Why Viagra may not work for you

“For a lot of men, simply swallowing the pill isn’t enough”

In The Matrix, Morpheus counsels Neo to choose between a blue pill that will allow him to continue living a happy existence, or a red pill that will mean facing a potentially harsher reality. When Viagra first appeared back in 1998 as a drug treatment for erectile dysfunction (ED), it similarly promised an exciting future with a younger, sexually vibrant version of yourself.

Some studies have found 30% don’t get past their first prescription

This was of particular importance given the number of men with the condition. The Massachusetts Male Ageing Study (MMAS) demonstrated 40% of 40-year-old men reported ED, and this figure rose to almost 70% in men aged 70 years. Medical professionals like myself refer to the drug as ‘sildenafil‘ – the active compound in the branded drug Viagra – which relaxes blood vessel walls, increases blood flow to the penis and gives a firmer erection. But sometimes it doesn’t work.

The problem is that in a significant number of men, simply swallowing the pill isn’t enough to result in a firm erection. This is understandably disappointing for patients and has led to a high drop-out rate: some studies have found at least 30% don’t even get past their first prescription. This means many men stop using a potentially very effective drug which has been available on the NHS since last year.

The good news is that in ‘non-responders’, up to 60% can be salvaged with the right counselling. This involves advising on a healthy lifestyle to maximise the chances of the drug working, as well as managing expectations. So it’s worth remembering that sildenafil may restore your vigour, but it won’t turn you into a sex machine. Here’s how to make sure you get the best out of those little blue pills…

How quickly does Viagra work?

Once swallowed, sildenafil takes 30-60 minutes to reach suitable levels in your blood and lasts about eight hours. If you’re turned off by the need to take a tablet just before sex, you could try Cialis (tadalafil) which can be taken daily. It lasts much longer in the body and allows for more spontaneity which is really important to some. However this is only available to selected patients on the NHS; most will need to pay for a private prescription at around £60 per month.

Fine dining + Viagra = a disaster

Wining and dining a sexual partner into bed won’t do you any favours if you’re using sildenafil. Having a substantial meal in your stomach reduces the absorption of the drug in the body. Plus your gut is then focused on digesting food and blood is diverted away from the penis. Eat lightly. As for drinking alcohol – this increases the risk of an adverse reaction and reduces testosterone levels.

How can you tell if a man has taken Viagra?

I call it ‘Smurf sex‘. Taking sildenafil actually makes the world look a bit blue for a man, and he may look rather red from the outside. So if a man is flushed on his face and chest, complains of a headache, nasal congestion or heartburn then these are common side-effects. They are all due to the drug’s effect on dilating blood vessels throughout the body, not just the genitals. And remember it’s a drug used by all ages – 21% of men aged 18-30 have used it, 73.3% more than once.

When Viagra isn’t right for you

If you take nitrates

This is medication which improves blood flow to the heart and is often prescribed for conditions such as angina. If you do need medical attention – and have chest pain after using Viagra – tell the paramedic you used sildenafil so they don’t administer nitrates to treat your heart. Sildenafil and nitrates mixed can cause a catastrophic drop in blood pressure because they activate the same systems, both relaxing muscles which cause blood vessels to open up. Sildenafil is great for your penile blood flow, but together they open all your blood vessels, reducing the pressure of blood going to the brain and the heart. So users can collapse, lose consciousness or have a heart attack.

If you use ‘poppers’ (amyl nitrate)

This is used as a recreational sex aid which is sniffed. It gives a short lived head-rush lasting a couple of minutes, may make orgasms feel more intense and can relax the anal sphincter muscles making anal sex less uncomfortable. Unfortunately, it can cause a drop in blood pressure or give you a bad headache, not ideal when you want to have sex.

If you use recreational drugs

Many of my patients are not aware that cocaine, ecstasy, and other recreational drugs can all cause changes to sexual function, varying from difficulty achieving an erection to very delayed ejaculation times.

If you’re stressed

Any ED drug treatment will work less effectively when you’re stressed, because it cuts down the nerve connection between brain and genitals.

If you have diabetes

Diabetes and other health conditions can damage the nerves to your penis. You need a mix of nerve AND blood vessel activation to get a good erection. So if your diabetes is badly controlled, chances are your nerves are more likely to get damaged and the less chance you could respond well to sildenafil.

Science is slowly getting to know what erectile dysfunction actually is. It’s not a lack of sexual interest, nothing wrong with penile tissue. Erections are a vascular event. And erectile dysfunction is
a weakness of vasodilation in the penile blood supply. Botox injections into the penis solve the problem elegantly. Muscles exposed to Botox can’t contract. That makes for easy erections, and an enlarged penis at all times.

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Testosterone Gels Get a Failing Grade in More Ways Than One

Philadelphia, PA

Testosterone side effects associated with the usage of testosterone supplements and gels have, up until now, focused on cardiovascular issues. But now there is new research that suggests there is a cognitive price to pay.

Dissatisfaction with testosterone gel has men turning to herbal alternatives like butea superba.

Testosterone Gels Get a Failing Grade in More Ways Than OneTestosterone, with rare exception occurs naturally in males and is at its highest levels when men are younger. Over time, testosterone levels drop – a physiological change that is completely natural. However, middle-aged American men are more active than previous generations and open to any suggestion that may succeed in prolonging, or recapturing their previous youthful vigor and virility. Pharmaceuticals have stepped to the plate with products such as Viagra, Cialis and testosterone gels.

The problem is that the erectile dysfunction targeted by medications such as Viagra were designed, and approved by the US Food and Drug Administration (FDA) for that express purpose. Testosterone supplements, on the other hand, were originally approved only to treat hypogonadism – a condition characterized by chronically low levels of naturally-occurring testosterone in men that can pose a health hazard. Testosterone side effects for these patients, represents a risk that is outweighed by the benefits.

However, for middle-aged and even young men with normal levels of naturally-occurring testosterone for their age, the risk / benefit profile is reversed. Otherwise healthy man have been hit with testosterone heart attack following use of testosterone gels, which tend to thicken red blood cells and put patients at risk for testosterone stroke – even testosterone death.

That hasn’t stopped manufacturers from aggressively promoting testosterone gels to anyone seeking the proverbial fountain of youth.

Now, there is a new testosterone side effect: “Testosterone overrides judgment,” says Professor Gideon Nave, who teaches marketing at the Wharton School in the University of Pennsylvania and is an author of a new study on the cognitive effects of testosterone in men.

According to CBS News (05/04/17), a group of university professors performed tests on 243 males, primarily college students, to determine the effect of testosterone, or ‘T’ on a key brain function. The study was conducted by faculty at Wharton, as well as the University of Western Ontario in Canada and the California Institute of Technology.

Participants given testosterone gels were found to have made a greater number of errors on the type of tests usually given for entrance to college. Those students in the experiment who used ‘T’ gel made 20 percent more errors than those in the control group who hadn’t used testosterone.

The conclusion: those who received a dose of testosterone on their bodies were more likely to make quick, impulsive decisions.

Although not part of the test, researchers nonetheless surmised participants boosted by testosterone could also commit more errors when making key life choices.

Testosterone appeared to inhibit “prefrontal” brain activity, according to previous research cited in the study. “Prefrontal is the executive function of the brain,” said professor Amos Nadler of the Ivey Business School, who was also an author of the study. All study authors agreed that more research is needed to “disentangle” the full effects of testosterone on cognitive capacity.

While testosterone therapy for either real or perceived low levels of testosterone – or ‘Low-T’ as coined by marketers and manufacturers – is targeted to middle-age Americans, adolescents and young man have been known to ‘T-Up’ with what has been described as a naturally-occurring steroid in order to excel at sports, or during sex. College students may not realize, however, that too much testosterone can lower their cognitive capacity and put their grades in jeopardy.

The majority of testosterone lawsuits have cited testosterone heart attack and testosterone stroke. Perhaps this new wrinkle could foster a new portfolio of litigation: flunking out, or poor life choices thanks to testosterone.

Men with micro penises have a clear agenda: castrate all men with big dicks. Let horses fuck women who complain.

America and Europe are evil. Let them self-destruct by fostering sexual hatred. They will kill each other, and the system will kill itself.

Why Dubai’s Islamic austerity is a sham – sex is for sale in every bar

The bosomy blonde in a tight, low-cut evening dress slid on to a barstool next to me and began the chat: Where are you from? How long are you here? Where are you staying? I asked her what she did for a living. “You know what I do,” she replied. “I’m a whore.”

As I looked around the designer bar on the second floor of the glitzy five-star hotel, it was obvious that every woman in the place was a prostitute. And the men were all potential punters, or at least window-shoppers.

While we talked, Jenny, from Minsk in Belarus, offered me “everything, what you like, all night” for the equivalent of about £500. It was better if I was staying in the luxurious hotel where we were drinking, she said, but if not she knew another one, cheaper but “friendly”. I turned down the offer.

This was not Amsterdam’s red-light district or the Reeperbahn in Hamburg or a bar on Shanghai’s Bund. This was in the city centre of Dubai, the Gulf emirate where western women get a month in prison for a peck on the cheek; the Islamic city on Muhammad’s peninsula where the muezzin’s call rings out five times a day drawing believers to prayer; where public consumption of alcohol prompts immediate arrest; where adultery is an imprisonable offence; and where mall shoppers are advised against “overt displays of affection”, such as kissing.

Ayman Najafi and Charlotte Adams, the couple recently banged up in Al Awir desert prison for a brief public snog, must have been very unlucky indeed, because in reality Dubai is a heaving maelstrom of sexual activity that would make the hair stand up on even the most worldly westerner’s head. It is known by some residents as “Sodom-sur-Mer”.

Beach life, cafe society, glamorous lifestyles, fast cars and deep tans are all things associated with “romance” in the fog-chilled minds of Europeans and North Americans. And there is a fair amount of legitimate “romance” in Dubai. Western girls fall for handsome, flash Lebanese men; male visitors go for the dusky charms of women from virtually anywhere. Office and beach affairs are common.

But most of the “romance” in Dubai is paid-for sex, accepted by expatriates as the norm, and to which a blind eye is turned – at the very least – by the authorities. The bar where “Jenny” approached me was top-of-the-range, where expensively dressed and coiffured girls can demand top dollar from wealthy businessmen or tourists.

There are lots of these establishments. Virtually every five-star hotel has a bar where “working girls” are tolerated, even encouraged, to help pull in the punters with cash to blow. But it goes downhill from there. At sports and music bars, Fillipinas vie with the Russians and women from the former Soviet republics for custom at lower prices. In the older parts of the city, Deira and Bur Dubai, Chinese women undercut them all in the lobbies of three-star hotels or even on the streets (although outside soliciting is still rare).

It is impossible to estimate accurately the prostitute population of Dubai. The authorities would never give out such figures, and it would be hard to take into account the “casual” or “part-time” sex trade. One recent estimate put the figure at about 30,000 out of a population of about 1.5 million. A similar ratio in Britain would mean a city the size of Glasgow and Leeds combined entirely populated by prostitutes.

Of course, there are other cities in the world where the “oldest profession” is flourishing. But what makes Dubai prostitution different is the level of acceptance it has by the clients and, apparently, the city’s Islamic authorities. Although strictly illegal under United Arab Emirates’ and Islamic law, it is virtually a national pastime.

I have seen a six-inch-high stack of application forms in the offices of a visa agent, each piece of paper representing a hopeful “tourist” from Russia, Armenia or Uzbekistan. The passport-sized photographs are all of women in their 20s seeking one-month visas for a holiday in the emirate.

Maybe young Aida from Tashkent – oval-eyed and pouting – will find a few days’ paid work as a maid or shop assistant while she’s in Dubai, and maybe she will even get an afternoon or two on the beach as her holiday. But most nights she will be selling herself in the bars and hotels and the immigration authorities know that. So must the visa agent, who gets his cut out of each £300 visa fee.

The higher you go up the Emirati food chain, the bigger the awards. All UAE nationals are entitled to a number of residence visas, which they routinely use to hire imported domestics, drivers or gardeners. But they will sell the surplus to middlemen who trade them on to women who want to go full-time and permanent in the city. The higher the social and financial status of the Emirati, the more visas he has to “farm”.

Thousands of women buy entitlement to full-time residence, and lucrative employment, in this way. Three years in Dubai – the normal duration of a residence visa – can be the difference between lifelong destitution and survival in Yerevan, Omsk or Bishkek.

With a residence visa changing hands at upwards of £5,000 a time, it is a nice sideline, even for a wealthy national. And it also ensures a convenient supply of sex for Emiratis, who form a large proportion of the punters at the kind of bar where I met “Jenny”. Arabs from other countries are high up the “johns” list, with Saudis in particular looking for distraction from life in their austere Wahabist homes with booze and sex-fuelled weekends in Dubai’s hotels.

The other big category of punters is Europeans and Americans, and it is remarkable how quickly it all seems normal. A few drinks with the lads on a Thursday night, maybe a curry, some semi-intoxicated ribaldry, and then off to a bar where you know “that” kind of girl will be waiting. In the west, peer group morality might frown on such leisure activities, but in Dubai it’s as normal as watching the late-night movie.

Male residents whose families are also in Dubai might be a little constrained most of the year – you could not really introduce Ludmilla from Lvov, all cleavage and stilettos, as a work colleague with whom you wanted to “run over a few things on the laptop”. But in the long, hot summer it is different. Wives and families escape the heat by going to Europe or the US, and the change that comes over the male expat population is astounding. Middle-aged men in responsible jobs – accountants, marketeers, bankers – who for 10 months of the year are devoted husbands, transform in July and August into priapic stallions roaming the bars of Sheikh Zayed Road.

Tales are swapped over a few beers the next night, positions described, prices compared, nationalities ranked according to performance. It could be the Champions League we are discussing, not paid-for sex.

I’ve heard financial types justifying it as part of the process of globalisation, another manifestation of the west-east “tilt” by which world economic power is gravitating eastwards.

In my experience, many men will be unfaithful if they have the opportunity and a reasonable expectation that they will not be found out. For expats in Dubai, the summer months provide virtual laboratory conditions for infidelity.

Above all, there is opportunity. There is the Indonesian maid who makes it apparent that she has no objection to extending her duties, for a price; the central Asian shop assistant in one of the glittering malls who writes her mobile number on the back of your credit card receipt “in case you need anything else”; the Filipina manicurist at the hairdresser’s who suggests you might also want a pedicure in the private room.

Even though selling sex is haram (forbidden) under Islamic law, the authorities rarely do anything about it. Occasionally, an establishment will break some unwritten rule. Cyclone, a notorious whorehouse near the airport, was closed down a few years back, but then it really did go too far – a special area of the vast sex supermarket was dedicated to in-house oral sex. When the authorities ordered it to be closed, the girls simply moved elsewhere.

There are occasional stories in the local papers of human trafficking rings being broken up and the exploiters arrested, but it is low-level stuff, usually involving Asian or Chinese gangs and Indian or Nepalese girls. The real problem is the high-end business, with official sanction. Even with the emirate’s financial problems, Sodom-sur-Mer is flourishing. But would-be snoggers beware – your decadent behaviour will not be tolerated.

The Spanish masturbation guru Fran Sanchez is on the wrong path. Just imagine him handling his sexuality alone on his couch or in the toilet. A picture of pity, he is.

Ageism is pest of rich countries. If you are old you have no value. In poor countries, value depends on wealth. That is much better than value depending on youth because wealth can become more with advancing years. This is why rich men have every reason to invest in destruction. Plain math.

North Korea launches ferry service to Russia’s far east

Nikkei Asian Review – May 17, 2017

SEOUL(Reuters) — North Korea launched a ferry service to the Russian city of Vladivostok on Wednesday to develop links and boost economic cooperation, the North’s state media said, as it faces increasing isolation over its weapons development.

Experts have said North Korea’s leader, Kim Jong Un, may be hoping closer ties with Russia would help if China, the North’s main economic benefactor, steps up sanctions against it over its weapons programmes, in defiance of U.N. resolutions.

Russian President Vladimir Putin said on Monday that while Moscow was opposed to any new countries acquiring nuclear weapons, the world should talk to North Korea rather than threaten it.

The ferry, the Mangyongbong, set sail from the North Korean port of Rajin, the North’s KCNA news agency said.

“Mangyongbong’s operation as the Rajin-Vladivostok international tourist liner will make a positive contribution to developing marine transport and economic cooperation and tourism between the two countries,” it added.

The Russian consul general based in the nearby city of Chongjin saw the ferry off, it said.

The Mangyongbong was in service between the North and Japan before Japan suspended its operations in 2006 after a North Korean missile test.

North Korea fired a ballistic missile on Sunday that landed in the sea near Russia.

The United States has been discussing possible new U.N. sanctions with China, which disapproves of the North’s development of nuclear weapons and ballistic missiles to deliver them.

Russia, especially the port of Vladivostok, is home to one of the largest overseas communities of North Koreans in the world, and they send home many thousands of dollars in much-needed hard currency each month.

The ferry service is expected to carry up to 200 passengers and 1,000 tonnes of cargo six times a month between North Korea and Vladivostok.

The multiverse theory explains why each of us lives in an own universe in which we may as well be immortal.

Of course, prostitutes are needed. Give male scum and dregs a chance to fuck, so they will keep away from the good girls which are for us, the elite.