THE FUNCTION OF THE CLITORIS

You’ve got to love the clitoris because its only function is to provide you with pleasure. In fact, this is the only organ in humans that exists only for pleasure. And having pleasure is important. When you have a clitoral orgasm, your body releases oxytocin, the feel-good hormone. When you don’t have enough oxytocin, you’ll feel stressed, which could lead to a host of health problems, such as obesity, headaches, depression and anxiety.

The head of the clitoris contains about 8,000 nerve fibers. This is more than anywhere else on the body and almost twice the amount as the nerve fibers on the head of the penis.

WHEN YOU’RE TURNED ON

When you’re sexually excited, the clitoris swells as it becomes engorged with blood. The vaginal lips also swell and open slightly, and the clitoral hood pulls back.

Your vagina begins to lubricate, and you can use this natural lubrication to stimulate your clitoris. You just need to rub your fingers under the clitoris to spread the lubrication up from the vagina to the clitoris.

SIZE VARIES

The size of the clitoris varies among women. Some are longer, and some are shorter. Some are thinner, and some are wider. Some are large and prominent, and some are difficult to find. And all of this is normal.

Hormonal changes also affect the size of the clitoris. A woman in her middle 30s can have a clitoris that is about four times larger than it was when she first entered puberty.

10 Sex Positions Sure to Get You Pregnant

If you're trying to get pregnant, there's one thing you should know: Those myths that certain positions (like having sex while standing) don't work are exactly that — myths. As long as you're having intercourse, you're potentially making a baby.
"Basically, a woman can get pregnant in any position at all," says Hilda Hutcherson, MD, senior associate dean at the Columbia University College of Physicians and Surgeons. "The sperm can swim upstream, sideways, and upside down — it doesn't matter."
But there are a couple of ways to improve your chances of getting pregnant — especially if you've been having difficulties — and that's where some good old-fashioned missionary comes in. Although any position that requires you to lie on your back will do the trick: "Make sure at the time the male ejaculates, you're in a position in which the semen pools around the cervix for a longer period of time. That's any position where you're lying on your back with your hips elevated," Hutcherson says. After ejaculation, remain with your hips elevated for 30 minutes to an hour.
Hutcherson has another tip that you're really (really, really, really) going to enjoy.
"I also tell women to experience orgasm. When you experience orgasm, there's a contraction — spasms of the pelvic floor of the uterus — and they think that helps suck the semen up into the cervix. You won't find it in a textbook, but anecdotally — not scientifically — I've found it helps women get pregnant," she says. "But then women ask, 'Well, how am I supposed to do that?' I usually tell them with a toy, with their partner's help, or manually — but it's just something else to think about."
Using these expert-approved tips, here are 10 positions — all on your back, some with elevated hips, and most making it easier to orgasm — that will have you shopping for baby clothes before you know it.

AMERICAN ARTIST

 

CLASSIC MISSIONARY

When it comes to baby-making, you can't beat missionary — and no, it doesn't have to be boring. Unlike other positions, you're getting a ton of skin-to-skin contact, making things even more intimate. Just lie on your back with your guy on top, and feel free to lock eyes while he's thrusting.

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AMERICAN ARTIST

 

BENT KNEES

The next time you're on bottom during sex, lie on your back and bring your knees up to your chest, wrapping your legs around your guy. The easy change will allow a deeper thrust — and give the sperm a better chance of getting where they need to go.

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AMERICAN ARTIST

 

LEGS IN THE AIR

Lying back with your legs in a V-shape might feel weird at first — but once you get comfortable, it'll start to feel good. (Really good.) The variation on missionary basically gives him full access to you, making it easy to thrust without any barriers. If your legs get tired, feel free to bend them.
RELATED: 20 Sex Moves That Are Guaranteed to Drive Men Crazy

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AMERICAN ARTIST

 

THE CAT

If you haven't heard of the coital alignment technique (CAT) sex position, just wait because it's about to blow your mind. Lie on your back and have your man hop on top, this time with his body positioned further up and slightly to one side, so his chest is near your shoulders and your legs are bent at around a 45-degree angle. Being in this position maximizes clitoralstimulation while you're having sex, which is great for making a baby.

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AMERICAN ARTIST

 

PIRATE'S BOUNTY

Ready for a real gem? To master Pirate's Bounty — and find some treasure in the form of an epic orgasm — lie on your back with your guy kneeling in front of you. Put one leg on his shoulder and the other wrapped around his thigh so your body is positioned kind of like a ship's mast. You'll be saying "Aye aye, captain!" all night.

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AMERICAN ARTIST

 

THE BUTTERFLY

Ready to spread your wings — or, um, your legs? To master the Butterfly, lie on your back with your hips right at the edge of the bed. Put your ankles on his shoulders and have him hold your hips up as he enters you, slightly tilting your hips toward the ceiling and giving him better access to your G-spot.
RELATED: 16 Couples Share Their Secret Sex Codes

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AMERICAN ARTIST

 

EDGE OF THE BED

Sometimes using a prop during sex makes all the difference, and all you need for this move is your bed. Position your hips at the edge and have your guy stand in front of you. Then simply place your feet on his chest as he deeply thrusts.

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AMERICAN ARTIST

 

SCISSORS

When it comes to the rock-paper-scissors of sex positions, scissors always wins. To master this move, all you need to do is lie on your back and let your guy do the rest of the work: Have him kneel on the bed in front of you and hold your legs apart in a V-shape. Then as he's thrusting, he can open and close your legs like scissors, creating a sensation that's hard to beat.

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AMERICAN ARTIST

 

SHOULDER STAND

The Shoulder Stand requires a little more work, but it's totally worth it. Lie on your back with your man kneeling in front of you, then have him boost up your hips with one arm as he supports himself on the bed with the other. Put a little weight on your shoulders to help hold your hips up, and enjoy.
RELATED: 26 Sex Games That Guarantee More Fun In Your Bedroom

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AMERICAN ARTIST

 

LEG WRAP

This might be one of the easiest moves, but it's also one of the best in terms of sensation. When you're in missionary, straighten your legs after he's inside you and gently wrap them around his. Add a pillow for an even deeper penetration.

14 POWERFUL MASTURBATION TECHNIQUES FOR INCREDIBLE ORGASMS

1. UP & DOWN

This first masturbation technique will get you started and is super easy. You’ll be focusing on the clit, and all you need to do is to take a finger and just start rubbing up and down on one side of it like in the illustration above. If you want more stimulation, then try rubbing your finger directly over your clit.

My most powerful sex tricks and tips aren't on this site. If you want to access them and give your man back-arching, toe-curling, screaming orgasms that will keep him sexually obsessed with you, then you can learn these secret sex techniques in my private and discreet newsletter. You'll also learn the 5 dangerous mistakes that will ruin your sex life and relationship. Get it here.

It’s that simple, but of course, you can experiment with how hard you rub your finger, how fast and the length of the strokes. This is also an easy technique to use on yourself while you are giving your man a blow job (Read the in-depth, illustrated Blow Job Guide here).

2. THE LONG SLOW STROKE

Using one or more fingers, very lightly and softly glide over the middle of your vagina and clitoris, from bottom to top like in the illustration above. Listen to your body to feel which areas provide the most pleasure and stimulation when touched.

Then experiment with fast strokes, slower strokes, as well as using more or less pressure. Also try switching direction, starting at your clit and rubbing downwards or rubbing up and down. You may not orgasm from this, but it’s a great masturbation technique for exploring all of your vagina to see what is most pleasurable and reacts most intensely to your touch.

3. FROM SIDE TO SIDE

This is another simple and straightforward masturbation technique focusing on your clitoris. As the name suggests, you are going to rubbing your finger from side to side over your clit.

Some women prefer indirect contact here, barely touching their clit, while others need more intense contact and pressure to enjoy themselves. As always, you’ll need to try different variations for yourself to see what you enjoy. Here are a few ideas

• Try different speeds.
• Change the amount of pressure you use.
• Try using some lube.
• Vary how many fingers you use (one, two, three or four)
• Switch between direct and indirect contact

This masturbation technique is perfect to use during any doggy style sex position if you want to add in a little extra clitoral stimulation. You can find 11 different doggy style sex positions to try here.

4. FANTASTIC FUN WITH FOUR FINGERS

This may be the most used and effective masturbation technique of the 14 listed here, as you will have four fingers running over and rubbing your clit, making it easy to climax. Performing this technique is a simple case of holding your four fingers together and rubbing them over your clit and vagina in a circular motion as demonstrated above.

You can rub in small circles to mostly focus on your clit, or your can use larger circles to stimulate your labia, U spot and the rest of your vagina too.

This instructional video may be a bit shocking for you, but it will teach you how to make any man completely & utterly obsessed with you & only you by using 3 simple techniques. Check it out here to learn how.

This masturbation technique is also great if you like giving yourself extra stimulation during sex when you can easily access your clit. Of course, your man can also take over during sex and use this technique on you. Doggy Style (check it out here) is the perfect position for this as both of you will have easy, unhindered access to your clitoris.

5. U SPOT

So many women don’t seem to know about the U Spot. I’ve indicated it with a slightly darker shade of pink in the diagram below (please note that it does not have any distinct coloring in real life). As you can see, it’s the area of skin just above your urethral opening and to the sides of it.

To stimulate it you just need to gently stroke it with the tip of your finger like in the illustration below. While rubbing only your U Spot is super pleasurable, an even better masturbation technique is to rub softly from your U Spot right up to your clitoris and back down again (demonstrated in the diagram below).

If you’re not already wet when rubbing your U Spot, then make sure to use some lube. And don’t be afraid to venture a bit off course and start massaging your labia or clit to vary the sensation.

For some women, the U Spot can extend higher than in this illustration, to right below the clitoris.

6. LOVE THAT SHOWER HEAD

If you haven’t yet used a shower head or faucet to get off, you are missing out! Women have been using this method to masturbate for decades [2]. While it’s a more hands off masturbation technique, it feels incredible and entirely different to your finger. All you need is a faucet that you can maneuver your vagina under so that the water can freely flow over it or a shower head that you can direct towards your vagina.

I don’t know the exact science behind it, but everyone that tries it reports that the running water feels wonderful and can help you get off very, very quickly. So experiment with the settings on your shower head to find out what feels best. Quick Hint: You may find that the ‘pulse’ setting is best. One of the benefits of masturbating in the shower is that if you are trying to make yourself squirt, everything gets quickly washed away by the water. And if you want to learn how to make yourself squirt, then check out the squirting guide here.

7. UNDER THE HOOD

Some women have a super-sensitive clitoris. Often it’s so sensitive, that it can feel almost unpleasant to touch. If you are one of these women, then you may find that using many of my masturbation techniques to be too uncomfortable…and possibly even painful.

If that’s the case, then instead of using my masturbation techniques to apply pressure directly to your clit, you need to use your clitoral hood as a sort of buffer or shield instead. That’s the flap of skin just above your clit that covers it. I’ve indicated it in the illustration above with a slightly darker shade of pink (in real life your clitoral hood has no distinct color).

So if you have an overly sensitive clit, then try rubbing your clitoral hood instead of your clit. You’ll notice that it’s a lot more pleasurable and not so sensitive. Alternatively, you may want to use some of these fingering techniques instead.

8. HOOD LIFE

You may have the opposite problem to the one I mentioned above in Under The Hood. You may happen to be someone who suffers from a lack of sensitivity and so need all the rubbing, grinding, touching & stimulation you can get on your clitoris. No problem, there is a pretty simple solution. To allow yourself to stimulate your clit intensely, you’re going to need to expose it more. It’s easy, and the demonstration above should be all you need to expose it more.

As you can see, by placing your fingers above your clit and on either side of it, then slowly pulling the skin backwards, you will pull back the clitoral hood and expose it much more. While pulling back your clitoral hood is not exactly a masturbation technique; it will allow you to use your other hand or a vibrator to stimulate it more directly. This can also be helpful in certain positions during sex if you want more intense clitoral stimulation. You can learn more clitoral stimulation techniques here.

9. ORGASMIC MEDITATION

When I first heard the words, “Orgasmic Meditation” I sort of imagined people practicing tantra. In a way, orgasmic meditation is sort of like tantric sex as there is a process you are supposed to follow and the end goal is not necessarily having an orgasm. So what does orgasmic meditation have to do with stimulating your clitoris?

Everything

The basic technique involves both you and your man. You need to start by getting comfortable while lying down on your back with your legs spread right open. Then your man needs to get into a comfortable position sitting down to your right side with his left leg bent and over your stomach and his right leg under your right leg. He then needs to start stroking the upper left quadrant of your clit with just one lubricated finger very slowly and lightly. I’ve indicated this upper left quadrant area between the dotted lines in the illustration above.His touch should be as light as possible.

The masturbation technique he needs to use – He’s going to move his finger a few millimeters back and forth making sure to apply only the slightest amount of pressure to your clit. Some women report that it just feels too frustrating, and they can’t keep doing it for long, that it seems like they are teasing themselves, while others say that the longer they do it, the better it feels.

My advice is to try it at least once and do your absolute best to hold out for as long as you can, making sure to use the very least amount of pressure possible. At a minimum, it can serve as great foreplay for your masturbation session.

It’s a little hard to describe with just words, so you may want to watch this detailed instructional video that will give you much more in-depth instructions on how to practice orgasmic meditation with your partner.

Can you reach orgasm from nipple play only?

“Nipplegasms” are real. Nipples are full of nerves, and MRI tests show that fondling them “lights up” the same part of the brain that’s linked to your genitals. This means that for some women, getting to second base is as much fun as going to home plate.

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The Sexual-Response Cycle: What Happens to Our Bodies During Sex

While most of us are sure that we like to have sex, most of us also haven't spent much time thinking about what happens physiologically while we are engaged in the act. Masters and Johnson (two groundbreaking sextherapists) coined the term "sexual-response cycle" to mean the sequence of events that happens to the body when a person becomes sexually aroused and participates in sexually stimulating activities (intercourse, masturbation, foreplay, etc.).

The sexual-response cycle is divided into four phases: excitement, plateau, orgasm and resolution. There is no distinct beginning or end to each phase -- they're actually all part of a continuous process of sexual response.

Keep in mind that this is a very general outline of what happens to each of us as we become sexually aroused. There is much variation among individuals, as well as between different sexual events.

Simultaneous Orgasms

Both men and women go through all four phases, except the timing is different. Men typically reach orgasm first during intercourse, while women may take up to 15 minutes to get to the same place. This makes the likelihood of simultaneous orgasm during intercourse a rare event.

Phase One: Excitement

This phase usually begins within 10 to 30 seconds after erotic stimulation, and can last anywhere from a few minutes to many hours.

Men: The penis becomes slightly erect. A man's nipples may also become erect.

Women: Vaginal lubrication begins. The vagina expands and lengthens. The outer lips, inner lips, clitoris and sometimes breasts begin to swell.

Both: Heart rate, blood pressure and breathing are all accelerated.

Phase Two: Plateau

The changes that started in the excitement phase continue to progress.

Men: The testes are drawn up into the scrotum. The penis becomes fully erect.

Women: The vaginal lips become puffier. The tissues of the walls of the outer third of the vagina swell with blood, and the opening to the vagina narrows. The clitoris disappears into its hood. The inner labia (lips) change color (although it's a bit hard to notice). For women who've never had children, the lips turn from pink to bright red. In women who've had children, the color turns from bright red to deep purple.

Both: Breathing and pulse rates quicken. A "sex flush" may appear on the stomach, chest, shoulders, neck or face. Muscles tense in the thighs, hips, hands and buttocks, and spasms may begin.

Phase Three: Orgasm

This is the climax of the cycle. It is also the shortest of the four phases, usually only lasting a few seconds.

Men: First, seminal fluid collects in the urethral bulb. This is when a man may have the sensation that orgasm is certain, or "ejaculatory inevitability." Next, semen is ejaculated from the penis. Contractions occur in the penis during the orgasmic phase.

Women: The first third of the vaginal walls contract rhythmically every eight-tenths of a second. (The number and intensity of the contractionsvary depending on the individual orgasm.) The muscles of the uterus also contract barely noticeably.

Both: Breathing, pulse rate and blood pressure continue to rise. Muscle tension and blood-vessel engorgement reach a peak. Sometimes orgasm comes with a grasping-type muscular reflex of the hands and feet.

Phase Four: Resolution

This phase is a return to the normal resting state. It can last from a few minutes to a half-hour or longer. This stage is generally longer for women than men.

Men: The penis returns to its normal flaccid state. There is usually a refractory period, where it's impossible to orgasm again until a certain amount of time has passed. The amount of time varies among men by age, physical fitness and other factors.

Women: The uterus and clitoris return to their normal positions. Some women may be able to respond to additional stimulation with additional orgasms.

Both: Swelling recedes, any sex flush disappears, and there is a general relaxation of muscle tension.

Understanding what's happening to you and your partner's bodies during sex can only aid in the full enjoyment of the experience. Combine this with some good communication skills, and you've found the key to unlock sexual pleasure and your heart's desires.

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Vaginismus

When a woman has vaginismus, her vagina's muscles squeeze or spasm when something is entering it, like a tampon or a penis. It can be mildly uncomfortable, or it can be painful.
There are exercises a woman can do that can help, sometimes within weeks.

Symptoms

Painful sex is often a woman's first sign that she has vaginismus. The pain happens only with penetration. It usually goes away after withdrawal, but not always.
Women have described the pain as a tearing sensation or a feeling like the man is "hitting a wall."
Many women who have vaginismus also feel discomfort when inserting a tampon or during a doctor's internal pelvic exam.

Causes

Doctors don't know exactly why vaginismus happens. It's usually linked to anxietyand fear of having sex. But it's unclear which came first, the vaginismus or the anxiety.
Some women have vaginismus in all situations and with any object. Others have it only in certain circumstances, like with one partner but not others, or only with sexual intercourse but not with tampons or during medical exams.
Other medical problems like infections can also cause painful intercourse. So it's important to see a doctor to determine the underlying cause of painduring sex.

Treatment

Women with vaginismus can do exercises, in the privacy of their own home, to learn to control and relax the muscles around the vagina.
The approach is called progressive desensitization, and the idea is to get comfortable with insertion.
First, do Kegel exercises by squeezing the same muscles you use to stop the flow of urine when urinating:

• Squeeze the muscles.
• Hold for 2 to 10 seconds.
• Relax the muscles.

Do about 20 Kegels at a time. You can do them as many times a day as you want to.
After a few days, insert one finger, up to about the first knuckle joint, inside the vagina while doing the exercises. It's a good idea to clip your fingernails first and use a lubricating jelly. Or do the exercises in a bathtub, where water is a natural lubricant.
Start with one finger and work your way up to three. You'll feel the vagina's muscles contracting around your finger, and you can always take your finger out if you're not comfortable.
For women whose vaginismus is related to fear or anxiety, therapy helps.

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Female Masturbation And Hymens

Q: So I've touched myself several times before but have never inserted any fingers because I'm afraid to break my hymen. Is it possible to insert fingers without breaking it? Or not? Please help!

Ans: Your Hymen is a very thin layer of skin that sort of covers the opening to your cervix (the opening to your uterus) and this can usually only be broken if you were to have intercourse. But still being virgin inserting fingers shouldn't break your hymen however if you were to use an object etc.. this could then be possible, A lot of girls find that loosing their virginity can be painful and may even experience bleeding as a result to the broken hymen. So in saying that you may even find that using fingers and other objects may be to painful as u are still a virgin. Also a lot of women find that they cannot reach climax (orgasm) by inserting objects or fingering.  A lot of women reach climax just by rubbing etc...

Its all a new experience and i cant tell you how your body will respond but if you wish to use your fingers, make sure your hands are washed well and clean, make sure you don't have sharp nails as you could scratch the insides of your vagina and this could be painful. but in the end you shouldn't worry about breaking your hymen with your fingers as this is very unlikely.

A Girls Experience tell How masturbation help to reach orgasm

“I was having sex way before the first time I masturbated, which probably didn’t help my sex life very much. I lost my virginity at 17, and I didn’t actually masturbate until I was 22. I also didn’t have an orgasm until I was 23, so I definitely think the two were related. I couldn’t get off until I knew exactly what I wanted and needed. Maybe these men were just terrible in bed, but masturbation definitely enables you to learn more about yourself sexually.” —Steph, 25

How Often You Should Have Intercourse According to Your Age

The 5 Best Sex Positions For Beginners

The 5 Best Sex Positions For Beginners (Or Anyone Who Can Appreciate Getting Back To Basics)

We’re always hearing that we could be having better sex, a better orgasm, or a better relationship. But how often do we hear the nitty-gritty of how we can actually better understand our deepest desires and most embarrassing questions? Bustle has enlisted Vanessa Marin, a licensed sex psychotherapist based in San Francisco, to help us out with the details. No gender, sexual orientation, or question is off limits, and all questions remain anonymous. Now, onto this week’s topic: The best sex positions for beginners.

Q: My boyfriend and I recently lost our virginities to each other. We’re still figuring out how it all works, but it’s gradually getting less awkward and more fun! We’ve only been doing missionary, but I’d like to try some new positions. I have some ideas of what we can try, but I’m not sure exactly how to get into certain positions and how to move in a way that will be fun for me. Any tips for a beginner that will be fun for both of us?

A: Absolutely! Starting to explore the wonderful world of sex positions is a lot of fun, especially when you’ve got a good partner by your side. Here are my recommendations for the five best sex positions for beginners.


1. Missionary, With Your Legs Pulled In





How to do it: When you’re in Missionary, lift your feet off the bed and pull your knees into your chest. You can do this while he’s inside of you or before he penetrates you. As he pushes in and out of you, let your hips rock back and forth. For him, the movement is pretty similar to what he’s doing during Missionary.

Variations to try: This position is a great example of the power of small changes. Even moving your legs closer to or further from your chest by a few inches will create a different angle of penetration. You can also pull your legs further apart or squeeze them closer together. Or keep one foot flat on the bed and the other leg lifted into the air. If you’re limber, you can also try resting both of your ankles on his shoulders.

2. Missionary, With A Pillow Under Your Hips

How to do it: Before you start having sex, place a pillow under your hips, then have him enter you like he normally does during Missionary. This is a super easy variation that can create mind-blowing results for some women. It helps his body push against your clitoris, which may help you reach orgasm. You can have him focus more on grinding against you instead of thrusting in and out.

Variations to try: You can invest in sex furniture like the Liberator, which is specially designed for this position. Its sloped surface helps you experiment with raising your body further up off the bed.

3. Dangling Over The Edge Of The Bed





How to do it: Get over to the edge of the bed and let your legs hang off. He places his body between your legs and enters you. You’re pretty much along for the ride with this one, and he gets to thrust away to his heart’s content! This is an easy position for guys because it doesn’t require him to hold up his body weight with his arms.


Variations to try: If your bed isn’t the correct height for your bodies to line up, you can try putting a pillow under your hips. Or you can have him kneel on the floor between your legs. Your man can hold each of your thighs in his arms for more leverage and intensity. You can also move your legs closer or further apart from each other. Or you can rest your ankles on his shoulders for extremely deep and powerful penetration.

4. Girl On Top





How to do it: Have him lie on his back. Crawl on top of him, resting one leg on either side of his body. Take his penis in your hand and slowly lower yourself down onto it. Girl on top can be an intense position to begin with if you’re not very wet, so you may want to start with another position first, or use some additional lubricant.

Variations to try: Try playing around with a number of different ways of moving your hips. You can grind in a slow circle. You can push your hips towards and away from his chest. You can move your hips up and down on his penis. You can also try changing the angle of your body by leaning forward or back while touching your clitoris. If you’re not sure how to move, ask him to hold on to your hips and show you what he likes.

5. In A Chair






How to do it: Have him sit in a chair. You want to find one that’s short and sturdy, and doesn’t have wheels. It’s also preferable to use something that doesn’t have armrests, since those can get in the way. Slowly lower yourself onto him like you did with girl on top(again, you may want to start with a different position first or use lube). Both of your feet will be on the ground, which will give you lots of leverage. You can also hold on to the back of the chair or to his shoulders for additional support. You can easily move up and down, or you can grind your hips in a seductive circle or figure-eight pattern.

Variations to try: You do this position on a sofa or on the bed against a headboard; he’s still sitting up, but you’re on your knees. Or you can try kneeling on the chair, if there’s enough space. You can try turning around and lowering yourself onto him backwards, which will create an entirely new angle of penetration.

Erectile dysfunction

Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex.

Having erection trouble from time to time isn't necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.

If you're concerned about erectile dysfunction, talk to your doctor — even if you're embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.

Symptoms

Erectile dysfunction symptoms might include persistent:

• Trouble getting an erection
• Trouble keeping an erection
• Reduced sexual desire

When to see a doctor

A family doctor is a good place to start when you have erectile problems. See your doctor if:

• You have concerns about your erections or you're experiencing other sexual problems such as premature or delayed ejaculation
• You have diabetes, heart disease or another known health condition that might be linked to erectile dysfunction
• You have other symptoms along with erectile dysfunction

Causes

Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.

Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.

Physical causes of erectile dysfunction

In many cases, erectile dysfunction is caused by something physical. Common causes include:

• Heart disease
• Clogged blood vessels (atherosclerosis)
• High cholesterol
• High blood pressure
• Diabetes
• Obesity
• Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
• Parkinson's disease
• Multiple sclerosis
• Certain prescription medications
• Tobacco use
• Peyronie's disease — development of scar tissue inside the penis
• Alcoholism and other forms of substance abuse
• Sleep disorders
• Treatments for prostate cancer or enlarged prostate
• Surgeries or injuries that affect the pelvic area or spinal cord

Psychological causes of erectile dysfunction

The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:

• Depression, anxiety or other mental health conditions
• Stress
• Relationship problems due to stress, poor communication or other concerns

Risk factors

As you get older, erections might take longer to develop and might not be as firm. You might need more direct touch to your penis to get and keep an erection.

Various risk factors can contribute to erectile dysfunction, including:

• Medical conditions, particularly diabetes or heart conditions
• Tobacco use, which restricts blood flow to veins and arteries, can — over time — cause chronic health conditions that lead to erectile dysfunction
• Being overweight, especially if you're obese
• Certain medical treatments, such as prostate surgery or radiation treatment for cancer
• Injuries, particularly if they damage the nerves or arteries that control erections
• Medications, including antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate conditions
• Psychological conditions, such as stress, anxiety or depression
• Drug and alcohol use, especially if you're a long-term drug user or heavy drinker

Complications

Complications resulting from erectile dysfunction can include:

• An unsatisfactory sex life
• Stress or anxiety
• Embarrassment or low self-esteem
• Relationship problems
• The inability to get your partner pregnant

For many men, a physical exam and answering questions (medical history) are all that's needed for a doctor to diagnose erectile dysfunction and recommend a treatment. If you have chronic health conditions or your doctor suspects that an underlying condition might be involved, you might need further tests or a consultation with a specialist.

Tests for underlying conditions might include:

• Physical exam. This might include careful examination of your penis and testicles and checking your nerves for sensation.
• Blood tests. A sample of your blood might be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health conditions.
• Urine tests (urinalysis). Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions.
• Ultrasound. This test is usually performed by a specialist in an office. It involves using a wandlike device (transducer) held over the blood vessels that supply the penis. It creates a video image to let your doctor see if you have blood flow problems.
  This test is sometimes done in combination with an injection of medications into the penis to stimulate blood flow and produce an erection.
• Psychological exam. Your doctor might ask questions to screen for depression and other possible psychological causes of erectile dysfunction.

The first thing your doctor will do is to make sure you're getting the right treatment for any health conditions that could be causing or worsening your erectile dysfunction.

Depending on the cause and severity of your erectile dysfunction and any underlying health conditions, you might have various treatment options. Your doctor can explain the risks and benefits of each treatment and will consider your preferences. Your partner's preferences also might play a role in your treatment choices.

Oral medications

Oral medications are a successful erectile dysfunction treatment for many men. They include:

• Sildenafil (Viagra)
• Tadalafil (Adcirca, Cialis)
• Vardenafil (Levitra, Staxyn)
• Avanafil (Stendra)

All four medications enhance the effects of nitric oxide — a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation.

Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing some men to function normally. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in men who get normal erections.

The medications vary in dosage, how long they work and side effects. Possible side effects include flushing, nasal congestion, headache, visual changes, backache and stomach upset.

Your doctor will consider your particular situation to determine which medication might work best. These medications might not treat your erectile dysfunction immediately. You might need to work with your doctor to find the right medication and dosage for you.

Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor's OK. Medications for erectile dysfunction do not work in all men and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes. Some medications might also be dangerous if you:

• Take nitrate drugs — commonly prescribed for chest pain (angina) — such as nitroglycerin (Minitran, Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket) and isosorbide dinitrate (Dilatrate-SR, Isordil)
• Have heart disease or heart failure
• Have very low blood pressure (hypotension)

Other medications

Other medications for erectile dysfunction include:

• Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Caverject Impulse, Edex) into the base or side of your penis. In some cases, medications generally used for other conditions are used for penile injections on their own or in combination. Examples include papaverine, alprostadil and phentolamine. Often these combination medications are known as bimix (if two medications are included) or trimix (if three are included).
  Each injection is dosed to create an erection lasting no longer than an hour. Because the needle used is very fine, pain from the injection site is usually minor.
  Side effects can include mild bleeding from the injection, prolonged erection (priapism) and, rarely, formation of fibrous tissue at the injection site.
• Alprostadil urethral suppository. Alprostadil intraurethral (Muse) therapy involves placing a tiny alprostadil suppository inside your penis in the penile urethra. You use a special applicator to insert the suppository into your penile urethra.
  The erection usually starts within 10 minutes and, when effective, lasts between 30 and 60 minutes. Side effects can include pain, minor bleeding in the urethra and formation of fibrous tissue inside your penis.
• Testosterone replacement. Some men have erectile dysfunction that might be complicated by low levels of the hormone testosterone. In this case, testosterone replacement therapy might be recommended as the first step or given in combination with other therapies.

Penis pumps, surgery and implants

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If medications aren't effective or appropriate in your case, your doctor might recommend a different treatment. Other treatments include:

• Penis pumps. A penis pump (vacuum erection device) is a hollow tube with a hand-powered or battery-powered pump. The tube is placed over your penis, and then the pump is used to suck out the air inside the tube. This creates a vacuum that pulls blood into your penis.
  Once you get an erection, you slip a tension ring around the base of your penis to hold in the blood and keep it firm. You then remove the vacuum device.
  The erection typically lasts long enough for a couple to have sex. You remove the tension ring after intercourse. Bruising of the penis is a possible side effect, and ejaculation will be restricted by the band. Your penis might feel cold to the touch.
  If a penis pump is a good treatment choice for you, your doctor might recommend or prescribe a specific model. That way, you can be sure it suits your needs and that it's made by a reputable manufacturer.
• Penile implants. This treatment involves surgically placing devices into both sides of the penis. These implants consist of either inflatable or malleable (bendable) rods. Inflatable devices allow you to control when and how long you have an erection. The malleable rods keep your penis firm but bendable.
  Penile implants are usually not recommended until other methods have been tried first. Implants have a high degree of satisfaction among men who have tried and failed more-conservative therapies. As with any surgery, there's a risk of complications, such as infection.

Exercise

Recent studies have found that exercise, especially moderate to vigorous aerobic activity, can improve erectile dysfunction. However, benefits might be less in some men, including those with established heart disease or other significant medical conditions.

Even less strenuous, regular exercise might reduce the risk of erectile dysfunction. Increasing your level of activity might also further reduce your risk.

Discuss an exercise plan with your doctor.

Psychological counseling

If your erectile dysfunction is caused by stress, anxiety or depression — or the condition is creating stress and relationship tension — your doctor might suggest that you, or you and your partner, visit a psychologist or counselor.

Alternative medicine

Before using any supplement, check with your doctor to make sure it's safe for you — especially if you have chronic health conditions. Some alternative products that claim to work for erectile dysfunction can be dangerous.

The Food and Drug Administration (FDA) has issued warnings about several types of "herbal viagra" because they contain potentially harmful drugs not listed on the label. The dosages might also be unknown, or they might have been contaminated during formulation.

Some of these drugs can interact with prescription drugs and cause dangerously low blood pressure. These products are especially dangerous for men who take nitrates.