Now we look at the treatments available for impotence and find out how Matt’s story ended.

Common Treatments For Physical Erection Problems

As mentioned in Part I, before treating impotence the doctor will probably run some tests or send the patient to a specialist to find the root cause.

Tests for physical problems include hormone tests, blood flow evaluations to check for blockages, nerve damage tests, and penile tumescence and rigidity testing to determine if the man has erections during the night. If he does, then his erection problems are likely psychological in nature.

Doctors today believe that physical factors are usually at play when impotence isn’t temporary and doesn’t go away on its own. If a patient has suffered from an erection problem for a long time (or has never achieved an erection), his doctor will likely find some physical trigger rather than psychological

Treatments for physical impotence include the following:

• Hormones. who have low testosterone levels may be prescribed hormone supplements.
• Medical Treatment. This involves treating the underlying illness or condition that may be causing the erection problem, such as diabetes, thyroid imbalance, high blood pressure or depression (see Part I of Matt’s Story for a list of impotence-related health conditions.)
• Kick The Habit. The doctor may also advise his patient to give up or reduce the amount of tobacco and alcohol he uses, as they may contribute to impotence.
• Prescription Drugs. Viagra, Cialis and Levitra are commonly prescribed by doctors to increase blood flow to the penis, helping men to achieve and maintain an erection.
• Mechanical Aids: When impotence can’t be treated with drugs, devices such as vacuum pumps and penile implants may help.

Common Treatments For Psychological Erection Problems

As mentioned in Part I of Matt’s Story, psychological impotence is extremely common. It can result from a man’s feelings of insecurity or low self esteem, fear, anxiety, depression, poor communication with his partner or other relationship problems.

The epidemic of depression in modern society has complicated matters for men suffering from erection problems because both the condition AND many of the drugs used to treat depression can cause impotence. Sometimes switching to a different anti-depressant can resolve the problem.

Here are some other common treatment methods for erection problems that start in the mind:

• Counseling. A trained therapist can help men deal with negative feelings like fear, stress or lack of confidence.
• Education. With so many of us having easy access to the Internet, it’s now possible to learn more about the workings of the mind and body in a private setting. Anonymously joining erectile dysfunction forums or discussion groups can help you figure out what’s normal and what isn’t, and learn about solutions that have worked for others
• Communication Learning to share your concerns about sex with your partner may not come easily at first, but it can help open the door to a healthier sex life and ease communication in every other aspect of your lives together.

Matt’s Story: The Conclusion

Matt was fortunate. His doctor gave him a clean bill of health and suggested he get counseling and learn how to share more with his partner

He also suggested Matt consider trying Viagra in conjunction with the therapy to help him and his partner "reconnect" while they work on their relationship issues.

Matt and Cindy are currently attending weekly counseling sessions and using Viagra when needed. They report things are getting better for them, both in bed and in their relationship.

Matt and Cindy have been together for over 12 years. They were best friends first and then became lovers, then life partners. But lately there hasn’t been much sizzle in the sex department. Cindy wants to deal with the problem, get professional help, and fix it.

But Matt hates talking about it. He’s afraid his erection problem might get worse if they focus on it too much. His fear is understandable.

The mind and the ego play a major role in a man’s ability to get and maintain an erection long enough to complete the sex act. Many emotional issues can actually cause impotence, like:

• depression
• anger or fear
• anxiety
• self-esteem issues
• relationship problems, poor communication

So how can Matt and his doctor figure out the root cause of his erection problem and resolve it before it starts to affect Matt and Cindy’s relationship?

Impotence Risk Factors

Let’s look at the various risk factors. In older men, impotence is more often the result of physical causes like prostate problems or diabetes.

In younger men, psychological factors are usually the culprit. So Matt, at 39, should seriously consider where his head and heart are at.

But ruling out physical causes is probably the best place to start any investigation into impotence.

There are many physical reasons for a man to develop erection problems. Some cause temporary impotence, others contribute to a more enduring erection problem:

• Chronic smoking reduces blood flow, which may result in erection problems.
• Alcohol and cocaine are famous for causing "whiskey dick".
• Neurological impairment due to Alzheimer’s, Parkinson’s or MS.
• Health conditions like heart or thyroid, diabetes, high blood pressure, spinal chord injury, depression, and prostate problems can contribute to erection problems.
• Prescription drugs like blood pressure, heart, ulcer drugs, sleeping pills and antidepressants.
• Pelvic trauma or surgery may cause nerve damage to the area.
• Vascular disease may lead to reduced blood flow to the penis.

By first considering all physical causes of impotence, the doctor can more easily diagnose his patient

Physical or Mental?

How will the doctor zero in on the cause of Matt’s erection problem? He may start by asking if Matt has erections in his sleep. Most men experience up to six erections every night.

There are devices that attach to the penis to find out if a man has erections while sleeping. If he does, it tends to indicate that his penis is working fine physically and that psychological causes may be the source of his impotence.

But that isn’t the only diagnostic tool in the urologist’s arsenal. There are at least eight other tests, some more complicated and invasive than others, that doctors use to diagnose impotence: ultrasound, penile reflex tests, electromagnetic vibration, angiograms and other procedures are available to help Matt’s (and your) doctor come to a diagnosis.

How To Treat Impotence

Once the doctor knows the cause of Matt’s erection problem, prescribing the right treatment becomes much easier.

In Part II of Matt’s story, we look at impotence treatments for both psychological and physiological erection problems. And we find out how Matt’s erection problems were finally resolved.

Click here for Part II

Whatever you call it, impotence has been an obsessive concern among men throughout the ages. No surprise that just the mention of the word impotence strikes fear into a man’s heart… the word carries a lot of baggage:

    Impotence: Lacking in power, strength, vigor or virility. Being incapable of accomplishing or effecting anything: helplessness, inadequacy, incapability, ineffectiveness, inefficacy, powerlessness, uselessness.

Uselessness? Inadequacy? No wonder impotence feels like a death sentence. No wonder there’s a multi-million dollar market for erectile dysfunction drugs like Viagra, impotence products like vacuum pumps, and books like these – just a small sample of what’s out there:

• Impotence: A Cultural History
• Hidden Anxieties: Male Sexuality
• Coping with Erectile Dysfunction: How to Regain Confidence & Enjoy Great Sex
• Cult of Impotence
• How to Eat Away Your Impotence
• From Impotence to Authority
• An Atlas of Erectile Dysfunction

Impotence Treatments Through History

There’s another reason why impotence is such a scary word. In the past, the cure for an erection problem was often worse than the condition.

For example, in ancient India, the sufferer was made to eat goat testes boiled in milk and seasoned with porpoise lard.

In old Egypt, the medical experts of the day treated impotence by smearing the man’s penis with baby crocodile hearts mixed with oil.

In the 11th century, things got much better. Men could pop a pill before sex, just like Viagra. The downside was the pills were made from ground-up sparrows, billy goats and honey hardened into a tablet. Doctor’s advice: Swallow don’t chew.

Much later, in Victorian times, authorities proclaimed that impotence was due to "sexual misconduct" otherwise known as masturbation. Stubborn impotence problems were treated by making small cuts in the perineum and suctioning out blood or inserting a thin flexible tube into the urethra. This was thought to remove any blockages that might be hindering performance. Or just cause you to lose your appetite for sex entirely.

In the 1920s and ’30s, there was an explosion in impotence cures involving goat gland implants. Stories still abound about experimental surgeries involving the replacement of a man’s gonads with those of an animal. Thankfully, only a few animals were sacrificed before that went out of style.

In the ’70s, medical science reached a zenith of sophistication by treating impotence with penile implants that were inflated when needed by squeezing a bulb in the scrotum. Better than animal parts to be sure, but the procedure gave "foreplay" a whole new meaning.

Then in 1983, a real shocker. At a big American medical convention, a British doctor dropped his pants and showed the gob-smacked audience his erection. He had injected himself with an alpha blocking agent, an early precursor to today’s erectile dysfunction drugs like Viagra, Cialis and Levitra.

That one unusual flashing incident eventually changed the course of sexual history for literally millions of men and their partners.

Impotence Comes Out of the Closet

The social stigma surrounding impotence and other urological matters is fading fast. Impotence can now be talked about in a much more open fashion. And modern treatments for erection problems can be easily obtained by visiting a specialist.

But for those who still find it embarrassing to talk about their erection problems, safe and effective treatments can be ordered discreetly over the Internet.

If you’ve never ordered prescription drugs online before, these short articles will explain how easy and private it is:

Embarrassing Condition? Get Relief at an Online Pharmacy

How to Get a Viagra Prescription and Order Viagra Online

How to Buy Viagra Online: 10 Quick Tips

And if "impotence" is still the scariest word in your vocabulary, learn more about the problem by browsing the articles in our learning center and then get an online prescription from edrugstore.md. It’s easy, fast and discreet to order your erectile dysfunction medications like Viagra online.

After consulting with his doctor about his periodic bouts of erectile dysfunction, the doctor had given Rob a free Viagra sample. Rob and Maggie had tried it out almost immediately.

"Really," said Rob, folding his newspaper, "it was almost like magic. Now I see why some people call Viagra the magic blue pill."

"What if it wasn’t the Viagra?" Maggie wondered. "I mean, maybe it was just the IDEA of the Viagra that made things different last night. You know… the placebo effect?"

"C’mon, Maggie, you and I both know that I’m always ready and willing and I’ve just had trouble lately in the ‘able’ department. That’s what erectile dysfunction is, and that’s what Viagra is for."

"I know, I know," Maggie said. "All I’m saying is that maybe there was a psychological factor behind your performance last night."

"Well," Rob offered, "whether it was the Viagra or the idea of Viagra, I was happy with the performance, if I don’t mind saying so myself."

"No argument there," Maggie chuckled. "And to be honest with you, I’m not sure I really care what did the trick."

Rob laughed. "Maybe I should get my doctor to prescribe a combination of Viagra and placebo pills without telling me which is which. Conduct our own erectile dysfunction experiment?"

"Let’s not," said Maggie. "Speaking of prescriptions, though, I’ve heard it’s pretty easy to order Viagra online. If you think you’d like to give it another try…"

"Yeah, I’ve heard that too," said Rob. "In fact, I hear it practically every day when I check my email — you know: Stay Harder Longer with Viagra… Strong Power Time Viagra!"

"I get those mails too," agreed Maggie. "They’re pretty ridiculous. But still, I bet we could find a good, genuine online Viagra pharmacy. The b–"

Maggie’s phone rang. "Hold that thought," she said, picking up the phone. It was her friend, Mira. While Rob was out in the yard earlier in the morning, Maggie had left a message with Mira, wanting to talk about the night before.

Before Maggie could get a word in, Mira started firing off questions about their Viagra adventure, Rob’s erectile dysfunction, did the free Viagra sample work, what was it like, etc.

"Whoa, there," interrupted Maggie. "Now’s really not the best time. We’re just finishing up breakfast. I’ll call you back later."

"OK, fine," answered Mira. "But just tell me quick… I’ve got to know. Did the Viagra work?"

"You bet," Maggie said with a smile, and hung up.

"You bet what?" Rob asked, not entirely comfortable with Maggie discussing their sexual issues, at least not while he was within earshot.

"Nothing," said Maggie, sensing his discomfort. "She just wanted to make sure I called her before she goes out. Anyway, I was saying that if we want to continue this Viagra experiment, we can probably get a good deal from an online pharmacy."

"I’m sure you’re right. But first I promised my doctor I’d let him know how it went with the free Viagra sample he gave me. After all, erectile dysfunction is a medical condition… always best to consult with a medical doctor."

"Sure," said Maggie, "but I heard you can get an online consultation with a real doctor when you place a Viagra order over the Internet. These Internet pharmacies have doctors and pharmacists that specialize in erectile dysfunction. But by all means give your doctor a call first. And thank him for the free Viagra sample!"

"I’ll do that, and I’ll let him know that I didn’t notice any of the side effects that some men have after taking Viagra… headache, flushing, that sort of thing. Then I’ll see what he recommends."

"OK. In the meantime," Maggie said, picking up a sugar cube from the breakfast table, "I’ve got an idea."

"Yeah, what’s that?" asked Rob sensing mischief.

"Well, you know I’m not entirely convinced it was the Viagra that did it for us last night."

"Yes, you said that already," said Rob.

"Well, Olivia’s out for a few hours. Want to give it another go?" asked Maggie with a sly smile.

Rob looked puzzled. "What do you mean? The doctor only gave me one Viagra pill. And Viagra usually works for only four hours or so."

"Right," said Maggie. "And a single dose of Viagra hasn’t been proven to work for more than a single attempt, so to speak. I know all that already."

"Then what do you mean?" asked Rob, now a bit befuddled.

Maggie held the sugar cube between thumb and forefinger and held it a few inches in front of Rob’s face.

"This," she said, waving the cube around in a mock tantalizing fashion. "I call it Sweet Sensation. Does wonders for erectile dysfunction. It may just be the next Viagra. In fact, you can consider it a free Viagra sample from me… Doctor Maggie!"

"You’re kidding, right?" asked Rob, even though he knew she was not.

"I most certainly am not. And if it doesn’t work, what’s the harm? We can always get a Viagra prescription as a backup. So open up, sugar. But watch out… this is powerful stuff."

Rob rolled his eyes and opened his mouth. Maggie popped the cube in. She gave him a nibble on the ear for good measure, took his hand and led him toward the bedroom.

THE END

After speaking with his wife Maggie and doing a little research on his own, he knew that erectile dysfunction was sometimes associated with diabetes and cardiovascular disease.

A huge rush of relief swept over Rob when the doctor said that nothing in his test results suggested any obvious physical cause for the erectile dysfunction. Once the relief sank in, though, Rob got worried all over again.

"So what can it be, then?" he asked the doctor.

"Look," the doctor began. "Lots of things can cause or be connected to erectile dysfunction. Lifestyle habits, diet, depression, medication, or a more serious disease. In your case, let’s be glad that we can rule out disease. You’ve also told me that you and Maggie are very happy with each other, and that the sparks are still there."

Rob jumped in quickly. "The sparks are absolutely there. It’s just that I’ve had some trouble getting the fire lit."

The doctor smiled and continued. "If I had to make an educated guess at this point," he said, "I’d say that you’re stressed at work and probably not getting enough sleep or exercise. All these can be factors with erectile dysfunction."

"Yeah, I know," said Rob. "And you’re right about the stress and exercise."

"My recommendation would be to skip out of the office a little early once in a while. Hit the gym, take Maggie out for a walk. That sort of thing. We can also try a Viagra pill, see if that helps."

Rob perked up like a dog that’s just heard the cookie jar opening.

"But do you think Viagra would work in my case?" Rob asked.

"The thing is, you never know until you try it," he doctor replied. "But many of my other patients with erectile dysfunction swear by Viagra. Tell you what. Let me give you a free Viagra sample. We can see how it works for you and how well you tolerate it. Then we can take it from there."

After talking with the doctor a while longer about how to take the Viagra and what to expect, Rob left the office Viagra pill in hand. Now, as he drove across town to meet his family at their favorite diner, top down on his car even though it was really too chilly for that, Rob couldn’t get that free Viagra sample out of his head.

Oddly enough, he felt a lot like the twenty-year-old Rob again. He recognized that familiar feeling of having just purchased a package of condoms on the sly, his mind caught up in a hopeful fantasy about the adventures coming his way.

In those days, of course, Rob had never heard of erectile dysfunction and Viagra did not even exist. Sitting at a traffic light, he noticed an attractive, younger woman in the car next to his, looking his way. "Me, or my car?" he wondered. He smiled back, and when the light changed he moved on feeling young again.

"Man, I’m armed and dangerous," Rob now said to himself as he examined the Viagra pill in the diner parking lot. In the next moment, it dawned on him how ridiculous that must have sounded, and he was glad no one was around to hear him.

After all, it wasn’t as if Rob’s erectile dysfunction was chronic and certainly he was able to perform well enough with Maggie… sometimes. Still, in the old days, you could set your clock by his erections.

Nowadays, he never quite knew what to expect, kind of like waiting for the cable TV guy to show up at your house. Maybe he’ll come sometime between 10 and 2 or maybe he won’t come at all. He had read that Viagra erections were strong and reliable and by now he’d grown curious to find out for himself.

"Hi Honey," Maggie said and greeted Rob with a kiss as he joined her at the corner booth.

"Hi. Hey, where’s Olivia?" Rob asked.

"She’s having dinner at Anna’s house. They’re going to the movies after that."

"Oh, so it looks we’ve got a few hours alone to kill," Rob said, with just the hint of a twinkle creeping into his eye.

"Looks like," said Maggie. "So what did the doctor say? You know, about the erectile dysfunction thing."

"Wanna say it a little louder? I think that guy at the far end didn’t hear you!"

Maggie laughed. "I wasn’t that loud. So, anyway… what did he say?"

Rob lowered his voice. "He said my erectile dysfunction isn’t connected to any disease. I’m basically healthy."

"That’s fantastic!" Maggie said, grabbing Rob and giving him a big hug. "These last few days I’ve been so worried about it."

"I know, me too," said Rob. "He said it’s probably just a combination of stress, working too hard, not getting enough sleep… that kind of thing."

"OK. We can work on those things. I told you you’re burning it at both ends these days," Maggie said.

"He also gave me one of these," Rob said, dipping into his pocket and pulling out the Viagra pill.

"Is that what I think it is?" Maggie asked, eyes lighting up.

"If you think it’s Viagra, then, yes," Rob answered. "The doctor gave me a free Viagra sample to try out and see what happens."

Maggie turned over the pill, as if looking for clues. "You know, Olivia’s out at the movies. How about we hurry up this dinner and conduct our own little science experiment at home?"

"Sounds good to me," Rob said, as he dropped the Viagra pill back into his pocket and quickly signaled the waiter that they were ready to order.

Continued. Read Part IV of ED Blues here.

"Damn," he said wearily. "That was for par."

His friend Raj stood watching a few feet away. "Man, that sucks. Your approach shot to the hole was amazing. Bummer that you couldn’t finish it off."

"Tell me about it," said Rob. "It’s the story of my life these days. And I don’t mean just golf."

"Whatdya mean?" asked Raj.

"Look," said Rob, after finally sinking the putt and retrieving his ball. "You’re a friend, which is why I’m telling you this. But Maggie and I, well…actually, just I, have been having some trouble in the bedroom. You know…finishing the job."

"You’re kiddin’ me?" asked Raj as they got into their cart and sped toward the next tee. "Guy like you? You’re only 50, right?"

Rob looked down and fiddled with his golf glove. "Right. Still, lately, my performance has been below par, which in this case is not a good thing. You’re in pharma, right? What do you know about Viagra? Do you think it could help?"

"Hey, I just work on the IT side," Raj answered. "So you know as much about Viagra as I do. Most of my Viagra knowledge comes from the spam in my email. You know: ‘Cheap Viagra for Longer, Harder Nights,’ ‘Order Viagra Now!’, ‘Viagra Home Delivery,’ and all that.

"Yeah, I know what you mean." Rob paused, and then probed a bit further. "Have you had any problems that like with Mira?"

"Well, there have been a few times when I had a drink or two more than I should have. It was late, and I sort of….ya know…crashed. I don’t think even Viagra could have saved me then!"

"Right," said Rob. "But other than that, you and Mira are pretty OK?"

"Actually," said Raj as he teed up on 18, "you won’t believe it. It’s like she’s always ready for it, even when I’m the one who’s too tired. Honestly, I don’t know where she finds the energy, between the kids and all the extra work she’s putting in these days. Sometimes I feel like I need Viagra just to keep up with her."

"Well, I’ve been a bit worn out, too, lately. Maybe Viagra would help get me going," Rob wondered.

"Maybe it’s not about Viagra," Raj suggested. "Maybe you guys just need to get away from it all for a few days."

"We tried that, remember? We dropped Olivia at Maggie’s parents and went up to the country for a long weekend. Just the two of us at the cabin, sky full of stars, a huge, full moon hanging over the lake. Some wine, a crackling fire…very romantic."

"And?" Raj asked.

Rob winced a little and then replied. "Turned out the moon was the only thing that was huge and full that night!"

"Oh, man, that’s awful!" Raj groaned.

Just as Rob was getting ready to hit his ball, a golf cart came barreling across the fairway about 50 yards ahead of them. The two young men in the cart, about 25 or so, appeared to be looking for a lost ball, but in the process were zigzagging around and making more noise than is generally acceptable on the golf course. One of the men was drinking a beer, while the other was singing, loud and quite poorly.

"Look at those guys," said Rob. "I’ll bet anything they’re not wondering about whether or not they need Viagra."

"Don’t be so sure," said Raj. "Some younger guys, I’ve heard, take Viagra just for fun, to give themselves an extra boost, even if they don’t really need it."

"Could be. And speaking of that," Rob continued, "did you hear about Viagra being used to treat infants that have some life-threatening lung condition? Viagra’s actually saved a few lives this way, I think."

"Yes, I did see something about that," Raj replied. "And by the way, that reminds me of something else I read recently about Viagra. Some study found that Viagra helped reduce the effects of jet lag in hamsters!"

"Hey, that’s great news for all those hamster business travelers out there. I wonder if Mrs. Hamster is reaping the rewards as well."

"Kind of tough when her husband is flying off somewhere all the time, right?"

Rob and Raj laughed and walked onto the green to finish of their round.

"Kidding aside," said Raj, "maybe you should talk to your doctor first, and make sure everything’s OK down there. Who knows, maybe he will suggest Viagra. Look, so many people are buying it, so obviously Viagra works. And not just for hamsters."

"You’re probably right," said Rob as he tapped in his final shot of the day. "My putting game is bad enough on its own. I could do without any more distractions."

Continued. Read Part III of ED Blues here.

She found herself fixated on an advertisement for an erectile dysfunction treatment. Maggie closed the magazine abruptly and let out a barely-audible laugh.

"What’s that you were looking at?" asked Mira, her lips curling into a curious smile. "And what’s so funny?"

"Believe it or not, it’s an ad for an erectile dysfunction drug," answered Maggie. "And what’s funny, if you must know, is that I was actually reading it, wondering if it could help Rob and me. Never in a million years would I have thought he might need treatment for erectile dysfunction."

This got the attention of Julie, who until now was more focused on the young waiters and busboys scooting about from table to table. Julie was the youngest of the three women, divorced not too long ago and testing the waters of being single again, especially now that her daughter was away at college.

"Erectile dysfunction? Really? I had no idea you guys were having trouble in that department," said Julie.

"Well," replied Maggie, "Rob’s been so busy with work, he’s stressed out and it’s just been really hard for the past few months." She quickly realized what she had said, and corrected herself with a chuckle. "It hasn’t been really hard… that’s the trouble."

Mira smiled and said, "You should count yourself lucky. I could use a little erectile dysfunction in my life right about now. Between my work at the institute and being the kids’ social secretary and chauffeur, I’ve got little left over at the end of the day. Honestly, I don’t use the names of the days of the week anymore. I wake up saying, ‘What’s today, soccer, karate or yearbook?’ A little ED or something to slow Raj down at night wouldn’t be the worst thing."

"Are you kidding me?!" Maggie shouted, hardly believing what she had just heard. "That’s so insensitive of you! Erectile dysfunction is a real problem that can really damage a relationship, and right now it’s hurting mine."

Mira saw now that this was no joking matter and tried to redeem herself. "I’m really sorry, sweetie. I know erectile dysfunction is real. I just didn’t realize it was that bad with you guys…"

Maggie took her fork and speared a pale, somewhat soggy piece of baby corn, lying limp and uneaten on her salad plate. She held it up, as if displaying a piece of evidence. "See this?" she asked, arching her eyebrow.

Julie burst out laughing. "Oh honey, I can’t believe it! For a minute there I thought you were going to show us that carrot," she said, pointing to Maggie’s salad.

Maggie bit into the baby corn dramatically. "Believe me, I wish that were the case," she said.

"Well, if it’s any consolation, I know how you feel," Julie offered.

"What do you know?" Mira asked. "You’ve been seeing that pool boy of yours, or gardener, or whatever he is, for the past three months. He’s barely 30, I doubt whether he can even spell erectile dysfunction."

Julie sat up and put on her best just-been-slighted expression. "Jeff happens to be my landscape architect, and he can too spell erectile dysfunction. But if what you meant is that he doesn’t suffer from erectile dysfunction, you’re right."

"Then," probed Mira, "what do you mean when you say you know how Maggie feels?"

"Look," Julie replied, "despite what you guys may think, being a single woman, especially at my age, is not what it’s cracked up to be. Jeff or no Jeff, erectile dysfunction or no erectile dysfunction, a woman has needs, and it’s not always so easy to satisfy them. That’s all."

Mira turned her attention back to Maggie, who by now was poking idly at a few stray chickpeas on her plate. "You know Maggie, Rob should probably see his doctor about this. I’ve heard that erectile dysfunction is sometimes a sign of some other physical problem. It would be a good idea to rule out other causes. Then the two of you can figure out what sort of treatment to look into."

Maggie looked up from her salad with a crest-fallen expression. "Treatment? Rob’s only 51. Don’t you think he’s too young to need treatment for erectile dysfunction? This is so depressing."

"Honey," said Mira, "There are plenty of things that are a whole lot worse than erectile dysfunction, you know. I mean, most of the time, it’s highly treatable. Maybe all he needs is a little blue pill…"

"You mean…Vi…Viagra?"

Continued. Read Part II of ED Blues here.

For many men, however, it is an all too painful reality… a reality that can foster feelings of inadequacy as one’s body changes dramatically. The lack of testosterone associated with andropause leads to many problems, including sexual performance issues. Which causes some men to wonder if Viagra or other erectile dysfunction drugs might help.

There are several ways to combat the symptoms of male menopause. A healthy diet and lifestyle, supplements, and prescription drugs all can play a vital role in improving your health and well-being.

The erectile dysfunction drug Viagra has become one of the most popular methods of restoring a healthy ability to enjoy sexual relations, thereby improving self-esteem and quality of life, too.

What are the signs and symptoms of male menopause?

Male menopause is very tricky to diagnose since it is different for everyone. The symptoms may include:

• Fatigue
• Irritability
• Depression
• Aches and pains
• Sweating and flushing
• Reduced libido
• Decreased sexual performance.

If you think you may be experiencing symptoms of male menopause, be sure to ask your doctor. A simple saliva or blood test may provide answers.

Why is andropause called male menopause?

Menopause is caused by the decrease in estrogen levels in a woman’s body as her ovaries stop producing eggs and she ceases menstruating.

Andropause is caused by a shortage of free testosterone in a man’s body. The testicles may still produce testosterone and sperm, but the level of testosterone available to the body may be insufficient.

Andropause is called male menopause because it represents a change in the levels of hormones produced by the reproductive glands, just as menopause is for women.

How is andropause treated?

Treatments for male menopause / andropause include supplementing testosterone levels in the body, either by injection or by taking pills. When the dosages are correct, there are few side effects.

If left untreated, however, male menopause can have very serious consequences. It may threaten your lifestyle and perhaps even your life. The loss of muscle mass, decline in energy, and difficulty in concentrating that many men complain of during andropause can contribute to accidents.

Surprisingly, men with male menopause are at high risk of developing osteoporosis, usually thought of as a woman’s disease. Osteoporosis, or loss of bone density, is a major cause of death. Many people die from osteoporosis-related injuries, especially broken hips.

Insomnia, irritability, loss of libido, and decreased sexual performance caused by andropause may negatively affect relationships. Male menopause may even lead to erectile dysfunction, the inability to achieve or maintain a satisfactory erection.

Can I take Viagra if I have male menopause?

The good news is that if you are taking medication such as Viagra for erectile dysfunction, that drug may actually be enhanced by supplementing your testosterone levels at the same time. Please be sure to ask your doctor if these treatments are suited for you.

I don’t have andropause and don’t want to get it. How can male menopause be prevented?

Many health experts are concerned that our environment and lifestyle are contributing to the rapid increase in cases of andropause.

They worry that the use of plastics may cause male menopause because chemicals that mimic estrogen can leach from several types of plastic. Pesticides and spermicidal agents also can raise the amount of estrogen in a man’s body, throwing hormone levels off balance.

Vegetarians may want to note that certain plants, such as soy, can raise estrogen levels as well. Protein is important for men because it helps to maintain muscle mass, which helps support testosterone levels. Whey protein is suitable for a vegetarian diet and is a good supplement for most men.

Eating small amounts of protein throughout the day is much better than having one large serving. Eating a small serving of protein before and after a workout will help to build your muscle mass. Triple fish oil is also a good supplement as it provides necessary fatty acids.

It’s important to get proper sleep. It gives the body time to heal damaged tissue and contributes to adequate testosterone levels.

Those men who are inactive and consume unhealthy snacks greatly increase their odds of developing male menopause.

Warning: Beer bellies and man breasts are signs that estrogen levels are having a rather noticeable effect!

If you suspect you may be experiencing the symptoms of male menopause, see your doctor and ask about treatment options such as testosterone supplements, erectile dysfunction medications, and lifestyle changes.

The good news is that millions of men with erection problems have found safe and effective relief through erectile dysfunction treatments like Viagra, Cialis and Levitra. And for most of those men, their erection problem seems like a lifetime ago.

So, how do you know if your erectile dysfunction treatment is really working? With apologies to the David Letterman Show, we present:

The Top 10 Signs That Your Erectile Dysfunction Treatment Is Working:

10. Your "erection problem" has magically morphed into your "not getting enough sleep problem."

9. The book on your bedside table – "The ABCs of Erectile Dysfunction" — has been replaced by "The Little Engine That Could."

    

8. Your wife no longer mutters in her sleep, "It’s OK honey. Lots of men your age get erectile dysfunction."

    

7. When a severe snowstorm threatens delivery of your erectile dysfunction tablets, you call the sanitation department and offer to help plow the roads.

    

6. You’re so ready and able, that finally your weary partner turns to you and says, "Ya know, your erection problem wasn’t all bad."

    

5. While reading men’s stories about erectile dysfunction on the Internet, you just shake your head and think, "I remember those days."

    

4. A friend you had confided in asks about your erection problem, and now you think he’s asking about the new addition you’re building on your home.

    

3. You notice that you get an erection just by watching television commercials for erectile dysfunction products.

    

2. When your neighbor begins discussing the big upcoming election, all you can think about is tonight’s big upcoming erection.

    

1. Your photograph is no longer pictured on the "Wanted: For Erectile Dysfunction" poster pinned up at the post office.

    

And Three Bonus Signs Just For You!

Bonus Sign #1  Your wife used to sit up nights watching "Desperate Housewives." Now she’s happy to snuggle up and watch reruns of "The Six Million Dollar Man" until you get home.

Bonus Sign #2  When you think about whether the term ED applies to you, you realize it does.. Extra Durable!

Bonus Sign #3  An unmistakable side effect of your erectile dysfunction treatment has been a significant increase in smiling.. for both of you.

For more information on erectile dysfunction treatments and what they can do for you, visit eDrugstore.md

"Give yourself a break", he said. Maybe the erectile dysfunction will go away on its own.

Coincidentally, my friend Thomas had been offering us the use of his cabin up by the lake. Walks in the woods, some fishing, curling up by the fire. Could be just the thing to take the edge off, I thought. Finally, I accepted his offer, secretly hoping it would be good medicine for my erectile dysfunction.

Is It Really Erectile Dysfunction?

My wife Susan and I hadn’t actually been calling it "erectile dysfunction" up until that point. "Having some trouble" was actually how we referred to my condition, which was becoming more troublesome as the months past. If it truly was erectile dysfunction, maybe we should do something about it.

"Let’s just use an online pharmacy and get some Viagra or Cialis," I finally suggested one night after another frustrating session in the bedroom. "It’s quick and private and they say it costs less if you buy it online."

But Susan balked at the idea, saying that even if it was erectile dysfunction, there must be better ways to deal with it.

"Fine," I said. "But, I’ll tell you… if this doesn’t clear up soon, it’s online pharmacy, here I come!"

Away From It All

Up at the cabin, we saw that Thomas’ modest description of the place had been understated. As we looked around, all thoughts of erectile dysfunction flew out of our heads. What he had described as a little country cabin was actually a luxurious, well-equipped country home sitting on the prettiest lake you could imagine. Away from it all, yes, but also outfitted with a fully-stocked bar, broadband Internet, home theater, the works. We settled in for a comfortable weekend with high hopes for the evening activities.

After dinner the first night, we opened a bottle of wine and sat down to watch some TV. We were both feeling relaxed, enjoying the quiet time together. Then, a commercial for some erectile dysfunction drug – I forget which one – came on television. We both groaned. Our mood was nearly killed by the fact that the couple in the commercial were about our age, and the way they described their erectile dysfunction sounded eerily like "the trouble" I’d been having.

We were determined not to let a silly commercial for an erectile dysfunction drug spoil things for us. We decided to switch off the TV and head upstairs with our wine. We lit the fireplace in the master bedroom and got ready for bed. As we snuggled quietly in front of the fire, we let the crickets outside do most of the talking.

Things got cozier and pretty soon we were both very much in the mood for more. As we undressed, I glanced down to take a quick survey of things. Nope, no erectile dysfunction here tonight, I thought happily.

A while later though, things didn’t look or feel so good. While I had started off strong, I had a hard time keeping it, well, hard. Susan was very understanding and tried to stay positive.

"Let’s just slow things down and take a rest," she suggested.

Quick…To The Online Pharmacy!

But by now, I had just about had it. "Look, the doctor said it could be erectile dysfunction and that drugs like Viagra can help. If he says it’s okay for me, then that’s it… I’m going online right now. I’m finding an online pharmacy and I’m going to order Viagra, even if we are out here in the boondocks!" I practically stormed out of the room.

"Wait," Susan called after me, grabbing her robe and following.

Downstairs, I quickly fired up the Internet. Susan and I searched around a little, reading a bit about Viagra and how to select a reliable online pharmacy. Finally, I found an online pharmacy that seemed trustworthy, one that a friend of mine had recommended for its low prices and quick deliveries.

After completing a brief online consultation about my erectile dysfunction symptoms and my medical background, I placed my very first Viagra order. Then I logged off the online pharmacy site, took a quick look at the weekend weather forecast, and closed down the computer.

Susan, who was initially opposed to the whole idea, now seemed relieved that we had placed the order with the online pharmacy and it was a done deal.

"Well," she said. "At least now we’ll find out whether you do have erectile dysfunction and whether Viagra can help it or not." I agreed, and we trudged back to bed ready for some sleep. If not truly contented, we were at least happy to have done something about our problem.

Saved by Erectile Dysfunction?

Just as we were about to hop back into bed, we saw something moving around in the rumpled sheets. A snake – black, with yellow and red stripes! We both froze and then slowly began backing towards the door.

"Do you think it’s poisonous?" Susan asked, not taking her eyes off the creature, which by now had spotted us and was swishing around even faster, trying to get some traction.

"Do I look like the Crocodile Hunter to you?" I replied, reaching slowly for the doorknob behind me.

We left the room quickly and tried to figure out what to do next. We decided that we should sleep in the other bedroom across the hall. But I had to go back and collect our bedclothes and a few other things first. I grabbed a poker from the fireplace, praying I wouldn’t have to use it and slowly opened the bedroom door.

Just as I entered the room, I caught sight of the snake, now poised on the open windowsill. Not wanting to interrupt what appeared to be his grand exit, I stopped. Slowly, the snake slithered out the window. I bolted for the window, slammed it down hard and even tried to lock it, not wanting to underestimate the reptile’s dexterity. I expect, though, that he was as glad to see the last of us as we were to see him go. We still slept in the other bedroom that night!

We called Thomas the next morning. He said there were plenty of snakes on the property, some of them poisonous in fact. Somehow he had neglected to share this little tidbit with us earlier. He insisted this was the first time a snake had gotten in… must’ve come through an open window, he said.

"You mean to say," Susan said to me later over coffee, "that if you hadn’t rushed off to do your online pharmacy order at some ungodly hour…"

"Yes…?" I replied, anticipating where she was heading with this.

"That we would have been sharing our bed with that snake, which could very well have been poisonous?"

"It sure looks that way, doesn’t it?" I answered. "In fact, I’m glad the erectile dysfunction kicked in when it did. Otherwise, we might have been in that bed a little longer."

"Don’t look so smug," said Susan. "You’re the one who’s been complaining so much about ED."

"Yes, but in this case, it’s quite possible that erectile dysfunction saved our lives," I replied.

Susan smiled. "So… maybe we should cancel the online pharmacy order? Maybe your erectile dysfunction will come in handy in the future?"

"No way," I answered. "Not on your life."

For more information on erectile dysfunction or to order ED medications, visit eDrugstore.md, the web’s leading online pharmacy.