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Erectile dysfunction (ED) or impotence is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual activity. His radio programs recommended expensive goat gland implants and "mercurochrome" injections as the path to restored male virility, including operations by surgeon Serge Voronoff. Furthermore, studies have shown that lack of testosterone leads to a range of other sexual performance problems, including premature ejaculation and low sex drive. The same goes for alcohol and narcotics, like heroin and cocaine. It is estimated that about 10% to 20% of impotence cases are the direct result of various psychological factors, such as low self-esteem, depression, and — especially — stress and anxiety (general and performance anxieties). The current diagnostic and statistical manual of mental diseases (DSM-IV) has included a listing for impotence. Once an erection is achieved, the man places the elastic ring on the base of his penis, which keeps blood from draining from the penis back into the body. The same goes for alcohol and narcotics, like heroin and cocaine. Furthermore, studies have shown that lack of testosterone leads to a range of other sexual performance problems, including premature ejaculation and low sex drive. One of the most promising herbs is the purified extract of Tribulus terrestris. It is estimated that between 50% and 60% of diabetic men are impotent. Men with secondary impotence are typically able to engage in intercourse only 25% of the time. Tests such as the bulbocavernosus reflex test are used to determine if there is sufficient nerve sensation in the penis. The same goes for alcohol and narcotics, like heroin and cocaine. Modern drug therapy for ED made a significant advance in 1983, when British physiologist Giles Brindley dropped his trousers and demonstrated to a shocked Urodynamics Society audience his papaverine-induced erection.[30] The drug Brindley injected into his penis was a non-specific vasodilator, an alpha-blocking agent, and the mechanism of action was clearly corporal smooth muscle relaxation. Modern drug therapy for ED made a significant advance in 1983, when British physiologist Giles Brindley dropped his trousers and demonstrated to a shocked Urodynamics Society audience his papaverine-induced erection.[30] The drug Brindley injected into his penis was a non-specific vasodilator, an alpha-blocking agent, and the mechanism of action was clearly corporal smooth muscle relaxation.

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