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Testosterone deficiency syndrome (TDS) is a clinical and biochemical syndrome frequently associated with age and co-morbidities and is characterized by deficiency in testosterone and relevant androgen-deficiency symptoms. Significant progress has been made in the field of medicine for erectile dysfunction (ED) since 1970s.
Testosterone is vital for normal functioning throughout a mana€™s life and a reduced testosterone level could compromise the mana€™s general well-being and his sexual function. Apart from penile erection, testosterone also regulates other aspects of male sexual desire. There is strong evidence that ED is an independent marker for subsequent cardiovascular disease and that the incidence of ED is more common in older patients with higher cardiovascular risks. The clinical presentation of TDS, defined as both low testosterone level and clinically significant symptoms, can be at times nonspecific and often overlooked or under-diagnosed. Patients with ED, together with other symptoms such as reduced libido, decreased muscle mass and strength, presence of type 2 diabetes mellitus and metabolic syndrome should be screened for TDS (Figure 1).
Physical examination should focus on cognition, neurological, cardiovascular and urological findings.
Laboratory diagnosis of testosterone deficiency: The exact pathogenesis of low testosterone remains contentious and several proposed mechanisms include decreased Leydig cell function, age-related increased in sex hormone binding globulin (which binds testosterone and lowers free bioavailable testosterone level), blunted circadian steady state of testosterone and decreased luteinizing hormone (LH) pulse by the hypothalamus [12]. The biochemical diagnosis of TDS is based on the measurement of serum total testosterone (TT), preferably before 11 am, though the diurnal rhythm of testosterone is less marked in men aged over 40 years.
While theoretically serum FT is more representative of the biological activity of testosterone, these assays may be more difficult to carry out (especially equilibrium dialysis, the reference method for FT), inaccurate (FT assay by testosterone analogue and a€?Free Androgen Indexa€™), or can only be performed by some laboratories. In the case of low or borderline testosterone value, the assay should be repeated, because of the frequent intra-individual fluctuations of serum testosterone, unless physical evidence of hypogonadism (i.e. When choosing which TRT to prescribe, primary care physician must exercises good clinical judgment together with adequate knowledge of the advantages and drawbacks of TRT and considers the bioavailability, safety, tolerability, efficacy and preference of each TRT product (Table 1). The effects of TRT may be perceived within 2-4 weeks, but sexual effects may sometimes take 3-6 months to become apparent and even up to 1 year for the nocturnal erections to reach normal range in previously untreated hypogonadal patients [16]. Since the occurrence of any adverse events during therapy (such as an elevated hematocrit or PSA) requires rapid discontinuation of TRT, short-acting preparation is preferred over long-acting depot preparation in the initial treatment of hypogonadal men, but there is no contraindication to start with longer acting preparations. Testosterone & PDE5 Inhibitors in ED: As previously mentioned, testosterone modulates the expression of isoforms of nitric oxide synthase and PDE5 enzyme [19]. At present controversies exist whether men with hypoandrogenism and ED should be treated initially with PDE5 inhibitors, TRT or in combination [16]. Motivated to do the things that make you feel good about yourself.Motivated to get off the couch, make money, exercise your body, and have sex with your woman.What else do you need? Erectile dysfunction and andropause are two conditions with the greatest impact on male quality of life. US Compounding’s pharmacists work closely with patients and their physicians who look to compounded hormones to improve their quality of life.
The first step on the road to treating andropause with restored hormone balance is setting up an appointment to review your medical history and symptoms.
At US Compounding, we take care of the whole patient, with the ultimate goal of improved overall health and well-being. Don’t settle for the “I’m just getting older” mentality when it comes to erectile dysfunction, hormone balance and your health. PubliciteVos articles preferesMedicaments facilitateurs de l'erection Vous souffrez de troubles de l'erection? What brings about the change in male and female bodies are the sex hormones that God has created in a highly organized manner.
The main sex hormone in the male is testosterone; in the female, they are estrogen and progesterone.
The testes and the ovaries then begin to produce the sex cells proper to males and females and to secrete the sex hormones.
Now, let us examine how the male and female reproductive systems develop and see what kind of system God has created for each new human being that has come into the world. The most important organ in the female reproductive system is the ovary, each of which weighs between 10-20 grams.
The sex hormones produced in the female body, for instance, cause the pelvis bones become wider because during pregnancy, it will make the needed room for the baby in the mother's womb. How do these cells that produce the female hormones know that the woman may later get pregnant?
Moreover, in women, the accumulation of fat in the hips and thighs is again physically the result of the influence of estrogen. The sex hormones cause the development of a high voice in women and low voice in men.- Rasyonel Tedavi Yonunden Tibbi Farmakoloji (Medical Pharmacology According to Rational Treatment), p.
It is a demonstration of great wisdom that female hormones are not secreted until a particular age. As a mother considers her child's every need, its health and development and makes long-term plans for it, the cells that make up the mother's reproductive organs show the same degree of care for the egg cells.
How is it that the follicle, which is itself not fully developed, has begun to produce a hormone? This is a wonder because the still developing follicle cannot consider the future of the cell inside it, yet it takes the required measures needed for the future nutritional needs of the egg.
After releasing the egg, how does the follicle know that it will reach the uterus and lodge there?
The chemical molecule produced by a tiny follicle not only gives shape to a human body from head to toe, but also makes the required arrangements for a new human to be born. When the mature egg enters the second period of its four-week life (about 14 days later), it is released from the ovaries. When the egg cell leaves the ovary and starts its journey, it is still supported by the inside of the ovary it left behind and also by the pituitary gland located at a far distance from it. When progesterone molecules reach the uterus, they cause, as in the case of the estrogen meeting the egg cell, that certain preparations are made. Progesterone also affects the ovary itself, by preventing a new egg cell from being released.
How does progesterone know that, after fertilization has occurred, a second fertilization must not happen and that it is necessary to stop the activity of the ovary to prevent it? Another special function of progesterone is to diminish the influence of the oxytocin hormone secreted by the pituitary gland. If oxytocin affected the uterus during the first days of fertilization, these muscles would eject the fertilized egg as it attached itself to the uterine wall, and pregnancy would never occur. Progesterone has another special feature, which is still another proof of the helplessness of human beings before God Who created them.
The moment a fertilized egg cell reaches the wall of the uterus and begins to grow there, it becomes something foreign in the mother's body. But progesterone prevents the cells of the immune system from attacking the zygote in the wall of the uterus.
As noted earlier, secretion of progesterone occurs in the second half of a four-week period. The secretion of the FSH hormone four weeks later in the pituitary gland corresponds to a new egg cell that begins to maturate in the ovary, and another new four-week preparation period starts. After birth, the hypothalamus secretes a hormone called LHRH every 3-4 hours, but the amount secreted is very small. Why do all these functions take so long to begin and how can we explain the timing of these mechanisms? When the LH hormone reaches the testes via the bloodstream, the cells there begin to produce a hormone called testosterone. Testosterone molecules disperse to various parts of the body and know what they must do to certain cells in these areas. At the same time, testosterone molecules affect the cells in the roots of the hair, causing the beard and mustache to appear. Testosterone affects the vocal cords causing a male voice to be lower than that of a woman.
This is such a flawlessly created system that the mechanism formed from the three-fold union of testosterone-enzyme-receptor finds the place allotted to it from among the numberless data codes contained in the DNA and, on the basis of this information, ensures production. From this we can clearly conclude that there is an exchange of information between the pituitary gland and the testes. At the same time, the FSH hormone secreted by the pituitary gland begins the production of sperm in the testes.
Cells without intelligence use the same raw material to produce molecules, each with their own flawless design (and each one destined for a very different purpose). This one example is enough to show the greatness of the intelligence manifested in these tiny cells too small to be seen by the naked eye. It is God Who created the seven heavens and of the earth the same number, the Command descending down through all of them, so that you might know that God has power over all things and that God encompasses all things in His knowledge.
The main physiological action of testosterone in male sexual function is in sexual desire by regulating the timing of the penile erectile with sex. In the past, male sexual dysfunction was thought to be purely psychogenic but increased understanding in the erectile physiology at molecular level has shown that testosterone deficiency plays a major role in sexual dysfunction. Published literature showed that testosterone controls, directly or indirectly, several mechanisms pertinent to penile erectile function such as the promotion and differentiation of penile stem cells to penile smooth muscle cell phenotype, activity of cavernosal nitric oxide synthase and that of RhoA-kinase pathway [1]. While erections are possible in hypogonadal conditions, studies showed that patients with decreasing levels of sexual desire have progressively lower concentrations of testosterone than men who maintain their sexual desire. The clinical symptoms associated with TDS can be divided into 3 main groups, namely psychosomatic, metabolic and sexual related problems. The initial assessment of subjects with clinical suspicion of TDS should include a comprehensive evaluation of medical and psychosocial, associated co-morbidities as well as identification of any reversible factors and conditions that could impact on the prescription of testosterone replacement therapy (TRT) such as in subjects with undiagnosed prostate cancer, obstructive sleep apnea and congestive heart failure (Figure 1).
In men over the age of 40 years, prior to TRT, the risk of prostate cancer must be assessed and if the digital rectal examination of the prostate gland or prostate specific antigen (PSA) reading is abnormal, further urological assessment should be arranged [10].



Transient decrease in serum testosterone level such as in acute physical illness should be excluded by careful evaluation and repeat testosterone measurement. Furthermore there are no accepted lower limits of free testosterone for the diagnosis of TDS [10].
Hypogonadal men restored to eugonadal state with TRT will experience improvement in sexual functions, particularly erectile, ejaculation, orgasm and penile sensations; and restored or enhanced responsiveness to PDE5 inhibitors [10].
At present the use of gonadotophic hormones such as human chorionic gonadotropin and selective estrogen receptor modulator (such as clomifene citrate) is not recommended except in selected cases of male infertility [18].
Several studies have demonstrated that TDS is associated with a reduced PDE5 inhibitors efficacy [19]. Testosterone and erectile function: from basic research to a new clinical paradigm for managing men with androgen insufficiency and erectile dysfunction. Investigative models in erectile dysfunction: a state-of-the-art review of current animal models. Autoeroticism, mental health, and organic disturbances in patients with erectile dysfunction. Hysterical traits are not from the uterus but from the testis: a study in men with sexual dysfunction. Dose-response relationship between testosterone and erectile function: evidence for the existence of a critical threshold.
Hypogonadism, ED, metabolic syndrome and obesity: a pathological link supporting cardiovascular diseases. ANDROTEST: a structured interview for the screening of hypogonadism in patients with sexual dysfunction. The controversial role of phosphodiesterase type 5 inhibitors in the treatment of premature ejaculation. Testosterone use in men with sexual dysfunction: a systematic review and meta-analysis of randomized placebo-controlled trials. Improvement of sexual function in men with late-onset hypogonadism treated with testosterone only.
Oral testosterone undecanoate reverses erectile dysfunction associated with diabetes mellitus in patients failing on sildenafil citrate therapy alone. Randomized study of testosterone gel as adjunctive therapy to sildenafil in hypogonadal men with erectile dysfunction who do not respond to sildenafil alone. Oral testosterone undecanoate reverses erectile dysfunction associated with diabetes mellitus in patients failing on sildenafil citrate therapy alone. Randomized study of testosterone gel as adjunctive therapy to sildenafil in hypogonadal men with erectile dysfunction who do not respond to sildenafil alone.
When we look at the mechanisms by which these hormones are secreted, we meet a few other wonders of creation. But the system that ensures this secretion is located very distantly from these organs, in the pituitary gland and the hypothalamus area. But when the right time comes, when the child has reached the age of adolescence, the hypothalamus sends a command (the GnRH hormone) to the pituitary gland. The LH and FSH hormones in men and women have the same molecular structure, yet each is responsible for different processes in the male and female bodies. If they had this knowledge, how will they tell the cells which form the pelvis bone how much they must multiply to widen the proper amount? In a male child, it is not fat that increases in the developmental stage, but the striated muscle mass.
In order to ensure the fertilization of the egg cell, they carry out long-term plans, and the most important factors affecting this plan are hormones.
Under the influence of the LH hormone from the pituitary gland, part of these egg cells begins to mature. How does it know that capillary vessels in the uterus will provide nutrients for the egg cell? Under the influence of estrogen, the muscles in the uterus begin to develop and their strength increases.
The growth in the women's breasts during the time of development is closely connected to the influence of estrogen. It knows what kind of voice needs to be produced and it knows how to make a woman's voice. Heed your Lord Who created you from a single self and created its mate from it and then disseminated many men and women from the two of them.
The pituitary gland knows that the released egg needs help and secretes a special hormone called LTH.
This hormone, although it never leaves the ovaries and never sees the world outside them, influences cells located far distant from it, ensuring that these cells act according to a definite plan. Otherwise, as an embryo was developing in the mother's womb, a second egg cell would be fertilized, producing a great danger both for the developing embryo and the mother. As we saw earlier, oxytocin is a hormone that goes into effect as the time of birth approaches and ensures that the uterine muscles will contract. Progesterone goes into effect at this stage and inhibits the influence of oxytocin, preventing the fertilized egg from being ejected. With the secretion of FSH and LH from the hypothalamus, the hormonal system is activated. And, in order for this planning to be done, this intelligence must know all the detailed aspects of the human body. It advances through the fallopian tube (2-3-4), and reaches the uterus where it lodges in the uterine wall (5-6). The immune cells in the mother's body would inevitably attack this group of cells as they multiply. Besides its other functions, progesterone also protects the developing group of cells from being attacked. If fertilization does not occur in this period of time, the amount of progesterone and estrogen in the blood quickly decreases because it is no longer necessary to make preparations for a new human. About 10 years after birth, when adolescence begins, male hormones come totally into play.
The cells that produce testosterone know the time has come for the body they occupy to pass from childhood to manhood. This molecule knows the particularities of the male body and directs trillions of cells in the formation of this body. Clear evidence of design can be seen in the mechanism by which this hormone exerts its influence. The resulting molecular combination unites with the cell's DNA and uses the information received from the DNA to bring about a new protein synthesis.
For example, for the growth of the beard, they act on the relevant regions in the DNAs of the hair root cells. But the LH hormone is just as much under the control of testosterone as testosterone is under the control of LH. Two unconscious glands control each other's production and cooperate to ensure the secretion of the ideal amount testosterone for the human being, and prevent any danger that might arise from the secretion of too little (or too much) testosterone. The male hormone, testosterone, and the female hormones, estrogen and progesterone, are made from the same raw material, cholesterol.
A testis cell gives shape to the raw material that it is given and forms male characteristics; with the same raw material, an ovary makes the estrogen and progesterone that produce female characteristics.
However sexual dysfunction associated with TDS also includes erectile dysfunction (ED) and delayed ejaculation.
Men with low testosterone levels may often be overlooked as the association between testosterone deficiency syndrome (TDS) and its related co-morbidities such as cardiovascular disease and metabolic syndrome is not appreciated and at times, the symptoms and signs of TDS may not be obvious. More importantly, testosterone also regulates the expression of phosphodiesterase type 5 (PDE5), and in so doing maintains a homeostatic ratio between isoforms of nitric oxide synthase and PDE5 enzyme that is responsible for penile erection [2]. The association between ED, low testosterone level and cardiovascular disease are well recognized and these disorders are associated with the presence of metabolic syndrome [9]. Unfortunately none of the symptoms is specific to the low androgen state but each symptom may raise the suspicion of TDS.
While standardized questionnaires such as the Androgen Deficiency in Aging Male (ADAM) checklist is designed to identify symptoms and signs of TDS [10], they are not very specific but may play a role in encouraging men to discuss their symptoms and for monitoring changes in symptoms. The recommended tests for men with ED are fasting glucose, cholesterol, lipids and testosterone level. The FT assays are generally set aside for the repeat assay and to certify the significance of a borderline TT level, or when SHBG concentration may be altered.
The magnitude of the effect on erectile function is inversely related to baseline concentration of testosterone. This underlies the important concept that TDS must be ruled out, or if present, should be adequately treated, before PDE5 inhbitors are prescribed in men with ED. Furthermore, some studies have suggested that erectile response may actually decreased when higher levels of testosterone were reached in men who were not hypogonadal [21]. Although hypoandrogenism can be the main cause of ED in younger patients, ED is often multi-factorial in pathophysiology and therefore it is unlikely that TDS is the sole contributor for the development and progression of ED. Une bonne raison de s'interesser a celle-ci !Production de la testosteroneLa testosterone est une hormone steroide secretee par les testicules chez l'homme. A beard appears in males, their voices deepen, their shoulders widen, and they come to have the typical features of the male body.
The fact that the hypothalamus does not make a mistake in timing (unless damaged) is remarkable. This function resembles a sculptor making a statue, but the hormones are not outside the body as the statue is outside the sculptor's body, rather, (in the case of the hormones) the statue is formed inside the body.
In women, the increase in the amount of fat is specially adjusted to store the energy that will be needed for the time of pregnancy and milk production.
369- This arrangement is certainly another proof that human beings have been created according to a definite plan.


From whom did it learn the formula for causing an increase in the number of capillary vessels?
This is a measure taken to protect the place where the egg will lodge in case of fertilization.- Rasyonel Tedavi Yonunden Tibbi Farmakoloji (Medical Pharmacology According to Rational Treatment), p. Estrogen increases the accumulation of fat in the breasts and, at the same time, ensures the multiplication of milk glands. Heed God in Whose name you make demands on one another and also in respect of your families. If it is fertilized during this journey, it will begin a new life; if it is not fertilized it will die and be expelled from the body. The estrogen and progesterone secreted as a result of this causes a female to enter puberty. God, Who has created human beings with all their special characteristics, has created an ideal harmony in the progesterone-oxytocin mechanism. Certainly, this shows once again that progesterone was created by a high intelligence, that is, by God. These preparations (the multiplying capillary vessels to feed the fertilized egg in the wall of the uterus) are expelled from the body, a process called menstruation. 392- The LHRH hormone moves to the second link in the chain of command, the pituitary gland.
In any case, this system (whose secrets human beings have not been able to solve) has operated since the beginning of history in the body of every human being. In order to bring about its effects, testosterone reaches the targeted tissues (the male genital organs) and enters the cells.
This operation ensures that the distinction between male and female bodies, and their different sexual functions, will continue. To lower the voice, they act on the appropriate region in the DNAs of the vocal cord cells. How does this unconscious, lifeless thing know that the information it needs to perform its function is located in the DNA? Then you will return to your Lord, and He will inform you regarding the things about which you differed.
When the amount of testosterone in the blood increases, testosterone molecules exert pressure on the pituitary gland to cause them to cease producing LH. More exactly, within the two glands molecular sub-systems are placed so as to ensure their harmonious cooperation.
Another example of design is that, with the beginning of adolescence, FSH is secreted and sperm starts to be produced at just the right time. The same substance, just because of the modifications given to it by a cell, causes the growth of the beard, the widening of the shoulders, the lowering of the voice, and the production of sperm. The link between ED, testosterone deficiency and cardiovascular disorders is well documented.
This review article aims to provide primary care practitioners a practical approach to the diagnosis and management of testosterone deficiency in patients with ED. It appears that testosterone is responsible in the regulation of the timing of the erectile process as a function of sexual desire, thereby coordinating erection with sex [4].
In fact a clear negative relationship exists between the presence of the risk factors for metabolic syndrome and levels of circulating testosterone in patients with ED [9]. Previously, a brief (12 items) structured interview called the ANDROTEST has been designed specifically to screen for hypogonadism in patients with sexual dysfunction [11]. As a general rule of thumb, the mean serum total testosterone decreases by 1% per year after the age of 40 years [13]. The indication to start TRT must be based on complete clinical assessment with an evidence of hypoandrogenism.
Men with severe lower urinary tract symptoms, polycythaemia (hematocrit >50%), untreated obstructive sleep apnoea, severe congestive cardiac failure, breast or prostate cancer should not be started on TRT without appropriate assessment and treatment by the respective specialists. Patients should be monitored at 3 months initially, and later at 3 to 6 monthly follow-up for adjustment of TRT and surveillance for any complication. Published literature showed the combination of TRT and PDE5 inhibitors enhances the overall efficacy in men with were previously PDE5 inhibitors unresponsive [19]. Hence, further studies are needed to evaluate the benefits of combination TRT and PDE5 inhibitors.
For this reason, combination therapy using TRT and PDE5 inhibitors should be considered as first line in the majority of cases as it might improve the clinical outcome better than TRT only. Cette hormone est aussi produite par les ovaires et les glandes surrenales de la femme, mais dans des quantites nettement moindres. How can a small piece of flesh take account of days, months and years without a calendar (or more precisely, without the conscious intelligence required to understand a calendar) and do everything with perfect timing? And how do hormones, with the same formula, produce a high voice in women and a low voice in men? But all of these operations happen in the context of a wonderful and flawless plan, at the end of which a boy or a girl is born. As soon as the pituitary gland receives the command, it secretes another hormone called LH. Inside the cell, it unites with an enzyme specially created for it whereby its effects are greatly increased. Even more important, how can it find so quickly (and accurately) the few letters it is looking for from among three billion letters (enough to fill thousands of volumes of an encyclopedia) in the DNA?
Again the same substance, because of the different shape given to it by another cell, causes the widening of the female pelvis bone, the growth of breasts, the raising of the vocal pitch and the preparations necessary to give birth to a child.
The recommended tests for men with ED include fasting glucose, cholesterol, lipids and testosterone level. Some studies showed that higher androgen level potentially play a dominant role in increased frequency of autoeroticism behaviors [5] and propensity for extramarital affairs [6]. The use of TRT in clinically symptomatic hypoandrogenism men treated previously for localized prostate cancer remains controversial [15]. Longer duration of combination TRT and PDE5 inhibitors use appeares to increase the patient response rate to PDE5 inhibitors [20].
La secretion de testosterone debute durant la vie foetale et entre en jeu dans la differentiation sexuelle qui commence au cours du troisieme mois. Two bodies that resembled each other closely, except for the sex organs, take on quite a different appearance after the secretion of the sex hormones in adolescence. This fact is a proof that the hypothalamus has been designed by God in a way to properly affect this timing.
The LH produced activates the testes and orders extra production in order to raise the amount of testosterone. Recent studies have also highlighted the role of testosterone in ejaculatory dysfunction via the effect of testosterone on nitric oxide metabolism in the central and peripheral control of ejaculation that could be accountable in condition such as premature ejaculation [7]. The selection of the TRT preparation should be a joint decision between an informed patient and his physician.
La production de testosterone s'arrete a la naissance pour reprendre a la puberte.Role de la testosteroneLa testosterone est une hormone androgene, soit une hormone responsable des caracteres physiques masculins, tels que le developpement des organes genitaux males, la pilosite ou encore la mue de la voix. Explications.Erections volontaires et involontaires Les erections peuvent etre volontaires (suite a une excitation sexuelle) ou involontaires (comme les erections (…)Comment se deroule une erection? A range of testosterone preparations are available for supplementation, and the combination of testosterone replacement therapy and phosphodiesterase type 5 inhibitors might improve outcomes in some cases. It is important to counsel younger men who wish to father children that exogenous TRT paradoxically results in infertility and this could potentially be irreversible. La testosterone a aussi un role anabolisant, ce qui signifie qu'elle favorise le developpement des muscles et des os. The selection of the testosterone replacement therapy should be a joint decision between an informed patient and his primary care physician, and regular follow-up should be conducted to assess treatment efficacy and surveillance for adverse events. C'est egalement ce qu'on pourrait appeler "l'hormone du desir sexuel".Troubles de l'erection lies a un manque de testosteroneUn deficit en testosterone peut entrainer une baisse de la libido et des troubles de l'erection (impuissance).
Par exemple, certaines formes d'obesite sont susceptibles de causer une diminution du taux de testosterone. Les troubles de l'erection sont parfois dus a des causes (…) Troubles de l'erection de A a Z Comprendre Causes Diagnostic Examens Consequences Traitement Sondage Votre compagne vous envoie un SMS disant qu’elle a loue un film erotique pour la soiree.
En effet, une augmentation importante de la masse graisseuse provoque la transformation d'une partie de la testosterone en oestrogenes. Ces hormones sexuelles peuvent alors engendrer l'apparition de caracteristiques feminines, comme une poussee des seins par exemple.La testosterone baisse avec l'ageEnfin, un deficit en testosterone est souvent lie a l'age. Dans bien des cas, les troubles de l'erection qui en decoulent peuvent etre traites a l'aide de medicaments. Choix Vous cherchez une echappatoire : rendez-vous de derniere minute, heures supplementaires… Vous vous persuadez que, cette fois, cela va marcher.
Mais avant de recourir a un traitement qui augmente la testosterone, mieux vaut proceder a un depistage du cancer de la prostate. Car en presence de ce type de cancer, un tel traitement risquerait de favoriser le developpement des cellules cancereuses. Thierry Roumeguere, chef du service (…)Plus de temoignagesZoom Adenome de la prostate et troubles de l' (…) 2 hommes sur 3 atteints de troubles de l’erection souffrent egalement de symptomes urinaires lies a une (…) Erection: qui peut le plus peut le mieux! La satisfaction sexuelle - des hommes comme des femmes – est notamment liee a la rigidite de l’erection.



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