A physician measures the latency between squeeze and contraction by observing the anal sphincter or by feeling it with a gloved finger inserted past the anus. As can be understood from the mechanisms of a normal erection, impotence may develop due to hormonal deficiency, disorders of the neural system, lack of adequate penile blood supply or psychological problems. Restriction of blood flow can arise from impaired endothelial function due to the usual causes associated with coronary artery disease, but can also be caused by prolonged exposure to bright light. It works as follows: The cylinder is placed on the penis and the pump is then used to draw air out of the cylinder. Stimulation of the penile shaft by the nervous system leads to the secretion of nitric oxide (NO), which causes the relaxation of smooth muscles of corpora cavernosa (the main erectile tissue of penis), and subsequently penile erection. Tribulus had been used as traditional medicine to treat sexual dysfunction and male infertility in Europe and Asia for many decades before improvement in scientific extraction techniques allowed identification of its active ingredient, protodioscin.
The physician squeezes the glans (head) of the penis, which immediately causes the anus to contract if nerve function is normal. In all, these studies proved that Tribulus works very well in curing sexual dysfunctions and maximizing sexual performance when taken regularly. Given the advances in medicine and nutrition research, however, it is no longer a scary thing.
Tests such as the bulbocavernosus reflex test are used to determine if there is sufficient nerve sensation in the penis. This device works quite well, although some men complain about the discomfort of the elastic ring in addition to the hassle of, well, pumping up. It does not work immediately. In fact, almost 100% of men who use cocaine regularly are impotent. It is estimated that about 10% to 20% of impotence cases are the direct result of various psychological factors, such as low self-esteem, depression, and — especially — stress and anxiety (general and performance anxieties). To date, its effects on treating impotence and other sexual dysfunctions have been extensively studied. If the stamp is no longer in place by morning, it means that a nocturnal erection occurred. Some of the most popular herbs available on the market today are Tribulus, yohimbe, ginkgo biloba, and others. Although they are generally safe and free of side effects (unlike chemical drugs), it is important to know that the quality of their extraction and preparation processes varies widely.