Author: Troy Browning

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 very few physical causes for erectile dysfunction (ED). Most healthy teens experience normal erections, especially during sleep or upon waking. However, injury,…

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…

Q: My 52-year-old husband has been having a lot of problems. First, he wasn’t able to get an erection and was having pain in his lower abdomen. His doctor treated him for prostatitis. It helped relieve the pain, but then he got worse. He went to a urologist and was put on Flomax. He has been able to get erections, but they are painful, especially at the tip. After taking this medicine for about a month, he began experiencing a curved penis. He went back to the urologist who told him he had Peyronie’s disease and said there was nothing…

Q. My husband is 42 and continually says that he is in the prime of his life sexually. I doubt that’s true. Can you please clarify this subject for us? A. You are correct. Most studies have shown that men reach their sexual maturity at age 17. At that time, their sexual drive and stamina are both at their peak. On the other hand, women reach their peak in their mid-30s. Nonetheless, individuals vary. Your husband may actually be in his prime, if that’s what he wants to believe.

Q: I am 51, and I have a problem with keeping an erection for more than 10 minutes. I think it is a blood circulation problem, because my feet always feel cold and my testicles feel cool to the touch. If only I could stay erect for another 10 minutes I would be satisfied. My doctor gave me a prescription for Viagra. He says I don’t need to use the whole pill, but to cut it in half and see how that works. What would it do if I cut it in quarters? Would that help me out for another…

Q: I’ve tried Viagra for erectile difficulty, but it gives me headaches. I’ve heard there are other sexual enhancers available or in testing. What can you tell me about these? A: Headache is a common side effect of sildenafil (Viagra). The good news is that “sexual enhancers” today include several evidence-based options with different dosing schedules and side-effect profiles. Rather than pushing through headaches, it’s reasonable to consider alternatives and complementary strategies with your clinician. Modern Oral Options (beyond Viagra) If your primary concern is side effects, discuss starting doses, timing, food/alcohol interactions, and potential drug interactions (especially nitrates and…

Q. My husband is addicted to marijuana. He has had difficulty maintaining a complete erection since I have known him. Could the long-term marijuana use be a factor in his inability to maintain an erection? What should I do? This is a very sensitive issue. A. To start with, your husband needs professional help. Addiction to marijuana is no different from addiction to alcohol or other mind-altering drugs. These drugs all affect a person’s ability to adapt in most social settings, resulting in difficulties in intimacy, friendships and all aspects of daily activities. I understand it is a sensitive issue,…

Q. What can you tell me about penile implants? Is that the same thing as the pump? How natural does it feel? Is it filled with fluid or made out of something rigid? A. Penile implants are quite diverse. In general, there are three categories. First are what we call rigid implants. These are solid rods of plastic or silicone that go in the penis. In this situation, the penis is erect all the time. The second category are the malleable implants. These are flexible silicone rods with reinforced centers that allow the person to flex the penis up and…

Q. I’m a 38-year-old man. I have undergone 15 surgeries since 1991, and I was doing fine until recently. I had a knee replacement and two discs removed, and I’ve been taking various medications. My problem is that I have the sex drive, but I’m lacking in the staying power. The most I can last is only two minutes, a far cry from my better days. My girlfriend of five years left me over this. I’m wondering what if anything can help me feel “manly” again. I’ve tried vitamins, DHEA, etc. to no avail. A. Because you have had back…