Any damage to the testes in the male or ovaries in the female will affect testosterone production. This can be seen in the removal of such organs or damage from chemotherapy for treatment of cancer. cialis 40mg Stress, anxiety, low mood and chronic fatigue are also very common causes of low libido. Assessment and treatment An assessment of libido problems requires investigation of medical, psychological and relationship aspects.

It is important to involve the couple in the assessment. Medical treatment if required may involve use of testosterone supplementation, usually in the form of daily applications or long acting depot injection. There are pharmaceutical guidelines that provide the level of testosterone in men that qualifies for a subsidised authority prescription. There are no approved guidelines for testosterone treatment in women. Counselling for libido problems comes under the domain of relationship counsellors, sex therapists and psychologists. Reproductive and sexual health changes occur as a man gets older.

Cheap cialis with no prescription. Fertility Sperm counts decline with age and the ability of an older man to father a child declines. Hormones Testosterone levels begin to slowly fall from the age of 40 years onwards. The fall is not as dramatic as the drop in oestrogen that occurs in women at the menopause.
Whilst low testosterone may result in a decreased libido, ageing men are at risk of osteoporosis and decreased muscle mass. Ongoing research is aimed at establishing at what level men should be treated with testosterone and at what dose. There is still no general consensus on this issue at this moment in time. Prostate The commonest change with the prostate gland in the ageing man is benign enlargement. This may affect urine flow. A less common change is prostate cancer which may present with the same symptoms as benign prostate disease or no symptoms at all. Regular prostate checks over the age of 50 years is recommended. This may be exacerbated by the presence of medical conditions such as high blood pressure, high cholesterol and diabetes. Can cialis pills be cut in half.
In general, women only have a relatively small amount of the libido hormone testosterone so that sexual interest and behaviour may be significantly influenced by personal wellbeing, relationship dynamics, context of the sexual activity, appropriateness of the sexual behaviour, sexual beliefs and sexual education. Women may be more affected by negative factors such as lack of time, fatigue, anger and resentment and lack of intimacy than men.
Among younger women lack of sex education and experience, shyness and insecurity about their bodies and lack of assertiveness may be major contributors to difficulties. However, each woman and each couple are unique in how contributory factors come together and play out. Inhibited sexual desire has to be evaluated understanding the broad range of normal female sexual desire which at one end may be that the woman is responsive to a male on a few occasions early in the relationship adequate for impregnation. And at the other end is the woman who wants and is initiatory daily. Nature is not particularly interested in recreational sexual activity. Orgasmic difficulties mainly require behavioural sexual techniques and encouragement to overcome inhibitory behaviours. The vast majority of women are capable of reaching orgasm given the opportunity to discover their individual pathway. Vaginismus needs a very empathic history and then supportive behavioural sex therapy. Optimally, the partner should be included in the management and his needs also considered. Buying cialis in peru.
With menopause and age related changes there needs to be a proper medical evaluation of the hormonal and anatomical situation before corrective advice is given. It is unusual for medical difficulties to be present in isolation from psychological and relationship issues. Increasingly we are seeing more and more women being unhappy with not only their bodies but also the look of their genitals.

There has been an exponential increase in labial and vaginal surgery which cannot be justified on medical grounds and in some cases has resulted in very damaging outcomes. If you are unhappy or worried about any aspect of your sexuality or relationship seek help early so that you can get the best possible out of your life. An intimate relationship involves the interaction between two (or more people) engaged with each other in more than just the social sense. Cheap canadian cialis online.
There are many aspects to how a couple relate with each other in the context of their relationship. Examples may be whether the couple are involved in an intimate non-sexual relationship or a sexual relationship or whether the couple are same sex or opposite sex. Relationships are not always easy and often require compromise by both members of the partnership. Desire discrepancy is an example of differing sexual needs within a relationship which usually requires a negotiated compromise solution for the long term contentment of the two individuals. There are many factors, both positive and negative, involved in the attraction between two people so forming a relationship may not be easy or without stress. All relationships benefit from good effective communication and commitment to making the relationship succeed.
All relationships require ongoing maintenance and attention to succeed happily for 50 years. Couples also benefit from time alone. Children may pose extra stress on intimate relationships as time becomes limited, energy is depleted and differences of opinion on parenting techniques arise. Viagra cialis online order.
It is also important for each member to have time out to pursue their own interests, but not to the detriment of the relationship. Over time sexual needs may change in relationships so the importance of ongoing respect, affection and attention to each partner must always be emphasised. There are many self help books available which address the many issues that most couples may face at one time or another. Sometimes the problems prove too difficult to manage without outside help. Relationship or couples counselling may then be an appropriateThe intention of this information is for educational purpose only and not to be used as a guide for self-management. Mindfulness exercises are a special type of relaxation technique that helps you stay in the present moment, rather than dwelling on the past or worrying about the future. Worries about everyday issues and stresses can inhibit sexual enjoyment. By helping you stay in the present moment mindfulness has a positive impact on stress and anxiety in everyday life as well as in sexual situations. Mindfulness exercises involve relaxation and breathing awareness that should be practised daily.
For those who practice yoga or meditation will be familiar with the mindful breathing process where the focus is on awareness of body sensations. It is easy to become distracted during the mindfulness exercises and this is dealt with by acknowledging the distraction and returning to the exercise. During mindfulness sexual practice, the distraction is often negative thoughts about fears about sexual performance (erection and ejaculation issues). When this happens bring your attention back to the nice sensations you are feeling rather than what you cannot achieve. Pleasure is absolutely possible without an erection or orgasm, these are not compulsory for sexual enjoyment. Specific sexual mindfulness exercises can be done with a partner or by oneself. It is commenced with the mindfulness breathing exercises which clears the mind and helps reduce distraction and straying thoughts. Physical stimulation involves experiencing pleasurable sensations through the entire body and not just the genitals.