Author: Troy Browning

Q. My friend has erectile dysfunction and was given injections of papaverine. These were painful, so he discontinued. Now he is using a vacuum pump device. Is it safe to use such a device? How long can one use it in one session? Are there any side effects to prolonged use? A. Vacuum devices to improve erections have been used for years. In fact, the U.S. Patent Office issued its first patent for such a device in 1917. The devices have undergone many changes since then, and today they are FDA- approved for erectile dysfunction. The vacuum erection device works…

Q. What are the properties of yohimbe root? What is it supposed to aid in? A. Yohimbe is an herbal supplement made from the bark of the Pausinystalia yohimbe tree. Until Viagra, the alkaloid yohimbine from yohimbe was the only FDA-approved oral medication for the treatment of impotence. So, yohimbe is available both as an herbal extract and a prescription medication. It does help to increase libido, but its primary action is to increase blood flow to erectile tissue like the penis. It does not affect testosterone levels. By itself, yohimbe has been shown to be effective in about 40…

Q: I am 39 and just got married. My problem is that I’m having difficulty ejaculating or reaching an orgasm. I really want to impregnate my wife, but I just cannot. Do you have any suggestions? Possible Physical Causes A: Sexual function problems can involve difficulty with erection, failure to maintain it, problems achieving orgasm, or issues with ejaculation. These can arise from several physical or psychological causes. A medical evaluation is essential to identify the root cause. Difficulty achieving or maintaining an erection may result from problems affecting the nervous system or blood flow. Common medical contributors include diabetes,…

Q. I am 18 and am unable to ejaculate. I can get and maintain an erection, but I cannot achieve orgasm by either masturbation or sexual intercourse with my partner. I have spoken about this with my doctor, but he does not consider it to be a serious problem at this stage. I do get “wet dreams” where semen is released in bed at night, so my GP says that my problem is likely to be psychological rather than physical. If this is the case, what can I do about it? Please help. A. You are describing a condition called…

Q. When I ejaculate, sometimes the color is a pale yellow, sometimes dark brown, and sometimes red. There is no pain associated with ejaculation. I have been to a urologist, and he said that there was no sign of infection or anything else that he thought could cause it. He did say he thought it could be a burst blood vessel. I notice that when I am on a exercise regimen, it slowly returns to a “normal” color. What might be causing this, and how would I find out for sure? A. Your symptoms are suggestive of hematospermia — that…

Q. My husband was just told he has stones in his ejaculation duct. We had noticed a problem when we were unable to conceive because no semen came out. He had an ultrasound, and the urologist found the stones. We were told some of them were embedded and therefore cannot be removed. We are trying to get a second opinion before we proceed with surgery. Can stones like this be removed? Will we have a better chance of conceiving after surgery? A. It sounds like your doctor told your husband that no semen comes out because stones are blocking his…

Q. I am 59, and my wife and I have experienced very good sex for 40 years. A few months ago, I had a severe episode of acid reflux and fainted. My family doctor prescribed Paxil and Prevacid. Since then I’ve struggled with erections and can’t ejaculate. Viagra helps my erection, but I still can’t climax. What can I do? A. You’re not alone—this is a well-recognized side effect of certain antidepressants. Paxil (paroxetine), an SSRI, commonly delays orgasm or prevents ejaculation altogether (sometimes called anorgasmia). Prevacid (lansoprazole) is unlikely to be the cause. The good news is there are…

Q. My husband and I are both 28. We were both virgins when we married three years ago. He has always experienced delayed ejaculation even after prolonged foreplay and intercourse, which has frustrated him. Recently, I have been giving him “hand jobs” with startling results — instead of the usual one or two teaspoonfuls of ejaculate, copious amounts of a translucent liquid come out, and I am also able to give him multiple ejaculations. This surprise discharge ONLY occurs after prolonged lovemaking, followed by my hand job with lubricant. However, my husband is worried that he’s urinating on me during…

Q. I bought an over-the-counter herbal supplement called yohimbe bark for impotence. Is it safe? Are there any side effects? A. The herb yohimbe is the bark from the Pausinystalia yohimbe tree that grows in West Africa. It contains the alkaloid yohimbine, which is also available as a prescription medication. Yohimbine blocks receptors in the sympathetic nervous system and has been prescribed to treat impotence. It is also a monoamine oxidase inhibitor.

Q. I am 53 and have the general symptoms of benign prostate enlargement. A year ago, my PSA was less than 4. I have been taking an over-the-counter herbal prostate pill twice a day for about two years, with no side effects. I’d like to know if it’s safe to also take a testosterone-precursor type of herbal supplement. I see several products advertised for increasing libido, but I have not seen any discussion as to the effect on the prostate. I am hesitant to consider such a pill at my age, due to my concern with prostate enlargement. A. You…