Archive for Sexual Health

Androstenedione (Steroids) & Sex Drive

Q. I’m 32, and for six years I’ve had a continuing loss of libido. In the last two years, I don’t think of sex or get an erection without serious coaxing from my partner. A hormone level test came back normal. My doctor gave me Viagra, which gives me an erection, but what’s the use when I have no urge to use it? Some time ago, when I lifted weights, I tried androstenedione and noticed that it increased my libido dramatically. I stopped taking it for health concerns, but lately I’ve tried it again to see if I could reproduce the side effect — and it worked! Now I’m weighing my (and my partner’s) sexual well-being against the long-term health concerns of this supplement. Is there anything else I should consider before continuing with androstenedione? Is it possible that although my testosterone levels test normal, my body isn’t using it efficiently?

A. Androstenedione is a precursor to testosterone, the male sex hormone responsible for our sexual drive and desire. Normally, androstenedione is made in the adrenal glands and released into the bloodstream. In the testicles, the androstenedione is converted into testosterone. As a category, these hormones are called anabolic steroids.

When a young man takes anabolic steroids as supplements, it can cause his testicles to lose their function. That is because the extra hormones lead his body to turn off its own hormone production. The hormones are produced in the testicles, so to turn off production, the body has to turn off the testicles. Sometimes this leads to permanent damage, resulting in low testosterone levels.

Most experts would agree that to identify a person with a hormone deficiency, you need to check testosterone levels at three separate time intervals. Usually, I will get morning testosterone levels once a week for three weeks before I say the patient has normal levels or not. If the levels are low, then I will give the person a prescription for testosterone patches to wear on a daily basis. These are safe and legal. Also, the dosage can be adjusted safely. I suggest you stop the steroids and let your doctor identify your hormone deficiency so it can be treated correctly and safely.

buy steroids jamaica

Did Medication Cause Erection Problems?

Q. My cardiologist prescribed Atenolol (25mg) for six months as a precaution after a false positive on a nuclear stress test. (I must have moved while the scanning machine was taking the images.) Could taking Atenolol for six months cause erectile difficulty? I have been off the medicine for three months now, and I still have ED problems. If this medicine was the cause, should this problem correct itself? How long will that take?

A. Atenolol belongs to a class of medication called beta blockers, whose side effects include erectile dysfunction. However, at the low dose of 25mg, I would not expect significant side effects. Instead I would suspect another cause for your erectile dysfunction.

Most men with erectile dysfunction have an identifiable cause. This can be as simple as the side effect of medications, atherosclerosis (clogged arteries) or diabetic neuropathy. For more detail, see my earlier article on erectile dysfunction. In your case, I would suggest you talk to your urologist about how he can help treat it, because I don’t think the problem will correct itself.

buy steroids winstrol

Correcting Diabetes-Related Erection Problems

Q. Are erectile problems reversible when the cause has to do with diabetes?

A. Unfortunately, diabetes has multiple effects on sexual behavior and particularly the ability to achieve erections. Diabetes may interfere with erections in any of three ways:

  • Diabetes can damage the blood supply to the penis. Damage to the blood supply results from early atherosclerosis (“hardening” of the arteries) and fibrosis of the small arteries of the penis.
  • Diabetes can damage the nerve supply to the penis. This occurs when high blood sugar damages the nerve fibers, and impulses that promote erections do not get transmitted to their targets in the penis.
  • Long-standing diabetes can alter the microstructure of the penis. This involves a loss of elasticity of the penis and fibrosis of the penis.

All of these changes are irreversible. However, some are treatable. In general, patients with diabetes have a mixture of these effects, so treatment for the erectile dysfunction is often very successful. If management with medications such as Viagra fails, the urologist can install a penile prosthesis; this typically produces excellent satisfaction and long-term durability.

steroids treatment

Does Quitting Smoking affect Erections?

Q. My friend is trying to quit smoking. He has started having problems getting and maintaining an erection. Could this be related?

A. Quitting smoking would not cause him to lose erections, unless perhaps he is suffering from stress or depression that has been aggravated by his efforts to quit.

On the contrary, smoking itself is more likely to cause erection problems. Smoking is a major cause of atherosclerosis (clogging of blood vessels), which affects the function of the penis. Most of the men I see in their 40 and 50s with erectile dysfunction are smokers. I insist that they stop smoking before I help them with their erections, because many times their erections improve after they quit. In fact, when I tell a man that smoking is slowly destroying the blood supply to the penis and that he will be at risk for erectile dysfunction, most men choose the erection over the cigarette.

Still, smoking is difficult to stop. I suggest he get help from his family doctor. The nicotine in the smoke causes a chemical dependency in his body that needs to be replaced and then slowly removed. The first step is to eliminate the psychological habit of the cigarette in the mouth. This can be done with fake cigarettes or nicotine gum. The chemical dependency can be controlled with nicotine patches. The process is stressful, and if he tries on his own he may fail, leading to anxiety and depression. The best suggestion I have is to get help and quit smoking. Then, if still has erectile dysfunction, he should see a urologist.

steroids research

Diet, Lifestyle & Impotence

Q. My boyfriend is 46, and over the last few years he’s started having trouble maintaining an erection. His doctor says there’s nothing medically wrong and has prescribed Viagra, but he’s nervous about using it. Are there any diet or lifestyle changes he could make that might make the drug less necessary?

A. Yes. When I was in medical school, I was taught that the major cause of impotence is psychological. We now know that it is mostly physiological. For many men, it’s not in their head, it’s in their arteries. The arteries in your heart aren’t the only ones that get clogged over time — it happens throughout your body, in men and in women. For men, the ability to get and maintain an erection is a direct function of blood flow to the penis, so anything that increases blood flow improves an erection, and anything that decreases blood flow makes it more difficult to have and maintain an erection. Approximately one-half of men over age 40 have problems at times with erectile dysfunction. Most men are embarrassed and don’t talk about it with their friends, or even their physicians, so they don’t realize how common it is — which often makes them feel even worse. No wonder Viagra is the biggest-selling drug of all time. Viagra works by stimulating nitric oxide, which dilates blood vessels and increases blood flow. (The Nobel Prize in medicine in 1998 went to the researchers who identified the role of nitric oxide in the cardiovascular system.) One of life’s ironies is that the very things our culture tells us are sexy and signs of the “good life” are also leading causes of impotence: A high-fat diet, alcohol, tobacco use, chronic stress, cocaine and many prescription drugs all reduce blood flow by constricting blood vessels, causing blood to clot, or promoting plaque buildup in your arteries. The good news is that when you change these behaviors, blood flow — and sexual function — can improve relatively fast. Your body also makes more nitric oxide — natural Viagra. For many people, improving sexual function is a more powerful motivator for lifestyle improvements than the prospect of living a little longer.

buy steroids vancouver

Alcohol & Impotence

Q. Chronic use of alcohol is often given as a cause for the inability to maintain an erection. If this is the cause in my case, how long would I have to abstain before I could expect to experience an improvement? I am 50 years old.

A. Men with chronic high-level alcohol consumption typically experience a decrease in the number of sperm as well as a decrease in sexual drive. Researchers believe that the alcohol lowers the level of the male hormone testosterone, both by decreasing the production of the hormone and by increasing the speed at which the body metabolizes it. This means that there is less testosterone available for normal sperm production and sexual function.

When men stop drinking, testosterone production returns. In other words, if you stop drinking, and if you have not already suffered permanent liver damage, your sexual drive and possibly your erections will return. There is no exact time for this return of function to occur, but I would expect it would take at least two months.

steroids direct

Erection & Urination Problems

Q. Local doctors don’t seem to take my problem seriously, and I don’t know who else to ask. For the last year or so I’ve had erection problems. I seldom wake up with an erection. This affects my social life because I’m afraid I won’t be able to perform. I also have no force behind my stream when I urinate. If I pee outside, I barely miss my shoes! And when I am done urinating, I have to shake and dance a great deal to get it all out, and it still leaves a spot in my pants! Sometimes I even smell like urine. This scares me. I’m only 33, 165 pounds at five feet seven inches. I never miss work due to illness, and I see a doctor only for emergencies. I smoke, drink and drink coffee. I need help and I don’t have a lot of money. Is there any inexpensive treatment or over-the-counter medication I can use?

A. I would recommend seeing a urologist to evaluate your condition. You may well have diabetes or another condition that affects either the nerve supply or blood supply to the penis. Swelling of the prostate gland can impede the flow of urine, lessening the force of the stream. Until a diagnosis is made, there is no treatment that can be recommended. As untreated diabetes can have serious life-threatening complications, you would do best to see a physician and undergo evaluation.

where to buy steroids online

Erection Help After Surgery, Medications

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 your erectile dysfunction. However, before you try a penile prosthesis (implant), I think you need to have a better understanding of the problem.

To get an erection suitable for penetration you need three things. The first is good arteries and blood flow into the penis. The second is a good nerve supply to allow the arteries to dilate and turn the blood flow on. Lastly, there needs to be no outflow of blood through the veins during filling, to ensure a rigid erection. So, the problem may not be as simple as medication that decreases the filling of the penis or back surgery that might affect the nerves to the penis.

I think your doctor needs a diagnosis of what exactly is causing the problem — such as arterial insufficiency, neuropathy or a venous leak — before you accept a prosthesis. The reason is that some forms of arterial insufficiency are reversible, and neuropathies should respond to injection therapy like prostaglandin E1 (Caverject). By jumping right to a prosthesis, you miss the opportunity to restore the natural erections. In addition, the average time a prosthesis lasts is 7-10 years. At 59, you would be looking at several operations in your lifetime.

where to order steroids online forum

Erections During Sleep

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 time, the penis is low on blood flow — which translates into low oxygen and low nutrients. Therefore, at night the body cycles the blood in the penis to bring in oxygen and remove toxic waste. This usually occurs during deep sleep.

The man you are asking about is almost certainly still going through these cycles while he is sleeping. Unless he has difficulty with his erection during sex, there is probably no need to see a doctor. If you are really concerned, you could perform the stamp test. This is done by attaching a postage stamp to the shaft of the penis before he goes to bed. If there is an erection while he is sleeping, than the stamp will be split when he wakes up.

purchase steroids online

Erection Problems with Diabetes

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 urinate, severe constipation and loss of erections. This can happen even in patients with good sugar control, and researchers still aren’t sure why. We do know that neuropathies occur much more quickly in people who do not control their sugar levels, so please keep your blood sugar under control.

Also, diabetes can destroy small arteries in the body; this leads to poor tissue blood supply. This also takes years, and it usually occurs in the feet. The same poor circulation can affect the penis, and you can lose your erection. But again, this usually happens to older men, around age 50.

So, at this point, you are at risk of developing these problems because of your diabetes. But I am not sure the diabetes is responsible for your difficulty in erections now — at least not physically.

However, dealing with your new condition may be having an effect on your mood as a whole, which can in turn affect your sexual response. Someone who is diagnosed with a severe medical condition typically goes through several stages. Usually there is some degree of denial, followed by anger. Eventually the person must learn to accept the problem and go on with life. Once there is acceptance, the person then begins to deal with major lifestyle changes. Your doctor will tell you what to eat and how much to weigh, and every time you go to the doctor there is often more bad news. With this much stress, it is not uncommon for a person, no matter how strong, to get a little depressed.

I am very pleased you are willing to take get help for your erections, because there are several options. First, your urologist can offer support — and Viagra. The Viagra can increase blood flow to the penis and strengthen your erection. Second, look up a diabetic support group — in your community or online — where you can talk to others living with your problem who share common stresses. There you can vent and get reinforcement and encouragement. I believe that a healthy mind leads to a healthy erection.

Don’t forget, also, that there are other causes of erectile difficulty you may wish to explore with your doctor. For more information on erection problems, see my earlier column, Can’t Get Full, Lasting Erection.

online steroids reviews

« Older Entries