Ultimate Erection Guide

Deleted member 9787

Deleted member 9787

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That’s tough
 
copeistani

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DesperadoRatado said:
mf does surface web research and people call him high iq

jfl
Do I smell....cope? Ego hurt?​
 
Arvenas

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DesperadoRatado said:
so u confirm that all u do is copy and paste surface web common knowledge and then just Bold, big font and add pics?

yeah "high iq" :soy::bluepill:

seems like u are farming for reps other than really helping anyone. u are a poor mans Golden Glass @Golden Glass
It has always been like this with both .net and .me so why complain now. Very few people who posted here had some actual lower level understanding of stuff, but copy pasted or not, something is always better than nothing and he obv put effort into the thread and ironically he probably understands and knows more than the majority of "doctors" who don't even realise low test is an issue.lol.
 
Soalian

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Arvenas said:
It has always been like this with both .net and .me so why complain now. Very few people who posted here had some actual lower level understanding of stuff, but copy pasted or not, something is always better than nothing and he obv put effort into the thread and ironically he probably understands and knows more than the majority of "doctors" who don't even realise low test is an issue.lol.
Just put info you deem valuable, into the hands of the lazy users. That's it. They won't go out fishing for it by themselves.
 
Beetlejuice

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Deleted member 3635

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tincelw said:
Long thread warning.

ED is one of the most brutal and misunderstood things. In most cases doctors will perscribe viagra which is nitric oxide boosting. While this is enough to cause erections in most people it doesnt fix the underlying cause, it just promotes so much blood flow that you can get it up despite that. In this guide we will learn how to correct all underlying problems + use enhancements to get the hardest erection possible.

The basics
The first step is to get the smooth muscle to relax, the second is to get blood into the penis and the third is to pinch the outflow vein closed so that the blood remains in the penis. And lastly, sexual activity triggers the bulbocavernosus reflex, causing the ischiocavernous muscles to forcefully compress the base of the perfused corpora cavernosa, resulting in further, or full, rigidity.

what causes this to occur?
Erection upon touch or stimulation is under the control of the peripheral nerves and the lower parts of the spinal cord, and the psychogenic erection is achieved by visual or mental stimuli (fantasies, etc), and uses the limbic system of the brain.

before we get into fixing response to touch or simulation we need to fix the limbic system, to make sure you actually get aroused. The way to do this is super simple so we get it out of the way first.

QUIT PORN:
View attachment 1056850
there are clear differences in brain activity between patients who have compulsive sexual behavior and controls, which mirror those of drug addicts. When exposed to sexual images, hypersexual subjects have shown differences between liking (in line with controls) and wanting (sexual desire), which was greater [8,100]. In other words, in these subjects there is more desire only for the specific sexual cue, but not generalized sexual desire. This points us to the sexual cue itself being then perceived as a reward [46]. (2)

Another one says (as im sure we all can relate too)
In a finding that may indicate escalation of pornography use, 49% described sometimes “searching for sexual content or being involved in OSAs that were not previously interesting to them or that they considered disgusting”

Basically, People with porn addiction have less sexual desire in general, but more desire for a specific sexual cue. And that cue is something which they actually find gross and would never do in real life.

review of the literature finds a number of studies that have correlated pornography use with arousal, attraction, and sexual performance problems [27,31,35,36,37,38,39,40,41,42,43], including difficulty orgasming, diminished libido or erectile function [27,30,31,35,43,44], negative effects on partnered sex [37], decreased enjoyment of sexual intimacy [37,41,45], less sexual and relationship satisfaction [38,39,40,43,44,45,46,47],a preference for using Internet pornography to achieve and maintain arousal over having sex with a partner [42], and greater brain activation in response to pornography in those reporting less desire for sex with partners [48].

More evidence

- Survey of 434 men reported that lower overall sexual satisfaction and lower erectile function were associated with problematic Internet pornography use [44].
- problematic online sexual behavior (defined as compulsive, persistent, uncontrolled use of pornographic content) was a significant predictor of a low level of erection [49].
- Neurobiological research indicates that the potentially negative effect of long-term pornography use on sexual desire may result from changes in the responsiveness of the reward system to sexual stimuli, preferentially more active as a result of stimuli associated with pornography than with real sexual intercourse [60,61]

In one case of severe Porn addiction and ED, Eight months after stopping all exposure to pornography the patient reported experiencing successful orgasm and ejaculation, and succeeded in enjoying good sexual relations [34].

Improve this by stopping porn completely

Sympathetic nervous system​

The sympathetic nervous system promotes the secretion of noradrenaline and adrenaline which inhibit erectile function (R). It promotes contraction of the smooth muscle and vasoconstriction.

Noradrenaline and adrenaline bind to the adrenergic receptors, of which there are 5, namely α1-, α2-, β1-, β2- and β3-adrenergic receptors.

α1 activation induces vasoconstriction and antagonizing it promotes relaxation and erection. Antagonism of α1‐adrenoceptors is a frequent cause of priapism (prolonged erections). Phentolamine is an α1-adrenergic receptor inhibitor that helps to prevent vasoconstriction to maintain an erection.

α2 activation lowers noradrenaline levels, but it is also anti-erection. Inhibiting it, with yohimbine (R) for example, promotes penile smooth muscle relaxation and promotes blood flow. This can increase the ease with which you can be an erection, but will not facilitate one by itself.

Symptoms of too much noradrenaline include:
  • short flaccid hang
  • finding it hard to get him up
  • struggling to keep him up
  • great morning wood but great sexual anxiety
  • likely excellent response to phosphodiesterase type 5 inhibitors or other NO precursors (R)
Copper is a cofactor necessary for the conversion of dopamine to noradrenaline. Too much copper and you can end up with an excess of noradrenaline. This is why zinc can help so much with sexual anxiety and erection because it lowers copper and noradrenaline.

Stress is one of the biggest contributors to elevated noradrenaline, so be sure to manage your stress to lower excess noradrenaline.

Improve this with: ZINC and Lower stress

Parasympathetic nervous system​

The parasympathetic nervous system is the opposite of the sympathetic nervous system. Acetylcholine is the main parasympathetic neurotransmitter.

Acetylcholine produces concentration-dependent relaxation of erectile tissues that has been precontracted with norepinephrine. Acetylcholine counteracts the effect of noradrenaline and may also suppress the release of norepinephrine (R).

Improve this with: Vitamin B1 and EGGS (choline)

Hormones and Neurotransmitters

Serotonin can inhibit erections by:
  • inhibiting nitric oxide synthesis (R)
  • lowering dopamine release
  • increasing prolactin
  • increasing renin (which promotes vasoconstriction and inflammation)
  • stimulating the adrenal axis (CRH, ACTH and cortisol) through activation of the 5-HT2A receptor (R, R).
Improve this with: Blocking the 5-HT3 seratonin receptor with Ginger, and 5-HT4 receptor with Lysine

Opioids​

also inhibit erection. cut out wheat, milk, and take coffee which contains natural anti-opioid compounds (which is not the caffeine) as well as phosphodiesterase-5 inhibitory properties, so coffee can have pro-erection effects

Histamine​

Histamine is another excitatory neurotransmitter and can promote vasodilation and smooth muscle relaxation in the penis independent of nitric oxide (R). The effect is mostly due to the H2 activation and H1 receptors antagonism (R). H2 antagonists such as cimetidine are known to cause impotence in men.

Injecting histamine can promote full erections in some people and partials in most (R). Too much copper in the body can contribute to low histamine, so lowering copper in the body with zinc, vitamin C and molybdenum can lower copper and increase histamine. Niacin and niacinamide can also help increase histamine by inhibiting its breakdown through methylation.

Kutaja bark extract (Holarrhena antidysenterica), an H3 antagonist, is also able to increase histamine and dopamine and might be effective for promoting erection.

Dopamine​

Dopamine is a major modulator of sexual function and is the primary prolactin antagonist. Prolactin lowers testosterone levels, inhibits DHT formation and reduces libido and erections. Prolactin, similar to serotonin, is also able to modulate dopaminergic function in specific brain regions and inhibit dopamine control in the hypothalamus (R). More on prolactin in part 2.

Dopamine is thought to regulate erection by acting on oxytocin containing neurons in the paraventricular nucleus of the hypothalamus, where prolactin has an inhibitory effect (R).

Dopamine can even induce an erection in the presence of a NOS inhibitor (R).

improve this with: lisuride, metergoline, amantadine and selegiline (careful these might have side effects)

Testosterone​

Testosterone improves libido and erections by:
  • inhibiting the ROCK pathway
  • promoting the commitment of pluripotent stem cells into muscle lineage and inhibit their differentiation into adipogenic lineage.
  • upregulating nitric oxide synthase (NOS) isoform expression and activity
  • downregulating PDE5 expression and activity
  • reducing the α-adrenoceptor expression and function
  • regulation of smooth muscle cell growth and response to vasodilators
  • reducing collagen formation and reversing fibrosis, thus restoring proper smooth muscle function
  • maintaining neural structure and function (R).
In a randomized, placebo‐controlled study with 20 men with ED who failed sildenafil treatment (100‐mg dose) on six consecutive attempts, had free testosterone in the lower quartile of the lower range. One month after treatment with transdermal testosterone and sildenafil on demand, there was a significant improvement in ED (R). - Viagra might not even help you if your testosterone is too low

Estrogen​

super complicated. Just keep this in the middle of the range, not too high but not too low.

Prolactin​

Prolactin is a hormone released from the pituitary gland which has erectile and sexual inhibitory properties.

Prolactin is able to block steroidogenesis, inhibit the conversion of testosterone to DHT, lower dopamine and block its actions, causing ED (R, R, R, R, R, R). If you’re feeling icky and not in the mood, it’s most likely prolactin.

But prolactin is rarely increased all by itself. It usually goes hand in hand with stress, low dopamine, elevated serotonin, estrogen and parathyroid hormone.

Parathyroid hormone​

This is an important hormone and it’s often overlooked.

Parathyroid hormone (PTH) is a hormone secreted by the parathyroid gland that regulates the serum calcium through its effects on bone, kidney, and intestine. It increases calcium absorption in the gut by converting vitamin D into its active form and it also mobilizes calcium from the bone.

You can probably see where this is going if PTH remains elevated for too long?

Excess PTH is inflammatory and can contribute to osteoporosis and vascular calcification. The inflammation produced by excess PTH usually manifests as autoimmune conditions either in the joints or on the skin, such as psoriasis, eczema, arthritis, osteoporosis, etc.

Improve this with: Zinc, magnesium, vitamin K2, selenium, iodine and some of the B-vitamins are also effective. Limit consumption of Grains, nuts, legumes, beans and red meat are significant sources of phosphorus. Calcium helps to balance the phosphorus. Leafy greens are good sources of calcium, and so are eggshell calcium, oyster shell calcium and milk.

Aldosterone​

Aldosterone is part of the renin-angiotensin-aldosterone system. Renin promotes the conversion of angiotensinogen to angiotensin I. Angiotensin I is then converted to angiotensin II by the enzyme ACE1 (angiotensin-converting enzyme). Angiotensin II is pro-inflammatory and promotes the release of aldosterone. Angiotensin II is then broken down by ACE2, into the anti-inflammatory and vasodilatory angiotensin 1-7.

Vitamin A (A) and D (A) increase ACE2, thus lowering inflammatory angiotensin II and increasing anti-inflammatory angiotensin 1-7.

Aldosterone is greatly involved in erectile dysfunction. It promotes vasoconstriction, oxidative stress, inflammation and inhibits nitric oxide synthesis, which contributes to vascular injury and ED (R, R, R).

Cortisol is a more potent aldosterone receptor agonist than aldosterone itself and progesterone can block both.

A low salt diet increases aldosterone in order to retain the little sodium that you ingest. Losartan is a good drug used to lower angiotensin II production and subsequent aldosterone release. Losartan can help to reduce vasoconstriction and inflammation in the penis.

Aldosterone is also elevated during stress. Low testosterone (due to stress) together with elevated estrogen, aldosterone and inflammation, promotes penile fibrosis. Staying in an unhealthy state long term could have permanent side effects.

Improve this with: Lowering stress (lifestyle or supplements)

Thyroid​

Your hormones, such as testosterone and DHT is proportional to your thyroid hormones. When thyroid hormones drop, so does your testosterone and DHT. When thyroid hormones go up…you get the idea.

Thyroid hormones, especially T3, increase testosterone and to a greater extent DHT. If libido is low and you have weak erections, look to PTH and thyroid levels. But don’t just check for TSH alone, check for total and free T4 and T3 and reverse T3 as well.

Both hypo and hyperthyroid lead to a higher chance of ED (R, R, R, R). Most people have hypothyroid, so don’t worry about the hyper part. Having your thyroid hormones in the right place will help you get the best boners for your buck.

Supplements: Thyroid hormone or iodine

IGF-1​

IGF-1 (insulin-like growth factor type 1) isn’t just something that’s needed to build big muscles.

Research shows that IGF-1 is reduced in men with ED (R).

IGF-1 plays a crucial role in the regeneration of nitric oxide synthase (NOS) containing nerve fibers and enhances the recovery of erectile function after nerve destruction (R). In other words, IGF-1 can rescue nitric oxide levels by regenerating damaged nerves in the penis.

IGF-1 also increases eNOS expression, NOS activity and cGMP concentrations, indicating increased cGMP production and/or reduced PDE5 (R).

Improve this with: MK677


Nitric Oxide
NO is created by nitric oxide synthase (NOS), of which there are three types, namely, endothelial NOS (eNOS), neuronal NOS (nNOS) and inducible NOS (iNOS).

All three can promote vasodilation and erection. iNOS is different from the other two, in that it can be induced. Once induced, iNOS can create a 1000 times more NO that the other 2 enzymes.

Research shows that oxidative stress and inflammation are elevated in people with ED. Look to markers such as homocysteine and hsCRP, both of which are usually elevated in ED (R).

Physical symptoms, such as psoriasis, IBS, eczema, arthritis, etc., are also present together with ED (R).

Improve this with Anti-oxidants, such as vitamin E, selenium, zinc, manganese, glycine, taurine, aspirin, etc.

Some other causes for ED

Iron & copper excess creates ROS​

Iron and copper are reactive metals that can react with a free radical, namely hydrogen peroxide (H2O2), in the process called the Fenton reaction. The reaction creates the hydroxyl radical (•OH) which can damage critical cell membranes in and around the penis leading to ED (R).

Polyunsaturated fats​

Polyunsaturated fats (PUFAs) are another danger to the body. The many double bonds in its structure are highly sensitive to ROS and can easily be oxidized. The more unsaturated the fat, the easier it gets damaged. Fish oils, being the most unsaturated, can be the most harmful if consumed in large amounts due to being the most unstable.

Apart from being easily oxidized, PUFAs can also be used by the cyclooxygenase 1 and 2 (COX1 and 2) enzymes, which creates vasoconstrictive prostaglandin F2-alpha (PGF2α), PGI2 and thromboxane A2 (R).

Improve this with Aspirin, which is a very potent COX inhibitor has been tested for ED, and PUFA depletion
I could go on but the basic idea is that oxidative stress and inflammation are seriously bad

TLDR
Healthy Brain
Neurotransmitters
Hormones
Oxidative and Inflammation

Before you go take any supplements or ED drugs fix this. It will drastically improve your life and erections. I suggest to take a blood test and see if everything is in order. Live a healthy lifestyle and minimize stress, change your diet to reduce inflammation. Read this post and see which areas you feel are lacking and improve those.


Supplements (COPEISH LIST)

1) Yohimbine​



It antagonizes alpha-2 adrenergic receptors, which then stimulates the release of dopamine and noradrenaline, causing an increase in sexual arousal and partially antagonize norepinephrine-induced contraction of corporeal cavernosal smooth muscle in the penis (R).

Although it can be a hit or miss with this supplement as there’s about a 50/50 chance of being a responder or not (R). People either experience an improvement in cognition, libido and erection, or get crushing anxiety, cold extremities. The other downside is that you can get all the negatives, but still get an erection or you can get all the positives without the erection.

According to this study, combining 6g arginine with 6mg yohimbine seems to be relatively effective at improving ED in patients with mild to moderate ED (R). I think 6mg is a little high and one can rather start at around 2.5mg to gauge your response.


2) Tribulus​

calms the adrenals, lowers prolactin and estrogen and increases dopamine, DHEA, testosterone (in men with low T) and DHT. It’s also effective at improving ED (R, R).

Just be sure to get a good brand with at least more than 120mg protodioscin per serving, as it’s the protodioscin that’s thought to have the aphrodisiac properties.

3) Tongkat Ali​

Tongkat Ali (TA) can significantly increase free testosterone, inhibit aromatase, act as an adaptogen, and boost cellular function to increase ATP production.

TA has been found to improve erections by inhibiting PDE-5 (and increase NO), arginase (which leaves more arginine for eNOS), and ACE (thus lowering inflammatory angiotensin II) in a concentration-dependent manner (R).

Tongkat Ali can also improve male sexual performance by increasing the conversion of pregnenolone to progesterone, cortisol, 5-dehydroepiandrosterone (DHEA), and testosterone in corpus cavernosum tissues.


4) Horny goat weed​

This one is seen in nearly every single ED supplement out there. It’s been shown to increase NO, by increase expression of eNOS, re-couple eNOS and lower oxidative stress (R, R). According to anecdotes, it works, but human studies are lacking.


5) Ginseng​

Ginseng, more commonly known for boosting energy levels, is also effective for erections. Ginseng can prevent neural damage, increase NO and hydrogen sulfide (H2S), increase stamina and it also has an anti-fatigue effect (R). No one wants to be horny, but too tired to do anything.

It’s only slightly effective at doses of 1.4g but much more effective at doses of 3g daily (R, R, R)(R).


6) Ginkgo Biloba​

Ginkgo Biloba extract enhances blood flow and can aid in erections and also preserve and regenerates neural function (R). However, human studies found it to be rather ineffective, although it can help with blood flow if that is your problem (R).


7) Butea Superba​

Butea Superba can significantly increase DHT, and DHT can potently enhance libido and sexual ability (R). However, no study so far has been done on erectile function in humans, but it is effective in animals (R). We’ll have to go on anecdotes for this one.


8) Mucuna pruriens​

dopamine is for energy, libido, desire, motivation, and erections. Mucuna contains L-dopa, which is the precursor to dopamine.

It’s been found that mucuna pruriens may also prevent penile tissue deterioration due to diabetes (R).

There aren’t human studies on this herb yet for erectile dysfunction, however, many people report that it works great for their erections, especially when combined with Catuaba bark and Muira Pauma.


9) Catuaba bark extract​

Catuaba bark extract is considered to be a central nervous system stimulant, without the side effects of caffeine. This is used in some Asian remedies for sexual weakness and lowered libido. European herbalists have found that Catuaba may have aphrodisiac properties and can be used to combat sexual weakness (R). It effectively increases dopamine as well.


10) Cordyceps Sinensis​

Cordyceps Sinensis is a fungus that grows on insects and it has anti-fatigue properties and can enhance libido, sexual activity, and performance, and restore impaired reproductive function in humans (R).


11) Muira Puama

This potency wood is actually the best known Amazonian folk medicine which increases libido and penile hardness. It acts as a nerve stimulant to heighten receptiveness to sexual stimuli as well as the physical sensation of sex. This herb is rich in sterols that activate the body’s receptors for hormones like testosterone to heighten libido and enhance performance. Also present are volatile oils like camphor which helps restore sex drive and inner depth of libido and mental ability to be aroused.

Waynberg reported in 1994 that 60% of men with low libido have reported increased sexual desire and 50% of men with poor erection have reported improved erectile function following Muira Pauma administration (R).

12) Maca​

The Incans found maca root so potent, it was restricted to royal use only. In one human study, 2.4g of maca daily for 12 weeks was effective to improve erectile function (R).

13) ATP​

A lesser known supplement that can aid with erections is ATP, the energy currency.

Positive effects have been found on erectile function with the combination of 200mg AMP and 8g arginine aspartate (R). ATP itself induces smooth muscle relaxation in the penis, which is synergistic with arginine (R).

AMP is the breakdown product of ATP, so supplemental ATP can also be effective. Inosine, which can also increase ATP levels, should thus also be effect. Cardenosine is a nice ATP boosting supplement, but don’t take it before bed as it will most likely keep you up.

Adenosine is also effective but might be too calming.


14) Arginine​

As we all know by now, arginine promotes circulation and helps with the pump. It’s been studied a lot and found to be relatively effective for people with ED who don’t have neurological issues. This analysis demonstrated that arginine supplements with dosages ranging from 1.5g to 5g significantly improved ED compared with placebo or no treatment (R).

Watermelon, which is a good source of citrulline, the precursor to arginine, has also been found to be effective for promoting erections (R).

My approach would rather be to inhibit excess arginase and eat enough protein, instead of supplementing arginine, to solve the issue. Plus, additional arginine could “feed” iNOS, which would create too much NO and create peroxynitrite when it reacts with superoxide.

15) Schisandra​

Schisandra chinensis, aka Magnolia vine, acts as an adaptogen and aids in the relaxation of the smooth muscle of the penis (R).

This herb goes very well with yohimbine to promote erections and to block its anxiety, panic and tachycardia effects.

17) Hexarelin​

Hexarelin, a synthetic growth hormone-releasing peptide, analog peptides stimulate erectile function by increasing the release of dopamine and oxytocin (R, R). Oxytocin stimulates erection and its effects are androgen-dependent.

18) French maritime pine bark​

In this study, the researchers combined 1.7g L-arginine and 40mg x3 daily Pycnogenol (extract from that pine bark), which proved to be effective for erectile dysfunction (R).

19) BH4​

BH4 is the cofactor for nitric oxide and neurotransmitter synthesis. Without BH4, NO, dopamine and serotonin synthesis drop.

BH4 itself acts as an anti-oxidant and removes free radicals but does not restore eNOS activity if it’s uncoupled. Supplementing 200 – 500mg BH4 before le’ sexy time can increase rigidity duration (R).

20) Saffron​

Saffron has anti-depressant (increase the release of dopamine and noradrenaline) and anti-oxidant properties. Saffron has been shown to reverse SSRI-induced sexual and erectile dysfunction (R).

21) Taurine​

Taurine is a fantastic anti-oxidant and has innumerable functions in the body. A low protein, and especially low shellfish intake, can lead to low taurine levels.

Taurine supplementation in rats resulted in notably increased mRNA levels and activity of eNOS and nNOS, as well as NO and cGMP content, in the corpus cavernosum (R). hydrogen sulfide (H2S) is also a vasodilator and an erectogen and taurine supplementation has been shown to increase H2S levels as well (R).

22) Gambir Sarawak​

Gambir is a plant that is dried, powdered and then turned into a paste. It can be rubbed topically on the penis to induce an erection and can also help against premature ejaculation (R).

23) Niacin​

Niacin (vitamin B3) alone can improve the erectile function in patients suffering from moderate to severe ED and dyslipidemia (R). Taking niacin at night after dinner can also help with sleep quality and proper growth hormone release during sleep.

24) Anti-oxidant erectogenic supplements​

oxidative stress can play a major destructive role and contribute to erectile dysfunction. Eating or supplementing anti-oxidants have been shown to improve erectile function by lowering free radicals and inflammation.

The free radicals damage the vasculature, muscles and nerves that innervate the penis.
  • Goji (R)
  • Du Zhong (R)
  • Ginseng (R, R)
  • Horny goat weed (R, R)
  • Melatonin (R)

Other factors to look out for​

1) Vitamin D levels​

Rought 45% of the people tested in this study were deficient in vitamin D and only 20.2% had optimal vitamin D levels. Patients with severe/complete-ED had vitamin D levels significantly lower than those with mild-ED.

Vitamin D serves many functions in the body, including boosting androgens and lowering PTH and as we’ve learned in the previous parts of this series, PTH is not pro-erection (R, R).


2) Vitamin B1 levels​

Alcoholism can induce impotence and one of its mechanisms is to deplete vitamin B1 (R). Vitamin B1 can also be reduced by eating an excess of refined carbs (wheat, sugar, energy drinks, etc.), stressing too much and consuming nutrient-poor food.

3) Magnesium levels​

Our data support that ED is related to hypomagnesemia in elderly patients with moderately to severely reduced kidney function (R). More on magnesium here.

4) Anxiety​

. Glutamate, NMDA overactivation and elevated adrenaline (secreted from adrenals) can contribute to anxiety and reduce erectile quality. To stay calm you can use supplements such as gelatin, magnesium, theanine, valerian, magnolia, Rhodiola Rosea, etc.

5) Homocysteine​

Homocysteine is created in the methionine cycle and is inflammatory and a neurotoxin in high amounts. PDE5 inhibitors are ineffective when hyperhomocysteinemia hasn’t been corrected yet (R). Low vitamin B12, folate, vitamin B2, B6, betaine or choline intake can reduce methylation and increase homocysteine levels.


In reality you probably dont need most of these supplements. IF you correct all your problems which Ive listed, your erection would be good and taking viagra would make them extremely good. These supplements are just the cherry on top. ED is such a terrible thing to have, and if this helps just 1 of you i would be super happy :)
Good thread thanks op
 
lasthope

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Need guide for premature ejaculation
 
T

terminus

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I might be suffering from high noradrenaline levels.
DO you think supplementing with griffonia (5-HTP) to increase serotonine might help ?
I'm currently supplementing with arginine for exercise, maybe it could prevent NO synthesis inhibition due to the use of 5-HTP
Awesome thread btw
 
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Proex

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not being able to get it up is superior ngl, 1 step closer to being asexual
 
RoundHouse

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Proex said:
not being able to get it up is superior ngl, 1 step closer to being asexual
 
BearBoy

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While on nofap can I still listen to music? smoke?
 
TioJohn

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Amexmaxx

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Just buy sildenafil (viagra) for erection and lidocaine spray/wipes for premature ejac. Easy fix if you dont have time or patience to fix your brain.
 
ifyouwannabemylover

ifyouwannabemylover

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what do you think about using artificial visual stimuli (not necessarily porn) to jerk off every once in a while? like once or twice a month?
 
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tincelw said:
Long thread warning.

ED is one of the most brutal and misunderstood things. In most cases doctors will perscribe viagra which is nitric oxide boosting. While this is enough to cause erections in most people it doesnt fix the underlying cause, it just promotes so much blood flow that you can get it up despite that. In this guide we will learn how to correct all underlying problems + use enhancements to get the hardest erection possible.

The basics
The first step is to get the smooth muscle to relax, the second is to get blood into the penis and the third is to pinch the outflow vein closed so that the blood remains in the penis. And lastly, sexual activity triggers the bulbocavernosus reflex, causing the ischiocavernous muscles to forcefully compress the base of the perfused corpora cavernosa, resulting in further, or full, rigidity.

what causes this to occur?
Erection upon touch or stimulation is under the control of the peripheral nerves and the lower parts of the spinal cord, and the psychogenic erection is achieved by visual or mental stimuli (fantasies, etc), and uses the limbic system of the brain.

before we get into fixing response to touch or simulation we need to fix the limbic system, to make sure you actually get aroused. The way to do this is super simple so we get it out of the way first.

QUIT PORN:
View attachment 1056850
there are clear differences in brain activity between patients who have compulsive sexual behavior and controls, which mirror those of drug addicts. When exposed to sexual images, hypersexual subjects have shown differences between liking (in line with controls) and wanting (sexual desire), which was greater [8,100]. In other words, in these subjects there is more desire only for the specific sexual cue, but not generalized sexual desire. This points us to the sexual cue itself being then perceived as a reward [46]. (2)

Another one says (as im sure we all can relate too)
In a finding that may indicate escalation of pornography use, 49% described sometimes “searching for sexual content or being involved in OSAs that were not previously interesting to them or that they considered disgusting”

Basically, People with porn addiction have less sexual desire in general, but more desire for a specific sexual cue. And that cue is something which they actually find gross and would never do in real life.

review of the literature finds a number of studies that have correlated pornography use with arousal, attraction, and sexual performance problems [27,31,35,36,37,38,39,40,41,42,43], including difficulty orgasming, diminished libido or erectile function [27,30,31,35,43,44], negative effects on partnered sex [37], decreased enjoyment of sexual intimacy [37,41,45], less sexual and relationship satisfaction [38,39,40,43,44,45,46,47],a preference for using Internet pornography to achieve and maintain arousal over having sex with a partner [42], and greater brain activation in response to pornography in those reporting less desire for sex with partners [48].

More evidence

- Survey of 434 men reported that lower overall sexual satisfaction and lower erectile function were associated with problematic Internet pornography use [44].
- problematic online sexual behavior (defined as compulsive, persistent, uncontrolled use of pornographic content) was a significant predictor of a low level of erection [49].
- Neurobiological research indicates that the potentially negative effect of long-term pornography use on sexual desire may result from changes in the responsiveness of the reward system to sexual stimuli, preferentially more active as a result of stimuli associated with pornography than with real sexual intercourse [60,61]

In one case of severe Porn addiction and ED, Eight months after stopping all exposure to pornography the patient reported experiencing successful orgasm and ejaculation, and succeeded in enjoying good sexual relations [34].

Improve this by stopping porn completely

Sympathetic nervous system​

The sympathetic nervous system promotes the secretion of noradrenaline and adrenaline which inhibit erectile function (R). It promotes contraction of the smooth muscle and vasoconstriction.

Noradrenaline and adrenaline bind to the adrenergic receptors, of which there are 5, namely α1-, α2-, β1-, β2- and β3-adrenergic receptors.

α1 activation induces vasoconstriction and antagonizing it promotes relaxation and erection. Antagonism of α1‐adrenoceptors is a frequent cause of priapism (prolonged erections). Phentolamine is an α1-adrenergic receptor inhibitor that helps to prevent vasoconstriction to maintain an erection.

α2 activation lowers noradrenaline levels, but it is also anti-erection. Inhibiting it, with yohimbine (R) for example, promotes penile smooth muscle relaxation and promotes blood flow. This can increase the ease with which you can be an erection, but will not facilitate one by itself.

Symptoms of too much noradrenaline include:
  • short flaccid hang
  • finding it hard to get him up
  • struggling to keep him up
  • great morning wood but great sexual anxiety
  • likely excellent response to phosphodiesterase type 5 inhibitors or other NO precursors (R)
Copper is a cofactor necessary for the conversion of dopamine to noradrenaline. Too much copper and you can end up with an excess of noradrenaline. This is why zinc can help so much with sexual anxiety and erection because it lowers copper and noradrenaline.

Stress is one of the biggest contributors to elevated noradrenaline, so be sure to manage your stress to lower excess noradrenaline.

Improve this with: ZINC and Lower stress

Parasympathetic nervous system​

The parasympathetic nervous system is the opposite of the sympathetic nervous system. Acetylcholine is the main parasympathetic neurotransmitter.

Acetylcholine produces concentration-dependent relaxation of erectile tissues that has been precontracted with norepinephrine. Acetylcholine counteracts the effect of noradrenaline and may also suppress the release of norepinephrine (R).

Improve this with: Vitamin B1 and EGGS (choline)

Hormones and Neurotransmitters

Serotonin can inhibit erections by:
  • inhibiting nitric oxide synthesis (R)
  • lowering dopamine release
  • increasing prolactin
  • increasing renin (which promotes vasoconstriction and inflammation)
  • stimulating the adrenal axis (CRH, ACTH and cortisol) through activation of the 5-HT2A receptor (R, R).
Improve this with: Blocking the 5-HT3 seratonin receptor with Ginger, and 5-HT4 receptor with Lysine

Opioids​

also inhibit erection. cut out wheat, milk, and take coffee which contains natural anti-opioid compounds (which is not the caffeine) as well as phosphodiesterase-5 inhibitory properties, so coffee can have pro-erection effects

Histamine​

Histamine is another excitatory neurotransmitter and can promote vasodilation and smooth muscle relaxation in the penis independent of nitric oxide (R). The effect is mostly due to the H2 activation and H1 receptors antagonism (R). H2 antagonists such as cimetidine are known to cause impotence in men.

Injecting histamine can promote full erections in some people and partials in most (R). Too much copper in the body can contribute to low histamine, so lowering copper in the body with zinc, vitamin C and molybdenum can lower copper and increase histamine. Niacin and niacinamide can also help increase histamine by inhibiting its breakdown through methylation.

Kutaja bark extract (Holarrhena antidysenterica), an H3 antagonist, is also able to increase histamine and dopamine and might be effective for promoting erection.

Dopamine​

Dopamine is a major modulator of sexual function and is the primary prolactin antagonist. Prolactin lowers testosterone levels, inhibits DHT formation and reduces libido and erections. Prolactin, similar to serotonin, is also able to modulate dopaminergic function in specific brain regions and inhibit dopamine control in the hypothalamus (R). More on prolactin in part 2.

Dopamine is thought to regulate erection by acting on oxytocin containing neurons in the paraventricular nucleus of the hypothalamus, where prolactin has an inhibitory effect (R).

Dopamine can even induce an erection in the presence of a NOS inhibitor (R).

improve this with: lisuride, metergoline, amantadine and selegiline (careful these might have side effects)

Testosterone​

Testosterone improves libido and erections by:
  • inhibiting the ROCK pathway
  • promoting the commitment of pluripotent stem cells into muscle lineage and inhibit their differentiation into adipogenic lineage.
  • upregulating nitric oxide synthase (NOS) isoform expression and activity
  • downregulating PDE5 expression and activity
  • reducing the α-adrenoceptor expression and function
  • regulation of smooth muscle cell growth and response to vasodilators
  • reducing collagen formation and reversing fibrosis, thus restoring proper smooth muscle function
  • maintaining neural structure and function (R).
In a randomized, placebo‐controlled study with 20 men with ED who failed sildenafil treatment (100‐mg dose) on six consecutive attempts, had free testosterone in the lower quartile of the lower range. One month after treatment with transdermal testosterone and sildenafil on demand, there was a significant improvement in ED (R). - Viagra might not even help you if your testosterone is too low

Estrogen​

super complicated. Just keep this in the middle of the range, not too high but not too low.

Prolactin​

Prolactin is a hormone released from the pituitary gland which has erectile and sexual inhibitory properties.

Prolactin is able to block steroidogenesis, inhibit the conversion of testosterone to DHT, lower dopamine and block its actions, causing ED (R, R, R, R, R, R). If you’re feeling icky and not in the mood, it’s most likely prolactin.

But prolactin is rarely increased all by itself. It usually goes hand in hand with stress, low dopamine, elevated serotonin, estrogen and parathyroid hormone.

Parathyroid hormone​

This is an important hormone and it’s often overlooked.

Parathyroid hormone (PTH) is a hormone secreted by the parathyroid gland that regulates the serum calcium through its effects on bone, kidney, and intestine. It increases calcium absorption in the gut by converting vitamin D into its active form and it also mobilizes calcium from the bone.

You can probably see where this is going if PTH remains elevated for too long?

Excess PTH is inflammatory and can contribute to osteoporosis and vascular calcification. The inflammation produced by excess PTH usually manifests as autoimmune conditions either in the joints or on the skin, such as psoriasis, eczema, arthritis, osteoporosis, etc.

Improve this with: Zinc, magnesium, vitamin K2, selenium, iodine and some of the B-vitamins are also effective. Limit consumption of Grains, nuts, legumes, beans and red meat are significant sources of phosphorus. Calcium helps to balance the phosphorus. Leafy greens are good sources of calcium, and so are eggshell calcium, oyster shell calcium and milk.

Aldosterone​

Aldosterone is part of the renin-angiotensin-aldosterone system. Renin promotes the conversion of angiotensinogen to angiotensin I. Angiotensin I is then converted to angiotensin II by the enzyme ACE1 (angiotensin-converting enzyme). Angiotensin II is pro-inflammatory and promotes the release of aldosterone. Angiotensin II is then broken down by ACE2, into the anti-inflammatory and vasodilatory angiotensin 1-7.

Vitamin A (A) and D (A) increase ACE2, thus lowering inflammatory angiotensin II and increasing anti-inflammatory angiotensin 1-7.

Aldosterone is greatly involved in erectile dysfunction. It promotes vasoconstriction, oxidative stress, inflammation and inhibits nitric oxide synthesis, which contributes to vascular injury and ED (R, R, R).

Cortisol is a more potent aldosterone receptor agonist than aldosterone itself and progesterone can block both.

A low salt diet increases aldosterone in order to retain the little sodium that you ingest. Losartan is a good drug used to lower angiotensin II production and subsequent aldosterone release. Losartan can help to reduce vasoconstriction and inflammation in the penis.

Aldosterone is also elevated during stress. Low testosterone (due to stress) together with elevated estrogen, aldosterone and inflammation, promotes penile fibrosis. Staying in an unhealthy state long term could have permanent side effects.

Improve this with: Lowering stress (lifestyle or supplements)

Thyroid​

Your hormones, such as testosterone and DHT is proportional to your thyroid hormones. When thyroid hormones drop, so does your testosterone and DHT. When thyroid hormones go up…you get the idea.

Thyroid hormones, especially T3, increase testosterone and to a greater extent DHT. If libido is low and you have weak erections, look to PTH and thyroid levels. But don’t just check for TSH alone, check for total and free T4 and T3 and reverse T3 as well.

Both hypo and hyperthyroid lead to a higher chance of ED (R, R, R, R). Most people have hypothyroid, so don’t worry about the hyper part. Having your thyroid hormones in the right place will help you get the best boners for your buck.

Supplements: Thyroid hormone or iodine

IGF-1​

IGF-1 (insulin-like growth factor type 1) isn’t just something that’s needed to build big muscles.

Research shows that IGF-1 is reduced in men with ED (R).

IGF-1 plays a crucial role in the regeneration of nitric oxide synthase (NOS) containing nerve fibers and enhances the recovery of erectile function after nerve destruction (R). In other words, IGF-1 can rescue nitric oxide levels by regenerating damaged nerves in the penis.

IGF-1 also increases eNOS expression, NOS activity and cGMP concentrations, indicating increased cGMP production and/or reduced PDE5 (R).

Improve this with: MK677


Nitric Oxide
NO is created by nitric oxide synthase (NOS), of which there are three types, namely, endothelial NOS (eNOS), neuronal NOS (nNOS) and inducible NOS (iNOS).

All three can promote vasodilation and erection. iNOS is different from the other two, in that it can be induced. Once induced, iNOS can create a 1000 times more NO that the other 2 enzymes.

Research shows that oxidative stress and inflammation are elevated in people with ED. Look to markers such as homocysteine and hsCRP, both of which are usually elevated in ED (R).

Physical symptoms, such as psoriasis, IBS, eczema, arthritis, etc., are also present together with ED (R).

Improve this with Anti-oxidants, such as vitamin E, selenium, zinc, manganese, glycine, taurine, aspirin, etc.

Some other causes for ED

Iron & copper excess creates ROS​

Iron and copper are reactive metals that can react with a free radical, namely hydrogen peroxide (H2O2), in the process called the Fenton reaction. The reaction creates the hydroxyl radical (•OH) which can damage critical cell membranes in and around the penis leading to ED (R).

Polyunsaturated fats​

Polyunsaturated fats (PUFAs) are another danger to the body. The many double bonds in its structure are highly sensitive to ROS and can easily be oxidized. The more unsaturated the fat, the easier it gets damaged. Fish oils, being the most unsaturated, can be the most harmful if consumed in large amounts due to being the most unstable.

Apart from being easily oxidized, PUFAs can also be used by the cyclooxygenase 1 and 2 (COX1 and 2) enzymes, which creates vasoconstrictive prostaglandin F2-alpha (PGF2α), PGI2 and thromboxane A2 (R).

Improve this with Aspirin, which is a very potent COX inhibitor has been tested for ED, and PUFA depletion
I could go on but the basic idea is that oxidative stress and inflammation are seriously bad

TLDR
Healthy Brain
Neurotransmitters
Hormones
Oxidative and Inflammation

Before you go take any supplements or ED drugs fix this. It will drastically improve your life and erections. I suggest to take a blood test and see if everything is in order. Live a healthy lifestyle and minimize stress, change your diet to reduce inflammation. Read this post and see which areas you feel are lacking and improve those.


Supplements (COPEISH LIST)

1) Yohimbine​



It antagonizes alpha-2 adrenergic receptors, which then stimulates the release of dopamine and noradrenaline, causing an increase in sexual arousal and partially antagonize norepinephrine-induced contraction of corporeal cavernosal smooth muscle in the penis (R).

Although it can be a hit or miss with this supplement as there’s about a 50/50 chance of being a responder or not (R). People either experience an improvement in cognition, libido and erection, or get crushing anxiety, cold extremities. The other downside is that you can get all the negatives, but still get an erection or you can get all the positives without the erection.

According to this study, combining 6g arginine with 6mg yohimbine seems to be relatively effective at improving ED in patients with mild to moderate ED (R). I think 6mg is a little high and one can rather start at around 2.5mg to gauge your response.


2) Tribulus​

calms the adrenals, lowers prolactin and estrogen and increases dopamine, DHEA, testosterone (in men with low T) and DHT. It’s also effective at improving ED (R, R).

Just be sure to get a good brand with at least more than 120mg protodioscin per serving, as it’s the protodioscin that’s thought to have the aphrodisiac properties.

3) Tongkat Ali​

Tongkat Ali (TA) can significantly increase free testosterone, inhibit aromatase, act as an adaptogen, and boost cellular function to increase ATP production.

TA has been found to improve erections by inhibiting PDE-5 (and increase NO), arginase (which leaves more arginine for eNOS), and ACE (thus lowering inflammatory angiotensin II) in a concentration-dependent manner (R).

Tongkat Ali can also improve male sexual performance by increasing the conversion of pregnenolone to progesterone, cortisol, 5-dehydroepiandrosterone (DHEA), and testosterone in corpus cavernosum tissues.


4) Horny goat weed​

This one is seen in nearly every single ED supplement out there. It’s been shown to increase NO, by increase expression of eNOS, re-couple eNOS and lower oxidative stress (R, R). According to anecdotes, it works, but human studies are lacking.


5) Ginseng​

Ginseng, more commonly known for boosting energy levels, is also effective for erections. Ginseng can prevent neural damage, increase NO and hydrogen sulfide (H2S), increase stamina and it also has an anti-fatigue effect (R). No one wants to be horny, but too tired to do anything.

It’s only slightly effective at doses of 1.4g but much more effective at doses of 3g daily (R, R, R)(R).


6) Ginkgo Biloba​

Ginkgo Biloba extract enhances blood flow and can aid in erections and also preserve and regenerates neural function (R). However, human studies found it to be rather ineffective, although it can help with blood flow if that is your problem (R).


7) Butea Superba​

Butea Superba can significantly increase DHT, and DHT can potently enhance libido and sexual ability (R). However, no study so far has been done on erectile function in humans, but it is effective in animals (R). We’ll have to go on anecdotes for this one.


8) Mucuna pruriens​

dopamine is for energy, libido, desire, motivation, and erections. Mucuna contains L-dopa, which is the precursor to dopamine.

It’s been found that mucuna pruriens may also prevent penile tissue deterioration due to diabetes (R).

There aren’t human studies on this herb yet for erectile dysfunction, however, many people report that it works great for their erections, especially when combined with Catuaba bark and Muira Pauma.


9) Catuaba bark extract​

Catuaba bark extract is considered to be a central nervous system stimulant, without the side effects of caffeine. This is used in some Asian remedies for sexual weakness and lowered libido. European herbalists have found that Catuaba may have aphrodisiac properties and can be used to combat sexual weakness (R). It effectively increases dopamine as well.


10) Cordyceps Sinensis​

Cordyceps Sinensis is a fungus that grows on insects and it has anti-fatigue properties and can enhance libido, sexual activity, and performance, and restore impaired reproductive function in humans (R).


11) Muira Puama

This potency wood is actually the best known Amazonian folk medicine which increases libido and penile hardness. It acts as a nerve stimulant to heighten receptiveness to sexual stimuli as well as the physical sensation of sex. This herb is rich in sterols that activate the body’s receptors for hormones like testosterone to heighten libido and enhance performance. Also present are volatile oils like camphor which helps restore sex drive and inner depth of libido and mental ability to be aroused.

Waynberg reported in 1994 that 60% of men with low libido have reported increased sexual desire and 50% of men with poor erection have reported improved erectile function following Muira Pauma administration (R).

12) Maca​

The Incans found maca root so potent, it was restricted to royal use only. In one human study, 2.4g of maca daily for 12 weeks was effective to improve erectile function (R).

13) ATP​

A lesser known supplement that can aid with erections is ATP, the energy currency.

Positive effects have been found on erectile function with the combination of 200mg AMP and 8g arginine aspartate (R). ATP itself induces smooth muscle relaxation in the penis, which is synergistic with arginine (R).

AMP is the breakdown product of ATP, so supplemental ATP can also be effective. Inosine, which can also increase ATP levels, should thus also be effect. Cardenosine is a nice ATP boosting supplement, but don’t take it before bed as it will most likely keep you up.

Adenosine is also effective but might be too calming.


14) Arginine​

As we all know by now, arginine promotes circulation and helps with the pump. It’s been studied a lot and found to be relatively effective for people with ED who don’t have neurological issues. This analysis demonstrated that arginine supplements with dosages ranging from 1.5g to 5g significantly improved ED compared with placebo or no treatment (R).

Watermelon, which is a good source of citrulline, the precursor to arginine, has also been found to be effective for promoting erections (R).

My approach would rather be to inhibit excess arginase and eat enough protein, instead of supplementing arginine, to solve the issue. Plus, additional arginine could “feed” iNOS, which would create too much NO and create peroxynitrite when it reacts with superoxide.

15) Schisandra​

Schisandra chinensis, aka Magnolia vine, acts as an adaptogen and aids in the relaxation of the smooth muscle of the penis (R).

This herb goes very well with yohimbine to promote erections and to block its anxiety, panic and tachycardia effects.

17) Hexarelin​

Hexarelin, a synthetic growth hormone-releasing peptide, analog peptides stimulate erectile function by increasing the release of dopamine and oxytocin (R, R). Oxytocin stimulates erection and its effects are androgen-dependent.

18) French maritime pine bark​

In this study, the researchers combined 1.7g L-arginine and 40mg x3 daily Pycnogenol (extract from that pine bark), which proved to be effective for erectile dysfunction (R).

19) BH4​

BH4 is the cofactor for nitric oxide and neurotransmitter synthesis. Without BH4, NO, dopamine and serotonin synthesis drop.

BH4 itself acts as an anti-oxidant and removes free radicals but does not restore eNOS activity if it’s uncoupled. Supplementing 200 – 500mg BH4 before le’ sexy time can increase rigidity duration (R).

20) Saffron​

Saffron has anti-depressant (increase the release of dopamine and noradrenaline) and anti-oxidant properties. Saffron has been shown to reverse SSRI-induced sexual and erectile dysfunction (R).

21) Taurine​

Taurine is a fantastic anti-oxidant and has innumerable functions in the body. A low protein, and especially low shellfish intake, can lead to low taurine levels.

Taurine supplementation in rats resulted in notably increased mRNA levels and activity of eNOS and nNOS, as well as NO and cGMP content, in the corpus cavernosum (R). hydrogen sulfide (H2S) is also a vasodilator and an erectogen and taurine supplementation has been shown to increase H2S levels as well (R).

22) Gambir Sarawak​

Gambir is a plant that is dried, powdered and then turned into a paste. It can be rubbed topically on the penis to induce an erection and can also help against premature ejaculation (R).

23) Niacin​

Niacin (vitamin B3) alone can improve the erectile function in patients suffering from moderate to severe ED and dyslipidemia (R). Taking niacin at night after dinner can also help with sleep quality and proper growth hormone release during sleep.

24) Anti-oxidant erectogenic supplements​

oxidative stress can play a major destructive role and contribute to erectile dysfunction. Eating or supplementing anti-oxidants have been shown to improve erectile function by lowering free radicals and inflammation.

The free radicals damage the vasculature, muscles and nerves that innervate the penis.
  • Goji (R)
  • Du Zhong (R)
  • Ginseng (R, R)
  • Horny goat weed (R, R)
  • Melatonin (R)

Other factors to look out for​

1) Vitamin D levels​

Rought 45% of the people tested in this study were deficient in vitamin D and only 20.2% had optimal vitamin D levels. Patients with severe/complete-ED had vitamin D levels significantly lower than those with mild-ED.

Vitamin D serves many functions in the body, including boosting androgens and lowering PTH and as we’ve learned in the previous parts of this series, PTH is not pro-erection (R, R).


2) Vitamin B1 levels​

Alcoholism can induce impotence and one of its mechanisms is to deplete vitamin B1 (R). Vitamin B1 can also be reduced by eating an excess of refined carbs (wheat, sugar, energy drinks, etc.), stressing too much and consuming nutrient-poor food.

3) Magnesium levels​

Our data support that ED is related to hypomagnesemia in elderly patients with moderately to severely reduced kidney function (R). More on magnesium here.

4) Anxiety​

. Glutamate, NMDA overactivation and elevated adrenaline (secreted from adrenals) can contribute to anxiety and reduce erectile quality. To stay calm you can use supplements such as gelatin, magnesium, theanine, valerian, magnolia, Rhodiola Rosea, etc.

5) Homocysteine​

Homocysteine is created in the methionine cycle and is inflammatory and a neurotoxin in high amounts. PDE5 inhibitors are ineffective when hyperhomocysteinemia hasn’t been corrected yet (R). Low vitamin B12, folate, vitamin B2, B6, betaine or choline intake can reduce methylation and increase homocysteine levels.


In reality you probably dont need most of these supplements. IF you correct all your problems which Ive listed, your erection would be good and taking viagra would make them extremely good. These supplements are just the cherry on top. ED is such a terrible thing to have, and if this helps just 1 of you i would be super happy :)
man , all of this typing just cause u cant get erect??
 

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