most ED was once attributed to psychological factors, pure psychogenic ED is in fact uncommon; however, many men with organic etiologies may also have an associated psychogenic component.
Associated morbidity may include various other male sexual dysfunctions, such as premature (early) ejaculation and male hypoactive sexual desire disorder. The NHSLS found that 28.5% of men aged 18-59 years reported premature ejaculation, and 15.8% lacked sexual interest during the past year. An additional 17% reported anxiety about sexual performance, and 8.1% had a lack of pleasure in sex. [51]
The first period occurs between 4 and 6 weeks of the gestation. Examples include genital virilisation such as midline fusion, phallic urethra, scrotal thinning and rugation, and phallic enlargement; although the role of testosterone is far smaller than that of dihydrotestosterone. There is also development of the prostate gland and seminal vesicles.
Can apple cider vinegar treat erectile dysfunction? Apple cider vinegar is thought to have many health benefits, but can it help treat erectile dysfunction (ED)? ED can result from cardiovascular problems, diabetes, and other factors. Apple cider vinegar may help improve symptoms of conditions related to ED. Find out how it may help, and how to use it safely. Read now
4. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Erectile dysfunction (updated Nov 2015). https://www.niddk.nih.gov/health-information/health-topics/urologic-disease/erectile-dysfunction/Pages/facts.aspx (accessed Nov 2016). myDr myDr provides comprehensive Australian health and medical information, images and tools covering symptoms, diseases, tests, medicines and treatments, and nutrition and fitness.Related ArticlesImpotence causesFind out the physical and psychological causes of impotence, also called erectile dysfunction or ED.Erectile dysfunction: visiting your doctorFind out what questions a doctor may ask when discussing erectile dysfunction (ED, or impotence8 Surprising causes of erectile dysfunctionOccasional erectile dysfunction is not uncommon, but if it's persistent, erectile dysfunction caAdvertisement
Even before the study yields its findings, Dr. Swerdloff said a few important points should be emphasized. "I want to make it clear that this is not a made-up disease," he said. "It is well known in younger men that if you have a failure to produce normal testosterone, there are certain signs and symptoms that create a kind of syndrome. Treatment for low testosterone has been documented to be beneficial."
Side effects include lightheadedness, fainting, priapism, urethral bleeding (intraurethral), dyspareunia in the partner (intraurethral), hematoma (intracavernosal) or penile curvature secondary to scar (intracavernosal). Efficacy of intraurethral alprostadil has been demonstrated to be around 50% ("able to have intercourse") in randomized controlled trials.31,32 For intracorporeal injection, typically alprostadil is tried alone, or compounded with papaverine (nonspecific phosphodiesterase inhibitor that increases intracellular cyclic adenosine monophosphate and cGMP) and/or phentolamine (competitive, non-selective alpha1- and alpha2-adrenoreceptor blocker). Pinsky et al33 reported an extensive review of the benefits and drawbacks of the combinations of these drugs.
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So what is this Big T, anyway? Derived from cholesterol, testosterone is a steroid hormone—called an androgen—that causes the development and maintenance of masculine characteristics. It's mainly secreted by the testicles in males, although the adrenal cortex and ovaries in females also secrete testosterone—though only about one-tenth the amount as in healthy males.
The hypogonadal-obesity-adipocytokine cycle hypothesis. Adipose tissue contains the enzyme aromatase which metabolises testosterone to oestrogen. This results in reduced testosterone levels, which increase the action of lipoprotein lipase and increase fat mass, thus increasing aromatisation of testosterone and completing the cycle. Visceral fat also promotes lower testosterone levels by reducing pituitary LH pulse amplitude via leptin and/or other factors. In vitro studies have shown that leptin also inhibits testosterone production directly at the testes. Visceral adiposity could also provide the link between testosterone and insulin resistance (Jones 2007).
Qaseem, A., Snow, V., Denberg, T. D., Casey, D. E., Forciea, M. A., Owens, D. K., & Shekelle, P. (2009). Hormonal testing and pharmacologic treatment of erectile dysfunction: A clinical practice guideline from the American College of Physicians. Annals of internal medicine, 151(9), 639-649. Retrieved from http://annals.org/aim/article/745155/hormonal-testing-pharmacologic-treatment-erectile-dysfunction-clinical-practice-guideline-from
Clinical experience in switching medications to improve ED has been disappointing in that improvement does not often occur. Nonetheless, it is important to try to discontinue possible offending medications before proceeding to more invasive ED treatment options. Oral ED medications have changed the way clinicians discontinue medications in patients with ED and has improved the approach. For example, a patient may develop ED on a thiazide diuretic. The diuretic may be withdrawn, but a trial of oral ED therapy can be initiated during the observation period while the patient is waiting to see if any spontaneous improvement in ED occurs after drug withdrawal. Alternatively, if diuretic therapy is effective, well tolerated, and controlling blood pressure, oral ED therapy can be used on an ongoing basis to treat the side effect of ED.
For people who are worried about low or high testosterone, a doctor may perform a blood test to measure the amount of the hormone in the patient's blood. When doctors find low-T, they may prescribe testosterone therapy, in which the patient takes an artificial version of the hormone. This is available in the following forms: a gel to be applied to the upper arms, shoulders or abdomen daily; a skin patch put on the body or scrotum twice a day; a solution applied to the armpit; injections every two or three weeks; a patch put on the gums twice a day; or implants that last four to six months.
Long-term predictions based on an aging population and an increase in risk factors (eg, hypertension, diabetes, vascular disease, pelvic and prostate surgery, benign prostatic hyperplasia, and lower urinary tract symptoms) suggest a large increase in the number of men with ED. In addition, the prevalence of ED is underestimated because physicians frequently do not question their patients about this disorder.
A physical cause can be identified in about 80% of cases.[1] These include cardiovascular disease, diabetes mellitus, neurological problems such as following prostatectomy, hypogonadism, and drug side effects. Psychological impotence is where erection or penetration fails due to thoughts or feelings; this is somewhat less frequent, in the order of about 10% of cases.[1] In psychological impotence, there is a strong response to placebo treatment.
Sally has a Bachelor's Degree in Biomedical Sciences (B.Sc.). She is a specialist in reviewing and summarising the latest findings across all areas of medicine covered in major, high-impact, world-leading international medical journals, international press conferences and bulletins from governmental agencies and regulatory bodies. At News-Medical, Sally generates daily news features, life science articles and interview coverage.
When females have a higher baseline level of testosterone, they have higher increases in sexual arousal levels but smaller increases in testosterone, indicating a ceiling effect on testosterone levels in females. Sexual thoughts also change the level of testosterone but not level of cortisol in the female body, and hormonal contraceptives may affect the variation in testosterone response to sexual thoughts.[51]
The development of an erection is a complex event involving integration of psychologic, neurologic, endocrine, vascular, and local anatomic systems. Positron emission tomography scanning studies have suggested that sexual arousal is activated in higher cortical centers that then stimulate the medial preoptic and paraventricular nuclei of the hypothalamus.5 These signals ultimately descend through a complex neural network involving the parasympathetic nervous system and eventually activate parasympathetic nerves in the sacral area (S2 to S4).
^ Butenandt A, Hanisch G (1935). "Uber die Umwandlung des Dehydroandrosterons in Androstenol-(17)-one-(3) (Testosterone); um Weg zur Darstellung des Testosterons auf Cholesterin (Vorlauf Mitteilung). [The conversion of dehydroandrosterone into androstenol-(17)-one-3 (testosterone); a method for the production of testosterone from cholesterol (preliminary communication)]". Chemische Berichte (in German). 68 (9): 1859–62. doi:10.1002/cber.19350680937.
Like other steroid hormones, testosterone is derived from cholesterol (see figure).[120] The first step in the biosynthesis involves the oxidative cleavage of the side-chain of cholesterol by cholesterol side-chain cleavage enzyme (P450scc, CYP11A1), a mitochondrial cytochrome P450 oxidase with the loss of six carbon atoms to give pregnenolone. In the next step, two additional carbon atoms are removed by the CYP17A1 (17α-hydroxylase/17,20-lyase) enzyme in the endoplasmic reticulum to yield a variety of C19 steroids.[121] In addition, the 3β-hydroxyl group is oxidized by 3β-hydroxysteroid dehydrogenase to produce androstenedione. In the final and rate limiting step, the C17 keto group androstenedione is reduced by 17β-hydroxysteroid dehydrogenase to yield testosterone.
Alprostadil (also known as prostaglandin E1 [PGE1]) is the prominent known smooth-muscle dilator of the corpus cavernosum. Its mechanism of action is believed to be the promotion of intracellular accumulation of cyclic adenosine monophosphate, thereby causing decreased intracellular accumulation of calcium and resulting smooth muscle relaxation. Alprostadil can be delivered to the erectile tissue either via an intraurethral suppository that is massaged and then absorbed across the corpus spongiosum of the urethra to the corpora cavernosa, or directly injected into the corpora cavernosa. When administered urethrally, doses are substantially higher than when directly injected (typical dosing is 500 mcg to 1 mg intraurethral compared with 2.5 mcg to 20 mcg intracavernosal).
Instead of the hesitation with which he had accosted the cardinal a quarter of an hour before, there might be read in the eyes of the young king that will against which a struggle might be maintained, and which might be crushed by its own impotence, but which, at least, would preserve, like a wound in the depth of the heart, the remembrance of its defeat.
A simple blood test can determine testosterone levels. There is a wide range of "normal" or healthy level of testosterone circulating in the bloodstream. The normal range of testosterone for men is between 250 and 1100 ng/dL for adult males, and between 8 and 60 ng/dL for adult females, according to the Mayo Clinic. Ask your doctor to test your testosterone levels if you have concerns about low testosterone (low T).
ED can also occur among younger men. A 2013 study found that one in four men seeking their first treatment for ED were under the age of 40. The researchers found a stronger correlation between smoking and illicit drug use and ED in men under 40 than among older men. That suggests that lifestyle choices may be a main contributing factor for ED in younger men.
Sugar is to testosterone what kryptonite is to Superman. Eliminating sugar is probably the single most powerful way to increase your performance, in part because sugar absolutely devastates your testosterone levels (but all carbs do not, especially under heavy training.) In one study of 74 men, a 75g dose of sugar – about the equivalent of a bottle of soda – decreased serum testosterone by 25% in under an hour, and levels stayed low for at least 2 hours [7]. On top of that, 15% of the men who started with normal testosterone dipped into the hypogonadal range after they ate sugar – that's the range in which doctors diagnose men's testes and women's ovaries as failing. When you do eat carbs, stick to Bulletproof ones like sweet potatoes and squash. My recommendations for types of carbs and how often to eat them are here.
Many clinical studies have looked at the effect of testosterone treatment on body composition in hypogonadal men or men with borderline low testosterone levels. Some of these studies specifically examine these changes in older men (Tenover 1992; Morley et al 1993; Urban et al 1995; Sih et al 1997; Snyder et al 1999; Kenny et al 2001; Ferrando et al 2002; Steidle et al 2003; Page et al 2005). The data from studies, on patients from all age groups, are consistent in showing an increase in fat free mass and decrease in fat mass or visceral adiposity with testosterone treatment. A recent meta-analysis of 16 randomized controlled trials of testosterone treatment effects on body composition confirms this pattern (Isidori et al 2005). There have been less consistent results with regard to the effects of testosterone treatment of muscle strength. Some studies have shown an increase in muscle strength (Ferrando et al 2002; Page et al 2005) with testosterone whilst others have not (Snyder et al 1999). Within the same trial some muscle group strengths may improve whilst others do not (Ly et al 2001). It is likely that the differences are partly due to the methodological variations in assessing strength, but it also possible that testosterone has different effects on the various muscle groups. The meta-analysis found trends toward significant improvements in dominant knee and hand grip strength only (Isidori et al 2005).
^ Jump up to: a b Sapienza P, Zingales L, Maestripieri D (September 2009). "Gender differences in financial risk aversion and career choices are affected by testosterone". Proceedings of the National Academy of Sciences of the United States of America. 106 (36): 15268–73. Bibcode:2009PNAS..10615268S. doi:10.1073/pnas.0907352106. PMC 2741240. PMID 19706398.
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Patients receiving penile prostheses should be instructed in the operation of the prosthesis before surgery and again in the postoperative period. The prosthesis usually is not activated until approximately 6 weeks after surgery, so as to allow the edema and pain to subside. The prosthesis is checked in the office before the patient begins to use it.
Findings that improvements in serum glucose, serum insulin, insulin resistance or glycemic control, in men treated with testosterone are accompanied by reduced measures of central obesity, are in line with other studies showing a specific effect of testosterone in reducing central or visceral obesity (Rebuffe-Scrive et al 1991; Marin, Holmang et al 1992). Furthermore, studies that have shown neutral effects of testosterone on glucose metabolism have not measured (Corrales et al 2004), or shown neutral effects (Lee et al 2005) (Tripathy et al 1998; Bhasin et al 2005) on central obesity. Given the known association of visceral obesity with insulin resistance, it is possible that testosterone treatment of hypogonadal men acts to improve insulin resistance and diabetes through an effect in reducing central obesity. This effect can be explained by the action of testosterone in inhibiting lipoprotein lipase and thereby reducing triglyceride uptake into adipocytes (Sorva et al 1988), an action which seems to occur preferentially in visceral fat (Marin et al 1995; Marin et al 1996). Visceral fat is thought to be more responsive to hormonal changes due to a greater concentration of androgen receptors and increased vascularity compared with subcutaneous fat (Bjorntorp 1996). Further explanation of the links between hypogonadism and obesity is offered by the hypogonadal-obesity-adipocytokine cycle hypothesis (see Figure 1). In this model, increases in body fat lead to increases in aromatase levels, in addition to insulin resistance, adverse lipid profiles and increased leptin levels. Increased action of aromatase in metabolizing testosterone to estrogen, reduces testosterone levels which induces further accumulation of visceral fat. Higher leptin levels and possibly other factors, act at the pituitary to suppress gonadotrophin release and exacerbate hypogonadism (Cohen 1999; Kapoor et al 2005). Leptin has also been shown to reduce testosterone secretion from rodent testes in vitro (Tena-Sempere et al 1999). A full review of the relationship between testosterone, insulin resistance and diabetes can be found elsewhere (Kapoor et al 2005; Jones 2007).
5. Medline Plus. US National Library of Medicine. NIH National Institutes of Health. Drugs that may cause impotence (updated 21 Jan 2015). http://www.nlm.nih.gov/medlineplus/ency/article/004024.htm (accessed Nov 2016). myDr myDr provides comprehensive Australian health and medical information, images and tools covering symptoms, diseases, tests, medicines and treatments, and nutrition and fitness.Related ArticlesImpotence treatmentsIf you have impotence (erectile dysfunction), the treatment your doctor recommends will depend on thErectile dysfunction: visiting your doctorFind out what questions a doctor may ask when discussing erectile dysfunction (ED, or impotenceGum disease linked to erectile dysfunctionAdvanced gum disease (periodontitis) has been linked to an increased risk of erectile dysfunction, wPeyronie's diseasePeyronie's disease is condition where a band of scar tissue forms in the penis, causing aAdvertisement
Do erectile dysfunction exercises help? Many people have erectile dysfunction (ED), but it is often possible to reverse this with exercises to strengthen muscles in the area. These include pelvic floor exercises. ED can often be due to lifestyle factors including obesity and low physical activity levels. Learn more about exercises for ED here. Read now
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When Solvay Pharmaceuticals, maker of market-dominating Androgel, launched its "Low T" campaign, in 2008, it claimed that 13 million American men over age 45 suffered from low testosterone, 90 percent of them undiagnosed. Its website, IsItLowT.com, showed dumpy, depressed men and their unhappy spouses remembering how it "used to be." Why settle for dumpiness and depression, the website and related TV ads suggested, when a little dab'll do you?
The doctor regularly measured my levels to be sure they were within the normal range for a male my age. In other words, I wasn't taking 'roids to get big; I was getting control of hormones that were not functioning well. This is how you should look at testosterone therapy – it is a gentle nudge to help you be in normal ranges, not a big push to get you huuu-yge. If you're like me, you want "normal ranges" of a 27-year-old, not of a 60-year-old. It's my plan to keep my testosterone where it is now (around 700) no matter what it takes. Right now, the Bulletproof Diet and the other biohacks I've written about do that! I'm 43.
Several studies accessed the prevalence of ED. The Massachusetts Male Aging Study reported a prevalence of 52%.2 The study demonstrated that ED is increasingly prevalent with age: approximately 40% of men are affected at age 40 and nearly 70% of men are affected at age 70. The prevalence of complete ED increased from 5% at age 40 to 15% at age 70.2 Age was the variable most strongly associated with ED.
Inside the cell, NOS catalyzes the oxidation of L-arginine to NO and L-citrulline. Endogenous blockers of this pathway have been identified. The gaseous NO that is produced acts as a neurotransmitter or paracrine messenger. Its biologic half-life is only 5 seconds. NO may act within the cell or diffuse and interact with nearby target cells. In the corpora cavernosa, NO activates guanylate cyclase, which in turn increases cyclic guanosine monophosphate (cGMP). Relaxation of vascular smooth muscles by cGMP leads to vasodilation and increased blood flow.
In many cases, diagnosing erectile dysfunction requires little more than a physical exam and a review of your symptoms. If your doctor suspects that an underlying health problem may be at play, however, he may request additional testing. Once you've determined the cause for your ED, you and your doctor can decide on a form of treatment – here are some of the options:
Erections are more complicated than you think. Your brain, nerves, heart, blood vessels, and a whole lot of hormones have to work together perfectly or nothing happens. It's a lot to ask, and sometimes things break down. And while ED happens to most guys at some point in their lives, erectile dysfunction isn't something you can just ignore and hope it goes away.
The participants were seen every 4 weeks. Blood was taken to measure hormone levels, and questionnaires were given to assess physical function, health status, vitality, and sexual function. Body fat and muscle measurements were also taken at the beginning and end of the 16 weeks. The study was funded in part by NIH's National Institute on Aging (NIA) and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Results appeared in the September 12, 2013, issue of the New England Journal of Medicine.
Some men report being helped by an oral medication called yohimbine, which comes from the bark of a tree that grows in India and Africa. This drug, which needs to be taken every day, has been reported to help about 20 to 25 percent of the men taking it. A relatively new but widely used oral medication called Viagra requires a careful medical evaluation by your doctor.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The nerves and endothelium of sinusoids and vessels in the penis produce and release transmitters and modulators that control the contractile state of corporal smooth muscles. Although the membrane receptors play an important role, downstream signaling pathways are also important. The RhoA–Rho kinase pathway is involved in the regulation of cavernosal smooth muscle contraction. [12]
The vascular processes that produce an erection are controlled by the nervous system and certain prescription medications may have the side effect of interfering with necessary nerve signals. Among the possible culprits are a variety of stimulants, sedatives, diuretics, antihistamines, and drugs to treat high blood pressure, cancer, or depression. But never stop a medication unless your doctor tells you to. In addition, alcohol, tobacco, and illegal drugs, such as marijuana, may contribute to the dysfunction.
Testosterone is observed in most vertebrates. Testosterone and the classical nuclear androgen receptor first appeared in gnathostomes (jawed vertebrates).[186] Agnathans (jawless vertebrates) such as lampreys do not produce testosterone but instead use androstenedione as a male sex hormone.[187] Fish make a slightly different form called 11-ketotestosterone.[188] Its counterpart in insects is ecdysone.[189] The presence of these ubiquitous steroids in a wide range of animals suggest that sex hormones have an ancient evolutionary history.[190]
It may also become a treatment for anemia, bone density and strength problems. In a 2017 study published in the journal of the American Medical Association (JAMA), testosterone treatments corrected anemia in older men with low testosterone levels better than a placebo. Another 2017 study published in JAMA found that older men with low testosterone had increased bone strength and density after treatment when compared with a placebo.
Having learned a great deal more about erectile dysfunction including its risk factors and causes, you should be equipped to assess your own erectile function. If you have experienced erectile issues or you have some of the risk factors mentioned above, it may be worth making a trip to your doctor's office. If you choose to seek help, give your doctor as much information as you can about your symptoms including their frequency and severity as well as the onset. With your doctor's help, you can determine the best course of treatment to restore sexual function.
Research shows little evidence of abnormal or unhealthy psychological changes in men receiving supervised testosterone therapy to treat their low T, according to a study in the journal Therapeutics and Clinical Risk Management.However, mental and physical risks are involved in self-administration of artificial testosterone. Anyone abusing synthetic testosterone, also known as anabolic steroids, may experience episodes of aggressive or violent behavior, along with physical side effects. Bodybuilders, athletes, or anyone who seeks to build muscle mass or achieve other benefits from artificial testosterone should be aware of these risks.
Trauma to the pelvic blood vessels or nerves can also lead result in ED. Bicycle riding for long periods has been implicated as an etiologic factor; direct compression of the perineum by the bicycle seat may cause vascular and nerve injury. [37] On the other hand, bicycling for less than 3 hours per week may be somewhat protective against ED. [37] Some of the newer bicycle seats have been designed to diminish pressure on the perineum. [37, 38]
The device consists of an acrylic cylinder placed over the penis that uses a lubricant to achieve a good seal between the penile body and cylinder. An erection is then achieved by creating a vacuum inside the cylinder with a pump connected to the cylinder. Once an erection is achieved, a constriction band is applied to the base of the penis to maintain the erection. The cylinder can then be removed and the patient can engage in intercourse with the constriction band at the base of the penis maintaining the erection. The band can remain on for approximately 30 minutes and then must be removed. The erection produced by the device differs from a normal erection likely because of venous occlusion from the constriction band resulting in generalized swelling of the entire penis, with probable preservation of arterial inflow.
Dr. Adriane Fugh-Berman, associate professor of pharmacology and director of the industry watchdog group PharmedOut.org at Georgetown University School of Medicine, calls this kind of direct-to-consumer pharmaceutical advertising "evil." She likened the efforts to sell TRT to earlier campaigns to push hormone replacement therapy for post-menopausal women. "They stole the playbook," she said. "This hormone is being thrown around like sugar water."
The mechanism of age related decreases in serum testosterone levels has also been the subject of investigation. Metabolic clearance declines with age but this effect is less pronounced than a reduction in testosterone production, so the overall effect is to reduce serum testosterone levels. Gonadotrophin levels rise during aging (Feldman et al 2002) and testicular secretory responses to recombinant human chorionic gonadotrophin (hCG) are reduced (Mulligan et al 1999, 2001). This implies that the reduced production may be caused by primary testicular failure but in fact these changes are not adequate to fully explain the fall in testosterone levels. There are changes in the lutenising hormone (LH) production which consist of decreased LH pulse frequency and amplitude, (Veldhuis et al 1992; Pincus et al 1997) although pituitary production of LH in response to pharmacological stimulation with exogenous GnRH analogues is preserved (Mulligan et al 1999). It therefore seems likely that there are changes in endogenous production of GnRH which underlie the changes in LH secretion and have a role in the age related decline in testosterone. Thus the decreases in testosterone levels with aging seem to reflect changes at all levels of the hypothalamic-pituitary-testicular axis. With advancing age there is also a reduction in androgen receptor concentration in some target tissues and this may contribute to the clinical syndrome of LOH (Ono et al 1988; Gallon et al 1989).
Epidemiological studies have also assessed links between serum testosterone and non-coronary atherosclerosis. A study of over 1000 people aged 55 years and over found an inverse correlation between serum total and bioavailable testosterone and the amount of aortic atherosclerosis in men, as assessed by radiological methods (Hak et al 2002). Increased intima-media thickness (IMT) is an early sign of atherosclerosis and has also been shown to predict cardiovascular mortality (Murakami et al 2005). Cross-sectional studies have found that testosterone levels are negatively correlated with carotid IMT in independently living men aged 74–93 years (van den Beld et al 2003), diabetic men (Fukui et al 2003) and young obese men (De Pergola et al 2003). A 4-year follow up study of the latter population showed that free testosterone was also inversely correlated with the rate of increase of IMT (Muller et al 2004).
Side effects include lightheadedness, fainting, priapism, urethral bleeding (intraurethral), dyspareunia in the partner (intraurethral), hematoma (intracavernosal) or penile curvature secondary to scar (intracavernosal). Efficacy of intraurethral alprostadil has been demonstrated to be around 50% ("able to have intercourse") in randomized controlled trials.31,32 For intracorporeal injection, typically alprostadil is tried alone, or compounded with papaverine (nonspecific phosphodiesterase inhibitor that increases intracellular cyclic adenosine monophosphate and cGMP) and/or phentolamine (competitive, non-selective alpha1- and alpha2-adrenoreceptor blocker). Pinsky et al33 reported an extensive review of the benefits and drawbacks of the combinations of these drugs.
In rare cases, the drug Viagra ® can cause blue-green shading to vision that lasts for a short time. In rare cases, the drug Cialis® can cause or increase back pain or aching muscles in the back. In most cases, the side effects are linked to PDE5 inhibitor effects on other tissues in the body, meaning they are working to increase blood flow to your penis and at the same time impacting other vascular tissues in your body. These are not 'allergic reactions'.
This is similar to magnetic resonance imaging. Magnetic resonance angiography uses magnetic fields and radio waves to provide detailed images of the blood vessels. Doctors may inject a "contrast agent" into the person's bloodstream that causes vascular tissues to stand out against other tissues. The contrast agent provides for enhanced information regarding blood supply and vascular anomalies.
Male hypogonadism is a clinical syndrome caused by a lack of androgens or their action. Causes of hypogonadism may reflect abnormalities of the hypothalamus, pituitary, testes or target tissues. Increases in the amount of testosterone converted to estrogen under the action of the enzyme aromatase may also contribute to hypogonadism. Most aspects of the clinical syndrome are unrelated to the location of the cause. A greater factor in the production of a clinical syndrome is the age of onset. The development of hypogonadism with aging is known as late-onset hypogonadism and is characterised by loss of vitality, fatigue, loss of libido, erectile dysfunction, somnolence, depression and poor concentration. Hypogonadal ageing men also gain fat mass and lose bone mass, muscle mass and strength.
The sexual hormone can encourage fair behavior. For the study, subjects took part in a behavioral experiment where the distribution of a real amount of money was decided. The rules allowed both fair and unfair offers. The negotiating partner could subsequently accept or decline the offer. The fairer the offer, the less probable a refusal by the negotiating partner. If no agreement was reached, neither party earned anything. Test subjects with an artificially enhanced testosterone level generally made better, fairer offers than those who received placebos, thus reducing the risk of a rejection of their offer to a minimum. Two later studies have empirically confirmed these results.[71][72][73] However men with high testosterone were significantly 27% less generous in an ultimatum game.[74] The Annual NY Academy of Sciences has also found anabolic steroid use which increase testosterone to be higher in teenagers, and this was associated with increased violence.[75] Studies have also found administered testosterone to increase verbal aggression and anger in some participants.[76]
When you become aroused, your brain sends chemical messages to the blood vessels in the penis, causing them to dilate or open, allowing blood to flow into the penis. As the pressure builds, the blood becomes trapped in the corpora cavernosa, keeping the penis erect. If blood flow to the penis is insufficient or if it fails to stay inside the penis, it can lead to erectile dysfunction.
If you're experiencing psychological ED, you may benefit from talk therapy. Therapy can help you manage your mental health. You'll likely work with your therapist over several sessions, and your therapist will address things like major stress or anxiety factors, feelings around sex, or subconscious conflicts that could be affecting your sexual well-being.
Failure to achieve an erection is not uncommon for most men and may be considered normal even if it happens as often as 20 percent of the time. There is a wide range of normal when it comes to sexual functioning and sexual relationships. "Generally if a couple feels comfortable with their sex life and they enjoy intimacy together, erectile dysfunction may not be much of an issue. But if erectile dysfunction is causing stress in a relationship, then help is available," says Feloney.
*all photos are models and not actual patients.If you are interested in a prescription product, Hims will assist in setting up a visit for you with an independent physician who will evaluate whether or not you are an appropriate candidate for the prescription product and if appropriate, may write you a prescription for the product which you can fill at the pharmacy of your choice.
Mood disturbance and dysthymia are part of the clinical syndrome of hypogonadism. Epidemiological studies have found a positive association between testosterone levels and mood, and depressed aging males have lower testosterone levels than controls (Barrett-Connor, Von Muhlen et al 1999). Furthermore, induction of a hypogonadal state during treatment of men for prostate cancer leads to an increase in depression scores (Almeida et al 2004). Trials of testosterone treatment effects on mood have varied in outcome. Data on the effects on men with depression are conflicting (Seidman et al 2001; Pope et al 2003) but there is evidence that testosterone treatment of older hypogonadal men does result in improvements in mood (Wang et al 1996) and that this may occur through changes in regional brain perfusion (Azad et al 2003).
^ Butenandt A, Hanisch G (1935). "Umwandlung des Dehydroandrosterons in Androstendiol und Testosterone; ein Weg zur Darstellung des Testosterons aus Cholestrin" [About Testosterone. Conversion of Dehydro-androsterons into androstendiol and testosterone; a way for the structure assignment of testosterone from cholesterol]. Hoppe-Seyler's Z Physiol Chem (in German). 237 (2): 89–97. doi:10.1515/bchm2.1935.237.1-3.89.
Cross-sectional studies have not shown raised testosterone levels at the time of diagnosis of prostate cancer, and in fact, low testosterone at the time of diagnosis has been linked with more locally aggressive and malignant tumors (Massengill et al 2003; Imamoto et al 2005; Isom-Batz et al 2005). This may reflect loss of hormone related control of the tumor or the effect of a more aggressive tumor in decreasing testosterone levels. One study found that 14% of hypogonadal men, with normal digital rectal examination and PSA levels, had histological prostate cancer on biopsy. It is possible that low androgen levels masked the usual evidence of prostate cancer in this population (Morgentaler et al 1996). Most longitudinal studies have not shown a correlation between testosterone levels and the future development of prostate cancer (Carter et al 1995; Heikkila et al 1999; Stattin et al 2004) but a recent study did find a positive association (Parsons et al 2005). Interpretation of such data requires care, as the presentation of prostate cancer could be altered or delayed in patients with lower testosterone levels.


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Jack Nowell, Henry Slade and Luke Cowan-Dickie will stay at Sandy Park until 2021
The three England Internationals, who have all come through the Devon's club academy, have put pen to paper on two-year deals that will keep them at Sandy Park until 2021.
"I know people have been waiting to hear the news on these guys for quite a while," says Exeter Chiefs director of rugby Rob Baxter.
"I know sometimes it must seem a little difficult when there is a lot of paper talk about players leaving or interest being shown in them, but all three guys said right from the beginning that their intentions were to stay at Exeter and they wanted to stay with us long term.
"We are delighted to keep them and we are hoping they will be a core element of what the team can go on to achieve over the next five or six years."
Exeter duo Mitch Lees and Ian Whitten also committed their future to the Chiefs having signed three year deals with the club earlier this week.


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How to put together for that ethics paper for the civil support?
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1/4 Inch Graph Paper Template 2018
2D shapes can be summarized by calling them flat shapes. Any shape that can be laid flat on a piece of paper or any mathematical plane is a 2D shape. 2D shapes including rectangles, squares, circle and triangles. 3D shapes including cubes, cuboids, pyramids and spheres. sort, make and describe common 2D and 3D shapes.
An essay is, generally, a piece of writing that gives the argument of the author, but the definition is vague, overlapping with those of a paper, an article, a pamphlet, and a short story.
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