VIMAX Pills can enlarge your penis size up to 3-4 Inches in length and up to 25% in girth !penis enlargment surgery vimax natural penis enlargement pills VIMAX Pills is a powerful natural herbal male enhancement formula that increases penis length and girth, sexual desire, sexual health and helps to achieve stronger erections. Combining the formulations of the type of herbs found in many parts of the world that have been proven to work for many years, you can now enjoy the full benefits of our product. Some of the same type of herbs found in Polynesia where the men of the Mangaian tribe have sex on the average of 3 times a night, every night. While this is not what you may wish, it is nice to know your sexual performance can improve substantially. After many years of medical Research and Development, our company is pleased to offer you a 100% Natural and Safe Product that can safely and permanently enlarge your penis size up to 3-4 Inches in length and up to 25% in girth. Discover what our "proven to work" formula can do for you by ordering today. Many men were skeptical at first but after they gave our pills a try their sex life and self esteem changed for the better.Our pills will improve your overall sexual health, make you feel younger and you will have more pleasurable orgasms. You can take one pill 2 times per day to keep the effects of VIMAX PILLS in your system and to promote virility enhancement. 100% Safe and Natural Herbal IngredientsEpunedum Sagitum or Horny Goat Weed - Known in China as Yin Yang Huo. Chinese top medical doctors report that horny goat weed boosts libido and improves erectile function. Used to restore sexual fire and allay fatigue. Saw Palmetto - Known to stimulate a low libido in males and to increase sexual energy. A compound in saw palmetto has aphrodisiac effects. Ginkgo - Medicinal use of ginkgo can be traced back 5,000 years in Chinese herbal medicine.The herb also increases blood flow to the genitals which improves sexual function. In one study 78% of a group of men with impotence reported significant improvement without side effects. Other Ingredients: Muira Puama (balsam), Velvet, Damiana (leaf), Cayenne (fruit), Oats (entire plant), Avena sativa, Ginseng (root), Panax Ginseng, Caltrop (fruit) Tribulus terrestris. penile enlargement stretcher penis enlargment VIMAX Pills helps you gain:
Do VIMAX Pills really work?We get many emails from our customers that say our pills helped them regain their sexual ego. It's up to you when to stop taking our pills since they are 100% safe and made from natural products. We had one customer write to us that he decided to stop the pills after he no longer felt embarrassed when making love. His penis used to be below average, 5 inches to be exact, now he is 7 inches and is fully satisfied. He wrote us saying that now his woman receives an orgasm 95% of the time they make love, before she could barely get excited. "I'm very grateful to Pillsexpert for bringing such miraculous changes to my life. Having gained 2.5 inches from the 4 months supply and became more passionate and sexually attractive I was even able to fix the relationship with my wife (we were on the verge of the divorce) by simply having great sex with her. I feel more confident now and …I'm just happy!!! You know how they say it: ”Miracles don't just happen, they are firstly very well prepared.” No doubt that your company put a lot of time and effort to start helping people. Thank you so much and good luck to you." Mark Andrew, FL penis enargement review natural pennis enlargement pills Why are we #1 on the market?Consider the difference between a 7, 8 or 9 inch penis that is thicker and a penis that is 4 to 6 inches and narrower. With a larger penis you penetrate more sensitive areas of the woman. Your longer penis probes deeper searching those special nerve endings. The added width to your penis fills and presses her from side to side to give your partner the most exhilarating sensations. The results are permanent. You control the growth because once you reach your optimum size you could stop taking VIMAX PILLS. We say you could stop taking VIMAX PILLS because it is not necessary to be larger then 9 inches. Most women can only comfortably accommodate a 9 inch penis. Anything larger than that may be too large for most women. Nine inches or more then 9 inches, the choice is yours. Unlike other clones, Vimax Pills are made from only high end ingredients available to bring you best results possible. We run a serious business and treat as such, unlike other companies that appear out of nowhere and then disappear with your money without ever sending you a product you paid for. best pennis enlargement pills top rated penis enlagement pills Prices
Most of the orders placed before 1PM Eastern Standard Time are shipped the same day. |
||||||||||||
KNOWING ROSACEA Rosacea is a disorder of the blood vessels. It is a common skin disorder. Approximately 48 percent of the world population suffers from Rosacea. However, Rosacea is one of the most misunderstood states of the skin. FAMOUS PERSONS SUFFERING FROM ROSACEA If you are having Rosacea, you are then in the august company of eminent persons. A few of the noted personalities suffering from Rosacea are JP Morgan, WC Fields, Cameron Diaz, Bill Clinton, Prince Harry of England, besides the late princess of Wales and mother of Prince Harry – Diana. ROSACEA SYMPTOMS The common symptom of rosacea is transformation of the skin color into red. The body portions most affected by rosacea are the cheeks, nose and forehead. At times, such redness and flushing of skin can also spread to the ears, scalp, chest or the neck. As Rosacea progresses, the reddish tinge can turn into a permanent condition. There can also be a marked visibility of the small blood vessels particularly at the skin surface, stinging or burning skin sensation, eyes turning gritty and reddish, and pus-filled or simple bumps that appear red. Among these severe symptoms are bulbous noses. The maiden rosacea symptoms are nagging redness which is often wrongly attributed to cleansing, exercising or temperature changes. SIMILAR SKIN DISORDERS Many confuse rosacea with seborrheic dermatitis or/and acne vulgaris. Mentionably, rosacea can co-exist with acne vulgaris and seborrheic dermatitis. THE ROSACEA VULNERABLE SECTION It has been generally noticed that the people with fair skin are the most vulnerable section with reference to rosacea. Therefore, rosacea does have a hereditary strain. Those having a descent from the Celtic or the fair-skinned European stocks are genetically inclined to suffer from rosacea. Notably, both the sexes can fall prey to rosacea. People of all ages can be affected by rosacea. It has also been noticed that people in the age group of 30-50 are easily affected by rosacea. Nonetheless, women in their middle ages are the most vulnerable section of the populace. The reason is, of course, menopause-abetted hot flushes. However, rosacea symptoms are more severe with reference to men. CAUSES OF ROSACEA There is no unanimity among the medical researchers as to the exact rosacea pathogenesis. Nonetheless, there is a concurrence in views insofar as to the cause of rosacea. Rosacea occurs when stimuli repeatedly dilate the blood vessels, and as a result of which the blood vessels get damaged. The damaged blood vessels dilate rather easily. Besides they either remain permanently dilated or stay dilated for a considerably long time. The consequence is redness of the affected portion and its flushing. ROSACEA PAPULES OR INFLAMMATORY PUSTULES The papule or inflammatory pustule can be I the form of a boil, or a pimple, or an eruption for that matter. In rosacea (papulopustular), the mediators (inflammatory ones) as well as immune cells ooze out from the skin bed that is basically micro-vascular by nature. This, in turn, leads to the inflammatory pustule or papule. OTHER CAUSES OF ROSACEA Various conditions can also lead to rosacea. One thing is for sure: strenuous movements cause blushing and flushing. A few of the situations where such flushing or blushing can be formed are as follows: Stress, cold weather, acute sunburn, and extreme heat exposure especially from the sun. Rosacea can also be caused by sudden changes in temperatures while traveling, or in heated rooms especially in winter. FOODS CAN ALSO CAUSE ROSACEA Certain food items that contain very high quantity of histamine have been identified as responsible for the eruption of rosacea symptoms in many people. Similarly, spicy food besides alcoholic substances can definitely trigger off rosacea. MEDICATIONS TOO CAN LEAD TO ROSACEA Several topical irritants and medications may at times cause rosacea. Take for example several drugs people take to hide wrinkles or to deal with acnes. Among these chemicals those particularly responsible for causing rosacea are tretinoin, benzoyl peroxide, isotretinoin, microdermabrasion, and certain chemical peels. Obviously, one should immediately stop the use of any such irritants the moment any rosacea symptoms appear. INDUCED (STEROID) ROSACEA The term ‘steroid induced rosacea’ points to such rosacea symptoms that are caused by steroids, particularly nasal and topical. Notably, these types of steroids are generally prescribed for patients suffering from seborrheic dermatitis. First aid: In such circumstances, immediately consult the physician. Moreover, one should begin the medication discontinuing process over a period of time. Decrease the dosages slowly. Else there may be a flare up of the rosacea symptoms. MITES & BACTERIA CAN CAUSE ROSACEA AS WELL A considerable number of rosacea people have been found to possess the species of mites known as demodex. This is more so the case with those people who have rosacea from steroids. Mentionably, the presence of a large number of these demodex mites can only cause rosacea. But, they cannot by themselves cause the rosacea condition. The demodex mites will have tom act in conjunction with other factors to be able to trigger off the rosacea states. Bacteria, especially the intestinal bacteria, can cause rosacea. These intestinal bacteria reside in our digestive highways. This is a neurological dysfunction. Such rosacea conditions can erupt after the intestinal bacteria activate the plasma kakllikrein-kinin system. THE KAKLLIKREIN-KININ SYSTEM The kakllikrein-kinin system or the kinin-kallikrein system or just the kinin system is a not well delineated structure of blood proteins. The blood proteins have a major role to play in causing pain, coagulation, control of blood pressure and inflammation. Mentionably, the major mediators of the kinin system are bradykinin and kallidin. Both of them act on different cell types. Both are vasodilators DIFFERENT FORMS OF ROSACEA Researchers have identified four forms of rosacea. Each of these subtypes can have its typical symptoms. More importantly, one person can have more then one of the subtypes at the same time. THE ROSACEA SUBTYPES The four rosacea subtypes are Ocular rosacea, Phymatous rosacea, Papulopustular rosacea and Erythematotelangiectatic rosacea. OCULAR ROSACEA Ocular rosacea mainly affects the eyes. The Ocular rosacea symptoms are burning and itching besides sensations as if there are foreign bodies within the eyes. When anyone is affected by ocular rosacea, the eyes and the eyelids turn dry and red. Irritation of the eyes and the eyelids is also very common. PHYMATOUS ROSACEA Phymatous rosacea affects the nose, ears, cheeks, forehead, chin and the eyes. Phymatous rosacea is also linked with the nose enlargement dysfunction called rhinophyma. Another disorder closely connected with phymatous rosacea is the visibility of small blood vessels near the skin surface. Other symptoms of phymatous rosacea are appearance of irregular surfaces on the skin and which may be also accompanied by nodularities. The skin can get thick as well. PAPULOPUSTULAR ROSACEA Many confuse Papulopustular rosacea with acne. However, Papulopustular rosacea remain reddish while acne do not. The common Papulopustular rosacea symptoms are papules (red bumps) filled with pus. Such bumps are called pustules. Papulopustular rosacea papules with or without pustules generally dissolve within five days. People having Papulopustular rosacea usually have permanent redness of their skin. This state is described medically as erythema. Another symptom of Papulopustular rosacea is they tend to flush or blush quite easily. Moreover, the patient can also have burning or itching sensations. ERYTHEMATOTELANGIECTATIC ROSACEA Erythematotelangiectatic rosacea causes the small blood vessels to appear rather prominently near the surface of the skin. This typical state is known as telangiectasias. TREATING ROASAEA There are various treatments for rosacea people. The strategies vary depending on the acuteness and the rosacea subtype that a particular person may be suffering from. Hence, there can be different treatments for different persons suffering from the rosacea symptoms. Hence, the dermatologists opt for the sub-type-directed method to diagnose, analyze and treat rosacea. LASER TREATMENT Laser treatment in dermatology is variously known as Broad spectrum (Intense Pulsed Light), or Single wavelength (Vascular laser). Laser treatment is one of the most popular treatment methods of rosacea. In laser treatment, light is made to infiltrate the epidermis. The light hits the skin’s dermis layer. It targets the dermis capillaries. The oxy-haemoglobin gets heated up after it absorbs the light. The process heats up the capillary walls till 70 degree centigrade. This heat destroys the capillary walls. The damaged walls are then absorbed by the body via its defence mechanism. CO2 LASER TREATMENT Focused thin beams of CO2 laser are manipulated to defocus or cut (as scalpels) the tissues. Then these tissues are vaporized. CO2 lasers are used to get rid of the excessive tissues formed by phymatous rosacea. In this method, our skin directly absorbs the CO2 lasers wavelength. SIMPLE STEPS TO TACKLE ROSACEA (i) Gentle skin cleansing regime Always deal with the skin gently and lovingly. Go for only those cleansers that are non-irritating. (ii) Shielding skin from sun Never venture out in the sun-bated beach sans protection shields. Regularly use sunscreens. Choose such a sunscreen that consists of a physical blocker agent. Such active blockers are titanium dioxide or zinc oxide. (iii) Trigger avoidance It is important to maintain a diary of the foods and the climatic or other factors that generally lead to rosacea. In fact, The National Rosacea Society promotes this habit. This approach also goes a long way in identification and reduction of the triggers. Moreover, trigger avoidance is ideal to control the onset frequency of rosacea. But, all alone it cannot check rosacea. Nonetheless, the mild rosacea attacks can be effectively checked if a patient avoids the factors that triggered off the rosacea symptoms. One can get flushing after consuming red wine or food items having high quantities of histamine. Then, go for antihistamines. Some common antihistamines are loratadine or cetirizine. (iv) Eyelid hygiene Eyelid hygiene is especially recommended for persons complaining of eyelid infections. Practice eyelid hygiene frequently. Here are some easy eyelid hygiene steps. Gently scrub the eyelids daily; You can use baby shampoo in a diluted form; Or, you can also opt for any across-the-counter eyelid cleaner. Apply the cleaner in warm compresses. But, mind you, never should it be hot. Carry on the practice several times in a day. MEDICATIONS (ii) Topical & Oral Antibiotics To get instant relief from the rash, redness, inflammation, pustules and papules, you can go for topical and oral antibiotics. An effective topical antibiotic is metronidazole. Similarly, ideal oral antibiotics are the tetracycline antibiotics. Some examples of tetracycline antibiotics are minocycline, doxycycline, and tetracycline. The oral antibiotics are rather effective in treating ocular rosacea symptoms. Isotretinoin is generally given to patients who complain of persistent pustules or papules. However, there are several side effects of isotretinoin. Therefore, isotretinoin is prescribed only in acute situations. It is also given to treat acute acne. Nevertheless, for patients suffering from phymatous and papulopustular rosacea, low dosages of isotretinoin have been delivering the goods. BETA BLOCKERS OR α-2 AGONIST The commonly used α-2 agonist is clonidine. It is helpful to deal with blushing and flushing. But it has side effects. One can feel drowsy or/and one’s blood pressure may also plummet. So, to neutralize this effect, one can use monoxidine as an alternative. Monoxidine has lesser side effects. But many do not find it as effective as clonidine. Propanolol is an ideal beta blocker. It is akin to α-2 agonists. And, it has been found to be effective in dealing with recurrent social blushing rather than the general rosacea flushing. It is also ideal to tackle anxiety. pennis enlargement before and after pennis enlargement drug herbal penis enargement pnis enlargement surgery cost top rated penis enlagement pills penis enargement fact pennis enlargement patch vig rx pic
Candida yeast infection is a very common disease and more and more people worry they may be suffering from it. Therefore there are a few questions people are asking them most often. The first most common question is: do I have a Candida yeast infection? Well, the answer to this question can be found in the symptoms which are characteristic for this disease. The most common symptoms are itching and the feeling of irritation in the vaginal area; redness or swelling of the vulva; a white, thick, unpleasant discharge which looks similar to cottage cheese and which has no scent, although sometimes it could smell like yeast; the feeling of burning whenever urinating or having sex. These are the most common symptoms for Candida yeast infection. But these symptoms are also similar to other vaginal infections or sexually transmitted diseases. Therefore you should always consult a doctor or a gynaecologist whenever having these symptoms. The doctor will give you the right Candida treatment, if it is necessary in your case. The second most common question is: are men immune to yeast infections? Well, men don’t really get these vaginal yeast infections. Because they don’t have a vagina! But there is an infection similar to Candida yeast infection at women. This infection is called balanitis and its symptoms are similar to Candida yeast infection’s symptoms. This balanitis is an infection of the head of the penis and it is caused by the same overgrowth of the same Candida fungi. Men who are suffering from diabetes are also more exposed to this type of infection. Men can also have a discharge or red and itchy areas like women have. Men who don’t have a circumcision must pay more attention to their hygiene in the genital area, focusing on the foreskin. The reason for this is the fact that the folds of the foreskin represent the perfect warm, moist environment for Candida fungi to multiply. Therefore, the foreskin area needs extra care for keeping it clean and dry. And the third most asked question is: can anyone prevent getting a Candida yeast infection? And the answer will be yes, definitely. The outfits you wear can prevent or cause a Candida yeast infection. Therefore you should avoid wearing nylon underwear, pantyhose, tight jeans, and tight exercise gear, wet bathing suits which are retaining moisture in the area as Candida fungi love this warm and moist environment. If you can’t avoid wearing these outfits, at least try to wear them for as little time as possible. You should also pay attention to dyes or perfumes in shower gels, soaps or sanitary products as they may cause you irritation to the genital area. If you feel this kind of irritation happening, stop using the product and try switching to a perfume-free one. Also keep your vagina clean and dry. Give up on nylon underwear and use the healthier cotton one. Avoid wearing too tight jeans or pantyhose. And don’t take antibiotics unless the doctor has prescribed them especially to you. Try to follow these few rules and you will never have to worry about getting a Candida yeast infection! compare penis enlarement pills penile enlargement tool enlargement penis pill vimax penis enargement drug pennis enlargement testimonials pennis enlargement pills pnis enlargement procedure penis enlarement pump vimax does penis enlargement work
NATO enlargement is doubtless one of the most important issues in NATO-USA relations and in attitude of American politics towards this organization. Therefore, in dealing with American-European relations within NATO, it is impossible to question the issue of enlargement of this alliance. NATO enlargement towards Central and Eastern European states was originally the major project in seconding NATO’s viability. The purpose of the first enlargement round was regarded by the USA in preservation of NATO as a form of military-political cooperation between the USA and Europe and conservation of American influence on European security along with strengthening Western military potential for resistance of possible, even in post-bipolar era, threats from the East. To this end, and also with the aim of overcoming alarm of many European allies as to Russian attitude towards enlargement, American diplomacy took to creation and consolidation in Western-European and American political discourses of idea on additional NATO’s function as an organization focusing on spread of democratic values and institutions and stabilizing internal political situation in member-countries. North Atlantic Alliance as instrument of promotion of democracy and stability was accepted by the European leaders as indubitably necessary. In that way, having ensured Europeans’ consent to such broadened understanding of NATO’s function, the United States consequently brought the conflict with Russia to acceptable intensity level by providing Moscow with “special status” in its relations with the Alliance, which was fixed in Fundamental Act between Russian Federation and NATO, signed in May of 1997. The current article isn’t aimed at complete revealing of all the details of NATO enlargement process but instead focuses on the principal issues of American policy shift regarding NATO in general and its enlargement in particular. While in the early January of 1994 the text of President’s „State of the Union” speech noted that American security will further depend on the US ability to most effectively ensure democratic development of Eastern European states, in this way putting particular emphasis on principal role of NATO enlargement for American interests, in the late 1990s and early 2000s this approach fundamentally changed. When in the middle 1990s there emerged an issue of NATO preservation in new circumstances, the United States regarded their North Atlantic allies as potential assistants in carrying out their military operations worldwide in interests of America. But Washington’s expectations concerning significant military contribution of Allies confronted with a cruel reality. For the USA, 1990s became a period of more intense economic growth as compared to the Europeans. This was attended by fast technological progress, particularly in military industry. At the same time, European Allies shortened their military budgets. Thus, 4,565 million dollars, being merely 13-% rise in American military budget, turned out to exceed total budget of any of NATO allies. By the end of the decade, this trend led to the fatal gap of Europe from the level of American military and technological potential. The Allies, apart from Great Britain in some particular cases, proved simply unable to grant the USA assistance in military operations requiring decent technological level. This gap very soon was revealed in action yet before the launch of second NATO enlargement debate. Thus, among the NATO resources involved in Yugoslav military campaign in spring-summer of 1999, American resources played the principal role: about 60-70% of air force and 80-90% of cruise missiles were American. During anti-Talib operation of autumn 2001 even British contribution couldn’t be compared to American: more than 90% of resources and 95% of advanced technology armaments were supplies by the Americans. American government was aware, already before taking decision on anti-Talib war launch, that there was no chance of reckoning on something more than political support and some complimentary military functions on NATO’s part. The last point demonstrating Washington’s attitude to the enlargement process was elaboration of Iraqi operation implementation scenario in 2002-2003, which didn’t even include NATO as military structure along with a number of minor allies. Among other reasons, this happened because absence of internal accord within North Atlantic Treaty Organization concerning necessity of the operation, firmly advocated by the USA and Great Britain. Consequently, American interest in NATO as a block of military allies in many ways expired. The main mission of the Alliance for the United States now turned into political and back support of American military operations. Such shift of mission caused change of American agenda for NATO. In such circumstances, avalanche-like Alliance enlargement became the most appropriate way of enlargement. Therefore, on Prague summit, the invitations to enter NATO were made to seven states: Bulgaria, Latvia, Lithuania, Romania, Slovak Republic, Slovenia, and Estonia. Many of these states had to undergo a long way at least to reach the level of first-wave entrant states. However, in what concerns political support of American military initiatives, newly invited counties showed their support of American policy right away after Prague summit in discussions, and then in actions relating to Iraq in 2002-2004. Since mid 2002, American political analysts have been growingly talking on shifting NATO’s role from military ally of the United States and instrument of collective protection of Allies’ security into “platform for coordination and facilitation of joint diplomatic actions with the uniformly thinking allies”. Besides, another advantage from mass enlargement of NATO to Easter-European countries was mentioned: possibility for the United States to “concentrate on other regions” after enlargement. Read other articles in the series at Politics. cheapest penile enlargment pills vimax homemade penis enlargement penis enlargment surgery cost erection penis pill size vimax natural penis enhancement penis enlarement before and after buy pnis enlargement pills penis enargement review vimax does penis enlargement work
Want to have big cum shots? Increase semen volume? For many men, it is a matter of confidence, a bigger load is means increased libido, fertility and potency. When you increase semen volume you also increase pleasure, the larger the load, the greater number of pleasurable muscle contractions. So what product can really increase your semen volume? The family jewels, it is a sign of our manhood and our strength. Men take all health issues about the penis seriously. We just want the best and not suffer humiliation or miss out on great sex. Some worry more on size or erections, but it all comes down to the big finally, ejaculation. Over time, the focus on the power of ejaculation has increased. Men not only worry about the power of their ejaculation but also on enjoying sex by having more semen volume in ejaculation. All this affects on our sexual identity but most important our pleasure and our partners pleasure. So are you worried you may not have a potent semen volume? Worried that it will affect your sex life? When should a man be concerned about his semen volume and potency? Sometimes a dramatic decrease in ejaculate volume may indicate blockage of one of the ejaculatory ducts. This is associated with the prostate so it’s good to check with your doctor on this before it gets worse. Decreased semen volume may also just be a normal part of aging. But you’re not just going to sit back and let aging to anything else keep you from enjoying sex. You need a solution that will increase semen volume. The advantages of having more semen volume and power are numerous. By increasing semen volume the load is not only bigger, more impressive and more pleasurable, but much more potent, too. The larger the volume of semen and sperm that's available for each ejaculation, the more contractions it takes to shoot all of it—and each contraction is stronger and more intense. The male ejaculation, typically quite a brief event, can become a much longer-lasting experience. Your partner will be amazed and you’ll be satisfied. So where can you get the magical potion? You can thank the power of nature. That’s right, nature. Sometimes we think chemically based medicines provide solutions but in this case Viagra won’t work and with all the possible side effects it’s not worth the risk. Nature provides man with herbs and all natural remedies that promote a healthier sex life and help increase semen volume and stamina. Take for example horny goat weed. It’s a self explanatory name of course. This plant boosts your testosterone and libido thereby giving you a stronger ejaculation. Other major herbs that will allow you to shoot father are Maca, muira puama, para para and more other freaky scientific names. So where can you get these ingredients? Of course you just can go to your back yard and pick some horny goat weed or muira puama. These herbs are found in certain places and grown precisely to provide the best results. Thanks to major industries, they’ve done all the work for you. Increase semen volume pills are big on the market right now, but only a few really give you real results. You have to make sure that penis pills are 100% natural. Do some investigation it’s better to be safe then sorry in this case. Look up the ingredients and make sure that there are no side effects. With the right dosage and blend of ingredients your body will be provided with the nutrients needed to create quality, thick semen with good mobility and life. herbal penis enlarement vimax enlargement forum free matter penis size best enlagement exercise penis enargement free penis pills sample free penile enlargement exercise penis enargement drug penis enlargement excersizes penile enlargment product vimax does penis enlargement work
Male factors are projected to produce about thirty percent of all infertility troubles and to contribute to them in another twenty percent. Whatever conventional wisdom may have to say about whose "fault" the problem is that figures indicate that the responsibility is split about equally between the sexes. Studies initiated by the National Institutes of Health at six universities are exploring the infertility consequences of the increase of sexually transmitted diseases among the young. At greatest risk are those between the ages of fifteen and nineteen regardless of socioeconomic differences. The production or quality of sperm may be affected by congenital and genetic abnormalities, injuries to the genital tract, heat, age, sperm agglutination, acute and chronic infection (often sexually transmissible infections), malnutrition, previous surgery, allergies, chronic illness, environmental or occupational factors (such as radiation), varicocele, or certain medications. Among these medications are Tagamet, used in ulcer treatment; drugs used for treating cancer; and some antibiotics (especially those used to treat tuberculosis). Also heavy smoking of marijuana and smoking generally, alcoholism and stress may result in impotence or inability to ejaculate. Varicocele, a varicose enlargement of the veins of the spermatic cord, is a potentially curable cause of male infertility. While this condition occurs in many men with normal fertility, it has been found to be present in as many as forty percent of infertile men. Half of all men with varicoceles have decreased sperm count or sperm motility or other changes in the semen analysis. Theories of the cause of these changes include heat, pressure and toxic substances from the dilated vessels. Permanent or temporary damage to the male testis can occur as a result of a genital infection or a systemic infection. Gonorrhea may do enough damage to the male genital tract to result temporarily in a marked decrease in the sperm count. Mumps in an adult male may involve one or both testicles and may cause severe testicular damage. Fortunately, usually only one testicle suffers severe impairment and the sperm count, though possibly reduced, is usually compatible with fertility. Any systemic viral or bacterial infection may cause a temporary depression in the sperm count. Because many of the infertility tests for women are more complicated and involve more risk than those for men, infertility testing often begins with the male. A semen analysis is a simple test that can provide a great deal of information. The male is asked to submit a recently ejaculated semen specimen to the physician or laboratory. This specimen is then examined microscopically to determine sperm count, their size and shape and if they are able to move normally. There is no sharp line of demarcation between fertility and sterility in the sperm count. Counts of less than twenty to forty million per cubic centimeter are often correlated with decreased fertility, although men with counts of five to ten million have fathered children. A high percentage of sperm with abnormal shape, size, or decreased motility is also correlated with decreased fertility. The semen can be analyzed also for antibodies and cultured for various infections. The hormone levels in the man's blood are also measured to make sure his hypothalamus and pituitary glands are functioning normally.