How to overcome Erectile Dysfunction And Premature Ejaculation

Last Longer and Perform Stronger Today! Sex is a basic human need central to a balanced and fulfilling life.

Important Message:

Erectile Dysfunction and Premature Ejaculation are medical conditions that require proper medical assessment and intervention. No single pill or herbal product can substitute for a medical consultation by an experienced physician. Treatment should be personalized to suit the individual’s needs and expectations. We hope you will find the following information useful and find an opportunity to once again re-discover sex in a safe and healthy manner. Human Sexuality With respect to a man’s psyche, sexuality is intimately related to his ability to perform which, when compromised may pose a fundamental threat to his well being. The effect can range from a feeling of inadequacy, frustration, denial, lack of motivation to low self-esteem, depression and even aggressiveness. Consequently, personal, family and business relationships may be adversely affected.

Boston Medical Group specializes in the diagnosis and treatment of two common sexual ailments, namely Erectile Dysfunction (or ED) and Premature Ejaculation (or PE)

Erectile Dysfunction is Sexuality reflects defined as the inability who we are and to achieve or maintain an erection sufficient how we relate to for satisfactory sexual the world and intercourse. This condition is therefore, an affects one in two adult integral part of males to various degrees. Even though effective our physical and treatments for ED had psychological well been available for at least a being. decade before Viagra® was released in March 1988, it had been difficult for the afflicted individual to know where to go to seek help. The massive advertising campaign and successful launch of this drug has changed that to a certain extent. Talking about sexual dysfunction and seeking help became less taboo. However, the topic remains a sensitive area for most men.

The advent of Viagra® and later on, Levitra® and Cialis® has helped many men restore their sex life. For many others, the high hope in the “miracle pill” has quickly deflated in light of certain side-effects and lack of efficacy. For these men, to re-confront these problems becomes more challenging than the first time.

These drugs are not for everybody and are not without risks. It is estimated that between 30-70 % of men do not respond to these drugs, depending on their age and underlying health problems and at least 15% suffer from undesirable side-effects.

Additionally, a possible link between these pills and sudden blindness was made public in May 2005. Despite the drug maker’s position that there is no direct evidence to support causality, the FDA has enforced new labeling to warn men of possible blindness arising from the use of these drugs. According to the Associated Press, as printed in the Washington Post July 9, 2005:

“Viagra® and two other popular impotence drugs may cause sudden blindness in rare cases, the Food and Drug Administration said in a formal alert Friday”

Although the statement said it remained unclear whether the drugs are actually causing the sudden blindness, it warned that men most prone to the ocular condition to discuss the newly identified risk with their doctors. The condition, called non-ar- teritic anterior ischemic optic neuropathy, or NAION, is caused by a blockage of blood to the optic nerve.

“Risk factors for developing NAION include diabetes and heart disease, two of the leading causes of impotence.

In addition, the agency identified other risk factors including being older than 50, smoking, high blood pressure, and high cholesterol.”

Note that these named risk factors are the same risk factors for ED!

According to Medscape Medical News Oct 19, 2007:

Sudden loss of hearing has been reported in patients taking phosphodiesterase-5 inhibitors (Viagra®, Levitra® and Cialis®), the US FDA warned healthcare professionals. In some cases, the sudden loss or decrease in hearing was accompanied by vestibular symptoms such as tinnitus, vertigo, and dizziness, according to an alert sent from MedWatch, the FDA’s safety information and adverse event reporting program. Hearing loss was temporary in about 33% of patients; for the remainder, hearing loss was either ongoing at the time of report or the final outcome not described. In almost all cases, the condition was one-sided.

According to WebMD Medical News Oct 19, 2007:

Viagra, Levitra, and Cialis haven’t been proven to cause hearing loss, but the alert was warranted due to “the strong relationship between the use of these drugs and sudden hearing loss in these cases,” states the FDA.

If you have tried Viagra®, Levitra® or Cialis® unsuccessfully or, if you cannot take these pills due to health problems or side-effects, or if you want to improve your sex life safely and effectively, Boston Medical Group has the answer. Our highly experienced doctors can offer you a personalized treatment that works in an overwhelming majority of cases even when other treatments have failed.

Premature Ejaculation (PE) or “coming too quick” is yet another sensitive and embarrassing condition affecting at least one in three sexually active men. Effective treatment is readily available. So, if you are not satisfied with your current performance or if your partner wishes you to last longer, Boston Medical Group can also help. Erectile Dysfunction Signs of Erectile Dysfunction:

• Difficulty achieving or maintaining an erection occurs at least once in every four times of attempting sexual intercourse, or the problem persists for more than one month. • Achieving an erection takes longer than usual or becomes more difficult in certain positions. • Sexual erection becomes weaker or less rigid. • Maintaining an erection becomes a conscious effort or becomes more difficult. • Morning erections becomes less frequent or less rigid. • Climaxing becomes more rapid or occurs with an incomplete erection. How Common Is Erectile Dysfunction?

Erectile Dysfunction is very common. And it happens to the best of us! Although it tends to be more common in men over 40 years of age, it can affect men of all ages.

In mid 1992, the results of the world’s largest Erectile Dysfunction study called The Massachusetts Male Aging Study (MMAS) became available. These results showed that:

• 52% of all men between the ages of 40 and 70 have some degree of erectile dysfunction. (Classified as minimal, moderate or severe.) • At least 1 in 10 men cannot get an erection at all (complete ED). • The majority of causes of erectile dysfunction are physical in nature. • There is a strong association between age and ED such that the prevalence of ED increases with age – 39% at 40 and 67% at 70 are affected.

100 90 80 70 60 50 LENCE OF

VA 40 IMPOTENCE

PRE 30 20 10 0 40 45 50 55 60 65 70 AGE (years)

MINIMAL IMPOTENCE MODERATE IMPOTENCE COMPLETE IMPOTENCE OVERALL IMPOTENCE “Erectile Dysfunction is more common than diabetes, hypertension and heart conditions combined. With safe and effective treatment available, we can help men quickly restore their erectile function and sexual relationship”

Barry Buffman, M.D. Urology

What Causes Erectile Dysfunction?

Psychological Erectile Dysfunction

Contrary to popular belief, psychological factors account for only about 10% of all cases of Erectile Dysfunction (ED). The psychological factors are mostly the result of nervousness, lack of confidence or performance anxiety.

These conditions cause an increased sympathetic tone and raised circulating catecholamine concentration. Which in turn, causes the blood vessels to constrict (vaso- constriction) resulting in a temporary reduction of blood flow to the penis, hence erectile difficulties.

Psychological ED can be self-perpetuating: each failure increases the associated anxiety levels and can frequently lead to a continual failure.

Other psychological causes include stress, guilt, sexual boredom, depression etc.

Physical or Organic Erectile Dysfunction

It is now known that 90 % of cases of ED are caused or contributed by physical factors, most of which are related to poor circulation, a condition referred to as “vascular insufficiency”.

The penis requires a very healthy blood flow to be completely erect. Even a marginally impaired blood flow can cause significant problems.

Risk factors include: • Diabetes • Hypertension • High blood cholesterol • Cardiac diseases • Smoking • Arterial sclerosis (age-related thickening and hardening of the arteries) • Poor overall circulation • Certain types of medication “The risk factors for most cases of Erectile Dysfunction, namely being older than 50 years of age, diabetes, hypertension, high blood cholesterol, cardiac disease and smoking are also the same risk factors for developing sudden blindness in association with (though not conclusively proven) the use of Viagra®, Levitra® and Cialis®, according to the FDA’s alert”. William Livingston, M.D. Urology

The effect of aging: With age, the artery becomes hardened and thickened and loses some of its elasticity. Other vascular risk factors, such as diabetes, cholesterol, hypertension, smoking etc. can aggravate the effect on aging on the artery, making it even more difficult to dilate in response to sexual stimulation.

Other physical causes are not common but can be readily diagnosed. These include: • Hormonal deficiencies caused by testicular disease, liver disease or thyroid problems. • Neurological problems such as Multiple Sclerosis, stroke, Parkinson’s Disease etc. • Trauma to pelvic area as experienced in certain types of surgery, radiation therapy or automobile accidents that results in damage to the pelvic nerves or arteries.

ED can affect completely healthy individuals as well. “We aim to provide both an immediate resolution to the problem and the possibility of long term improvement. The best treatment is a balanced decision between risks and benefits taking into account the short term gain and future prognosis”. Alan Sperber, M.D. Urology

Should Erectile Dysfunction Be Treated?

Yes! Like any medical problem, erectile dysfunction should be treated promptly. The sooner it is diagnosed and treated, the better the outcome, for the following reasons:

First, the underlying problem needs to be identified and corrected to prevent further damage.

Second, lack of treatment would result in progressive loss of normal healthy tissue and progressive loss of erectile function. A mild problem can become severe and irreversible. This condition is called “disuse atrophy” and should be avoided.

Third, erectile dysfunction is more than just a sexual problem. A fulfilling sex life is reflected in one’s social, family, and work environments.

In addition, good sex means good health.

Recent studies indicate that couples with a healthy sex life are affected less by problems such as depression, anxiety, hypertension, diabetes, ulcers, chronic fatigue, virus illness and other ailments. They also have a greater life expectancy!

“I’ve helped thousands of men restore their self-esteem and their sexual confidence. As their personal relationship improves, so does their outlook in life” Nathaniel Horn, M.D. Cardiology “Premature Ejaculation is very common. Recent studies show that at least one in three sexually active men is affected by this problem…”

John Hayes, M.D.

Premature Ejaculation

Premature Ejaculation (or PE) is medically defined as the persistent and recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration; and before the person wishes it to occur. In common terms, it can be defined as: • The inability to control your ejaculation. • Ejaculating before you are ready to, or, have satisfied your partner. • Ejaculating before or within several minutes of penetration. There are two types of PE: primary and secondary. The latter is associated with Erectile Dysfunction (ED) and treating ED would help resolve PE. The following information concerns primary PE.

How Common is PE?

Primary PE is very common. Recent studies show one (1) in three (3) sexually active men is affected by this problem. The psychological and social impacts can be profound. It would be conceivable to say PE is a very common medical condition. Yet, it is under-recognized, under-treated, and has caused tremendous psychological hardship and relationship disharmony.

What Causes PE?

There are essentially three aspects - physical, psychological and habitual - which together are responsible for causing and perpetuating this problem. Physical Aspect or Oversensitivity

The head of the penis (called the glans penis) is the most sensitive part of the penis. The penile sensory perception is supplied by a pair of cavernosal nerves, which when stimulated will transmit the signals back to the spinal cord and the higher center of the brain. A signal is then sent out to eventually cause a chain reaction culminating in an ejaculation. It is now recognized that men who have recurrent and persistent PE have a lower perception threshold than those who do not. The condition is diagnosed by measuring the lowest recordable vibratory threshold using an instrument called a biothesiometer. The lower the threshold, the easier it is to provoke an ejaculatory response, even with a minimal amount of sexual stimulation. This physical aspect of PE, on its own does not imply a deficiency or weakness; it’s just the way you are “wired”, so to speak.

Psychological Aspect or Anxiety-induced Response

Once Premature Ejaculation happens more often than it should, men would naturally feel embarrassed, overly concerned and pre-occupied with the idea of it happening again. In response to such a psychological stress, the sympathetic nervous system is activated to “deal” with the situation. Such activation in turn, causes an involuntary relaxation of the very “muscle” that controls ejaculation, called the external urethral sphincter. In other words, performance anxiety or nervousness will activate the sympathetic nervous system and predispose men to having uncontrolled ejaculation.

The harder you try to stop ejaculating, an anxiety on its own, the more rapidly ejaculation seems to occur!

Habitual Aspect

After having ejaculated with minimal stimulation, men will learn to repeat this experience as a “learned” response with the next sexual stimulation. A “habit” is formed, which becomes reinforced over the years, which is difficult or impossible to break out of without help.

It is important to recognize that all three aspects, individually or jointly are responsible for causing PE. Fixing one aspect does not fix the problem. Is PE a Serious Problem? The answer is no. It is not a serious medical problem. Boston Medical Group doctors however, would treat it seriously for the following reasons: (a) Even though some lovemaking sessions may last a little longer than others, PE will not just go away without intervention. (b) PE is difficult or impossible to resolve on its own. (c) PE inhibits full sexual enjoyment, potentially creates disharmony, is potentially embarrassing and imposes a strain on the relationship. (d) Definitive help is readily available that could make the difference, potentially improving a man’s psychological well-being and his immediate social interactions.’

How Does PE Affect Your Sex Life?

Having Premature Ejaculation makes it difficult for you to fully enjoy your sex life. Instead of relaxing and enjoying the pleasures of love making, you can become pre-occupied with ejaculating too rapidly. As a result, there may be a tendency to avoid lovemaking and other forms of intimacy. This problem may even affect your confidence in everyday life or impair your ability to socialize.

How Does PE Affect Your Partner?

It would be difficult for your partner to enjoy love making when it’s “all over” too quickly. Even though there are other ways to satisfy your partner, most couples prefer to climax as close to simultaneously as possible. They can then relax and together enjoy the “after glow”. Premature Ejaculation can therefore interfere with a healthy sex life. Lack of sexual satisfaction can lead to sexual avoidance and is often a cause of relationship disharmony.

Should PE Be Treated?

If PE is affecting your sex life or if you would like to achieve greater sexual satisfaction, the answer is yes. The best reason of all however, is that PE can be overcome. The ability to achieve good ejaculatory control will enable you to last longer, have greater sexual fulfillment and thus, improve the quality of your relationship.

“…..Our success rate is unparalleled. Safe and effective treatment is now a common experience at Boston Medical Group…” Gregory McGinley, D.O. Cardiology Internal Medicine “….One of the biggest obstacles in the treatment of ED and premature ejaculation is not the lack of effective treatment, but the procrastination caused by either lack of information or resources. I always urge my patients to seek treatment with urgency to avoid further deterioration…” Marianne Labarbera, M.D. Medical Director BMG Treatment Philosophy Before a specific treatment option can be offered, the underlying cause must be properly diagnosed. Successful treatment is more than just popping a pill.

With 20 years of worldwide experience, with advanced understanding and specialized skills, our physicians will find you a personalized treatment that aims at your specific condition and specific need to provide you not only the immediate erectile response that you are seeking, but also a possibility of long term improvement.

Treatment for ED

Many of the treatments we recommend aim at improving the penile health by increasing the blood flow to the penis, revitalizing the penile tissue, increasing the penile elasticity and consequently improving the erectile function. Many patients find that after using their personalized treatment for the recommended time, they may no longer need it or need it less often. The extent of improvement can vary depending on age, the severity and duration of dysfunction, the presence of concurrent illnesses and other health risk factors.

When considering ED treatment, one needs to be mindful of the long term effect of lack of treatment: progressive loss of normal healthy tissue, hence progressive loss of erectile function. So it is important to treat ED with urgency regardless of how severe the condition may present or what the future outlook may hold. Long term improvement might be complete or partial but either is worth the effort. How about Viagra®, Levitra® and Cialis®?

With the exception of specific differences, these pills have more or less the same clinical efficacy. They work wonders in a percentage of men with ED, apparently causing no significant side-effects. However, most patients who seek help at Boston Medical Group have tried one or all of these pills unsuccessfully or experienced unpleasant side-effects. These drugs are not for everybody and are not without risks. It is estimated that between 30-70 % of men do not respond to these drugs, depending on their age and underlying health problems. Many cannot take these drugs due to contraindications, and at least 15% suffer from undesirable side-effects.

In addition to reports of major cardiac events, the FDA has recently issued two alerts on its website regarding the following significant concerns:

• Development of sudden vision loss in one or both eyes (May 2005)

• Development of sudden hearing loss in one or both ears. (Oct 2007)

The side-effects appear to develop within a short time of taking these drugs. Even though it is not yet possible to conclusively prove causality, the FDA has required the drug makers to change their label to include these alleged side-effects!

Treatment for PE

Regarding PE, it is known that even though Viagra® is not indicated for the treatment of PE, it may shorten the refractory period and allow men to resume sexual activity sooner. It has no impact on the ejaculation time. Our patients find that such assistance is of limited benefit compared to what they can achieve at Boston Medical Group.

Our treatment philosophy is geared towards addressing the three underlying causes mentioned above. Treatment aims to enable you to have the ability to last significantly longer, even after ejaculation. You can immediately satisfy your partner and with time learn to relax and switch off the performance anxiety. With prolonged sexual encounter, you will also learn to get used to the sensation of a longer lasting sexual experience and gradually become less sensitive. Like any learned behavior, when the new habit is formed, your body will learn to react to sexual stimulation in a controlled and reliable fashion as the rule rather than the exception. “…I have helped men restore their sexual health and improve personal relationship by apply- ing BMG treatment method….. so remarkable that a simple solution can literally transform a person’s life” John Fina, M.D. Internal Medicine

About Boston Medical Group

Boston Medical Group is a global alliance of medical clinics sharing research information, treatment methods and the common goal of finding individually tailored solutions to the problems of Erectile Dysfunction and Premature Ejaculation.

Boston Medical Group operates in North America including the United States and Mexico, Europe, Latin America and the Middle East.

You Should Expect the Following When Visiting Our Clinic:

Total Privacy Each Boston Medical Group clinic features separate waiting rooms to ensure your privacy. Consultations are by appointment only and can be scheduled by calling our toll free number.

Highly Experienced Physicians. Boston Medical Group’s physicians are qualified medical practitioners who devote their career specifically to the field of Erectile Dysfunction and premature ejaculation. You can rest assured that you will be attended to by one of the most dedicated, experienced and skilled physicians available today.

On-site diagnostic facilities and treatments. All the testing and treatments are conducted directly in the clinics and by the treating physicians. Personalized Treatment The personalized treatment offered can be used safely and successfully by almost all patients with ED or PE.

We have treated patients from the age of 18 to the age of 96! Patients with diabetes, high blood pressure, high cholesterol, cardiac problems, those who smoke or those who are on nitrates and other vasodilators who have been cautioned against the use of the more popular drugs such as Viagra® can also receive great benefits from our treatments.

An Immediate and Long Term Solution to Your Problem. Regardless of whether your problem is Erectile Dysfunction or Premature Ejaculation, our physicians can provide you with a treatment that focuses on both short-term and long- term results.

For men with ED, we aim to significantly improve your erectile function by improving the circulation and penile elasticity.

For men with PE, our methodology allows you to immediately last longer in order to satisfy your partner and, in time, gain control over the urge to ejaculate so that ejaculatory control can be established.

A Free Phone Counseling Service.

Our all-male phone counseling service is available seven days a week to answer any questions that you may have regarding Boston Medical Group and to give you essential information about Erectile Dysfunction and Premature Ejaculation. You can also make appointments, in the strictest of confidentiality through this service. Please see our list of toll-free numbers world-wide on the back of this brochure. Contact our physicians today for more information or to schedule a confidential appointment.

USA 1-800-337-7555 Los Angeles • Costa Mesa • San Francisco • San Diego Seattle • Dallas • Houston • Chicago • Detroit • New York Philadelphia • Pittsburgh • Atlanta • Washington, D.C. Tyson’s Corner • Orlando • Tampa • Ft. Lauderdale Miami • Phoenix • Denver

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