A vacuum device composed of a plastic cylinder, pump and elastic ring or band can be used to affect an erection. The same goes for alcohol and narcotics, like heroin and cocaine. 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. Impotence can be treated — sometimes even without drugs. More drastically, inflatable or rigid penile implants may be fitted surgically. Ultrasound is then used to see vascular dilation and measure penile blood pressure. In fact, almost 100% of men who use cocaine regularly are impotent. If you suspect this may be the cause, you can perform a simple test to see if impotence is just in your mind. When pharmacological methods fail, a purpose-designed external vacuum pump can be used to attain erection, with a separate compression ring fitted to the penis to maintain it. In this case, the impotence lasts as long as you are taking the drugs.

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Men with secondary impotence are typically able to engage in intercourse only 25% of the time. These studies showed that Tribulus helps treat impotence caused by low testosterone levels or an imbalance in the body's level of sex hormones. Be sure to select a Tribulus extract that contains at least 45% protodioscin.. Impotence caused by psychological factors is often temporary; it lasts as long as the underlying factor is still there.

-Mr.Robinson, Ohio