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The holidays are touted to be the time of year to be joyful and most of all have fun and spend time with family and/or friends. For some, however, the holidays when families and/or friends gather to celebrate and share the joy of the season are not joyful. Because family matters are conducted behind closed doors this 'unhappy event' goes unnoticed and the victim of this cruel experience takes its toll. I speak of the unspeakable—sexual child abuse. Countless children are abused at family gatherings. While everyone is talking, laughing and having a good time, beloved Uncle Lewey, Grandpa or family friend, walks out of the living room (ostensibly to go to the bathroom) but instead goes into his niece's/granddaughter's or family friend’s room, where she is 'hanging out.' He nonchalantly chats with her and before she realizes what he is about to do, he has planted a kiss on her lips and forced his tongue into her mouth and/or fondles her breast. He then tells her she is so sexy he couldn’t stop himself, she is very special and it is their secret or he threatens her that if she tells he will say she is a 'liar' or worse yet, she 'came onto' him. Thus, she is forced into silence and shame. While I realize this scenario is difficult to fathom, it is all too real and all too frequent. However, this scenario doesn't need to end tragically, something can be done to prevent or mitigate it. No one is born a molester, yet all too often victims become perpetrators. Sexual child abuse has become a family tradition-Uncle Lewey was abused by his father, mother, uncle, cousin or aunt and now he has abused his niece. Or grandpa was abused by someone and he now has abused his granddaughter. How, you may ask, can this be possible when so many people are around-no one would risk being seen sexually abusing a child? Unfortunately, this rationalization merely avoids accepting the truth about sexual abuse perpetrators. It only takes a second to abuse a child. Furthermore, few people recognize what constitutes sexual child abuse. Sexual touch—a sensuous or ‘wet’ kiss on the lips, touching or fondling erogenous areas cause as much trauma as genital contact. All sexual abuse and/or sexual touch is damaging because it is first and foremost a betrayal of trust. PREVENTION is possible. However, for a child to be able to prevent this experience, she or he needs to have knowledge of and permission to exercise self-protection. Without knowledge of and permission to exercise self-protection, the only defense a child has against any kind of abuse is to accept the blame. A child cannot conceive the idea, "My father, uncle, mother, grandpa, grandma, aunt, brother, sister, cousin, friend, teacher, or baby-sitter is sick and is harming me." Therefore, the only way to survive sexual abuse or incest is to assume that it is his or her fault. A child has unquestioning trust for everyone in the family or persons of acquaintance or authority. Parents generally teach girls to be passive, compliant, non-assertive, co-operative and reward them for doing so. Girls are raised to be 'quiet, sweet and pretty' they are never to make a 'scene.' It is not surprising then, that girls are (according to statistics) twice as likely to be sexually abused. Perpetrators know who and how to target their victims. Boys are taught, expected and praised to be tough and self-assured, even at times when something troubles them. Whenever a person is traumatized, he or she resorts to familiar behavior; for girls this behavior usually means passivity while boys usually 'tough it out'-thinking if they are strong and unemotional, no harm can occur. Self-protection offers a direct and effective way to empower children to help themselves. Since perpetrators cunningly and with forethought sets the stage to perpetrate this crime in secrecy, who is better able than the child to protect him or herself? Perpetrators say they can sense a child to victimize; they sense this by the child's demeanor, body language and facial expressions. They sense the fear, the helplessness, their compliant attitude and their passivity. Perpetrators choose victims who they assume will keep their secret. No child needs to fall prey to these cunning predators. The first response the majority of people form when hearing of sexual abuse or incest is denial. 'I do not have to be concerned about that in my community. This would never happen in my family.' The unbelievable reality is that a person who sexually abuses children may seem very average and ordinary to the world. He or she may be a leader in the church, in the community or in business. He or she does not fit a classic stereotype and is not necessarily uneducated, unemployed, impoverished or an alcoholic. Furthermore, we find sexual abuse and incest even more difficult to believe or accept when the person we like, admire, love, and/or marry is the perpetrator of the abuse. Tragically, the unwillingness to accept the facts concerning sexual abuse perpetrators leaves children vulnerable to becoming victims and increases the likelihood that they will be abused. 'Traditionally, incest was defined as: sexual intercourse between two persons too closely related to marry legally--sex between siblings, first cousins, the seduction by fathers of their daughters. This dysfunctional blood relationship, however, does not completely describe what children are experiencing. To fully understand all sexual abuse, we need to look beyond the blood bond and include the emotional bond between the victim and his or her perpetrator. Thus, a new definition has emerged. The new definition now relies less on the blood bond between the victim and the perpetrator and more on the experience of the child. Incest is both sexual abuse and an abuse of power. It is violence that does not require force. Another is using the victim, treating them in a way that they do not want or in a way that is not appropriate by a person with whom a different relationship is required. It is abuse because it does not take into consideration the needs or wishes of the child; rather, it meets the needs of the other person at the child's expense. If the experience has sexual meaning for another person, in lieu of a nurturing purpose for the benefit of the child, it is abuse. If it is unwanted or inappropriate for her age or the relationship, it is abuse. Incest [sexual abuse] can occur through words, sounds, or even exposure of the child to sights or acts that are sexual but do not involve her. If she is forced to see what she does not want to see, for instance, by an exhibitionist, it is abuse. If a child is forced into an experience that is sexual in content or overtone that is abuse. As long as the child is induced into sexual activity with someone who is in a position of greater power, whether that power is derived through the perpetrator's age, size, status, or relationship, the act is abusive. A child who cannot refuse, or who believes she or he cannot refuse, is a child who has been violated. (E. Sue Blume, Secret Survivors)." Sexual abuse can be as subtle (covert) as any person showing pornographic pictures or movies to a child. It is any man hugging a child while pressing his hard penis against her. It is anyone consistently invading a child's privacy, such as entering the bathroom or bedroom without knocking, catching her unaware and indisposed. It is playfully pulling her swimsuit bottom down in the pool or pulling her panties down without her permission. Sexual abuse is anyone bathing the child when the child is old enough to bathe herself. It is any person who touches or caresses the child in ways she does not like or in ways that are sexual. It is any man holding a child on his lap when he has an erection. It is any trusted adult who stares at or makes comments about the child's body. It is anyone kissing the child in a way that is sexual for the giver. It is seemingly innocuous touching, wrestling, tickling, or playing which has sexual overtones or meaning for the other person. Sexual abuse is as blatant (overt) as instructing or asking the child to lie in bed in an intimate position, fondling, digital, penis or object penetration of the rectum or vagina, or instructing a child to perform oral sex or performing oral sex on the child. It is forcing the child to touch others or be touched by others, including other children. A classic example of covert sexual abuse while people are present is exemplified by a 39 year-old woman who came to me after having a severe panic attack. During our investigation as to what was the root cause of the panic attack she revealed she had been sexually abused when she was nine by a 'nice man,' who was a family friend. "He helped me on with my coat while attending a family gathering. As he adjusted my coat onto my shoulder, he fondled my breast." This type fondling is often times referred to as 'coping a feel.' No matter the label, it is sexual abuse and causes damage. As an adult woman you know how icky it feels when a man 'cops a feel.' Can you imagine what it would feel like for a nine-year-old, who has no information to comprehend and emotionally resolve what she experienced? Overt sexual abuse is openly sexual and apparent. Although there may be an attempt to deny that it is abusive, there is no attempt to hide the fact that it is sexual in nature. Covert sexual abuse is more insidious. Thus, identifying it is harder, because the sexual nature of the action is disguised. The perpetrator acts as if she or he is doing something non-sexual, when in fact he or she is being sexual. The betrayal then becomes two-fold. The child is not only abused, but also tricked or deceived about the act. In this dishonesty, the child is unable to identify or clarify his or her perception of the experience. The unreal or surreal sense that accompanies any sexual abuse is intensified when the child is tricked into disbelief. Thus, the child doubts his or her perceptions and feelings and believes that there is something wrong with himself or herself because he or she feels terrible. To make matters worse, everyone around her or him acts as if nothing is wrong. Thus, she or he feels crazy, as if she or he is the one with the problem. A classic example of overt sexual abuse while people are present is exemplified by the incident a client, who is a sexual abuse survivor, reported about seeing her father (her perpetrator) kiss her one-year-old niece on the pubic area after her niece had taken a bath. Her sister, the child's mother, the child's grandmother, (wife of the perpetrator) were present. "My sister and mother (the child's grandmother) laughed and I got sick to the stomach. Am I over reacting," she asked. Obviously, her sister and mother are unaware of the definition of sexual abuse. Except for the fact this woman was in recovery and could clarify the experience she would not have considered it sexual abuse either. The frightening truth about sexual abuse and incest perpetrators is that within their mindset, they do not hold beliefs reflecting society's moral and ethical values. Because of a child's innocence and trust of the abuser, usually pressure or violence is not required. Thus, the sexual abuse or incest perpetrator can unequivocally state, "Never ever. I could never harm a child or anyone. It's not in my heart. It's not who I am." Michael Jackson, 1993. Sexual abuse and incest perpetrators frequently pass lie detector tests. They feel no inner conflict with what they have done. Their moral and ethical values do not reflect the standards on which the test is based. If you have the slightest cause for concern, trust your intuition and seek professional intervention. Trusting and acting on our intuition or sixth sense is paramount to protecting children from perpetrators, no matter whether they are family members, family friends, doctors, dentists, teachers, etc. When intuitiveness or a sixth sense has been activated in detecting danger, it can be identified by a change in one's physiology. First: Accept the fact that sexual abuse perpetrators may seem very average and ordinary to the world. In spite of all the reports of sexual abuse by pillars of the community-teachers, clergy, coaches, we still want to cling to the belief that a sexual abuse perpetrator is the disheveled man with a scraggly beard, wearing a dirty trench coat. It is difficult to believe the people we like, admire, trust and love would do such a heinous thing. Second: Accept the definition of sexual abuse. (See definition above) Third: Know the signs your child is being targeted: Self-protection offers a direct and effective method for children to protect themselves. Who, other than the child, is in a better position to protect him/herself? Perpetrators say they can sense a child to victimize. They can tell by the child's demeanor, body language, and facial expression. They sense the fear, the helplessness, the passivity. They chose a child who is easily intimidated or controlled so hopefully the child won't tell. Secrecy is paramount for the perpetrator. Whenever a person is traumatized, he or she resorts to familiar behavior; for girls this behavior is usually passivity, while boys usually 'tough it out'-thinking if they are strong and unemotional, no harm can occur. Sexual crimes against children can only be committed if the perpetrator finds someone who will hopefully keep the secret. No child needs to fall prey to these cunning predators. There are seven child tested, parent approved sexual child abuse prevention techniques, which will protect your child from the most cunning predators. If you heed and investigate these warning signals you can prevent continued abuse. Warning signals include: • * an aversion to a person, place or event. • * outbursts of anger and there is no apparent reason known for such anger. • * any unusual or unexplained behavior change. Ceasing an activity that was once done without hesitation. • * not wanting to be around a particular person. • * family member/friend seems to foster a relationship with your child more for him/herself than for your child. • * secretiveness between the child and adult Fourth: What to do: • * Teach Good/Appropriate Touch with regard to anyone. • * Teach Appropriate Body Boundaries with regard to anyone. • * Foster Self-Esteem and Good Body Image • * Teach the "Tell Mommy and Daddy Everything-No Secrets rule. • * Allow your child to command respect regarding dislikes and touch with family members, friends or authority figures. • * Talk with and listen to your child until you are satisfied the aversion is unrelated to improper behavior by anyone. • * Check on your child occasionally whenever they are with another adult or other times to become 'known' as an attentive parent. • * Trust and honor your child's intuitive reactions. If your child feels uncomfortable with someone, respect their intuitive sense—honor their intuitive sense. • * Appropriate Suspicion—trusting and acting on your intuition or sixth sense is paramount. If you have confusion regarding a person's actions, nagging/persistent thoughts or feelings, hesitation, general suspicion, apprehension, fear, doubt, a hunch, curiosity regarding a person's actions or statements, or questions regarding a person's proclamation that is not substantiated by their actions—trust your intuition or sixth sense. • * If you err in evaluating the situation, make the error on the side of caution. The important factor is not that you have avoided offending someone, but that you have protected your child's interest. • * Remember it only takes a second to sexually abuse anyone—child or adult prosolution penile enlargement pills penis enlargement herb vimax homemade penis enlargement vimax top rated penis enlargement pills get vigrx buy place vig rx top pennis enlargement pills free natural penis enlarement

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Sexual relations can foster union and harmony if a couple is kind to each other throughout the day and also learns some simple love-making techniques to create peace and satisfaction in their sex life. We can think of sexual relations as a balancing of the male and female energies. The most satisfying lovemaking does not end in sexual explosion. It ends in peace. For this kind of balance and peace to arise, time is required. If intercourse lasts at least half an hour, with deep, gentle penetration, a couple will cultivate love and peace together. Unfortunately it can be difficult for a man to delay ejaculation for the length of time required to reach this state of loving surrender. Unfulfilling sexual encounters will create tension, even anger, in a once loving relationship. Tantric and Taoist texts recommend that a man strengthen his prostate through exercise. A stronger prostate will allow the man to delay, or even avoid, ejaculation. The resulting longer intercourse will allow the balancing of energies, fostering peace and love in the relationship. The prostate is a few inches back from the anus. When a man tightens and relaxes his anus, he automatically massages and strengthens his prostate. (This is called Kegel's exercise.) A man can do this exercise at any time, day, or night, to strengthen his prostate. He can also do the exercise during sexual relations. During sexual relations the exercise causes increased circulation to the prostate, which causes the prostate to partially empty semen into the man's own blood stream. The partial emptying of the prostate takes away the urgency to ejaculate, and allows intercourse to continue. The exercise can be repeated every so often during intercourse as long as the couple desires to continue relations. If a man wishes to avoid ejaculation completely, he can do so without harm if he does Kegel's exercise after intercourse. Kegel's exercise empties the prostate into the blood stream and eliminates the erection. In this way his lovemaking is more harmonious and his physical and emotional energy are conserved. For More information on this topic, see The Tao of Sexology, by Dr. Stephen Chang. Important: Even if a man learns to avoid ejaculation, pregnancy is possible. The man's arousal fluid, called Cowper's fluid, contains sperm. Cowper's fluid leaks out of the penis during sexual arousal. In addition, seminal fluid, containing millions of sperm, may leak out of the penis during sexual arousal but before ejaculation. For these reasons, pregnancy is possible with no ejaculation. Even with no penetration, the microscopic sperm can swim in the woman's fertile-type mucus, into her vagina and up to her fallopian tubes. Therefore, during the fertile time, pregnancy is possible with only genital contact (touching of the penis near the vagina.) vig rx ingredient penis elargement cream best penis enlagement pills free pennis enlargement video best penis elargement penis enlarement pills review pnis enlargement tool do penis enlargement pill really work penis enlarement program

VIAGRA What is Viagra? Viagra is an anti-impotence drug manufactured by Pfizer with an active ingredient sildenafile citrate for treatment of male impotence. Sildenafile citrate relaxes the muscles and increases the blood flow to particular areas of the body. The intake of Viagra increases the ability to achieve and sustain erection on being sexually stimulated. Men taking Viagra have reported an amplified sex drive, increased stamina, and quicker recharge. Viagra works together with sexual stimulation to help achieve maximum sexual satisfaction. However, Viagra does not guarantee protection from getting sexually transmitted diseases, including HIV and Hepatitis. How Viagra works? Viagra enables many men with ED to respond to sexual stimulation. When a man is sexually aroused, the arteries in the penis relax and widen, allowing more blood to flow into the penis. As the arteries in the penis expand and harden, the veins that normally carry blood away from the penis become compressed, restricting the blood flow out of the penis. With more blood flowing in and less flowing out, the penis enlarges, resulting in an erection. It is to be noted that Viagra is not a hormone or aphrodisiac, it works only when a man is sexually stimulated. Viagra Dosage Viagra is available in the form of tablet and is meant to be taken orally. Ideally it is to be taken almost an hour before the sexual activity. However, Viagra can be taken anytime from 4 hours to 30 minutes before sexual activity. It takes 30 – 45 minutes for showing Viagra’s effect and this effect lasts for almost four hours. If you take Viagra after a high-fat meal (such as fish & chips, cheeseburger or French fries), it may take a little longer to start working. Viagra should not be taken more than once a day unless prescribed by your doctor. Warnings/Precautions It is always advisable to consult physician before starting the intake of Viagra. In case you have the history of an heart attack, stroke, or life-threatening irregular heartbeats within the last six months; or have heart failure in the past; coronary artery disease; angina; high or low blood pressure; liver problems; kidney problems; blood problems, including sickle cell anemia or leukemia; a bleeding disorder; stomach ulcer; retinitis pigmentosa (an inherited condition of the eye); physical deformity of the penis such as Peyronie's disease; or a condition that could lead to prolonged and painful erections, such as a tumor of the bone marrow, sickle cell anemia, or leukemia; or you are taking any other medicine containing nitrates your blood pressure could suddenly drop to an unsafe level and can risk your life. All these medical conditions and also allergy to sildenafile or any of its ingredients can lead to disastrous results. So it is always advisable to consult your doctor for adjusting the dosages after monitoring the treatments listed above. Viagra is not approved or recommended for use in women. Therefore, women should not take Viagra under any circumstances. It also not recommended for men older than 65 years unless they tolerate it in small doses for those who are sensitive to the effects of Viagra. Missed Dose Viagra can be taken as and when needed and there is no concept of missed dosage. Possible Side Effects of Viagra Every medicine has some or the other side effect and so does Viagra. It depends on individual to individual and is usually mild to moderate and don't last longer than a few hours. Mostly these side effects are evident with high intakes of Viagra. The most common side effects of Viagra are headache, nausea, flushing of the face, and upset stomach. Also there can be some temporary changes in color vision (such as trouble telling the difference between blue and green objects or having a blue color tinge to them), eyes becoming sensitive to light, or blurred vision. But if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw during sexual activity, stop and call your doctor right away. You could be having a serious side effect of Viagra, or if you have sudden vision loss or have any of these signs of allergic reactions like hives; difficulty breathing; swelling of your face, lips, tongue, or throat seek emergency medical help immediately. It is also advisable to stop using Viagra and call your doctor immediately if you have any of these serious problems like - chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling; irregular heartbeat; swelling in your hands, ankles, or feet; shortness of breath and vision changes. In rare instances, men have reported an erection that lasts many hours. But if this is the case then you should call a doctor immediately if an erection lasts more than 4 hours. If not treated right away, permanent damage to your penis could occur. Heart attack, stroke, irregular heartbeats, and death have been reported rarely in men taking Viagra. Most, but not all, of these men had heart problems before taking this medicine. It is not possible to determine whether these events were directly related to Viagra. do penis enlargment pills work enargement forum free matter penis size pnis enlargement operation penis enhancement patch plus vigrx extra pro solution strength natural penis enargement exercise penis enlagement patch penis enlarement program

Nigerian government is advising its people to eat chocolate for enhancing their sexual pleasure instead of spending on high cost drugs like Viagra, Cialis and Levitra. After Goji berry, is that a new gimmick? Dr. Dora Akunyili has proved through her scientific tests that cocoa has libido enhancing qualities, is it not quite an old story? Actually there is a scientific reason behind the trend of gifting chocolate bars and candies to our lovers. It is said to stimulate the hormones that is responsible for the feelings related to love, because of a natural chemical present in chocolate, it works as an aphrodisiac. Now Nigeria's national committee for the development of cocoa is giving examples of marketing campaigns by the British trade association that talks about the sexual enhancement qualities of chocolates. Compared to Viagra, chocolate has no side effect, says Dr. Akunyili. It is a great anti-oxidant known to prevent heart attack, diabetes as well as hypertension. Of course chocolate would have been far better option compared to the PDE5 inhibitors if it was able to treat the erectile dysfunction. Because it tastes better, costs less with no side effect at all. But unfortunately, human mechanism is not so simple, neither is the anatomy of erection. Having high libido is not enough for a satisfactory sexual intercourse until a man can have a strong penis erection and hold it till the end. Do you agree? I think there is no other way to do it right when vaginal penetration is the question. Yet again, this is time to remind you that the terms like ‘low libido’ or ‘less’ or ‘no sexual drive’ do not mean a man has erectile dysfunction. At the same time, a man with ‘erectile dysfunction’ or ‘impotence’ may enjoy high libido or sexual excitement. Goji berry and cocoa may act as a natural aphrodisiac, enhancing a person’s sexual drive, PDE 5 inhibitors like Viagra treat the disease that causes inability to get an erection or sustain an erection even with good amount of sexual stimulation or high sexual drive. Viagra treatment is totally different! It relaxes the muscles in the penis and increases blood flow into it so that the blood engorges the penile section helping a man get a strong erection for a successful vaginal intercourse. Viagra is not an aphrodisiac, so it does not enhance your sexual drive. More importantly, you need sexual stimulation to get an erection after the oral administration of Viagra. Viagra is a treatment for the most common disorder erectile dysfunction in men that makes them ‘impotent’. There is no use comparing Goji berry or cocoa like natural substances with Viagra and other PDE5 inhibitors from sexual perspective. But of course they can be compared for their benefits in life threatening matters like preventing heart attack and pulmonary diseases. ___________________________________________________________________ penis enhancement drug vigrx pill pnis enlargement before and after photo herbal natural pennis enlargement herbal natural pennis enlargement male penile enlargement penis enlarement system penile enlargement operation penis enlarement program

Penile Implants These are the most irreversible and drastic ways of achieving artificial erection. Only when all other measures have been exhausted with no longer-lasting effects are achieved is that penile implants are warranted. These are prosthetic devices made of inert silicone, which are surgically inserted into the penis. Normal erection cannot be achieved after that. There are two kinds of penile implants: Passive Implants: Two rods of silicone are inserted into the penis, which remains erect all the time. The silicone rods can be put in different angles, but this may be an embarrassment in public occasions such as swimming. Orgasm may be achieved unless there are hormonal or neural factors which impede it. Active Implants: These are inflatable silicone pouches which are also implanted into the penis. The penis remains in flaccid state until a proper manipulation of the prosthesis causes its inflation and consequent erection. One type of implant is activated by pressing the glans (the head of the penis) with one hand. Liquid is transferred from a reservoir to the main inflatable pouches. In another type, the liquid reservoir is implanted into the scrotal sac, and can be pumped by hand. Other Treatments Other surgical and non-surgical treatments for impotence are being tried in an experimental basis, and there may be a promising future for some of them. For instance, groups of physicians in Russia and Germany have been experimenting with electrical stimulation of the pelvic area using an external pad applied to the abdomen and back. There are already commercial devices using this principle, which seems to increase the blood flow in the genital area. Direct stimulation of pelvic nerves (leading to a nerve-induced erection) by using implanted electrodes and an electrical pacemaker-like device are also being considered. "Natural" or alternative methods do abound. They range from "natural" foods which have high testosterone or DHEA levels, such as green oats (marketed under the brand name of SEXATIVA) or saw palmetto; to yoga exercises to increase muscle tone and blood flow in the genital area. It is hard to say whether there are real effects or they are just the effect of suggestion or placebo phenomena. One thing has been scientifically determined, however. The blood levels of testosterone increase just after exercise, or by loosing excessive weight. Thus, a natural way of combating mild hypogonadism might be frequent exercising and keeping a normal weight. Controversial and unapproved treatments Controversial and unapproved treatments Bremelanotide The experimental drug Bremelanotide (formerly PT-141) does not act on the vascular system like the former compounds but increases sexual desire and drive in male as well as female. It is applied as a nasal spray. Bremelanotide works by activating melanocortin receptors in the brain. It is currently in Phase IIb trials. Ginseng A double-blind study appears to show evidence that ginseng is better than placebo: see the ginseng article for links and more details. Enzyte Enzyte is a product that has been advertised by saturation coverage on television channels such as Court-TV. However, the Center for Science in the Public Interest (CSPI) has filed a complaint with the Federal Trade Commission (FTC) about Enzyte for deceptive advertising. It is manufactured by Berkeley Nutritionals, which is alleged to be the subject of an investigation by the Attorney General of Ohio and the defendant in class-action lawsuits. Enzyte is a supplement that claims to increase the male libido or frequency of erections of the penis. Commercials for Enzyte are shown regularly on television. These commercials feature a man named Bob who never stops smiling, apparently because he had taken Enzyte and improved the size of his sex organs. The commercials are riddled with symbolic phallic imagery, e.g. golf clubs, remarkably tall glasses of iced tea, and a hose spraying barely a trickle of water (carried by someone who doesn't use Enzyte). The effectiveness of Enzyte is in dispute. Some medical professionals in fact advise against taking Enzyte, saying that it can lead to damage. The Center for Science in the Public Interest have urged the Federal Trade Commission to disallow further television advertising for Enzyte due to a lack of proper studies supporting claims. Enzyte maker Berkeley Premium Nutraceuticals, Inc., is currently under a class action lawsuit for false advertising. Enzyte is said to contain: Tribulus terrestris; Yohimbe Extract; Niacin; Epimedium; Avena sativa; Zinc Oxide; Maca; Muira Pauma; Ginkgo biloba; L-Arginine; Saw Palmetto. Other ingredients: gelatin, rice bran, oat fiber, magnesium stearate, silicon dioxide. Herbal and other alternative treatments These are generally ineffective when tested blind, but may be useful for their psychological (placebo) effect: if a good result is expected, any highly-praised, and often expensive, treatment can be effective. Reputable drugs can also benefit from the same effect. Uncontroversial treatments for erectile dysfunction PDE5 Inhibitors The prescription PDE5 inhibitors sildenafil (Viagra®), vardenafil (Levitra®) and tadalafil (Cialis®) are prescription drugs which are taken orally. They work by blocking the action of PDE5, which causes cGMP to degrade. cGMP causes the smooth muscle of the arteries in the penis to relax, allowing the corpus cavernosum to fill with blood. Vacuum pump An external vacuum pump will produce an engorged penis with success approaching 90%; a penis ring will maintain this state, although it should be removed after not more than 30 minutes. The erection is not as rigid or hard as a natural erection; drugs or injections, when they work, may be preferable. Various studies show the degree of satisfaction of users and their partners to be vary variable, even when drugs and injections do not work; in one study, about 20% of men who tried a (high-priced) pump decided to proceed to purchase one. Other studies show higher percentages of satisfied users. In some cases frequent use of a vacuum pump can eventually improve the degree of erection attainable without use of the pump. Claims of cheap "penis pumps" to permanently increase maximum penis size should be viewed with caution, however. Some vacuum pumps are sold at a higher price with 100% refund within 90 days to dissatisfied users, with a somewhat lower price with 50% refund guarantee (Osbon Erecaid, [7]). This pump is supported by medical insurance schemes, including the UK's NHS and US Medicare and private insurers. The better-known pumps sell for prices of around 200 GBP/400 USD (2006). There is at least one vacuum pump with rings which sells for around one-fifth of this price (Noogleberry, [8]). Specific devices are mentioned for information only; mention should not be taken as endorsement.