Author: Troy Browning

Q. Thank you for your information on the use of a pump for erectile dysfunction. My friend, age 42, had a bad construction accident and suffered spinal damage some 10 years ago. We enjoy each other sexually, and he achieves an orgasm without the pump. We only used the pump once due to pain on his part. Would Viagra help him? I have not read anything on Viagra for men with spinal injury. He is otherwise healthy and active in every other way. This is hard on him emotionally, as you can imagine. A. The erectile reflex mechanism is so…

Q. Does Viagra have any effect on sperm in a man trying to have a child? Does it affect the sperm count, mobility, etc.? A. Viagra has no known effects on sperm production, morphology (shape), motility (movement) or count. If a man has organic impotence — meaning the problem is due to a medical rather than psychological condition — then Viagra may improve the chances for achieving conception simply by restoring potency. Remember, though, that while Viagra can improve rigidity, it does not necessarily bring about ejaculation. Many men with impotence may have diabetes or other conditions that affect the…

Q. I’m a 34-year-old man. I’m in good shape and watch my diet, but I’ve always had a problem with early ejaculation. It’s gotten so bad that I sometimes avoid sex because I’m afraid I won’t “do the job well.” I don’t talk about it because it feels petty, but it’s been bothering me for a long time. Do you have any suggestions? A. First, well done for speaking up—naming the problem is the first step. Premature ejaculation (PE) is common and very treatable. The two biggest traps are secrecy and self-blame: keeping it hidden can fuel performance anxiety, which…

Q. I have suffered from premature ejaculation for years. Recently, I have even had orgasm and ejaculated without any direct penile stimulation, just heavy kissing and nipple play. Is this normal? I didn’t think it was possible. It’s quite embarrassing! How can I overcome this? A. Orgasm is a learned response. In a man who suffers from premature ejaculation, the trigger mechanism for orgasm is very sensitive. The stimuli to climax can be visual, auditory or physical (direct penile stimulation). Regardless of which form of stimulus is involved, the man’s brain learns to interpret it in such a way that…

Q. I have no problem with erection, but no semen comes out from either masturbation or even intercourse. A doctor has checked for prostate problems and it is negative. I used to be able to produce semen. I am diabetic. A. You probably have a common condition called retrograde ejaculation, which is frequently seen in people with diabetes. The semen enters the penis via the ejaculatory ducts, which pass through the prostate. At the time of ejaculation, a muscle at the opening to the bladder squeezes shut. With each muscle contraction, the semen is propelled down the urethra and out…

Q. When I am fortunate enough to have an orgasm, very little ejaculate comes out. The problem is that after an orgasm, the ejaculate oozes out over the next five to ten minutes. Without the discharge of semen, this reduces the intensity of the orgasm as well. I know that jumping up and urinating will solve most of the problem, but on occasion it will continue to ooze even after urination (though not in the same quantity). Can you offer any advice? A. This type of delayed semen release often points to a blockage in the urethra that prevents normal…

Q. My husband does not ejaculate when we have intercourse. He says he starts to feel it, but then the feeling disappears. He does ejaculate with manual stimulation. He has no problem obtaining and maintaining an erection. What do you think? A. Your situation is not uncommon, and I can assure you there is nothing wrong with you or your husband. In general, ejaculation and orgasm are learned responses. This means that the body gets used to certain types of stimulation required for climax. So, if his penis is used to getting manual stimulation, that’s what he is going to…

Q. I’ve never been able to ejaculate or orgasm while awake. Every few months, I have a wet dream. I get strong erections, but they are almost “boring.” I’m not numb, but I don’t get a lot of feeling. Occasionally I get a fleeting twitch on the tip of my penis, with a lot of feeling, but that’s all. Sometimes I feel pain on the head of my penis and behind my pubic bone after an erection. Otherwise I’m a healthy 20-year-old. I’ve never had sex. My doctors have ruled out prostate cancer, prostatitis and testicular cancer. Can you suggest…

Q. After ejaculation I seem to have a clear, jelly-like substance in my semen. What is this? Should I be worried? A. Your semen contains sperm, fluid and numerous proteins and enzymes whose whole purpose is to keep sperm alive in the woman’s vagina. After the semen leaves your body with ejaculation, it undergoes a complex series of changes. The first step is what we call coagulation, during which it tends to separate into protein and water, forming a somewhat jellylike substance. In the vagina, the elevated temperature keeps the semen liquid for some time, but outside the body, it…

Q. During arousal, what is the clear fluid that flows from my penis prior to ejaculation? Is this normal? A. The clear fluid that is present before you ejaculate comes from the prostate and periurethral glands. That fluid serves to lubricate the urethra before ejaculation. All men have it, some more than others. You should know that since this fluid comes from the prostate, it can have sperm in it. That is why men always need to wear protection during arousal if they wish to avoid making their partners pregnant. Some men believe that if they pull out of the…