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A slow and steady revolution is sweeping the market for erectile dysfunction drugs – Cialis. Most people may not even be aware of it. Lilly ICOS, the pharmaceutical alliance, which launched the blockbuster drug Cialis, announced that the drug has achieved 1 billion dollars in global sales since launching in Europe less than two years back. In fact Cialis has become the top Erectile Dysfunction treatment in France, since January 2005, based on the latst market data, easily overtaking Viagra, the first brand to be launched in this market. It is also doing very well in United Kingdom, Italy, Germany, United States, Canada, Australia, Mexico and Brazil. So much so that a Lilly ICOS press release contained these words from Rich Pilnik, President of Lilly's EMEA region "We are very pleased with the performance of Cialis and the steady development of the brand since its launch two years ago. Millions of men suffer from ED and the growth of the market demonstrates that patients are speaking to their healthcare providers about ED and seeking treatment options." Not only has Cialis been able to expand the market but it has also eaten heavily in the market share of Viagra from Pfizer, the first drug to be launched in this market and Levitra from Glaxo-Bayer-Schering Plough. In fact Cialis was the second PDE5 inhibitor drug to become available in Europe. It is currently promoted in approximately 100 countries including the United States, Australia, Brazil, Mexico, Canada and across Europe and Asia for Erectile Dysfunction. According to Paul Clark, Chairman and Chief Executive Officer of ICOS Corporation. "Passing the $1 billion mark is an important milestone for Lilly ICOS and a great accomplishment for the Cialis team. Since 2003, men with erectile dysfunction have had a choice of oral treatments for their condition - a condition which may impact on relationships and daily life." Beyond all the hype and the jubilation is the sheer superiority of Cialis over all the other drugs available in this indication. To understand the benefits of Cialis, we need to firstly understand this complex condition. Erectile Dysfunction or Impotence is defined as the inability to ensure and maintain an erection sufficient for sexual intercourse. ED affects an estimated 180 million men worldwide . 90 percent of ED cases are related to a physical or medical condition, such as diabetes, cardiovascular diseases, and prostate cancer treatment, while 10 percent are due to psychological causes . In many cases, however, both psychological and physical factors contribute to the condition. Where physical factor play an important role PDE-5( Phosphodiaterase) inhibitors have a significant role to play. These include drugs like Sildenafil (Viagra) and Vardenafil(Levitra). But none are as good as Tadalafil(Cialis). Why? Firstly let’s understand how PDE-5 inhibitors work. They work by inhibiting the enzyme phosphodiasterase-5 which is responsible for degrading another enzyme called cGMP(cyclic Guanosine Mono Phosphate) which through a series of reactions is responsible for the synthesis of nitric oxide. Nitric oxide is an important vasodilator responsible for dilation of the blood vessels that supply blood to the penis. Thus, there is an increase in the blood supplied to the penis and this increased blood engorges the penis and leads the formation of an erection through hydraulic pressure. All PDE-5 inhibitors work in the same way but because they are different molecules, they also have different properties. The body quickly eliminates both Sildenafil and Vardenafil. Therefore their action lasts for only 4 hours, while Tadalafil(Cialis) is absorbed and eliminated slowly therefore it remains in the body for a longer period of time. Therefore its duration of action is 9 times that of other drugs - 36 hours. This ensures that Cialis will act over a whopping 36 hours and any patient on Cialis does not need to have hurried sex , but sex at his or his partner’s leisurely pace. That is why Cialis has been nicknamed as “Le Weekend Pill” in France. It allows the man to relax with his partner and have spontaneous sex. Also other drugs like Viagra act on the enzyme PDE-6, which is found in the eyes, leading to bluish discolouration of vision, which will not occur with Cialis. Cialis can be taken with a 100% fat meal and there will be no change in it’s action. The same is not true for Sildenafil or Vardenafil, which are affected by food. All this makes Cialis currently the best drug for erectile dyfunction. 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The holidays are touted to be the time of year to be joyful and most of all have fun and spend time with family and/or friends. For some, however, the holidays when families and/or friends gather to celebrate and share the joy of the season are not joyful. Because family matters are conducted behind closed doors this 'unhappy event' goes unnoticed and the victim of this cruel experience takes its toll. I speak of the unspeakable—sexual child abuse. Countless children are abused at family gatherings. While everyone is talking, laughing and having a good time, beloved Uncle Lewey, Grandpa or family friend, walks out of the living room (ostensibly to go to the bathroom) but instead goes into his niece's/granddaughter's or family friend’s room, where she is 'hanging out.' He nonchalantly chats with her and before she realizes what he is about to do, he has planted a kiss on her lips and forced his tongue into her mouth and/or fondles her breast. He then tells her she is so sexy he couldn’t stop himself, she is very special and it is their secret or he threatens her that if she tells he will say she is a 'liar' or worse yet, she 'came onto' him. Thus, she is forced into silence and shame. While I realize this scenario is difficult to fathom, it is all too real and all too frequent. However, this scenario doesn't need to end tragically, something can be done to prevent or mitigate it. No one is born a molester, yet all too often victims become perpetrators. Sexual child abuse has become a family tradition-Uncle Lewey was abused by his father, mother, uncle, cousin or aunt and now he has abused his niece. Or grandpa was abused by someone and he now has abused his granddaughter. How, you may ask, can this be possible when so many people are around-no one would risk being seen sexually abusing a child? Unfortunately, this rationalization merely avoids accepting the truth about sexual abuse perpetrators. It only takes a second to abuse a child. Furthermore, few people recognize what constitutes sexual child abuse. Sexual touch—a sensuous or ‘wet’ kiss on the lips, touching or fondling erogenous areas cause as much trauma as genital contact. All sexual abuse and/or sexual touch is damaging because it is first and foremost a betrayal of trust. PREVENTION is possible. However, for a child to be able to prevent this experience, she or he needs to have knowledge of and permission to exercise self-protection. Without knowledge of and permission to exercise self-protection, the only defense a child has against any kind of abuse is to accept the blame. A child cannot conceive the idea, "My father, uncle, mother, grandpa, grandma, aunt, brother, sister, cousin, friend, teacher, or baby-sitter is sick and is harming me." Therefore, the only way to survive sexual abuse or incest is to assume that it is his or her fault. A child has unquestioning trust for everyone in the family or persons of acquaintance or authority. Parents generally teach girls to be passive, compliant, non-assertive, co-operative and reward them for doing so. Girls are raised to be 'quiet, sweet and pretty' they are never to make a 'scene.' It is not surprising then, that girls are (according to statistics) twice as likely to be sexually abused. Perpetrators know who and how to target their victims. Boys are taught, expected and praised to be tough and self-assured, even at times when something troubles them. Whenever a person is traumatized, he or she resorts to familiar behavior; for girls this behavior usually means passivity while boys usually 'tough it out'-thinking if they are strong and unemotional, no harm can occur. Self-protection offers a direct and effective way to empower children to help themselves. Since perpetrators cunningly and with forethought sets the stage to perpetrate this crime in secrecy, who is better able than the child to protect him or herself? Perpetrators say they can sense a child to victimize; they sense this by the child's demeanor, body language and facial expressions. They sense the fear, the helplessness, their compliant attitude and their passivity. Perpetrators choose victims who they assume will keep their secret. No child needs to fall prey to these cunning predators. The first response the majority of people form when hearing of sexual abuse or incest is denial. 'I do not have to be concerned about that in my community. This would never happen in my family.' The unbelievable reality is that a person who sexually abuses children may seem very average and ordinary to the world. He or she may be a leader in the church, in the community or in business. He or she does not fit a classic stereotype and is not necessarily uneducated, unemployed, impoverished or an alcoholic. Furthermore, we find sexual abuse and incest even more difficult to believe or accept when the person we like, admire, love, and/or marry is the perpetrator of the abuse. Tragically, the unwillingness to accept the facts concerning sexual abuse perpetrators leaves children vulnerable to becoming victims and increases the likelihood that they will be abused. 'Traditionally, incest was defined as: sexual intercourse between two persons too closely related to marry legally--sex between siblings, first cousins, the seduction by fathers of their daughters. This dysfunctional blood relationship, however, does not completely describe what children are experiencing. To fully understand all sexual abuse, we need to look beyond the blood bond and include the emotional bond between the victim and his or her perpetrator. Thus, a new definition has emerged. The new definition now relies less on the blood bond between the victim and the perpetrator and more on the experience of the child. Incest is both sexual abuse and an abuse of power. It is violence that does not require force. Another is using the victim, treating them in a way that they do not want or in a way that is not appropriate by a person with whom a different relationship is required. It is abuse because it does not take into consideration the needs or wishes of the child; rather, it meets the needs of the other person at the child's expense. If the experience has sexual meaning for another person, in lieu of a nurturing purpose for the benefit of the child, it is abuse. If it is unwanted or inappropriate for her age or the relationship, it is abuse. Incest [sexual abuse] can occur through words, sounds, or even exposure of the child to sights or acts that are sexual but do not involve her. If she is forced to see what she does not want to see, for instance, by an exhibitionist, it is abuse. If a child is forced into an experience that is sexual in content or overtone that is abuse. As long as the child is induced into sexual activity with someone who is in a position of greater power, whether that power is derived through the perpetrator's age, size, status, or relationship, the act is abusive. A child who cannot refuse, or who believes she or he cannot refuse, is a child who has been violated. (E. Sue Blume, Secret Survivors)." Sexual abuse can be as subtle (covert) as any person showing pornographic pictures or movies to a child. It is any man hugging a child while pressing his hard penis against her. It is anyone consistently invading a child's privacy, such as entering the bathroom or bedroom without knocking, catching her unaware and indisposed. It is playfully pulling her swimsuit bottom down in the pool or pulling her panties down without her permission. Sexual abuse is anyone bathing the child when the child is old enough to bathe herself. It is any person who touches or caresses the child in ways she does not like or in ways that are sexual. It is any man holding a child on his lap when he has an erection. It is any trusted adult who stares at or makes comments about the child's body. It is anyone kissing the child in a way that is sexual for the giver. It is seemingly innocuous touching, wrestling, tickling, or playing which has sexual overtones or meaning for the other person. Sexual abuse is as blatant (overt) as instructing or asking the child to lie in bed in an intimate position, fondling, digital, penis or object penetration of the rectum or vagina, or instructing a child to perform oral sex or performing oral sex on the child. It is forcing the child to touch others or be touched by others, including other children. A classic example of covert sexual abuse while people are present is exemplified by a 39 year-old woman who came to me after having a severe panic attack. During our investigation as to what was the root cause of the panic attack she revealed she had been sexually abused when she was nine by a 'nice man,' who was a family friend. "He helped me on with my coat while attending a family gathering. As he adjusted my coat onto my shoulder, he fondled my breast." This type fondling is often times referred to as 'coping a feel.' No matter the label, it is sexual abuse and causes damage. As an adult woman you know how icky it feels when a man 'cops a feel.' Can you imagine what it would feel like for a nine-year-old, who has no information to comprehend and emotionally resolve what she experienced? Overt sexual abuse is openly sexual and apparent. Although there may be an attempt to deny that it is abusive, there is no attempt to hide the fact that it is sexual in nature. Covert sexual abuse is more insidious. Thus, identifying it is harder, because the sexual nature of the action is disguised. The perpetrator acts as if she or he is doing something non-sexual, when in fact he or she is being sexual. The betrayal then becomes two-fold. The child is not only abused, but also tricked or deceived about the act. In this dishonesty, the child is unable to identify or clarify his or her perception of the experience. The unreal or surreal sense that accompanies any sexual abuse is intensified when the child is tricked into disbelief. Thus, the child doubts his or her perceptions and feelings and believes that there is something wrong with himself or herself because he or she feels terrible. To make matters worse, everyone around her or him acts as if nothing is wrong. Thus, she or he feels crazy, as if she or he is the one with the problem. A classic example of overt sexual abuse while people are present is exemplified by the incident a client, who is a sexual abuse survivor, reported about seeing her father (her perpetrator) kiss her one-year-old niece on the pubic area after her niece had taken a bath. Her sister, the child's mother, the child's grandmother, (wife of the perpetrator) were present. "My sister and mother (the child's grandmother) laughed and I got sick to the stomach. Am I over reacting," she asked. Obviously, her sister and mother are unaware of the definition of sexual abuse. Except for the fact this woman was in recovery and could clarify the experience she would not have considered it sexual abuse either. The frightening truth about sexual abuse and incest perpetrators is that within their mindset, they do not hold beliefs reflecting society's moral and ethical values. Because of a child's innocence and trust of the abuser, usually pressure or violence is not required. Thus, the sexual abuse or incest perpetrator can unequivocally state, "Never ever. I could never harm a child or anyone. It's not in my heart. It's not who I am." Michael Jackson, 1993. Sexual abuse and incest perpetrators frequently pass lie detector tests. They feel no inner conflict with what they have done. Their moral and ethical values do not reflect the standards on which the test is based. If you have the slightest cause for concern, trust your intuition and seek professional intervention. Trusting and acting on our intuition or sixth sense is paramount to protecting children from perpetrators, no matter whether they are family members, family friends, doctors, dentists, teachers, etc. When intuitiveness or a sixth sense has been activated in detecting danger, it can be identified by a change in one's physiology. First: Accept the fact that sexual abuse perpetrators may seem very average and ordinary to the world. In spite of all the reports of sexual abuse by pillars of the community-teachers, clergy, coaches, we still want to cling to the belief that a sexual abuse perpetrator is the disheveled man with a scraggly beard, wearing a dirty trench coat. It is difficult to believe the people we like, admire, trust and love would do such a heinous thing. Second: Accept the definition of sexual abuse. (See definition above) Third: Know the signs your child is being targeted: Self-protection offers a direct and effective method for children to protect themselves. Who, other than the child, is in a better position to protect him/herself? Perpetrators say they can sense a child to victimize. They can tell by the child's demeanor, body language, and facial expression. They sense the fear, the helplessness, the passivity. They chose a child who is easily intimidated or controlled so hopefully the child won't tell. Secrecy is paramount for the perpetrator. Whenever a person is traumatized, he or she resorts to familiar behavior; for girls this behavior is usually passivity, while boys usually 'tough it out'-thinking if they are strong and unemotional, no harm can occur. Sexual crimes against children can only be committed if the perpetrator finds someone who will hopefully keep the secret. No child needs to fall prey to these cunning predators. There are seven child tested, parent approved sexual child abuse prevention techniques, which will protect your child from the most cunning predators. If you heed and investigate these warning signals you can prevent continued abuse. Warning signals include: • * an aversion to a person, place or event. • * outbursts of anger and there is no apparent reason known for such anger. • * any unusual or unexplained behavior change. Ceasing an activity that was once done without hesitation. • * not wanting to be around a particular person. • * family member/friend seems to foster a relationship with your child more for him/herself than for your child. • * secretiveness between the child and adult Fourth: What to do: • * Teach Good/Appropriate Touch with regard to anyone. • * Teach Appropriate Body Boundaries with regard to anyone. • * Foster Self-Esteem and Good Body Image • * Teach the "Tell Mommy and Daddy Everything-No Secrets rule. • * Allow your child to command respect regarding dislikes and touch with family members, friends or authority figures. • * Talk with and listen to your child until you are satisfied the aversion is unrelated to improper behavior by anyone. • * Check on your child occasionally whenever they are with another adult or other times to become 'known' as an attentive parent. • * Trust and honor your child's intuitive reactions. If your child feels uncomfortable with someone, respect their intuitive sense—honor their intuitive sense. • * Appropriate Suspicion—trusting and acting on your intuition or sixth sense is paramount. If you have confusion regarding a person's actions, nagging/persistent thoughts or feelings, hesitation, general suspicion, apprehension, fear, doubt, a hunch, curiosity regarding a person's actions or statements, or questions regarding a person's proclamation that is not substantiated by their actions—trust your intuition or sixth sense. • * If you err in evaluating the situation, make the error on the side of caution. 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For some men making decision not to have children (or not to have more children) is simple. But when it comes to action to prevent that, it is just much easier to say than do. Do you trust your partner to take her contraceptive pill? Sometimes an 'accident' does happen and then the big decision about going through with the pregnancy becomes complicated. Natural law leaves the decision to have a child once it has been conceived firmly in the domain of the woman, so you will no longer have the final say about. You can use other birth control method- condoms. But this option is not 100% reliable under any circumstances and condoms can be inconvenient. Those reasons make many people in monogamous relationships choose to rely on the contraceptive pill. Condoms should be used as a matter of course for sexual activity where you have concerns about sexually transmitted diseases as well as pregnancy.. The most reliable method seems to be permanent sterilization - an operation called a vasectomy. Although it is a small operation it has big implications. You should discuss with your partner this issue very carefully before making final decisions. Keep in mind that it would be difficult if not impossible to reverse the operation. With all sexual matters there are emotional and practical issues to consider so it can be one of the most important decisions in your life. You should know answers to those questions to make the decision. What is a vasectomy? It is minor surgery to tie the 'tubes' what causes permanent sterility, because tying the tubes prevents sperm from getting out of your testicles. Will I be able to achieve an orgasm and ejaculation? Vasectomy does not affect the man's ability to enjoy sex, have orgasm or ejaculate. There will still be a fluid ejaculated, but there will be no sperm in this fluid. Is the operation difficult? No it is not. There is a small cut made in the upper part of the scrotum, under the penis. The tubes (vas deferens) are tied off and cut apart. The skin incision is stitched closed. Vasectomy is usually done in the surgeon's office and most men only have local anesthetic, so are awake during the operation. The procedure is painless and you should be able to return home immediately. Is vasectomy permanent? You should consider vasectomy as permanent and should be 100% sure you do not want future pregnancies. Although it can be reversed it is not recommended and it can jeopardize your health. natural penis elargement pills penis enlargement tool real penis enlargment penis elargement surgeon penis enlargment system penis enlagement before and after picture best penis enlargement pill pennis enlargement system buy pnis enlargement pills

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