All posts by Hanru de Klerk

I am an urologist from Cape town, South Africa
Treatment Guidelines: Depression

Mental Health is just as important as physical health, depression has no boundaries

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Common Misunderstandings About Depression

Depression is a highly prevalent condition across the world, a mental health condition that is mainly characterized by a few key symptoms that manifest in most, but not all, patients. The predominant symptoms are somewhat self-explanatory from the name, the net underlying symptom for patients suffering from depression is a generally depressed or otherwise hampered mood. This can take many forms depending on the case and the person and their daily life, but largely this comes in the form of either phasic periods of depression offset by upswings in mood, or it can just be a general low hum of depressed mood throughout one’s day, and to some degree, life.

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Symptoms of depression

The more specific symptoms of depression are very dependent on the person, but they come in a few broad categories. The first being appetite, patients dealing with depression may experience either a reduced or increased appetite, or, they may alternate between these two extremes. There are also other accompanying symptoms that go along with these depressed moods like anhedonia. This is a state in which one doesn’t really derive the same pleasure from life events and activities that they once did, furthering the depressed mood and causing something of a feedback loop that continues to bring the patient down. Other symptoms include withdrawing from social circles, increased or decreased levels of sleep and feelings of fatigue and exhaustion throughout the day, and general emotional reactivity.

The prevalence and absence of these symptoms do not mean a patient does or does not have depression, as it can truly manifest in a variety of ways depending on far too many factors to list here.

What causes depression

The underlying mechanism behind what causes depression isn’t fully understood yet, as with anything dealing with the brain and its functioning there is a ton of wiggle room and space for confusion based on the individual variance between humans. The general cause, biologically, as we understand it is related to the function of serotonin in the brain and arises when there is a relative dearth of serotonin found in the brain. This could also manifest as a reduced ability of the brain to respond to serotonin, not just a reduction in the overall levels of the neurotransmitter in the body. There is some evidence that indicates depression is accompanied by a reduction in the mass of specific areas of the brain, with that mass returning when the depression is treated and the patient reports fewer symptoms, however, a causative relationship is difficult to pin down in that case.

Depression is a mental illness

Moving away from the biology aspect, depression is chiefly a mental illness, one that inhabits the mind and is caused in large part by life events. Abuse early in life, neglect, social rejection, loss of a loved one, difficult times in one’s life, these can all be causes of depression and neither is more or less valid than each other as an inciting event. There is of course sadness that follows sad times, or the loss of a loved one, however, it is when these feelings spiral beyond grief at the loss, or a general sense of struggle and begin to infect daily life and taint one’s thoughts that depression occurs.

Treatment options

In terms of treatment, depression is dealt with in a couple of key ways, therapy, and medications. The medication primarily used to treat depression is a class of drugs called SSRIs, selective serotonin reuptake inhibitors. In layman’s terms, this means that the drugs work to increase the serotonin available in the brain without actually increasing its production, hopefully helping the brain receive appropriate signaling from the chemistry at work inside, these pills take some time to work and are definitely not without negative side effects. When dealing with neurochemistry, there is a fairly large margin of error, with side effects ranging from weight gain to weight loss, to actually worsening depression.

Seek a mental health professional

One must always be in close contact with a medical professional when starting or changing to a new medication regimen to treat depression. Therapy is the other side of this treatment, with cognitive-behavioral therapy being the most frequently utilized and common style. Essentially, the goal is to help overcome the internal monologue associated with depression and anxiety, taking the harmful self-thoughts and with the aid of the therapist, making them stop. These treatments aren’t comprehensive, and there remains a great deal to learn about this condition and how to best overcome it, but the most important note is: Depression is serious, and your feelings are valid and important if you feel that you or a loved one are suffering from depression take the time needed to help with that, mental health is as important as physical health.

Premature Ejacuation

New Science to Counter Age Old Problem of Premature Ejaculation

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What is premature ejacuation?

Premature ejaculation is one of the many sexual-related conditions that can either impair or diminish the quality of a person’s sexual life, either for a specific period of time or in a permanent fashion. Compared to other similar complications, premature ejaculation is not as severe, as it doesn’t completely ruin a person’s sexual experience. It can be very unsettling, specially if the person becomes too self-aware because of it and develop psychological insecurities. In that case it can lead to erectile dysfunction, which then in many cases completely ruin a person’s sexual life. Or it can make someone completely avoid having sexual relationships, trying to avoid the embarrassment resulting from it.

Since there are many personal and subjective reasons for someone to think that their ejaculation is happening too fast, the International Society for Sexual Medicine standardizes the condition as when someone ejaculates on the first minute after penetration. For reference, information is available that says about three-quarters of men ejaculate within two minutes of penetration in over half of their sexual encounters, and the more general categorization says that the typical process of ejaculation takes between 4 to 8 minutes. Of course ultimately the partner or partners of each person is supposed to communicate if they feel that ejaculation is happening too quick, and anyone who experiences this can and should be looking into ways to deal with their situation, since mutual pleasure is essential to any healthy sexual relationship. But what that standard serves for is to diagnose when a medical intervention would be necessary. Still, that diagnosis can only properly happen after dialogue with the patient, and a specific analysis of their particular case.

With that many variations of cases, it is very hard for doctors or health professionals to establish a cause for premature ejaculation

There seems to be a strong correlation between excessive masturbation and complications with sexual sensations in general, including in some cases premature ejaculation. Psychological reasons can come from all sides, and can only be useful in individual, case by case, appliances. The most radical, and somewhat rare cases, may be an indication that a person has prostatitis, an inflammation of the prostate gland which requires medical intervention for many other reasons, beyond the symptomatic effect on ejaculation.

In some cases, people are able to perform self-treatment, and just ‘re-educate’ their psychological processes during sexual intercourse, since naturally the mental processes are as responsible for those processes as the physical ones. Although some people report managing to delay their ejaculation, this type of procedure tends to make the sexual act feel unnatural or disrupted, and so they are not recommended as truly capable of improving the quality of sex life someone would be seeking.

Usually, for those who want to cure themselves, the method with a higher success rate and that feels more natural is to explore the physical sensations, along with the partner, and try to find the sensations, rhythms, touches and ways of having sex that make the most sense for each person.

For those who are not able to sort their situation in these manners, there are treatments, some of them quite easy and without dangers, and, even better, with a very high success rate

Out of those, the one that has the most striking record of improving people’s sexual performance, even if they do not feel they ejaculate too fast, is the set known as Kegel exercises. Those consist on movement that strengthen the muscles of the pelvic floor by doing repetitive movements with their genital apparatus and related regions, in order to work the muscles the same one would do with their arms and legs. Another techniques that are mentioned as having helped people looking to deal with premature ejaculation are called Master and Johnson’s “stop-start technique”, which consists in creating very short but constant intervals that make the sensitive responses more controlled, and the “squeeze technique” one, which consists in squeezing one’s penis in a moderately aggressive way until the arousal is reduced.

Drugs can also have a similar effect, such as the substances known as paroxetine, dapoxetine or clomipramine. They are able to increase the time one takes to ejaculate even 10 times more than before the treatment started. Those are intense substances and can bring about many undesired effects, and should be considered a last case scenario.

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Kamagra oral jelly: do you need it?

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A new drug that is now available on the market that has claims to cure erectile dysfunction is Kamagra Oral Jelly. Kamagra Oral Jelly is such an effective drug that it is catching everyone’s attention with its claims to actually cure erectile dysfunction instead of providing temporary relief of the symptoms associated with erectile dysfunction, much like what is observed with other drugs.

Different types of erectile dysfunction are able to be cured by taking Kamagra Oral Jelly, no matter how moderate or severe the erectile dysfunction case may be. Currently, Kamagra Oral Jelly is very popular in South Africa and continues to grow in popularity among men. Kamagra Oral Jelly is being distributed throughout South Africa by way of virtual pharmacies and can also be found under the name Kamagra Gel.

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One may wonder why there is this huge revolution of a cure for erectile dysfunction now

There is an overwhelming popularity for the new drug and a ton of benefits that have been observed from the men who have had the pleasure of trying out the drug. Kamagra Oral Jelly is much like the age old drug, which we might refer to as the granddaddy of erectile dysfunction drugs, Viagra. Much like Viagra, Kamagra Oral Jelly allows men to be able to have a long lasting and steady erection whenever he is sexually stimulated. This is seen among men of all ages. Kamagra Oral Jelly even with the claims of being able to cure erectile dysfunction, has been observed to provide stead results for about upwards of six hours. This is even the lifespan observed in older men as well. Kamagra Oral Jelly provides an unimaginable absorptions rate by the body due to its jelly form. The jellies dissolve and are absorbed by the body much faster than any other erectile dysfunction drug on the market. Men are also favoring Kamagra Oral Jelly due to their jelly form as well. The gummy type consistency allows for easy swallowing and could be a safer alternatives for some men especially if they have swallowing issues.

On a biological level, Kamagra Oral Jelly has great influence on the same pathways as do Viagra

This is mainly due to the fact that both Viagra and Kamagra Oral Jelly have the same active ingredient, Sildenafil Citrate. The small implication with Kamagra Oral Jelly being similar to Viagra is that much of the contradictions that follow Viagra are also seen with Kamagra Oral Jelly in a much minor capacity. Kamagra Oral Jelly takes no longer than a maximum of thirty minutes to become effective and remains effective for no less than six hours. This drug is top priority for men in that it is one of the fastest working drugs on the market.

In reference to the contradictions, some men have reported having an allergic reaction to the active ingredient as also seen in Viagra

Unfortunate for these men they cannot take Kamagra Oral Jelly. This is also true for men who take drugs that contain nitrates. Mixing nitrates with the active ingredient is Kamagra Oral Jelly could cause a dangerous reactions that could result in a life threatening consequence. This is true for all drugs that contain nitrates being mixed with drugs containing the active ingredient of Sildenafil Citrate. This makes it important for men to first receive medical clearance from a licensed medical professional to be cleared of any adverse consequences. Typically men that suffer from illnesses such as diabetes, cancer and/or cardiovascular disease may not be approved to take Kamagra Oral Jelly.

Some many wonder why Kamagra Oral Jelly is the drug that is able to do what so many other drugs were striving to do but failed

One of the main reasons is that Kamagra Oral Jelly contains ingredients that makes the drug more stable and overall improves its effectiveness. Kamagra Oral Jelly also comes in a variety of desirable flavors that makes taking the drug more desirable then other drugs on the market.

 

Do you or your loved one need Kamagra oral jelly in your life?

Kamagra Oral Jelly is being used widely in the therapy for multiple sexual disorders and has shown to be exceptional effective in containing healing agents to cure erectile dysfunction. Studies have found that early uses of Kamagra Oral Jelly to the onset of erectile dysfunction provides as great outcome of curing the condition in the long run.

Erectile dysfunction or erectile dysfunction is a difficulty, if not a total impossibility, to have or maintain an erection sufficient to obtain satisfactory sexual intercourse and to penetrate durably his partner. “It’s when the erection does not come, or does not hold in. In both cases, the report can not take place and the man enters a spiral that generates a deleterious climate”

Medication treatments have helped to break the darkness of erectile dysfunction, long taboo. After years of monopoly of the blue pill, the tension rises on the impotence market. Discover all the solutions that today allow you to climb the slope.

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A very promising drug

Kamagra oral jelly has the same mechanism of action as Viagra®: it acts by inhibiting phosphodiesterase 5. This means that it prevents this protein responsible for the disorders from acting and allows, if there are stimulations and desire, to get an erection. But unlike Viagra®, it offers the advantage of being taken more than 24 hours before intercourse. 60% of men taking 20 mg of Kamagra oral jelly still respond to this product 36 hours after 1. This long time of action removes some psychological blockages related to the need to plan relationships.

This flexibility in the possibility of being able to be taken more than 24 hours before intercourse should make it a great success, considers Dr. Jean-Jacques Weitzman. “Indeed, Viagra® must be taken one hour before a possible meeting, and many men are embarrassed by the need to schedule sex without knowing how the partner will be prepared for it. content with Viagra® but often complain about taking the medicine for nothing that causes anxiety, taking a 24-hour tablet will be radically different psychologically because you have the whole day to get in the mood.

More than 80% efficiency

Kamagra oral jelly has been the subject of more than 60 studies worldwide and has been tested in 1,112 men aged 22 to 82 years against an inactive substance (placebo). After taking 20 mg of this drug, the erection is improved in 81% of men (only 35% under placebo) and three-quarters of men then achieve full sex 2.

Kamagra oral jelly also works regardless of the age of men who use it and it corrects erectile dysfunction of various origins, especially those related to diabetes, usually very difficult to treat. For example, one study found a 64% improvement in erections in men with diabetes after 20 mg Kamagra oral jelly (25% on placebo), which is a great success in this condition.

It also seems to be well tolerated, as the percentage of treatment discontinuations reported under this drug is relatively low (1.7%) compared to the placebo (1.1%). The main side effects are headaches and gastric problems (dyspepsia) but they are generally not very intense.

With Kamagra oral jelly patients with erectile dysfunction find a sex life. Without having their eyes fixed on the clock, they have, with their partner, the freedom to choose the best moment for their intimate relationships

How long does it take to start working?

  • Kamagra oral jelly normally begins to function 30 to 60 minutes after taking oral tablets. It can take up to two hours to work.
  • Kamagra oral jelly does not work alone. You will always need to feel sexually excited to have an erection. Feeling comfortable and at ease can also help Kamagra oral jelly produce its effects faster.

How long does it last?

Kamagra oral jelly lasts an average of two to three hours before its effects begin to diminish. Kamagra oral jelly can last up to five hours or more, depending on your dosage, your body’s metabolism, and other external factors.

Depending on how your body metabolizes it, you may be able to have an erection several times with Kamagra oral jelly. Kamagra oral jelly will probably not make you last longer in bed. No research has definitively proven that Kamagra oral jelly can increase the duration of your sexual relationship.

Kamagra oral jelly may not work immediately after intercourse. Normally, you can not have another erection just after ejaculating, because your body is not physiologically prepared for this activity. This is known as the refractory period. It may only take a few minutes, but it can take hours or days.

Premature Ejacuation

Premature Ejaculation? Is your Partner Worried About That? You Might Want to Read About this Issue

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‘Quick sex’ or premature ejaculation: two words that many men hate to hear. But what are the margins of time that define it?

Three minutes or less, according to a new study by an international group of scientists who have agreed to diagnose the disorder for over a century since it was first documented.

The vague definitions have so far caused confusion among doctors and led many men to mistakenly believe they suffer from the disorder, explains the director of the South African Center for Sexual Health, Chris McMahon, one of the authors of the report published in the Journal of Sexual Medicine. While historical studies of the population suggest that between 25 and 30% of men reach orgasm too soon, the most recent data indicate that the proportion is much lower.

According to the definition of the diagnosis agreed in the study, he suffers from the permanent form of the condition, which occurs from the first time one has sex, between 2 and 3% of men. These men typically last a minute or less. In another 4-6% of cases they get it during their lifetime and ejaculate after about three minutes or less.

There are three conditions in the diagnosis, McMahon explains, and it is necessary that all three occur

In addition to duration, it is necessary that men cannot control or delay ejaculation during sex, and that these performance problems cause negative psychological consequences of frustration, to the point of avoiding sex. Cases of ‘variable premature ejaculation’, when the man sometimes comes too early and sometimes not, and ‘subjective premature ejaculation’ when he only has the impression that the conclusion was premature are not included in the diagnosis.

Remedies for Premature Ejaculation

Premature ejaculation is by far the most felt and frequent male sexual dysfunction. It occurs when the man, during sexual intercourse, reaches intercourse after a brief sexual arousal, since he cannot dominate his ejaculatory reflex. Premature ejaculation is due to a complex intertwining of emotional factors (stress, anxiety, fatigue, etc.) and physical-organic factors (alcoholism, short frenulum, prostatitis, urethritis, vesiculitis, erectile dysfunction, etc.).

What to do

  • Carve out a daily space for yourself: this behavior relieves anxiety and drives away stress, the worst enemies of love
  • Supplement the diet with zinc supplementation, a useful remedy against stress
  • Constantly playing sports: practicing sports allows you to get a greater awareness of yourself and your body
  • To fully live the relationship as a couple, trying to remove anxieties and fears that hinder the relationship
  • Always discuss with your partner about the disorder: dialogue can benefit the couple and the relationship itself
  • Perform the “start and stop” practice: the woman interrupts her partner’s sexual stimulation as soon as she senses an excessive (male) excitement. After that, the woman gently squeezes the penis under the glans. After a short period of time, stimulation is resumed. Repeat this procedure up to 10 times. Such behavior helps the man to control his own ejaculatory reflex, in addition to identifying the point of inevitability of ejaculation (beyond which orgasm is no longer controllable).

What NOT to do

  • Consume large meals: especially before a relationship, a large lunch or dinner could prevent or hinder a subsequent sexual relationship
  • Don’t admit the disturbance: hiding the disturbance behind excuses can cause serious problems to the couple’s relationship
  • Lack of dialogue and exchange of opinions: in the couple, communication is essential to tackle any disorder together, including premature ejaculation
  • Postponing the doctor’s check: when premature ejaculation becomes a big problem for humans, consulting with a specialist is recommended (eg sexologist)
  • Sedentariness and smoking
  • Drug addiction: abuse of illegal drugs can cause serious disorders in the sexual sphere (eg erectile dysfunction, premature ejaculation)
  • Take vasoactive drugs – such as sildenafil, tadalafil and the like – in case of heart disease, regressed history of stroke, blood pressure changes (hypertension), administration of anticoagulants, angina, uncontrolled diabetes.
  • Trying to reduce pleasure during intercourse (eg thinking about other topics, politics, economic problems, etc.), in the belief that such an attitude can delay ejaculation. Instead of stifling pleasure, it is advisable to surrender to it.
  • Believing that the partner can achieve maximum pleasure exclusively through coitus: this thought can instill anxiety in the man and, seeking female pleasure, ends up unconsciously accelerating his ejaculatory times.

What to eat

  • Follow a healthy and balanced diet, limiting excesses
  • Prefer foods rich in omega 3 and omega 6 (fish, nuts, flaxseed oil)
  • Take food rich in bioflavonoids (lemons, grapefruit, grapes), very useful for controlling ejaculatory impulses
  • Take lots of fruit and vegetables, as it is rich in antioxidants (vitamin C and E).

What NOT to Eat

  • Avoid consumption of foods that are difficult to digest, such as dips, fries and foods rich in fat (especially before a report)
  • Limit the consumption of foods rich in caffeine (coffee, chocolate, cocoa, cola-based drinks, mate, guarana), which with their stimulating effect can aggravate erectile dysfunction, reducing the time needed to produce an ejaculatory stimulus

Natural Cures and Remedies

Natural remedies are recommended when the patient suffering from premature ejaculation does not interpret this condition as a serious and impassable problem.

Among the remedies indicated to overcome the mild forms of premature ejaculation sprout plants with active anti-sedative-sedative principles, useful for removing anxiety and stress:

  • Valerian (Valeriana officinalis) – relaxing, anxiolytic properties
  • Passiflora (Passiflora Incarnata) – sedative properties
  • Tiglio (Tilia cordata) – relaxing, anxiolytic properties

Pharmacological care

Topical application (directly on the penis / glans) of desensitizing creams: local anesthetics are a useful remedy to postpone ejaculation. The use of anesthetic creams can lead to a reduction in female pleasure: therefore, we recommend using a condom

  • Lidocaine (eg Lidoc C FN cream, Xylonor spray)
  • Prilocaine (eg. Emla)

Tricyclic antidepressants: prolong the duration of a relationship by postponing ejaculation:

  • Fluoxetine (eg Azur, Prozac)
  • Sertraline (eg. Zoloft, Sertraline)
  • Lomipramine (eg. Anafrinil)

Vasoactive substances: for severe forms of premature ejaculation associated with erectile dysfunction. The drugs promote the relaxation of the smooth muscles of the cavernous bodies of the penis, improving erection:

  • Sildenafil (ES. Sildenafil Teva, Viagra, Revatio, Sildenafil Actavis, Sildenafil ratiopharm).

Prevention

  • Avoid stress and anxiety
  • Perform Kegel’s exercises consistently: the domination of the pubococcygeus muscle in the male prone to premature ejaculation allows the management of ejaculatory impulses, postponing orgasm.
  • Alternative treatments and remedies
  • Sexological rehabilitation therapy
  • Psychodynamic therapy
  • Alternative therapies: ayurveda, aromatherapy, homeopathy
  • Circumcision associated with glandular neurotomy: this surgical practice reduces glans hypersensitivity, a useful remedy for premature ejaculation.
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Cialis: A prescription for rejuvenating a relationship?

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Tadalafil, sold under the brand name Cialis, among others, is a drug used to treat erectile dysfunction (ED), favorable prostatic hyperplasia (BPH), and aspiratory blood vessel hypertension. It is a tablet taken by mouth. The beginning is normally inside thirty minutes and the term is as long as 36 hours.

Regular symptoms incorporate migraine, muscle torment, flushed skin, and sickness. Alert is exhorted in those with cardiovascular sickness. Uncommon however genuine reactions incorporate a delayed erection that can prompt harm to the penis, vision issues, and hearing misfortune. Tadalafil isn’t suggested in individuals taking nitrovasodilators, for example, nitroglycerin, as this may bring about a genuine drop in circulatory strain. Tadalafil is a PDE5 inhibitor which builds bloodstream to the penis with sexual excitement. It additionally enlarges veins in the lungs, which brings down the aspiratory conduit pressure.

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Tadalafil was affirmed for medicinal use in the South Africa in 2003

It is accessible as a nonexclusive medicine in the South Africa and United Kingdom. In the UK it costs the NHS about 0.80£  per portion starting at 2019. In our country the discount cost of this sum is about $0.91.  It was the 280th most endorsed drug in the South Africa with almost 1.5 million solutions in 2018.

The FDA loosened up rules on physician endorsed medication showcasing in 1997, permitting ads focused to consumers

Lilly-ICOS employed the Gray Worldwide Agency in New York, some portion of the Gray Global Group, to run the Cialis promoting campaign. Marketers for Cialis has exploited its more prominent term contrasted with its rivals in ads for the medication; Stuart Elliot of The New York Times opined: “The persistent nearness of ladies in Cialis advertisements is an unpretentious sign that the medication makes it simpler for them to establish the tone with their men, rather than the principally male-driven symbolism for Levitra and Viagra.” Iconic topics in Cialis promotions incorporate couples in baths and the motto “When the minute is correct, will you be ready?”

Cialis advertisements were exceptional among the ED sedates in referencing points of interest of the drug

Subsequently, Cialis advertisements were additionally the first to portray the reactions in an ad, as the FDA requires notices with particulars to specify symptoms. One of the principal Cialis promotions circulated at the 2004 Super Bowl. Just weeks before the Super Bowl, the FDA required progressively conceivable reactions to be recorded in the commercial, including priapism.

Although numerous guardians questioned the Cialis promotion being disclosed during the Super Bowl, Janet Jackson’s halftime “closet glitch” dominated Cialis. In January 2006, the Cialis advertisements were changed, including a speCialist screen to portray symptoms and just running advertisements where in excess of 90 percent of the group of spectators are grown-ups, adequately finishing Super Bowl ads. In 2004, Lilly-ICOS, Pfizer, and GlaxoSmithKline spent a joined 3.1 million to publicize Cialis, Viagra, and Levitra respectively. Cialis has supported many games, including the America’s Cup and the PGA Tour, once being title supporter of the PGA Tour Western Open competition.

When we talk about one of the most prestigious brands in the world for ED we have to refer to Cialis. This drug is not only one of the best known, it is also one of the most purchased in South Africa and other countries.

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Erectile dysfunction is a serious problem for many men

But like every problem, it also has a solution and that solution has always been Cialis with its multiple presentations.

Why is Cialis better than other drugs?

This drug is manufactured by one of the best laboratories in the world. That laboratory is Eli Lilly also known as only Lilly. This company has 143 years in the pharmaceutical industry.

Cialis has been manufactured and backed by Lilly for over 15 years. Originally Cialis was a drug designed to compete with another famous ED drug sold in South Africa and other parts of the world by the Pfizer company.

The effect of Cialis is more lasting.

This drug as a treatment for erectile dysfunction is considered one of the best in the market. Not only because of the company that supports it, but because of the long effect it has on men with ED.

Cialis has a total effect of 36 hours in most men. It is a highly effective drug if the man takes the maximum recommended dose of 20mg, 30 minutes before having sexual contact.

Does Cialis have the same component as other drugs for ED?

This is another important point in favor of Cialis. The difference with other drugs and generics is much bigger. The company that sells Cialis in South Africa and other countries does not use the same component as other drugs (Sildenafil Citrate) on the market.

The main and totally different component of Sildenafil is called Tadalafil and it is the secret ingredient of Cialis. This component acts faster but with the same effect: dilate the blood vessels of the penis to increase blood flow so that man can have a more lasting erection.

Where can I buy Cialis online in South Africa?

Edonlinestore.net: It is an establishment store not only online but also based in Perth. This store offers two types of Cialis. The cheapest version with 10 pills of 10mg for $ 47.50. The second option is the dose of 20mg x 12 pills with a cost of $ 156.19 ($ 12.98 each pill). This same store offers other offers of up to 90 pills between 10mg and 20mg with discounts of $ 300 or more. The store accepts all Visa, Mastercard, Dinners, JCB and transfer credit cards. Shipments are made by the national service of South Africa.

Viagrastoresa.com: It is the second option to buy Cialis online in South Africa. The offers are a little cheaper than the other store. A package of 20mg x 10 pills costs only $ 49.95. Other discounts for 20mg x 30 pills up to $ 99.95. Ozmedsdirect accepts credit cards and bank transfers. Shipments have a minimum cost of $ 19.95 for all purchases.

Side effects

This drug is one of the safest in the market. But men who abuse this drug for ED may suffer from side effects such as dizziness, vomiting, facial paralysis, chest pain, headache, temporary blindness. With the lasting effect of 36 hours, it is best to take no more than 3 pills per week. That amount is much less harmful than other brands.

Is Cialis legal in South Africa?

This drug has been legal in the country for more than 15 years. The company’s main office (Eli Lilly South Africa Pty Limited) is at 112 Wharf Road, West Ryde, NSW 2114. Legal records of each of the doses available in the market are 5 mg (AUST R 128496), 10mg (AUST R 90590), 20mg tablet (AUST R 81137). The company phone number in South Africa is 800 454 559.

Premature Ejacuation

Premature ejaculation is a very common dysfunction seen in men all over the world

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Premature ejaculation is the inability to control, manage or delay an ejaculation. In turn, this results are a dissatisfied sexual partner and unaccomplished man during intimacy. Premature ejaculation has been classified as something that is either acquired or a lifelong condition, with lifelong condition being a primary issue.

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In South Africa, the occurrence of premature ejaculation observed in men is around 21 to 31 percent.

In a dramatic sense, premature ejaculations have a very diminishing effect on the quality of one’s life and the life of their sexual partner. Premature ejaculation can lead to other more damming issue that correlate with the quality of life. Some things that may occur due to premature ejaculation is men feeling distressed psychologically, a decrease in self-esteem and adequacy, erectile dysfunction, anxiety, a decrease in libido and/or stressed interpersonal relationships. Because of the emotional burden that premature ejaculations causes a man, some men are reluctant to the idea of seeking help from a medical professional.

 

Usually conditions involving sexual dysfunctionality is under-reported and under-treated because men have shame and low self-esteem due to the condition

This along with doctors being uncomfortable helping men manage the condition because they are uncertain as to how to approach treatment and the discussion to uncover what the condition is that is being experienced. The implications of premature ejaculation is heavily a contributor to psychological effects and become damaging to interpersonal relationships. Premature ejaculation causes men to avoid emotional and physical intimacy due to the psychological stress the condition puts on them and they do not want to pass on that stress to a partner or expose their condition. Men experiencing this condition and hiding it usually fall victim to bogus medical claims and advertisements that has no evidence basis to actually help men overcome premature ejaculation. These advertisements prey on the weak and profit greatly from men vulnerability.

Premature ejaculation is a very common sexual dysfunction among men, with a greater impact observed among men of the younger age group

In seeking help in a medical setting, some doctors are uncertain on how to approach the assessment process to uncover the issue. This makes its challenging when trying to obtain the necessary information to be able to properly remedy the dysfunction. Men should undergo a full medical assessment to investigate their medical, sexual, social, psychological and drug history, accompanied with their sexual partner’s history. Treatment should be done with the man and his partner to ensure that there are not other factors contributing to the condition.

Treatment choices are likely to vary based on the symptoms being experienced, psychological implications, side effects and patient decision of what approach they want to explore

Currently, surgical management for premature ejaculation is not recommended. Surgical management is under investigation and is in an experimental phase. Some of the surgical therapies that are underway are the dorsal penile nerve cryoablation, neuromodulation and hyaluronic acid gel gland augmentation.
Also, botulinum toxin injection are being explored to be injected into the ejaculatory muscle in the penis to help minimize the sensitivity during sexual activity. None of these treatment options are currently promoted as the side effects are undetermined. There are no particular investigation that is done to confirm or reject premature ejaculation.

Even though surgical management is not currently recommended, in South Africa there is a new device that is designed to elongate the time men experience a sexual encounter prior to ejaculation

The device is currently approved by the US Food and Drug Administration and is available locally to South Africans and online to everyone else. The device works in a way to greatly reduce the sensitivity during intercourse that cause premature ejaculation. The idea of the device is that a man will masturbate with a start-stop process three times while the device is in place. Men are expected to see results from using this device after the use of 3 times a week for 6 weeks.

All in all, men who experience premature ejaculation will more than likely require multiple management techniques that will target psychological and behavioral components. Men should be under the supervision of a medical provider when being treated for the condition to ensure the targeted results are being met and sexual satisfaction is being obtained. Additional investigation is more so geared to rule out contributing factors that are uncovered in the history.

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Kamagra jelly ? what is Kamagra jelly alot of people are curious as to what it is

I am here today to explain a few things about this product along with the pros and cos and possible side effects of this Kamagra jelly.

Kamagra jelly is used to treat erectile dysfunction or in other words the short name would be ED. This product contains sildenafil citrate which is also used in the more common brand Viagra and sildenafil.

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Kamagra in tablets and jellies

Kamagra comes in a tablet form that can be taken orally or this product can be taken by oral jelly. This is a very great alternative product since it is much cheaper than the standard brand Viagra and can be bought at a much more reasonable price. Kamagra is taken like Viagra its meant for people who cant get or keep erections during sexual intercourse. This jelly is meant to increase the blood flow in the penis and makes it much easier to keep and hold an erection. A few things to note about Kamagra jelly is that it contains the same effective ingredient as Viagra which is sildenafil in theory it should work just as great as Viagra does.

Is it worth the risk one might as ?

I would say to consult with your doctor before taking anything in a pill or jelly form and to get a second opinion from your local doctor before taking this. One thing that i would recommend that you do not take this jelly if you have heart failure, if you have had a heart attack before, if your not 18 years of age, or if you have ever had degenerative diseases in the retina.

Dosage

You can take this Kamagra jelly in 25mg 50mg or 100mg pills. I would talk with a doctor to see which mg would be the best for you to take for your erectile disfunction or ED. If you have any of the following symptoms i would seek immediate attention from the hospital or doctors office if you have dizziness, visual impairment, flushed out face, or indigestion.

Precautions

Do not use this drug with other drugs that contain the ED because there have not been enough studies yet to determine if this is safe or not. Some known side effects have been reported from taking the Kamagra jelly such as headache, flushing, nose bleeding, indigestion, sleeplessness, diarrhea , dizziness , or bloody and cloudy urine, you may want to talk to a health provider if you have any of these symptoms.

Kamagra jelly benefits

Some of the pros of taking Kamagra jelly are that the jelly form comes in some nice flavors such as mint, banana, pineapple, orange, black currant, vanilla, and strawberry which is a nice change from the standard Viagra brand which does not have a taste, also those who do not do well with swallowing pills would love this product and it would be a much better option considering the flavors that this comes in. Another benefit of the Kamagra jelly is that it has a much faster absorption rate compared to tablet versions.

Another pro is that people who have taken this product say that they experience the effects kicking in within 14 minutes after taking the product.

Disadvantages

Some of the cons about this product is that the jelly taste so good so some people will take more than the recommended amount of the jelly because they love the taste of the jelly and they forget how much they are taking.
Another con is that some people have been sick from taking the product but it is rare and most people do fine with taking this product compared to other drugs that are on the market that treat erectile dysfuncion.

Another side note is that you should not take this product if you have a history of liver disease because this may not be a good drug to take with having any type of liver issues.
You can buy Kamagra jelly in South Africa from this website Edonlinestore.net. They will offer wide range of Kamagra jelly for you to choose from and they have some pretty great prices. You do not need a doctors approval to buy this jelly from this website so if you live in South Africa this might be a good option for you if your in the market to buy Kamagra jelly. With that being said i would suggest you try it out for yourself and to try to get a free sample to see if this product is right for you or not.

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SEXUALLY TRANSMITTABLE INFECTIOUS DISEASES

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Both humans and animals struggle with Sexually Transmitted Diseases (STD’s) and Sexually Transmitted Infections (STI’s) since time immemorial. They are as ancient as mankind. Epidemics of this nature are even mentioned quite often in the Old Testament.

Remember Sodom and Gomorrah anybody?

In the olden days, when superstition was very much part of our everyday life, it was believed that these diseases/infections were inflicted upon the individual by mysterious moral forces that came to punish for a wrong conduct, belief system or morality.

STI’s/STD’s are bacterial/viral infections which are most commonly spread through sexual activity. Most commonly, they spread through oral sex, because of close contact between the oral and genital areas. And also through anal sex, because of the absence of naturally released lubrifying fluids. Which obviously results in greater friction during the act itself and therefore in an increased exchange of blood and hummers. What’s truly sneaky about these conditions is how they often give no symptoms at all during the first weeks or months implying an even greater risk to transmit the disease/infection to others..

There are over 30 among bacteria, parasites and viruses which can be transmitted through sexual engagement, and they all generate a wide spectrum of conditions. The most well known are:

-HIV/AIDS Human Immunodeficiency Virus
-Chlamydia
-Syphilis
-Gonorrhea
-Genital Herpes
-Genital Warts

The most alarming signs to look for if one thinks about having a STD/I include vaginal discharge, pelvic pain, penile discharge and the presence of ulcers on or in proximity of the genitals.

STD/I’s can severely impair the ability to get pregnant in women, and even if pregnancy occurs it affects the infant in devastatingly undesirable ways. Then of course we have AIDS, or HIV, which is viral and entirely hijacks the immune system of the infected person rendering it vulnerable to the slightest cold or infection.

STD’s and STI’s are on the rise in Australia and some other developed nations which is incredibly alarming. According to article from ABC News Health. SOURCE: https://www.abc.net.au/news/health/2017-08-16/why-are-stis-on-the-rise-in-australia/8774378

Findings are remarkable. The Internet, improved travel technology and the habit to rarely use condoms are the main influencing factors in this steady rise. Think of the thousands of online dating platform that clutter the World Wide Web. Also travelling makes diseases spread over larger distances in smaller fragments of time and what seemed to be a long forgotten and embarrassing issue is becoming again a pressing modern issue.
Again quoting the article:

In the past decade, online dating has had probably the biggest single impact on our sexual lives. Websites and apps designed to facilitate sex and romance are everywhere.
Love them or hate them, online services offer unique features which have interesting implications for the spread of STIs. For example, they can make it easier to have sex with more people.

A recent British study found 35 per cent of sexually active men and 21 per cent of sexually active women reported five or more sexual partners in a year.
Men who found partners online were six times more likely to have five or more sexual partners than those who didn’t, and women who dated online were seven times more likely.

This difference is important because the number of sexual partners you have is strongly correlated with your likelihood of getting an STI. More people online means more partners per person, which might mean more STIs.

It’s very difficult to admit, especially for the most libertines of us, but the best thing you can do to make sure you never incur in these gruesome infections is to having a monogamous relationship with one partner and avoiding group sex and other practices as much as possible.

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The reason why your bed will never be empty again: Cialis!

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Being able to have the guarantee of not failing at the time of sexual intercourse or at least having a little help has always been something that the human being wanted, especially that of the male gender. In the late 1980s, more precisely in 1988, Viagra was created the best known and most popular drug used in treatments of erectile dysfunction (or sexual impotence) With them appeared their similar and one of them is Cialis, whose active ingredient is Tadalafil. All of them function in a similar way, i.e., they are PDE5 inhibitors, making it possible to improve the dilation of the penile blood vessels, thus facilitating erection.

Viagra vs Cialis

Both Viagra and Cialis have been indicated by doctors for patients who claim to have lost the active sexual life they had with their partners, a problem that occurs in men, especially after the age of 50, where by several factors they begin to have problems getting erection.

The differences between these two medications are that Cialis works in 30 minutes and lasts up to 36 hours, whereas Vaigra lasts only 4 hours, i.e. Ciallis can be considered a stronger remedy, in addition is available in doses of 10 mg and 20 mg, while its competitor is found in 25 mg, 50 mg and 100 mg. However, each of them is indicated for different types of men according to their physical condition and severity of the problem, and only the doctor will know which would be best for each case.

Cialis side effects

As any medicine the Cialis can bring side effects to the patient, among them the headache, the main problem, reported by more than 10% of users. In addition, low back pain, dizziness, dyspepsia, facial flushing, myalgia and nasal congestion have also been reported, and in some cases conjunctival hyperemia, sensations described as pain in the eye, swelling of the eyelids, dyspnea, abdominal pain and gastroesophageal reflux, and for sedentary users with a bad physical condition, may also notice muscle problems.

Contraindications

The drug is also not indicated for men with allergies or hypersensitivity to the active ingredient or any of the excipients of Cialis, who have changes in blood pressure or who have already suffered a stroke, heart attack or any type of coronary or ocular disease such as non-arteritic ischemic optic neuropathy. It may also not be used by patients who take nitrate or nitric oxide donors to treat other diseases. And obviously the product cannot be sold to people under 18 years of age.

How to buy Cialis in South Africa legally?

Cialis is legally sold in South Africa in physical stores or online, with fast delivery and good prices if the patient does a good research, the average value is $ 29.95 for the pack of 10 tablets of Cialis 10 mg and there is also the option to buy the generic Cialis, for a lower price.

It is important to emphasize that any type of medication to help sexual performance should never be used without a doctor’s prescription. Only then will the medicine help men return to the same performance and sexual pleasure that they used to have in their youth, thanks to a simple, small pill.

Read this to learn how Cialis can give you a firm long lasting erection!

Erectile dysfunction in South Africa in the 20th century was one of the main problems for men over 40. In the country, at that time there was no solution for this condition.

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In the 21st century, Cialis appears in all world markets, especially in South Africa, as an effective solution for the treatment of ED in men of any age at a low cost. The fame of this wonder drug started to grow as more male patients used it.

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What is the component of Cialis that makes it such an effective drug?

The main component is Tadalafil https://www.webmd.com/drugs/2/drug-77875/tadalafil-oral/details, manufactured by Eli Lilly South Africa Pty. Ltd (founded in 1960). This component is one of the most powerful in the market for the treatment of ED. Tadalafil has an effect on the blood vessels of the penis. The blood vessels dilate and that makes the blood flow faster for longer erection time.

How powerful is the effect of Cialis?

The company that manufactures Cialis in South Africa and other parts of the world, has focused on the Cialis having a long lasting effect. According to the instructions of this drug for ED, the effect on man can last up to 36 hours with a single 20mg tablet. The best dose for the more powerful effect is the 40mg tablet.

What kind of people can take Cialis?

Cialis is sold mostly for men between 40 and 65 years. But in general any man with sexual maturity can buy this drug. The main objective is to treat ED, but Cialis also works to improve men’s sexual performance. Using Cialis on daily basis can help the patient to avoid depression caused by ED.

Where can you buy Cialis online in South Africa?

Cialis is available in several online shops on the internet. But it is advisable to check what kind of supplier is the store. Some stores sell counterfeit drugs and these can cause severe damage to men’s health. But, here we have a list of the best online shops, prices and quantities available to buy Cialis:

  • viagrasouthafrica.net: This store is well known in South Africa. The 20mg dose is available for AU $ 2.65 per pill for purchases of 120 pills with free airmail shipping. The cheapest option in this store is 20 pills for AU $ 77.98 (3.90 per pill). The 40mg option is also available.
  • viagrastoresa.com: This is the second option to buy Cialis online in South Africa. It is a store with slightly more expensive prices, but just as reliable as the other store. www.viagrastoresa.com only sells 20mg per dose. The cheapest option is 10 pills for AU $ 76.99, and the best offer is 90 pills for AU $ 412.94 (4.59 per pill).

All stores accept credit cards such as visa, mastercard and dinners. Money transfers are available. Shipments are made by South Africa Post Office, EMS, POS Singapore and New Zealand Post. Some orders are shipped outside the country.

Is it bad to take Cialis daily?

It is not bad, but it is not the best way to consume this powerful drug for the treatment of ED. Doctors recommend a dose of 20mg for new patients, and up to 40mg for men with more severe ED problems. Some known side effects are caused by not eating before using Cialis: Dizziness, vomiting, stomach pain, headache, dry mouth, cramps.

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Viagra: Three Reasons to take it and even more reasons not to

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Before the 1980s, men with erection problems didn’t have many options to solve this problem, apart from some practical and very aggressive ones such as injections and penile bombs.

Viagra for the high blood pressure

Until accidentally, during research to create a drug that would originally be intended for the treatment of high blood pressure ended up becoming what we know today as Viagra. It acts on the blood vessels inside the penis, facilitating dilations.

Viagra and its competitors

Viagra competitors

With really notable effects when returning the erection to men who had this problem of erectile dysfunction, the drug was proving to be efficient and becoming increasingly famous and becoming a sales success even today despite its competitors like Cialis and Kamagra jelly.
However, contrary to what many people think, Viagra is not able to increase male libido, it improves erectile response but only when the man is already sexually stimulated, in other words, the remedy will only take effect if there is sexual stimulation after taking Viagra.

Beware of side effects!

You need to be aware of the side effects of Viagra, such as headache, nasal congestion, vision problems, light sensitivity and indigestion. Other serious problems that may occasionally occur are a heart attack, sudden hearing or vision loss, increased intraocular pressure, ventricular arrhythmia, and a lasting but painful erection condition.

Visit a doctor first!

It is essential to visit your doctor so that he or she can prescribe Viagra because the drug should not be used by people with cardiovascular problems, because of increased blood flow that overloads the system, people with severe liver failure or kidney disease, because in this case the medicine may not be metabolized properly causing unwanted reactions. It can also not be consumed by men who have had a stroke or a heart attack recently, because this part of the body is fragile, and also by individuals with hereditary disorders of problems with degeneration of the retina, precisely because of the side effect that causes increased intraocular pressure.

Viagra risks: recreational use

Another very worrying factor is that Viagra, which is generally recommended for men over 50, is also widely used by healthy young people who do not need the drug.

Because of insecurity, to avoid anxiety, or because they believe in an improvement in sexual performance, they take the medication without a medical prescription, which can lead to all the side effects mentioned above and still cause addiction, because the young adult consumes the medication and understands that he had a good sexual relationship because of it, which starts a worrying cycle in which he can no longer have sex without being medicated because he believes I will decrease the level of his performance.

It is important to know that no medication of this type will provide greater pleasure to those who have an erection normally and will not even cause an increase in the size of the penis, its function is to facilitate male erection by acting on the blood vessels inside the penis, facilitating the dilations by increasing the flow of blood in the place, thus facilitating the erection.

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Purchase Viagra in South Africa

There are many pharmacies in South Africa that sell Viagra online, some deliver it in 1 to 3 days or even overnight. The drug is also easily found in physical stores and costs an average of 4 to 10 dollars in its generic formula, sildenafil. The original version created by Pfizer used to cost $30 per tablet in the year it was released.

Created more precisely in 1988, Viagra can be considered one of the greatest revolutions of modern medicine, brought back a population that could have a quality routine sexual activity, and transformed the lives of those who thought they could no longer have the same sexual pleasure they had already had in their youth. The benefits are several, the small blue pill, came to save marriages that could be ending, because when the man can not play his sexual role with his partner, he can feel minimized and the stress on both sides ends up weakening the couple’s relationship. It also brought more confidence for men to talk more openly about this problem, since it became a more scientific subject and with solutions by medicine, and before it was believed that it would be a problem to be treated with psychologists.

Therefore, as long as he uses the proper care, and prescribed by the doctor, as well as all medication, he can be considered a miracle that helps men and also women.

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In South Africa, you can purchase Viagra online without a prescription unlike the United States. Men feel powerless with sexual inadequacy. They always think it is going to be impotency. South African doctors have confirmed that erectile dysfunction is not a total lack of erection. It can be any number of factors among which the fact that the erection is weaker or a decrease in the humber of erections is noted. A doctor determines if there is a disorder or not.

The most well-known medicine in South Africa for men is Viagra. They can be administered orally or they can be administered through a needle which can be inserted in the penis. The needle injections last longer. The pills are and still remain the first and most popular choices. The South African pharmacies offer different medicines for increasing sexual potency. Recommended doses vary from 20 to 200 milligrams.

Cialis and Viagra

Other medicines, for example, Cialis have a longer life from one to three days. South Africans tag it as the weekend Viagra. All of the medicines are prototypes of Viagra and how to expand the range of activity which changes throughout one’s lives. TV commercials continually asking men which one they want to choose.

Pharmacies in South Africa charge low prices on popular drugs for sexual potency. This is due to the fact that generic drugs are distributed mimicking the original but with a completely valid imitation. People can go directly to the website instead of having stores that have to rely on renting warehouses, shipping to pharmacies, training, and advertising. This, in turn, drives up the prices.

New drugs for erectile dysfunction

Online pharmacies gives men a unique opportunity to buy not only the inexpensive drugs for increasing potency but also carry a new drug for increasing potency (Stendra or Avanafil). The pharmacies only carry tested and quality drugs, have the lowest prices, 100% confidentiality in ordering and delivery, and flexible payments. Anyone in the world may order directly from the website.

What is Kamagra?

Kamagra is an unlicensed treatment for erectile dysfunction. Some folks call to the Viagra gel. It has the same ingredient as Viagra.
It’s a pill or jelly taken with sexual stimulation and meant to increase the blood flow to the penis. The pills can be swallowed orally or the jelly is dissolved on the tongue. If you are buying in UK or Europe, it is illegal. Some of the websites offering it often sell generic or dangerous imitations. Since it is unlicensed, there is no way to control the the ingredients of Kamagra sold in either the UK or EU. To date, there is very little knowledge of side effects it may have. Some people’s bodies react very, very differently due to their medical history and lifestyle.

One of the arguments against Kamagra: is does it work?

All countries have access to licensed and regulated drugs of Cialis and Viagra from websites and it is legal. If folks are traveling internationally and want to try it, you can get it but you need to ensure it’s regulated and licensed in that country.

What is Sildenafil?

Kamagra is supposed to have the same ingredient as Viagra. That ingredient is called Sildenafil. It should work exactly the same way. It has the normal waiting time of about 45 minutes to kick in. Kamagra jelly lasts around 4-6 hours and always varies from person to person. Purchasing unregulated and unlicensed drugs is never worth the risk to your personal health and safety. Find a location that will give on an assessment form from an online doctor or you own doctor. Either would be able to give you a full overview of the appropriate treatment option.

Sildenafil: Side effects

As with any medication, please be aware if you take the 100 mg tablet, there are side effects. They include headache, nosebleed, indigestion, sleeplessness, diarrhea, dizziness, bloody and cloudy urine, burning, numbness, and tingling in arms and feet, visual disturbances.

Also sensitivity to light, prolonged and painful erection, painful urination, excessive tearing of the eye, ringing or buzzing in the ears, deafness, nasal congestion, nausea, and palpitations. Always seek a professional and get his/her feedback.