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BURROWS: Libido and erectile dysfunction are often confused. Some men have no trouble obtaining erection but have no desire to engage in sexual activity. These men should have their blood levels tested for testosterone and if this is found to be low, have the option of receiving testosterone replacement therapy.
Supplements such as DEHA do not appear to improve libido significantly. MEMBER QUESTION: I have been married for 4 years and had a baby about 5 months ago. Since then, and while I was pregnant, my husband refuses to have intercourse or anything sexual for that matter. It’s been 10 months and he will not talk about it.
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I have tried talking to him a million times in non-accusatory ways. Everything else in our relationship is great and he adores our baby. I don’t know what else to do. I’ve tried everything. I wish I knew what he was thinking. BURROWS: Your husband may benefit from an underlying evaluation of his general health.
Most likely these will return normal and the two of you would benefit from couples counseling. Possibly, however, seeing a physician rather than counselor would be a good step to initiate this process. MEMBER QUESTION: Hi Dr. Burrows, thanks for answering our questions. I have read so much research on saw palmetto saying it’s a weak inhibitor, and it does not reduce the prostate by much compared to Proscar.
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Is that true? BURROWS: Saw palmetto was initially thought to act similarly to medications such as Proscar. However, after extensive testing it does not appear to inhibit the same enzyme that Proscar works on. Saw palmetto does seem to have a beneficial effect for men with DPH symptoms, and also may be beneficial in preventing prostate cancer.
MEMBER QUESTION: I recently heard of an experimental drug developed as a tanning agent that also caused erections and weight loss. Do you have any information? (And, can we all buy stock in the company?) BURROWS: I think you’re referring to a melanocyte-stimulating hormone (MSH) product that is in development by a company called Palotin.
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I am uncertain of its effect on diet and weight loss. This medication looks promising and is in phase two of trials, possibly one to two years away from being released. MEMBER QUESTION: I play college hockey and I was wondering if taking shots to the groin frequently will affect me later on in life.
BURROWS: If you have ever noticed significant bruising or swelling after one of these injuries, then a scrotal ultrasound should be done to see if there has been a rupture to a testicle. Injuries which cause testicular rupture can result in scarring which will decrease both sperm production and testosterone production.
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He refuses to go to the doctor. What should I do? BURROWS: Send him to the doctor emergently for an ultrasound. He likely, however, has a hydroseal, which is water around the testicle, but he should be evaluated for testicular cancer. MEMBER QUESTION: Why does cranberry juice help urination so much? What’s special about it? BURROWS: Cranberry juice does not appear to have any beneficial effect on urinary tract infections or prostatitis.
Lexapro, Paxil. They are not taken daily, such as for depression, but as a low dose along with the potency medication. MEMBER QUESTION: I have been having problems when I get aroused with maintaining an erection. I have also noticed a lot of semen leakage when I have this problem.
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What might be going on? BURROWS: This sounds like premature ejaculation and loss of erection with a climax, hence the semen leakage. You should discuss this with your physician to determine if you are a good candidate for medical therapies. BURROWS: Many men have a difficult time reaching sexual climax with vaginal intercourse when they are accustomed to masturbation or manual stimulation.
It may be worthwhile to have a testosterone check as occasionally, when testosterone is low, there is less penile sensitivity. MEMBER QUESTION: My husband had a trauma injury to his urethra. It was torn in half. The urologist reattached and after months of surgery he is normal, except for a sexual problem with erection.
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Certainly the alcohol intake is a factor, but I suspect the majority of the impotency is from the injury and the subsequent repair. MEMBER QUESTION: I am currently taking samples of Levitra and Cialis and they have helped with erection, but I am having problems with achieving an orgasm. There seems to be less sensitivity in the penis.
Is there anything I can do? BURROWS: Lack of sensitivity may be a sign of low testosterone. This should be checked through a blood test. Diabetes can slowly injure the nerves that contribute to penile sensitivity. This problem however, is irreparable and I would suggest having the testosterone checked and replaced if it is indeed low.
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MEMBER QUESTION: Recently I had a birthmark removed from my groin area. It was a simple cut and stitch. Before removal, I would have erections easily, but afterwards, I haven’t been able to. It has been about two weeks. I am young, I don’t smoke, I have a healthy diet and I am not overweight.
MEMBER QUESTION: Will ejaculation (intercourse or masturbation) daily be good or bad or really doesn’t make any difference for prostate health? I assume regular ejaculation, whatever that is, is good for my prostate. BURROWS: Regular ejaculation daily, weekly, or monthly, depending on the man’s sexual habits, is helpful for prostate health and preserving sexual function.
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MEMBER QUESTION: I masturbate a lot and now I have white bumps on both sides of the head of my penis. What can I do for this? BURROWS: These are likely pearly papules, a harmless benign condition, but you should see your doctor for confirmation that you do not need any treatment.
A lot of new medications that can treat libido, premature ejaculation and erectile dysfunction are on the horizon. A man or couple should never be afraid or embarrassed to bring these topics up with their physician because very likely in your community there is someone specialized in this new area of medicine.
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There does not appear to be a single supplement at this point that has greater than placebo effect. Spend your money wisely. Erectile dysfunction may also be a symptom of underlying medical conditions, such as coronary artery disease, hypertension, diabetes or heart disease. These should all be addressed and discussed in the evaluation of erectile dysfunction.
And thanks to you, members, for your great questions. I’m sorry we couldn’t get to all of them. ©1996-2005 Web, MD Inc. All rights reserved.
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Contents Loss of or reduced sexual desire or interest Erection difficulties (erectile dysfunction / ED) Ejaculatory and orgasmic changes including dry ejaculation Most sexual difficulties experienced by men living with cancer or living beyond cancer present as a loss or reduction in sexual desire, erectile difficulties (ED) and ejaculatory and orgasmic changes.
These include the supplementation of testosterone, oral medicines and psychosexual therapy. Sexual difficulties should not be taboo, getting help when it’s required is as important to your recovery as any other aspect of care you receive. Sexual dysfunction is common among men (and women) living with cancer and living beyond cancer.
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Here, Perci’s psychosexual therapist Dr. Isabel White and our cancer specialist nurse Johanna Bowie outline the sexual difficulties that can occur, plus ways to reduce or alleviate the symptoms post cancer treatment or surgery. The most common cancer treatment-induced sexual difficulties experienced by men are: Loss of or reduced sexual interest or desire, Erection difficulties (ED)Ejaculatory and orgasmic changes People going through or having completed cancer treatment can experience a low or loss of sex drive for several psychological, relationship or physical reasons and sometimes it is a combination of factors that cause and maintain this reduction in sexual wellbeing.
You may be referred to a urology or andrology service to further investigate the most appropriate medical management for your low testosterone level. If you / and or a partner are distressed by a change in your sexual wellbeing then you may decide to seek professional advice or support Low testosterone levels are more commonly seen after intensive systemic cancer treatments such as after high dose chemotherapy or stem cell transplantation but may also occur after testicular surgery (if the remaining testis is not working optimally or must be removed) or a prostatectomy.
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In this clinical situation it is usually contraindicated to offer testosterone treatment. Where the man is on long-term ADT, some consultants will consider a “hormone holiday” for a few months where ADT is temporarily stopped. If that is something the man and his partner wish to explore, it allows some time to see if testosterone level recovery will lead to improvements in sexual desire and arousal (erectile function).
Erection difficulties are typically more severe when it has not been possible to spare the nerves that control erectile function due to the extent of surgery necessary to remove the cancer successfully. After surgery erection difficulties are present immediately and nerve recovery, where it can occur, can take up to two years.
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Whether your changes in erection function are temporary, intermittent, or persistent and whether it is still possible for you to get a partial erection or there is no non-assisted erectile function at all, there are a number of effective treatments available through your treatment team or GP that can help.
Intracavernosal injection (ICI) of Alprostadil or Invicorp where a small amount of the active drug is injected (self-administered) at the side of the base of the penis to create an erection, Surgical implantation of a semi-rigid or inflatable penile implant (NB. this treatment option is usually reserved for men who have tried all other treatments without success as it is necessary to remove the erectile tissue in the penis to insert the implant and is thus an irreversible procedure).
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This can also be helpful where biomedical treatments have not been able to completely resolve erection difficulties. Reaching climax or orgasm through sexual stimulation by ourselves or with a partner is seen by many as one of the satisfying aspects of being sexual / expressing ourselves sexually. The majority of men consider orgasm and ejaculation an important element of sexual satisfaction but may vary in the type and intensity of stimulation necessary to achieve orgasm.
Orgasmic changes may be experienced after pelvic surgery or radiotherapy for a rectal or urological cancer, they can also occur following treatments that affect our level of male hormones, such as ADT for prostate cancer or after the testicles have been removed or irradiated, especially if we are not able to have testosterone replacement therapy.
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Men still experience the sensation of orgasm, but it is what some men call a “dry orgasm”. Retrograde ejaculation can be treated by a urologist or andrologist and treatments can include the use of medication called alpha agonists (such as Ephedrine).: the ejaculation of little or no semen. Usually happens after removal of the prostate (prostatectomy), removal of the bladder (cystectomy) or after radiotherapy to treat cancer in the pelvis.
One of the first ways you might notice that you are having porn-induced erectile dysfunction issues is if you can’t get or maintain an erection when having real sex with a partner. Or, you might have noticed that you only ever masturbate to porn or porn-related fantasies. If this is the case, then taking this simple test can help you figure out if PIED has become an issue.
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Even if they are only pixels on a screen and not “real.” When you watch porn, a part of your brain thinks that the super-attractive women you see on your screen are real, and sexual interactions will be “real” as well. Then you pleasure yourself and achieve an orgasm so wonderful that you do it again and again.
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