Treatment for erectile dysfunction depends on the cause. Testosterone supplements may be used for cases due to hormonal deficiency. However, the cause is more usually lack of adequate penile blood supply as a result of damage to inner walls of blood vessels. This damage is more frequent in older men, and often associated with disease, in particular diabetes.

Most treatments work on a temporary basis: they enable an erection to be attained and maintained long enough for intercourse, but do not permanently improve the underlying condition. There are different treatments available:

Oral treatment
These work when there is sexual stimulation. Depending on the treatment, it will need to be taken 20 minutes to 1 hour before sex and the period of time over which it works can vary between 3 hours and up to 36 hours.

Alprostadil
This can be injected into the penis or inserted using a special applicator - usually just before sexual intercourse.

Vacuum pumps
These work by drawing blood into the penis and are also used just before sexual intercourse.

Hormone treatment
It is rare, but some men receive hormones for their erection problem. This does depend on the cause of the problem as well as other factors.

Surgery
Often, as a last resort if other treatments have failed, the most common procedure is prosthetic implants which involves the insertion of artificial rods into the penis.

Counselling
Counselling is often a consideration, both where a psychological cause is suspected or must be ruled out, or to assist in management of any distress.
ED can in many cases be treated by drugs taken orally, injected, or as penile suppositories. When pharmacological methods fail, a purpose-designed external vacuum pump can be used to attain erection, with a separate cock ring fitted to the penis to maintain it.

More drastically, inflatable or rigid penile implants may be fitted surgically. Implants are irreversible and costly.

All these mechanical methods are based on simple principles of hydraulics and mechanics and are quite reliable, but have their disadvantages.

In a few cases there is a vascular problem which can be treated surgically.

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There are a variety of sex toys out there to pick from. Different styles, sizes and materials make it hard to figure out which one is best. There are some questions that you need to ask yourself first.

What do you want to use it for – clitoris, vaginal, or anal? Do you want something that will hit the clitoris and vagina at the same time? Then a dual action vibe like a rabbit or pearl panther is for you. If you want something for just anal play then remember to make sure it has a flared base so that it doesn’t slip all the way in. G-spot vibrators, glass dildos, and anal vibrators are for more advanced stimulation.

How strong do you want your vibration? If you masturbate with a firm rub on the clitoris rather than a light touch, you are more likely to appreciate a strong vibration. Picking a toy with variable speed control so that you can play with it to see what works for you would be a good way to go.

How big do you want it? If you are someone who travels a lot then maybe something small like a pocket rocket is the way to go. If you plan to use the vibe for penetration, the girth of the toy may be just as crucial as the vibrating intensity. If you are not sure how much girth you want, go smaller rather than larger so you will know your new toy will fit.

How much do you want to spend? A bullet or vibrating egg may be the least expensive option for you but don’t let their size full you. They are quite strong and can be used all over both of your bodies in all of your erogenous zones. Some people like to start off with the cheaper one if they have never had a vibrator before but if you talk to anyone who has had one they will tell you that the deluxe, spinning dual action vibes are the best way to go. These are what some people refer to as the pearl rabbit, pearly panther, or lickin lizard vibrators.

Sex toys have come a long way. They now have different materials to pick from too so get familiar with them and have fun trying out all kinds of different ones to see what works best for you.

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Here are just a few great positions that anyone can do.

Blossoming Flower Position
A variation on the Missionary position is the Blossoming Flower. In this position, the woman lies on her back and lifts her legs up. With her legs spread and open in this manner, she takes on the appearance of a flower in bloom. She can grasp under her knees for better leverage, as well. This is an excellent position for deep penetration, easy access to the clitoris, and face-to-face intimacy between partners. Long periods in this position may create kinks in the woman’s legs, but since the woman’s hands are free, she can always use them to massage her legs while penetration occurs.

Butterfly Position
A sex position that was touted as revolutionary a few years ago is the Butterfly. It’s a bit tricky since proper alignment is necessary. The location needs to be a place where the woman’s pelvis is about a foot lower than the man’s. This could be a tall bed, desk, countertop, even a large exercise ball. The woman lies back while the man stands in front. (If the surface is very low, he may be able to kneel instead.) Now, the woman lifts her legs and rests her feet on her partner’s shoulders. She tilts her pelvis up so that he back becomes straight and forms a straight line, angling up toward the man, and both crotches meet. The man can place his hands just under his partner’s hips so he can hold her at the perfect angle while he thrusts. In this position, the pelvic tilt is ideal for G-Spot stimulation and deep penetration. An excellent tip is not to rush this one. Use a lot of lubrication and go slowly. With so many sensations going on, the orgasm that follows will be momentous!

Pressed or Push-and-Pull Position
In the Pressed Position, the man is very much in control. The woman lies on her back, with her legs together. She lifts her feet and presses them to the man’s chest. This position offers a good deal of friction. The man can grasp his partner’s hips to aid in thrusting. He needs to pay attention to her comfort level, however, as this position can be uncomfortable at certain angles or if continued for a long period of time. A variation of this position is the Half-pressed. Here, the woman leaves one leg free, letting it rest to the side or placing it on her partner’s shoulder. Better access to the clitoris is experienced, and it’s also a nice way to change up the position without stopping rhythm.

Pair of Tongs
This is a great woman-on-top sex position if you and your partner want to turn things around, literally! In Pair of Tongs, the man lies back and the woman faces opposite him. There’s plenty of variation in this position. The woman can lie back and lift her hips slightly, giving her partner room to thrust from underneath. Or, she can sit up and control penetration herself, not to mention clitoral stimulation. It’s a great opportunity to introduce sex toys like vibrators into the act as well. The woman can use them on herself as well as her partner. One word of warning for women: Keep in mind a man’s comfort and pay attention to how far forward you bend!

Congress of the Cow / Doggie-Style / Piercing Tiger
No matter what you call this rear-entry position, it’s a popular one for G-Spot stimulation. The man stands or kneels behind and vaginally penetrates the woman who is typically on all fours. Men like this position, as it offers a new and exciting view of their partner. He is also able to control penetration by grasping his partner’s hips. Women have perfect access not only to their clitoris, but to her partner’s testicles as well. Many men love to be stroked or even squeezed in this area as they thrust. Women with back problems should be careful not to arch their back too much. Men can assist by not pulling upward on their partners’ hips. As it is with many positions, it’s best to go slowly when entering from this angle. Also be sure to use plenty of lubrication.

On The Side
A lovely and intimate sex position is On the Side. In this position, you face each other while lying on your sides. Think of Missionary position turned to a 90-degree angle. The woman can lift her top leg over her partner’s hips, allowing him to enter her easily. Variations are endless here. Either or both of you can lift up on your elbows for leverage. You can even angle back down 45 degrees, for more friction. This position doesn’t allow for much clitoral stimulation, but that is easily fixed: The man stays lying on his side, while the woman lies perpendicular to him, draping her knees over his hips (or, if she spreads her legs, her knees actually rest on his waist/ribs and thigh, respectively). This is a fantastic position for clitoral stimulation and mutual control of penetration. And it’s a great for when neither of you really feels like being on top!

The Spoon
We all know The Spoon to be a nice way to cuddle, but it makes an excellent sexual position as well. Both man and woman lie on their sides, the woman facing away from the man. The man enters from behind. If the woman keeps her legs closed tightly, there is better friction. She can even bend her torso forward and anchor herself so that she can offer a little resistance during the thrusting, which increases penetration. However, she can certainly lift her top leg for easier access to the clitoris. Her partner can even hold her leg up so that it won’t get tired and/or as an anchor while he thrusts. Not surprisingly, this is a popular morning sex position, as couples awaken and get snuggly.

Hiding in the Crevice
In this sex position, the woman lies on her belly, and the man lies on top. Some women may find it more comfortable to have a pillow underneath them. Legs are kept straight, and the man enters from behind. For men with longer penises whose partners have trouble accommodating them, this is a great position, as the woman can squeeze her buttock and P.C. muscles, giving the illusion of having a longer vaginal canal. The man can lift himself up slightly and kiss or blow on his partner’s back for added stimulation. Both partners’ hands are free for interlacing fingers or light touching, which makes this a very intimate position even though you are not face-to-face.

Female Superior or Woman on Top
Sometimes a woman wants to take charge during lovemaking. When a woman sits or lies on top of her partner, this is called the “Female Superior” position. And it can be superior for everyone involved! In Female Superior positions, the woman is able to better manipulate penetration to facilitate orgasm. This is a perfect position to stimulate the G-Spot, in fact. Lean your torso forward and arch your back, keeping yourself close to the base of his penis. Try rocking back and forth (not bouncing up and down). Squeeze your P.C. muscles once you’ve got a nice rhythm going. Another option is to lean back and place your hands on his thighs. This time, move up and down along his penis. At this angle, you’ll get great stimulation of the G-Spot. And your partner gets a great angle to watch your pleasure.

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Anal sex is a topic that most people want to learn about and possibly try but they don’t want to talk about it. It’s one of the “forbidden pleasures” in life.

The highest concentration of nerve endings is around the anal opening and you can use a finger or tongue to focus on this area. For many this will give you enough stimulation. Others may like an object to be inserted beyond the opening. The inner portion of your rectum responds mostly to pressure.

If this is your first time then you may want to try some anal pleasure on your own. Take a warm bath or shower and clean the area well. Next relax and take a moment to touch the area with a finger or two. Apply different types of pressure to your anus to discover where you feel sensation most. You may wish to insert a finger into your anus a small amount at a time. Be sure you have proper lubrication to ensure an easy movement; you should never force anything in there. Pay attention to your body’s instinctive reaction. Your sphincter may clamp down and squeeze your finger and this is normal. Simply stop moving and concentrate on relaxing your sphincter. Practicing on your own will allow you to be more comfortable if you choose to try anal sex with your partner.

Always keep in mind that you should never place your penis or any toy that has been in an anus directly into a mouth, vagina, or anus. You must wash thoroughly to avoid any bacteria from traveling to these areas. A generally safe bet is to use a condom during anal sex.

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Men and women like to be pleased orally but they don’t necessarily know how to give good fellatio or cunnilingus. Here are some tips on giving good oral sex to your partner.

Fellatio

The basics for both start with teasing your partner. When you are giving oral sex to your male partner then you would start at the head of the penis and tease it with your tongue since it is the most sensitive part. You’ll slide your hand up and down his penis, closing it slightly when you reach the top and opening it slightly as you move back down. While doing this keep his penis moving in and out of your mouth (lips covering teeth) which should be applying a firm but comfortable pressure. Now you can lick his penis with long slow movements.

Also try twisting your head to one direction as your hand twists gently the other way. Men can find it very erotic to watch you lick their cock so be sure to remember that part of sex is showmanship; look him in the eye and while you do dirty things to him. Judge his reaction and what he likes and match it with that you are comfortable doing. Tease your partner by changing the speed, get him really aroused by moving faster and sucking harder and then slow down so that he does not reach orgasm. Take him to the very brink of orgasm (not easy) and then slow him down.

Don’t be shy about adding something a bit tasty to your playtime. A little flavored lubricant, chocolate, honey, pop rocks, ice, a sip of something hot or anything else that you think tastes good will make this a feast that can satisfy both of you. Pop some toothpaste in your mouth before you put his penis in your mouth and it will give a very cool feeling (temperature-wise). Another trick is to try popping an Altoids into your mouth before you begin. These curiously strong mints can give a fabulous tingle.

A question that always gets asked is what is deep throating and how do I do it? Deep-throating is where you take the whole penis into your mouth rather than keeping a hand or two on it. This can be very difficult and uncomfortable, resulting in gagging. If you aren’t comfortable deep-throating your partner it’s ok because the head of the penis is the most sensitive part anyway so that’s what’s most important.

Discuss the matter of ejaculation before you start. Always remember to keep an open line of communication between you and your partner as to what both of you like and dislike. Try new things and see what works and what doesn’t.

Cunnilingus

If this is your first time giving cunnilingus then you’ll want some light on so that you can see what you are doing and where things are at. Women need to be teased as much as men when giving oral sex. You can begin by stoking and kissing her body and then teasing her by stroking her genitals.

Something that you want to ask her is if she likes it slow or fast and gentle or hard. Some women may not know so you may have to experiment and see what works best. You’ll want to start by wiggling your tongue around and over the clitoris and then move into longer strokes with your tongue. Remember that it’s not all about her clitoris. You need to keep your hands moving all over her body and keep a good rhythm going. She will let you know when to stop so keep going until she tells you to or pushes you away.

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