Santa Barbara

Archive for November, 2011

Let’s admit it, nearly all men watch porn. There’s nothing strange about it because visual representation of sex is very arousing for the male eye, in contrast to the emotional aspect of it that most women tend to. The porn industry is a multi billion business with hundreds of studios all over the globe and tens of thousands of titles produced every year. Porn movie development is less complicated, costly and time consuming as mainstream film production. A typical pron movie is shot during one day with actors sometimes being required to have sex several time during the shoot. When you realize it and take a look at the intense action on the screen there’s only place for wonder how come male performers are able to pull it all off in front of the camera. Well, of course, there are certain secrets of the trade and it turns out that Viagra is one of them.

Male porn performers are usually paid times less than female performers because the entire industry is focused on actresses. Rarely does a male actor get an exclusive contract with a good salary. Usually the paycheck is quite average, especially for the effort you have to give. All in all, no matter how good and pleasant sex may be when it turns into a 9 to 5 job with several sex acts every day, it turns into a real challenge that not many men can actually accept. It’s no longer a matter of when you want to do it, it’s a matter of doing it right all the time. And no wonder that under such pressure many men often face problems with erections. You can’t be 100% hard all the time on snap when the director asks you to. The female actress isn’t always your type, there are dozens of people on the set watching you and you could get more sleep yesterday. So when the camera starts rolling there’s a high risk of erection fading away.

Back in the day it was really hard to be “hard” all the time. There was even a job called “fluffer” that involved a person whose sole responsibility was to keep the male actor’s penis hard through masturbation and other techniques during the pauses of the shoot. Not to mention many experimental drugs that were used just to keep the performers ready for action all the time. However, with the advent of Viagra pron movie producers have found a new way to eliminate long breaks and optimize their shootings.

Today Viagra has become an industry standard. While male performers were trying to object the use of the drug when it was introduced back in 1998, as time passed they have realized that there’s simply no way to go around it. An average male performer can take a double daily dose of Viagra during an intense shooting day so the side effects are pretty common in this industry. But that’s the price of having sex with some of the most luscious women on the planet and getting paid for it.

“There are three kinds of lies: lies, damned lies, and statistics.”

Benjamin Disraeli

You open a book on cancer and it would more likely than not start with numbers: So many thousand were diagnosed with the disease in such a period and so many died. They will also give a prognosis as to how these numbers would look like for a period in the future. In the case of prostate cancer in particular we are told that in the coming year so many thousand men will find out that they are afflicted with the disease and another number also in thousand, will succumb to it, some of them unnecessarily. These numbers are significant in as much as they indicate the extent and trend of the disease. But how meaningful are they to an individual? Can he benefit from this knowledge? We can put the answer to these questions also in terms of numbers – fifty for yes fifty for no. There are no known precautions that a man can take to ward off the disease. One can have regular tests and examinations to insure early detection that would help in deciding the course of treatment. But early detection by itself is no guarantee for cure. As long as a person is not a confirmed patient these numbers are impersonal like the statistics on the number of people dead or likely to die in traffic accidents in a given period.

However, the situation changes as soon as the person becomes a part of the statistic. Now he moves into the realm of other numbers. For each treatment option available to him he is confronted with numbers related to the success of these options. He is told of survival rates and now we are talking not just numbers but probabilities. Not that probability is new to us. We deal with them in every day life without even being conscious of it They are wrapped up in weather forecasts, sports, in economic events, and so on. In fact probability and statistics have become an integral part of our lives, even determine the quality of life through processes ranging from mundane ones like quality control of consumer goods to highly sophisticated like space communications.

But statistics by its very nature is impersonal, it deals with a population or sample. Means and averages are meaningless when applied to a particular member of the sample. We have all watched the Dow Jones average soar during the past couple of years. It is supposed to indicate the state of the economy. On the average we would think that everyone playing the stock market would have doubled or tripled his investment. I know several persons whose portfolios shrank during that period. It does not, of course, negate the fact that many stocks soared and people made money in the market. The point is, though, that the statistical results cannot be applied directly to an individual. It is all the more so when we are using statistics in the field of medicine where the unknowns and variables are far more than in other fields.

I have a friend who recently had cataract surgery. These days it is supposed to be a routine procedure with hardly any chance of serious complications. If one insisted on getting numbers, the doctor might put the probability of things going wrong at less than one percent. A month after surgery my friend did develop a problem – for no apparent reason the implanted lens had moved and he had only peripheral vision in that eye. The doctor could not explain it; in fifteen years of his experience with this procedure it had happened only twice. That was, of course, no consolation to my friend; for him the less-than-one percent probability had changed into certainty. He had to get the procedure done again and was terrified at the prospect of things going wrong again. When it comes to personal life there are things over which no one has any control. There is an element of luck in every sphere of activity in life; some may deny its existence but denial does not negate the fact.

There is another aspect of statistics that may present problems; it is the size of the sample or the database. The larger the database, the more reliable are the results. For statisticians, of course, there is never enough data; it may be adequate but it is not the same as enough. In the case of prostate cancer the data is not extensive, at least in some respects, and the statistical inferences may therefore be viewed with caution. For a patient confronted with a decision as to the course of treatment the database for most options is small.

For the options of definitive treatment ten-year survival numbers were available only for radical surgery; for brachytherapy the data did not go that far back for any meaningful analysis. The choice becomes more difficult when the patient has to choose a particular surgeon or oncologist. Then he has to know that particular doctor’s numbers and the size of the sample shrinks to an inadequate level. And then there is the question of luck also. A patient can have problems even with the most experienced and famous surgeon, while another may come out fine with another relatively unknown doctor. One can certainly attempt to obtain the best possible facility and care within his reach not worrying about things beyond his control. To that extent the numbers become less important, they should be used as general guidelines only.

How important is the statistics? If we had to base everything on experience and statistics, there would be no new approaches, no developments. For breaking new grounds it is necessary to venture into the unknown, it is true for any field of knowledge. This is not to belittle the role of accumulated knowledge and experience. To probe the unknown it is imperative to make full use of all that is known. In this process, though, it is sometimes necessary to ignore or go against the accumulated evidence or the statistics. This happens, and not infrequently, in the field of medicine where new data force a revision of opinions based on old. What is considered normal today may not remain so tomorrow.

This brings us to the all-important number for prostate cancer – the prostate specific antigen (PSA) level. This number by itself has nothing to do with statistics. It represents a test result, an observation. However, it provides the raw material for building statistics. After a series of revisions in the past the normal range of PSA is taken to be from zero to four. Without going into the mathematical definition of the word normal, this statement can be interpreted to mean the following: If the PSA is measured for a sufficiently large number of men having no prostate problem, a significant majority of them would have PSA lying between zero and four; the exact percentage will depend on the specific distribution.

Conversely if the measured PSA for a man is within this range, he most probably does not have any prostate problem. The remaining may have PSA beyond this range, i.e. greater than four, since negative values are not possible, and still be disease free. The farther the number from four, the smaller would be the percentage of men having that PSA level. Mathematically this percentage will never become zero, but for all practical purposes there must be a limit. A man having PSA higher than this limit would certainly have a prostate problem. What is this limit and where can one draw the line? I do not think anyone can answer these questions. So the mathematical aspects of the term ‘normal’ are ignored and a rule of thumb is applied: Any test result yielding PSA of greater than four is suspect and further tests are needed. If the additional tests do not show an obvious problem, the person is put in the wait and watch mode. He is not a patient yet but may soon be.

However, even with this ‘primary’ number we run into ambiguities. If the PSA level for a person is below four, it does not automatically mean that he is cancer free. About twenty percent of prostate cancer patients have PSA below four. As a corollary it may be expected that an equal number of men having PSA greater than four would not have the cancer. So PSA alone cannot unambiguously reveal the presence of the cancer.

Once the cancer has been detected there is another number that indicates the degree of activity of the tumor. It is called Gleason score and is determined from pathological analysis of the biopsy samples; it ranges from two to ten. The higher the number, the more active is the cancer. A score of seven and above usually means a highly active fast growing cancer, perhaps in an advanced stage. Gleason score plays an equally important role in the choice of a treatment but by its very nature it is no more reliable than the PSA level.

On the other hand if the tests confirm the presence of cancer, the person is faced with immediate decision. The first question that comes up – and this has to be answered by the doctor – is whether the cancer is contained within the gland or it has spread outside. Even the doctor cannot answer without recourse to surgery and with that too he can not say anything with certainty. The absence of malignant cells at the lymph node does not preclude the possibility of the cells having migrated into the areas just outside the prostate. Again a rule of thumb is applied: If the PSA is not too far out of the normal range, the cancer is assumed to be localized. Now we are stuck with the problem of defining the term ‘too far’. I do not think any urologist would be willing to draw the line or even set a reasonable range. Unfortunately the survivability numbers, thrown at the patient, are affected by this uncertainty.

Male sexual health is a rather delicate topic if looked at from different perspectives. Men don’t like discussing their sexual health especially if there are some problems present. Male sexuality is the basis of male psyche in general so when there are some issues present it can lead to psychological complications as well. And even the nature of such unpleasant condition as erectile dysfunction can be characterized as delicate, because it involves a sophisticated balance of different body systems. That’s why ED is often classified as a lifestyle condition, which can be prevented and even eliminated through serious changes of the way you live your life. So what can be done to reduce the risk of impotence through the lifestyle way?

Overall health

Overall health is a rather loos term yet it describes the nature of ED development very well. Erectile dysfunction isn’t a condition on its own but rather a symptom to more complicated health issues, as it never takes place in a perfectly healthy organism. Some of the most common factors contributing to the development of ED include high cholesterol, diabetes, hypertension, obesity, lack of physical activity, certain types of cancer, use of specific medications, substance abuse and many others. So if you want to avoid ED you should keep your health as best as possible.

Bad habits

The most common bad habits of modern society include cigarette smoking, alcohol abuse and drug addiction. And aside from all the health risks these activities are known for they also represent a serious factor contributing to ED. Men who are long term smokers or with serious alcohol or drug problems have a much higher risk of suffering from male impotence. So if you still want to have good erections without using Viagra all the time it’s best to kick all bad habits as early as possible.

Physical activity

Lack of physical activity is one of the main factors contributing to many health conditions that ultimately lead to the development of erectile dysfunction in men. Obesity, hypertension, high cholesterol and diabetes can all stem from not being physically active on a regular basis. The cardiovascular system plays an important role in the mechanism of erection, so if you keep it in a good shape through exercising you can rest assured that you won’t be needing Viagra for a long time. And it doesn’t matter what kind of activity you choose for as long as you are doing it on a regular basis.

Proper diet

It may sound surprising to some of you but the food you eat can also be the cause for erectile problems in the long run. If your regimen is rich with saturated fats, processed foods, fast foods, sweets, caffeinated drinks, sugar and other products that are usually labeled as unhealthy then you can expect to require Viagra at a much earlier stage than your peers following a healthy diet. Enrich your regimen with fruits, vegetables, poultry, fish, nuts and grain and you will see the difference both in your overall health and your performance in bed.

Associations between particular feelings, people, places, and events becomes intertwined with the alcoholic or addicts drinking and drugging behavior.

If you have ever been to pharmacies or bought drugs online you’ve probably ran across the type of drugs called generics. These drugs are usually much more affordable than their branded variations and are stated to provide the same effects. There are people who only use generic drugs because they are much cheaper, yet there are also people who revert only to branded variations as being of a higher quality and much safer. Virtually any medication brand in the world has several generic variations produced by different pharmaceutical factories all over the globe. And erectile dysfunction medications aren’t any different. So let’s take a closer look at the conflict between generic and brand drugs and try to understand what’s really better.

When a new drug is being developed the pharmaceutical company spends millions and even billions of dollars on research, testing, manufacturing and marketing. Since it’s a totally new product the company gains a patent, which allows it to produce and sell the drug exclusively for a limited period of time in a given region of the world. However, when the term of the patent expires the company is obliged to share the recipe of the new drug with the rest of the world, allowing numerous smaller companies to produce the product too. Because the initial developer spends large amounts of money on the development it sets a higher price on the new product. However, the smaller companies that ultimately start producing the shared recipe don’t have such large costs because they don’t need to develop the drug from scratch, they just use the formula. That’s why the smaller companies can set much lower prices on their variations of the new drug, since they do not need to reimburse their initial investments like the large developer does. That’s why generic drugs are much cheaper than brand variations.

Now, when it comes to the safety and the real difference between brand and generic drugs it all depends on the manufacturers involved. On paper, all generic variations are produced using the same chemicals as the brand drug. Assuming that both big and small companies often receive raw chemicals from the same sources you can rest assured that there won’t be much of a difference, except for the pill shape, the package and the name on it. However, sometimes smaller companies tend to cut their costs through weaker quality control. This may lead to production errors and reflect in the final quality of the drug. Although it’s not a general rule for all generic drug manufacturers yet these situations still take place so you have to be aware of them.

So which Viagra should you order when buying it online, generic or brand? The answer depends on your needs. If you have the money and want to get the famous blue pill then don’t hesitate to pay more for a brand drug. After all even the psychological expectation of taking an expensive drug can really boost up its effectiveness. Yet, if you don’t have much money on your hands and don’t care about the name on the package generic Viagra can prove to be a great option for you. Just remember to consult with your doctor about the correct use of Viagra regardless whether you’re buying brand or generic variations.

Erectile dysfunction is a condition that virtually all men would regard as one of the most discouraging and unpleasant health issues possible. And not because it’s severe and may affect a person’s productivity or quality of life. Male psyche is strongly linked to sexuality, so when there’s something wrong on the love front the patient starts to experience psychological problems ranging from simple anxiety to depression and even mental issues. That’s why erectile dysfunction is so feared by men. If you don’t want to deal with this issue it is highly recommended to learn about the causes of the condition, so that you could prevent and avoid it for as long as possible. So what are the primary causes of erectile dysfunction in men?

Doctors distinct two main types of causes that may influence the development of erectile dysfunction in men. The first type is the most common and involves physiological conditions such as hypertension, diabetes, hormonal imbalance, heart problems, obesity, high cholesterol, neural conditions, damage to the spinal chord, damage to penis, different types of cancer, use of certain medications, drug and alcohol abuse, among many others. Most of these conditions affect the blood circulation in the body in general and in the penile area in particular. And that’s a crucial aspect for having strong and solid erections. Physiologically induced erectile dysfunction can be treated by eliminating the problem at cause, which can be a bit problematic with some of the conditions mentioned earlier due to their chronic nature. Yet, there’s also a solution in the form of Viagra. This medication is designed to stimulate blood flow to the penis when necessary and that’s very effective for most of the physiological conditions associated with erectile dysfunction.

The second type of factors affecting erectile function are psychological issues. These account for the lesser part of all ED cases, yet still they can also be very widespread, especially in urban areas with high phase of life and abundance of psychological issues. Conditions such as excessive stress, depression, anxiety, relationship problems, mental disorders and others can seriously affect a person’s ability to relax and get aroused. When there’s no sexual arousal it’s nearly impossible to have a suitable erection, even if you’re using drugs like Viagra. The solution for psychologically induced male impotence would be eliminating the problem at cause, which is usually much easier compared to physiological problems mentioned earlier. Cognitive therapy, medications and relaxation techniques can effectively relieve most of psychological disorders and put you back on track in what concerns erectile function.

There can also be cases of mixed erectile dysfunction where both psychological and physiological factors are involved. It usually takes the form of a positive feedback where one type of factors contributes to the formation of the second type and it all turns into a vicious cycle. These cases aren’t very common yet they require a serious work from your doctor and may need the use of both drugs like Viagra and psychological techniques for effective treatment.