Because a lot of guys are too embarrassed to ask their doctors certain questions about their sexual health, they turn to Google. It’s not always easy to figure out if the information is good or bad. I can help answer your questions and sort out fact from fiction on:
2. Penile curvature
3. Ejaculatory dysfunction
Guys, remember, you can always ask your doctor. Whatever your question, you can bet he or she has heard it all.
1. Erectile Dysfunction (ED)
I talk about this topic all the time and there’s one thing you should realize – you are not alone. Men think and talk about this a lot, whether or not they admit it.
What is ED?
Erectile dysfunction is difficulty or the inability to achieve and maintain an erection. Generally, anything that interferes with the vascular system, which includes the veins and arteries that supply blood to the penis, can cause ED. Factors that can lead to ED include:
Erectile dysfunction increases with age. Although men at any age may experience ED, aging plays an important role. ED affects 5 percent of men in their 50s; between 15 and 20 percent of men in their 60s; and about half of men 75 and older. In all, ED affects about 40 percent of all men at some time in their lives.
Diseases and conditions
Diabetes, stroke, kidney disease, heart disease, hypertension (high blood pressure) and other conditions, even being overweight, can cause ED.
Medications such as antidepressants and hypertension medications can cause ED. In the case of hypertension, both the condition and the treatment can cause ED.
Surgery or injury
Any surgery or severe injury in the abdominal area that damages the nerves may result in ED.
ED can be treated
There are many treatment options for ED. If ED is caused by your medication, simply changing or reducing your medication, if possible, may help. If your ED is due to surgery, I usually advise waiting a year before providing any therapy to see how much function you regain.
Other options include: oral medication, injectable medication, and surgery. Depending on your condition, I usually start with oral medications that improve blood flow (you’ve seen the commercials on TV). You may receive injectable medication that increases blood flow by dilating the blood vessels.
Surgery is the last option
Surgery to implant devices for treatment of ED is almost always the last option, and is only indicated if all other available therapies do not work. There are several types of implant devices, and I have several examples in my office that you can see and examine during your first appointment. And be sure to bring your partner!
Symptoms could be warning signs of other problems
Erectile dysfunction can predate other related conditions by a few years. If you have ED with no obvious causes, see your doctor or a urologist. You may benefit from early diagnosis of a serious condition or rule it out altogether.
You have lots of options to improve
Some men aren’t bothered by ED. They may not be sexually active or, for whatever reason, it doesn’t matter to them. For others, it’s a huge quality of life issue. For those men, there are lots of options for treatment and improvement.
2. Penile Curvature
Also known as Peyronie’s disease, penile curvature is an acquired condition, not congenital. It results from a strong inflammation or inflammatory reaction that causes scar tissue to develop deep inside the penis tissue. This causes the penis to curve, bend or rotate.
Penile curvature usually develops slowly. You may first notice curvature or pain during an erection.
Possible treatment options include:
There is no FDA-approved oral treatment for penile curvature, and no off-label oral therapies have shown success. There is one FDA-approved, doctor-administered injectable therapy that shows reasonable improvement.
Do you need treatment?
During your first visit, I will discuss options with you and your partner. Before any treatment, we make sure the curvature is stabilized and not getting worse.
It’s important to know that penile curvature is not dangerous to your health in any way. It only looks different. Unless curvature causes you or your partner pain and discomfort during intercourse, or if it causes undue psychological distress, there is no need for treatment.
Even if you and your partner just need reassurance, the first visit is the most important.
3. Ejaculatory Dysfunction
There are many forms of ejaculatory dysfunction. It can be painful, premature or delayed. Each has its own questions and treatment options. My job is to help guys sort out the problem and decide what to do.
The most discussed problem
- Injury during regular intercourse that may not be obvious
- Surgery on the penis
- Radiation from therapy or other source of exposure
- Out of all the types of ejaculatory dysfunction, the most discussed is premature ejaculation. So first, let’s set the record straight. On average, most guys last about five minutes during sexual activity. Premature ejaculation is defined as less than one minute of sexual activity prior to ejaculation. These are the guys I treat most often
Causes of premature ejaculation include medication and surgery. These may require changes in medication or waiting for complete recover from surgery to see if function improves. Otherwise, I can prescribe medications that delay ejaculation. I also help men receive sexual counseling and training that can improve their timing and allow them to functionally enjoy sexual activity.