Author: fitness-expert
Q. I’m 59, and I’ve had difficulty getting an erection suitable for intercourse since I started taking antihypertensives about 20 years ago. I have also had four back surgeries (three procedures for herniated lumbar discs and a total lumbar fusion) that left me with some permanent nerve damage, causing foot drop and weakness in one leg. I have tried penile suppositories and injections. Although the injections were somewhat helpful, they were not ideal. Might an implant be my best option at this point? Should I see another urologist for an opinion? A. You have pointed out two possible causes for…
Q. When a man wakes up in the morning, should he always have an erection? If he does not, should he see a doctor? A. Nocturnal erections are part of the normal physiologic rhythm for men. There is nothing sexual about nocturnal erections. The erections are the body’s way of refreshing the blood in the penis. Unlike other parts of the body that have a high blood flow all the time, the blood flow to the penis is low during the flaccid (soft) state. When the penis is erect, the blood flow goes up. That means that most of the…
Q. I am 26 and was recently diagnosed with diabetes. I am having a hard time maintaining an erection or reaching orgasm. Can anything be done to correct this problem? A. Diabetes is not just a sugar problem. Unfortunately, while researchers and doctors can develop effective medicines to control blood sugar, other manifestations of the disease can still occur. For instance, long after the original diagnosis — typically 10-20 years — some of the body’s autonomic nerves (which control the bladder, bowel and erectile function) may start to fail. This is called diabetic neuropathy. Symptoms could be the inability to…
Q. Can eating foods containing phytoestrogens lower a man’s testosterone ratio, thus leading to erection dysfunction? A. Estrogen supplements can lower testosterone, and in fact some of the early forms of treatment for prostate cancer were estrogen therapies to lower testosterone production. However, I am unaware of any study with phytoestrogens that has been shown to affect testosterone levels. In urology, the most famous phytoestrogen is an herb called saw palmetto. This substance has been investigated extensively, and it is commonly used for enlarged prostates. Some studies have shown that it can affect prostate growth without affecting sex drive or…
Q. I am considering taking Propecia for male-pattern baldness. Besides the figures the company supplies, can you refer me to any independent information regarding its effect on a man’s erection and urge to have sex? A. Propecia is the trade name for finasteride. Finasteride was designed for treating enlarged prostates. It works by blocking an enzyme responsible for changing testosterone into dihydrotestosterone (DHT). High levels of DHT can be bad because the substance promotes cell growth in the prostate. If we decrease the production of DHT, the prostate shrinks. The formulation of finasteride used to treat the prostate comes in…
Q. I am 32 and can’t sustain a rigid erection for a long period of time. I’ve been to one doctor, two urologists, an impotence center and a psychologist and the only answer I have is a prescription of Viagra. The impotence center did thorough testing and determined I had a blood leak. An electrode rigid meter verified I did not have normal erections during sleep. I obtained two semi-erections, about 50 percent of normal. With Viagra I feel like I did when I was younger. However, I don’t want to depend on drugs the rest of my life. The…
Q. My fiance is 49 and has liver cirrhosis and is positive for the hepatitis C virus. His erection is short-lived and very weak, and it is not easy for me to get orgasm with him. He was a heavy alcoholic, but he stopped drinking completely six months ago. Do you think there is a possibility of improvement in his case? What medication or advice can you suggest? I am shy about telling him my problem with this, as he thinks he is perfect. A. From what you are describing, your fiance has a very serious problem. First, hepatitis C…
Q. Would you recommend Viagra for increasing the libido in a man who can get an erection but has trouble with sex drive? A. Viagra works by increasing the blood flow to the penis and in effect producing a stronger erection. Unfortunately, it requires the user to supply the desire. for sexual relations (libido). Viagra alone will not increase libido. In general, men with a decreased sex drive have either a physiologic issue or a hormonal imbalance. When I see a man with this complaint I spend time trying to identify stressful social issues like problems with work or money.…
Q. My boyfriend is only 17 and cannot get an erection. I thought only older men had this problem. What could possibly be causing this? I fear that I am not attractive to him, or perhaps he is cheating on me. Am I the cause of the impotence? Is there anything I can do? I try to talk to him about it, but he just gets quiet or frustrated. A. You must be patient. At 17, there are few medical reasons for erectile dysfunction. In fact, I don’t think I have ever treated or seen a healthy 17-year-old with this…
Q. If a person is on a cholesterol-lowering drug (Zocor 10mg) but otherwise healthy (no high blood pressure, no diabetes, no nitrates), can he safely take Viagra to overcome an erectile dysfunction problem? I heard Viagra has side effects only for people on nitrates. A. As you correctly pointed out, there is only one contraindication to Viagra, and that is for people on nitrates. The interaction of the drugs can cause heart attacks, and several patients taking nitrates and Viagra together have died. I refer all my patients to the manufacturer’s insert, which lists all the side effects associated with…