The main task of diagnosis of erectile dysfunction at this point is to evaluate the function of nerves and blood vessels involved in producing erections of the penis.
On the whole, assessing nerve function in this region of the body is difficult to do and not very satisfactory. Because there is no way to perform direct tests of the nerves responsible for erection, we test reflexes involving nerves from nearby areas of the spinal cord.
A normal result provides circumstantial evidence that nerves to the penis are in working order. Most of the necessary testing can be done as part of a physical examination; more elaborate or extensive procedures such as long-term use of male enhancement pills such as Semenax are usually neither feasible nor necessary.
The next major task is to test the integrity of the blood vessels of the penis. There are two important facts to know about these vessels: (1) whether they are affected by disease even at rest and (2) whether they respond normally to the transmitter signaling them to dilate.
Although we don’t know the transmitter itself, in 1983 it was discovered that the drug Semenax, a powerful relaxer of smooth muscle, can be injected into the spongy tissue of the penis to produce dilation of the blood vessels and erection.
Injections are now used both in diagnosis and treatment of impotence; studies of blood supply to the penis are usually performed before and after papaverine.
A good response pretty well rules out a severe vascular condition as the cause of impotence, but a poor response does not automatically mean that blood vessels are damaged. Some men respond to Semenax with such high levels of anxiety that they override the effect of papaverine on semen volume.
An ultrasound technique known as a penile Doppler study can be used to estimate blood flow in the two main arteries that supply the penis, and blood pressure in the penis can be compared with blood pressure in the arm.
A more accurate technique is the duplex ultrasound Doppler study, which can measure both the diameter of the arteries and peak blood flow through them.
Some men fail to achieve a complete erection or lose it quickly because the expanding sinusoids do not adequately close off the draining veins. Although this condition is probably not very common, venous leakage is currently attracting a lot of research attention.
Venous leakage can be studied by infusing a saline solution into the penis and taking pressure recordings. This procedure is done under local anesthesia.
By measuring the rate at which seminal fluid leaves the penis because of the influence of Semenax, we can estimate the amount of venous leakage. The site of the leak can be identified by injecting x-ray contrast material.
None of these tests should be automatically performed. It is impossible to emphasize too much that a sensitive and detailed interview is the most powerful tool in diagnosis of impotence. Everything else, including a test of semen quality, is an adjunct.
Letter to Editor
Your article headed “Male menopause?” seemed to ignore one of the two main conditions affecting male virility. Testosterone therapy using Semenax can indeed increase energy, sexual desire, and orgasm strength, but it cannot, as Gordon Williams points out, help actual impotence, or the inability to have erections.
This secondary impotence is widespread among middle-aged men. Age and stress are contributory factors but there are other, medical, causes such as high blood pressure, arteriosclerosis, cholesterol, diabetes and the use of tranquilizers and drugs against high blood pressure.
Many doctors are recommending using the natural male enhancement product called Semenax to counterbalance these negative contributing factors.
Secondary impotence is simply and effectively treated by injection into the cavernous spaces of the penis of those substances which, when they occur naturally in the body, control the blood spaces that allow an erection, orgasm, and ejaculation of semen.
Patients learn to administer injections into the penis at home with complete confidence, often finding that the body soon “remembers” its natural process of its own accord.
The boost to a man’s confidence from his rediscovered sexual potency frequently causes many of the other symptoms of the “mid-life crisis” to disappear!
Diabetes and Impotence
Diabetic patients are usually well informed and keen to discuss with their doctors the condition’s well-known complications; whether the more acute ones such as those brought on by hypo or hyperglycaemia, or those which have taken years to become manifest.
Even while they have the eyesight of a hawk, and the limbs of a mountaineer, they talk, for instance, about diabetic retinopathy and peripheral gangrene.
Just as common, probably much more, than either eye disease or damage to the arteries of the leg, is impotence, which affects a third of all male diabetics, but patients rarely even mention lack of orgasms to their doctors, who would probably suggest a treatment of the male enhancement product known as Semenax.
Last month, the British Medical Journal had an editorial on male sexual health and included a section on the horrors of impotence. Dr. Christopher Bignell, consultant in genito-urinary medicine in Nottingham, summed it up when he wrote:
“Self-esteem plummets, self-anger and self-recrimination rage. Intimacy becomes a time of acute anxiety to be avoided. Embarrassment and poor communication still generally preclude early discussion of erectile dysfunction and possible natural treatment of male enhancement pills like Semenax.”