{"id":2334,"date":"2010-09-21T17:00:56","date_gmt":"2010-09-21T21:00:56","guid":{"rendered":"http:\/\/ehealth.cooperhealth.org\/?p=2334"},"modified":"2010-09-21T17:00:56","modified_gmt":"2010-09-21T21:00:56","slug":"mens-sexual-health-qa","status":"publish","type":"post","link":"https:\/\/blogs.cooperhealth.org\/ehealth\/2010\/09\/21\/mens-sexual-health-qa\/","title":{"rendered":"Men\u2019s Sexual Health Q&A"},"content":{"rendered":"

\"concernedMore than 30 million American men suffer from sexual dysfunction \u2013 a condition that has a tremendous impact on a person and his partner\u2019s quality of life. Even though our bodies and minds change as we get older, that doesn\u2019t mean we should put our sexuality on a shelf. In fact, a study published by the AARP in the last decade revealed that one in four men over the age of 75 have intimate relations with their partners at least once a week.<\/p>\n

Health issues are the major contributing factor for men with erectile dysfunction. The most common problems include difficulty in achieving or maintaining an erection, premature ejaculation and age-associated emotional, physical and hormonal changes.<\/p>\n

The good news is help is available. Men have a variety of options, not just the \u201clittle blue pill\u201d that has brought the issue of impotency from the shadows into the spotlight. Here, world-renowned men\u2019s health expert Allen D. Seftel, MD, FACS, Head of Urology at Cooper University Hospital, answers some of the most pressing questions men and women have about male sexual health.<\/p>\n

Question: I am 63 and have had heart problems for 17 years now. I recently had open heart surgery and after a few weeks I noticed that my erection is stronger. My surgeon explained that this is not uncommon. However, I still cannot enter my partner. I am taking a lot of medications and have been told that they are causing the problem.<\/strong><\/p>\n

Dr. Seftel:<\/strong> First and foremost, speak to your primary care doctor or cardiologist to discuss your medications. If you are not taking nitroglycerin and your cardiac status is stable, then you may benefit from a phosphodiesterase inhibitor (PDE-5 inhibitor) such as Viagra\u00ae, Levitra\u00ae or Cialis\u00ae.<\/p>\n

I also recommend checking your testosterone level. Low testosterone levels \u2013 often referred to as andropause or male menopause \u2013 can have a dramatic impact on a man\u2019s ability to enjoy sex and maintain an erection. Testosterone levels in men begin to decrease steadily starting in their 30s and about 5 percent of men have lower than normal levels. An unusually low level of testosterone is called hypogonadism. Testosterone replacement therapy may help and can come in a prescription for synthetic testosterone or injections, patches or gels. It usually takes one to three months for the testosterone to take full effect.<\/p>\n

If these don\u2019t work, MUSE is a reasonable option, but you may experience discomfort. MUSE is a suppository a man inserts into his urethra which releases a pellet containing the medication alprostadil. Other options can include a vacuum erection device, penile injection therapy or insertion of a penile prosthesis.<\/p>\n

Question: I discovered I have Peyronie’s plaque about seven months ago. I\u2019ve been taking medications for three months and they haven\u2019t corrected the Peyronie\u2019s. Is there something I can do?<\/strong><\/p>\n

Dr. Seftel: <\/strong>Peyronie’s disease is also known as \u201ccurvature of the penis\u201d and is caused by plaque build-up. The plaque can develop anywhere in the layers of the penis that contain erectile tissue. It can also shorten the area in which it forms. The result is an abnormal bend in the penis that occurs during an erection and can make erections, penetration and ejaculations very painful. There are a variety of ways we can treat this. Verapamil can be used as a topical cream or be injected directly into the plaque that has formed within the penis. Many men find help by using a vacuum pump. We can also correct Peyronie’s through surgery.<\/p>\n

Question: My prostate has been removed via surgery and I am unable to obtain an erection. I have tried medications with little success. I recently obtained a vacuum pump. It seems to help but it is cumbersome and not very comfortable. Are there any other treatments for my problem? I do not have any other health problems at the moment.<\/strong><\/p>\n

Dr. Seftel: <\/strong>You can try injections of certain medications such as prostaglandin E1 directly into the penis. You can also have a penile prosthesis surgically implanted. Penile prosthesis are either malleable (bendable) or inflatable and are surgically implanted within the erection chambers of the penis.<\/p>\n

Malleable implants leave the penis semi-rigid. They are lifted or adjusted into the erect position prior to sex.<\/p>\n

Inflatable implants are the most popular. They allow a man to have an erection when he chooses and are much more natural. They work by allowing for the transfer of fluid within the components of the device to create a rigid erection or return it to its flaccid state. They do not change sensation on the skin of the penis or a man’s ability to reach orgasm or ejaculate.<\/p>\n

The surgery takes between two to four hours and usually requires an overnight stay in the hospital. Most men can return to strenuous physical activity within a month and can resume sexual intercourse within four to six weeks.<\/p>\n

Penile implants are especially helpful for men with vascular disease, diabetes, benign prostate disease, Peyronie\u2019s disease, neurological disease, hypogonadism, pelvic fractures and impotence related to diseases such as chronic renal disease, alcoholism, multiple sclerosis, genital trauma, Parkinson\u2019s disease, and drug therapy.<\/p>\n

Question: I am taking medications for peripheral arterial disease (PAD), congestive heart disease and hypertension. My question is: Am I doomed with little or no sex in my future? I am 60 years old and have tried pills and the vacuum pump. Nothing works. Help!<\/strong><\/p>\n

Dr. Seftel: <\/strong>Try the penile injections. They are great. If these do not work for you, then consider a penile prosthesis.<\/p>\n

Question: My question is that my husband performs very well, but he doesn\u2019t satisfy me. He stays only three to five minutes and ejaculates. Please advise me on how he can stay longer to give me satisfaction that I need as a wife?<\/strong><\/p>\n

Dr. Seftel: <\/strong>This is a tough question. There are drugs to help him last longer, but lasting longer may not translate into you being more satisfied. Open communication is a good first step toward solving this problem.<\/p>\n

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