Category: Sexual Health

What are sex headaches?

  May 25, 2020
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Sex headaches (also called orgasmic headaches, benign coital headache, or orgasmic cephalgia) are headaches associated with sexual activity. They can occur with intercourse, masturbation, oral sex, and anal sex.
They may build gradually as a person reaches orgasm. More commonly, they are sudden and intense at the point of orgasm, resulting in a stabbing pain.
Usually, they last for a few minutes, but in some cases they may last a few hours or even a couple of days. They may happen every once in a while or every time a person has an orgasm.
Men tend to get sex headaches more than women. People who have migraines may also be at greater risk for sex headaches.
It’s not clear why people get sex headaches, but the headaches may be linked to blood vessel spasms in the head.
While bothersome, sex headaches usually aren’t serious. But it’s best for anyone with sex-related headaches to see a doctor to rule out another medical condition, like bleeding in the head. The doctor may order tests, such as an MRI, CT scan, angiogram, or spinal tap.
Sometimes, sex headaches go away quickly on their own. But if there is a pattern of sex headaches and no underlying cause, doctors may prescribe medication to prevent them.

How can sex headaches be prevented?

Some doctors prescribe medications to prevent sex headaches.
Patients who have frequent, lengthy sex headaches might take a beta blocker like propranolol every day. Beta blockers are sometimes used to treat high blood pressure, glaucoma, and migraines as well.
Alternatively, patients might take a medication an hour before sex. The anti-inflammatory drug indomethacin is sometimes prescribed for this purpose. Some people take a triptan, a type of anti-migraine drug, instead of indomethacin.
Some other strategies for handling sex headaches include:
  • Stopping sexual activity when the headache begins.
  • Taking a more passive role in sexual activity.
  • Massaging head and neck muscles to relieve tension before sex.

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Young Men and Erectile Dysfunction

  February 2, 2020
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If you pay attention to the media, you might think that erectile dysfunction (ED) happens only to older men. The ads for ED medications tend to show men with salt and pepper hair discussing how their improved erections helps them feel young again. Comedians may joke about an elderly man’s sex life – or lack of it.
It’s true that the chances of developing ED increase with age. Many medical conditions associated with ED, such as diabetes and heart disease, start occurring as men get older.

But did you know that ED affects a considerable number of younger men as well?

In 2017, Sexual Medicine Reviews published a study that focused on ED younger men. The authors estimated that just over half of men between 40 and 70 have erection problems to some extent. But younger men are still affected.

How many? Here are some research results the scientists shared:

In a multinational study of almost 28,000 men, 11% of men in their 30s and 8% of men in their 20s had ED.
A Swiss study of over 2,500 men between the ages of 18 and 25 found that around 30% of men had some degree of ED.
An Italian study revealed an increase in ED in men under 40, with rates rising from 5% to 2010 to over 15% in 2015.
It’s important to understand that the severity of ED can vary. Some men with ED can’t get erections at all. Others have trouble occasionally. And others feel that their erections aren’t as firm as they’d like.
ED rates could be higher than reported, too. A lot of men aren’t comfortable discussing their erections with a doctor, so they suffer in silence. Some doctors might not realize that ED affects younger men and may not ask about sexual health.

Why Might Younger Men Get ED?

Age is a major risk factor for ED. So why might younger men get it?

The answer is complicated. ED can be caused by both physical and psychological issues, and sometimes there are a combination of factors involved.

The study authors discussed several possibilities:

Vascular problems.

A rigid erection depends on good blood flow to the penis. If anything obstructs that flow, such as plaque buildup in blood vessels, an erection might be difficult to achieve.

Hormonal disorders.

Conditions like diabetes, over- or under-active thyroid, Klinefelter syndrome, and others can interfere with erectile function.

Nervous system disorders.

Men with multiple sclerosis, epilepsy, spinal cord injury, or other nervous system disorders may have trouble with erections because important messages from the brain can’t “connect” with the genitals.

Medication side effects.

Many medications, such as antidepressants, non-steroidal anti-inflammatories (NSAIDs), and antipsychotics have sexual side effects, including erectile dysfunction.

Psychological and emotional concerns.

Erectile dysfunction can also occur in men with depression and anxiety. Relationship issues can play a role as well.

Smoking and illicit drug use.

In another study, published in 2013 in the Journal of Sexual Medicine, younger men with ED were more likely to smoke or use recreational drugs compared to their older counterparts. Marijuana in particular has been linked to erectile problems. The drug’s active ingredient, tetrahydrocannabinol (THC), interacts with proteins called cannabinoid receptors. This interaction can impair normal functioning in the brain. Research has shown that it may affect the penis as well.
Sometimes, these causes work together. For example, a man with diabetes may have occasional ED, but become so anxious about his ability to perform and please his partner, the ED becomes more frequent. Or, a man may be taking medication that causes mild ED, but the stress of a life event (such as losing a job) could make the ED worse.

Hints of Future Medical Problems for Younger Men with ED?

Younger men should know that ED is often a symptom of other medical conditions, like diabetes and heart disease.
As we mentioned above, a man needs good blood flow to his penis to have an erection. Blood is what gives an erection its rigidity.
But diabetes or heart disease can cause atherosclerosis – hardening of the arteries. When a man has atherosclerosis, cholesterol and other materials build up in his arteries, making it more difficult for blood to pass through. Atherosclerosis can happen anywhere, but because the penile arteries are so small, they’re often among the first to become blocked. As a result, less blood flows to the penis and erection problems occur.
ED is sometimes called a “sentinel marker” – a warning sign of other diseases that need to be addressed.

What Can Younger Men Do About ED?

If you’re having problems with erections, take it seriously. Talk to your doctor. If your ED is a symptom of another medical condition, start treatment. You might need to make some lifestyle changes or go on medication, but taking care of the situation now can help you enjoy more sex in the future.
If you pay attention to the media, you might think that erectile dysfunction (ED) happens only to older men. The ads for ED medications tend to show men with salt and pepper hair discussing how their improved erections helps them feel young again. Comedians may joke about an elderly man’s sex life – or lack of it.
It’s true that the chances of developing ED increase with age. Many medical conditions associated with ED, such as diabetes and heart disease, start occurring as men get older.

But did you know that ED affects a considerable number of younger men as well?

In 2017, Sexual Medicine Reviews published a study that focused on ED younger men. The authors estimated that just over half of men between 40 and 70 have erection problems to some extent. But younger men are still affected.

How many? Here are some research results the scientists shared:

In a multinational study of almost 28,000 men, 11% of men in their 30s and 8% of men in their 20s had ED.
A Swiss study of over 2,500 men between the ages of 18 and 25 found that around 30% of men had some degree of ED.
An Italian study revealed an increase in ED in men under 40, with rates rising from 5% to 2010 to over 15% in 2015.
It’s important to understand that the severity of ED can vary. Some men with ED can’t get erections at all. Others have trouble occasionally. And others feel that their erections aren’t as firm as they’d like.
ED rates could be higher than reported, too. A lot of men aren’t comfortable discussing their erections with a doctor, so they suffer in silence. Some doctors might not realize that ED affects younger men and may not ask about sexual health.

Why Might Younger Men Get ED?

Age is a major risk factor for ED. So why might younger men get it?

The answer is complicated. ED can be caused by both physical and psychological issues, and sometimes there are a combination of factors involved.

The study authors discussed several possibilities:

Vascular problems.

A rigid erection depends on good blood flow to the penis. If anything obstructs that flow, such as plaque buildup in blood vessels, an erection might be difficult to achieve.

Hormonal disorders.

Conditions like diabetes, over- or under-active thyroid, Klinefelter syndrome, and others can interfere with erectile function.

Nervous system disorders.

Men with multiple sclerosis, epilepsy, spinal cord injury, or other nervous system disorders may have trouble with erections because important messages from the brain can’t “connect” with the genitals.

Medication side effects.

Many medications, such as antidepressants, non-steroidal anti-inflammatories (NSAIDs), and antipsychotics have sexual side effects, including erectile dysfunction.

Psychological and emotional concerns.

Erectile dysfunction can also occur in men with depression and anxiety. Relationship issues can play a role as well.

Smoking and illicit drug use.

In another study, published in 2013 in the Journal of Sexual Medicine, younger men with ED were more likely to smoke or use recreational drugs compared to their older counterparts. Marijuana in particular has been linked to erectile problems. The drug’s active ingredient, tetrahydrocannabinol (THC), interacts with proteins called cannabinoid receptors. This interaction can impair normal functioning in the brain. Research has shown that it may affect the penis as well.
Sometimes, these causes work together. For example, a man with diabetes may have occasional ED, but become so anxious about his ability to perform and please his partner, the ED becomes more frequent. Or, a man may be taking medication that causes mild ED, but the stress of a life event (such as losing a job) could make the ED worse.

Hints of Future Medical Problems for Younger Men with ED?

Younger men should know that ED is often a symptom of other medical conditions, like diabetes and heart disease.
As we mentioned above, a man needs good blood flow to his penis to have an erection. Blood is what gives an erection its rigidity.
But diabetes or heart disease can cause atherosclerosis – hardening of the arteries. When a man has atherosclerosis, cholesterol and other materials build up in his arteries, making it more difficult for blood to pass through. Atherosclerosis can happen anywhere, but because the penile arteries are so small, they’re often among the first to become blocked. As a result, less blood flows to the penis and erection problems occur.
ED is sometimes called a “sentinel marker” – a warning sign of other diseases that need to be addressed.

What Can Younger Men Do About ED?

If you’re having problems with erections, take it seriously. Talk to your doctor. If your ED is a symptom of another medical condition, start treatment. You might need to make some lifestyle changes or go on medication, but taking care of the situation now can help you enjoy more sex in the future.
If you pay attention to the media, you might think that erectile dysfunction (ED) happens only to older men. The ads for ED medications tend to show men with salt and pepper hair discussing how their improved erections helps them feel young again. Comedians may joke about an elderly man’s sex life – or lack of it.
It’s true that the chances of developing ED increase with age. Many medical conditions associated with ED, such as diabetes and heart disease, start occurring as men get older.

But did you know that ED affects a considerable number of younger men as well?

In 2017, Sexual Medicine Reviews published a study that focused on ED younger men. The authors estimated that just over half of men between 40 and 70 have erection problems to some extent. But younger men are still affected.

How many? Here are some research results the scientists shared:

In a multinational study of almost 28,000 men, 11% of men in their 30s and 8% of men in their 20s had ED.
A Swiss study of over 2,500 men between the ages of 18 and 25 found that around 30% of men had some degree of ED.
An Italian study revealed an increase in ED in men under 40, with rates rising from 5% to 2010 to over 15% in 2015.
It’s important to understand that the severity of ED can vary. Some men with ED can’t get erections at all. Others have trouble occasionally. And others feel that their erections aren’t as firm as they’d like.
ED rates could be higher than reported, too. A lot of men aren’t comfortable discussing their erections with a doctor, so they suffer in silence. Some doctors might not realize that ED affects younger men and may not ask about sexual health.

Why Might Younger Men Get ED?

Age is a major risk factor for ED. So why might younger men get it?

The answer is complicated. ED can be caused by both physical and psychological issues, and sometimes there are a combination of factors involved.

The study authors discussed several possibilities:

Vascular problems.

A rigid erection depends on good blood flow to the penis. If anything obstructs that flow, such as plaque buildup in blood vessels, an erection might be difficult to achieve.

Hormonal disorders.

Conditions like diabetes, over- or under-active thyroid, Klinefelter syndrome, and others can interfere with erectile function.

Nervous system disorders.

Men with multiple sclerosis, epilepsy, spinal cord injury, or other nervous system disorders may have trouble with erections because important messages from the brain can’t “connect” with the genitals.

Medication side effects.

Many medications, such as antidepressants, non-steroidal anti-inflammatories (NSAIDs), and antipsychotics have sexual side effects, including erectile dysfunction.

Psychological and emotional concerns.

Erectile dysfunction can also occur in men with depression and anxiety. Relationship issues can play a role as well.

Smoking and illicit drug use.

In another study, published in 2013 in the Journal of Sexual Medicine, younger men with ED were more likely to smoke or use recreational drugs compared to their older counterparts. Marijuana in particular has been linked to erectile problems. The drug’s active ingredient, tetrahydrocannabinol (THC), interacts with proteins called cannabinoid receptors. This interaction can impair normal functioning in the brain. Research has shown that it may affect the penis as well.
Sometimes, these causes work together. For example, a man with diabetes may have occasional ED, but become so anxious about his ability to perform and please his partner, the ED becomes more frequent. Or, a man may be taking medication that causes mild ED, but the stress of a life event (such as losing a job) could make the ED worse.

Hints of Future Medical Problems for Younger Men with ED?

Younger men should know that ED is often a symptom of other medical conditions, like diabetes and heart disease.
As we mentioned above, a man needs good blood flow to his penis to have an erection. Blood is what gives an erection its rigidity.
But diabetes or heart disease can cause atherosclerosis – hardening of the arteries. When a man has atherosclerosis, cholesterol and other materials build up in his arteries, making it more difficult for blood to pass through. Atherosclerosis can happen anywhere, but because the penile arteries are so small, they’re often among the first to become blocked. As a result, less blood flows to the penis and erection problems occur.
ED is sometimes called a “sentinel marker” – a warning sign of other diseases that need to be addressed.

What Can Younger Men Do About ED?

If you’re having problems with erections, take it seriously. Talk to your doctor. If your ED is a symptom of another medical condition, start treatment. You might need to make some lifestyle changes or go on medication, but taking care of the situation now can help you enjoy more sex in the future.

Read More

Sex and Anxiety

  December 17, 2019
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We often talk about the role of the brain during sexual activity. While the genitals may seem more involved with the “action,” the brain is a great coordinator. It takes in sexual stimuli (like a provocative smile or a touch), processes them, and sends messages to the genitals to start getting ready, either through erection or vaginal lubrication.
But there’s more to the brain and sex than these physiological processes. The brain also filters our emotional and psychological responses to sex. It analyzes questions like:
·         Do I trust my partner?
 
·         Will my partner or I become pregnant?
 
·         Does my partner have a sexually-transmitted infection?
 
·         Is this a safe place to have sex?
 
·         If I can’t perform sexually, what will my partner think?
 
·         Will sex hurt?
 
·         Will my spouse find out I’m having an affair?
 
·         Do I really want to have sex with this person right now?
 
The list could go on. Such anxieties – and more formally diagnosed anxiety disorders - can have an impact on our sexual function. That’s what we’ll be talking about today.
 

What is anxiety?

 
We’ve all felt anxious at times. Life events like starting a new job, getting married, or having a baby can all be anxiety-inducing. But so can smaller-scale events like asking for a raise at work or handling a dispute with your neighbor.
 
Sometimes, these feelings of apprehension occur in situations that wouldn’t make the average person anxious. The feelings can start to interfere with daily life.
In that case, a person might be diagnosed with an anxiety disorder, such as generalized anxiety disorder (excessive anxiety), panic disorder (episodes of great fear), social anxiety (fear of social situations and judgement by others), or posttraumatic stress disorder (PTSD – anxiety triggered by a traumatic event).
The relationship between anxiety and sex, however, can be circular.
Feeling anxious can impair your sexual function. For example, if you’re concerned about your partner’s fidelity, you might find yourself focused on that during sex, making it more difficult to relax and stay in the moment.
Conversely, if you have a medical condition that can make sex uncomfortable, such as endometriosis, the anticipation of pain can dampen your sexual desire or lead you to avoid sex altogether.

How can anxiety impact sex?

 
The brain works in many mysterious ways and anxiety’s effects on sexual function can take many forms. Here are some of the more common ones:

Low desire.

Anxiety can make us less interested in sex. For example, if a woman suspects that her partner is unfaithful, she may feel inadequate, angry, and less inclined to have sex.
Performance.
Sometimes people are so worried about pleasing their partner that their performance suffers. Men might have trouble getting an erection or might ejaculate before they want to. Women might have trouble relaxing enough to allow penetration.
 
·         Pain. Pain is a common sexual problem, especially for women. Unfortunately, the expectation of pain can become so intense that it blocks out any pleasure.
 
·         Trouble with orgasm. The effects of anxiety can have a cumulative effect, making it more difficult to reach orgasm.
 
·         Avoidance. People may be so anxious about sex that they shy away from dating, relationships, and sex.
 
What can people do?
 
If you think anxiety is interfering with your sex life, there are several steps you can take:
 
·         See your doctor. Sometimes, people feel awkward about seeing a professional for anxiety and try to manage it on their own. But there’s nothing wrong with asking for help. Your doctor can refer you to a mental health specialist who will come up with a treatment plan tailored just for you.
 
·         Consider couples counseling. If you feel anxious about some aspect of your relationship, you might see a specialist who focuses on couples therapy. You and your partner can learn to work through your issues constructively and come up with strategies to improve life at home. You can also learn better communication skills.
 
·         Try sex therapy. Sex therapy is another type of counseling, but it focuses more on sex itself. It can be a helpful option for people with performance anxiety or sexual fears.
 
·         Be up front with your partner. Lots of couples have trouble discussing sex. Sometimes, we just need to take a deep breath and start the conversation. Be honest about how you’re feeling. Your partner might be thinking about the same issues and feel relieved that you brought them up. Also, be open with your partner about what feels good to you and ask for what you want sexually.
 
·         Focus on the intimacy. Your fears and anxieties can take a lot of your mental energy and keep you from just enjoying sex for what it is – a connection between two people at one moment in time. Try to focus on what’s happening. Use your senses – what sorts of touch, sounds, and smells are you experiencing? Are they pleasant? Put your attention there.
 

 

·         Say “no” if you want to. If you don’t want to have sex with a certain person or at a certain time, you do not have to. You have every right to say “no.” This is also true if you and your partner disagree on sexual practices, like condom use.

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Cycling and Sexual Health

  September 3, 2019
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Over the last several years, there has been some debate on whether cycling has a negative impact on one’s sex life. In fact, back in 2012, we thought that biking could harm one’s sexual health. Is that still true? Today, we’ll take a look at the latest research.
What is the problem?
For both men and women, biking puts pressure on the perineum – the area between the anus and scrotum (for men) or vulva (for women). The perineum contains blood vessels and nerves that are essential for sexual arousal and urinary function. When those blood vessels and nerves are compressed, they might not work correctly, causing genital numbness and, for men, erectile dysfunction.
The bike seat (called the saddle) is often to blame. Women have also been warned about positioning the handlebars below the saddle, a stance that puts more pressure on the perineum.
New Research for Women
In March 2018, the Journal of Sexual Medicine published a study on the sexual and urinary effects of cycling for women.
Researchers surveyed over 3,000 women. About two thirds were cyclists, and the remaining third were runners and swimmers.
How did the sexual function of these athletes compare?
Women who were high-intensity cyclists – biking over two years, at least three times a week, with a daily cycling average of at least 25 miles – had betters scores on sexual health assessments. And the scores for low-intensity cyclists (who didn’t meet the high-intensity criteria), runners, and swimmers were about the same.
Still, cyclists were more prone to urinary tract infections, saddle sores, and genital numbness when compared to the runners and swimmers.
Good News for Men
Cycling doesn’t appear to affect men’s sexual function, according to research published in the Journal of Urology in October 2017.
This study compared cyclists with runners and swimmers, too. Almost 4,000 men participated. About 30% were non-cyclists, 47% were low-intensity cyclists, and the rest were high-intensity cyclists (defined with the same criteria as the female cyclists described above).
In this study, both high-intensity and low-intensity cyclists had better scores on sexual health assessments compared to the runners and swimmers. Histories of urinary tract infections were also similar in the men.
However, the cyclists were at higher risk for urethral stricture, a narrowing of the urethra (the pathway in the penis that allows urine and semen to exit the body).
The study also suggested that men could lower their risk for genital numbness if they stood while cycling at least 20% of the time.
“Adjusting the handlebar higher or even with the saddle had lower odds of genital numbness and saddle sores,” the authors added.
Cycle Smart
While these studies have encouraging results, you know your body best. If you’re having sexual difficulties, urinary problems, or genital numbness, make an appointment with your doctor. It’s best to have a full checkup to rule out any medical issues.
If you think the problems are related to cycling, you might try the following strategies:
Take a break from cycling for a while.
Make adjustments to your bike. A bike shop professional can tell you if your bike is a good fit for you and suggest any changes you may need, such as a different type of saddle or another handlebar position.
Consider your stance while riding. Try to sit up straight on your sit bones and avoid leaning forward on your perineum. Also, ride your bike standing every once in a while.
Ask your doctor about recommended cycling habits.
Otherwise, cycling is still fantastic exercise, It keeps your blood pumping, builds strength and endurance, and helps you maintain a healthy weight – all important factors for sexual health and general health.

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How Do Women Feel About Orgasms?

  June 13, 2019
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One word that’s often used to describe women’s orgasms is “elusive.” Sometimes, they’re easy to achieve, sometimes not. They can be fueled by both physical stimulation and emotional bonding. They might not happen all the time. They might not happen at all. Or, they might happen multiple times in one encounter.
Indeed, women’s orgasms can be mystifying. But that doesn’t stop researchers from learning more about them, even to the point of asking volunteers to pleasure themselves in an MRI machine for scientific study.
Last year, a team of researchers from Finland analyzed the results of five sex surveys conducted between 1971 and 2015. Focusing on orgasms, the team looked at women’s history with orgasm and what mattered most to them and their partners. Overall, the project involved over 10,000 men and women. The results were published in the journal Socioaffective Neuroscience and Psychology.
In this post, we’ll take a closer look at what the researchers discovered, Note: Not all of the surveys asked the same questions. In some cases, results pertain to just one survey.

First Orgasms

Most women had their first orgasms through masturbation; for some, it occurred before age 13. However, first orgasms during intercourse tended to happen at a later age. The women’s average age of first intercourse was 17. Only a quarter had their first intercourse orgasm in their first year of partnered sexual activity. (In contrast, three-quarters of the men did experience orgasm during that first year.)

Importance of Orgasms

About 60% of the women said that having an orgasm was “rather important” while less than 20% felt orgasms were “very important.” About 10% didn’t think orgasms were important at all.
Among women who rated orgasms as very important, about 30% had multiple orgasms the last time they had sex.
For women who didn’t consider orgasms to be important, only 13% climaxed during their last intercourse. One study noted that women in this category may place less value on orgasms as a “sensible coping strategy.” In other words, if women don’t value orgasms, they won’t be disappointed about not having them.
Almost all the women thought that helping their partner reach orgasm was important.

Pathways to Orgasm

Forty-eight percent of women said they climaxed more easily while masturbating compared to intercourse. For 14%, the reverse was true, and for 17%, both methods were equally effective.
Was stimulation of the vagina or clitoris more effective? Over half the women said they usually reached orgasm through stimulation of both areas. Thirty-four percent preferred the clitoris, and 6% climaxed mainly through vaginal stimulation.
For many women, a longer duration of intercourse made them more likely to reach orgasm. For example, those who had intercourse for fifteen minutes were more likely to climax than those who had sex for a shorter time period. However, more time was not always better. Intercourse lasting 20 minutes was not more likely to bring about climax.
Sexual positions could also contribute to orgasm. Some women attained orgasm more easily if they were in an active role, such as with the woman-on-top position. In this way, they had better control over the encounter. Women who took on more passive roles, such as with the man-on-top position, were less likely to climax.

What’s Next?

Throughout this research, there is one common thread: orgasms can be as individual as women themselves. And what works for one woman doesn’t necessarily work for another.

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Taking ED Drugs Watch What You Eat and Drink

  June 11, 2019
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Ali finally talked to his doctor about his erection problems. He’d been struggling for a while, but he had been too embarrassed to say anything. Then his wife Lila showed him an article about erectile dysfunction (ED) and how common it was, especially for older men. She went with him to his appointment and, with her support, he had a new prescription for a phosphodiesterase type 5 inhibitor, something his doctor called a PDE5i.
So far, it was going pretty well. He took his pill when he and Lila were starting to feel amorous, and in about a half hour, he was ready to go. Sure, they couldn’t be as spontaneous as they used to be, but that was a small price to pay for a better sexual relationship. Dina said she was enjoying their intimacy again, too.

There was just one problem.

There were times when the medicine didn’t work so well. Last week, they had their first barbeque of the season. Dina made amazing cheeseburgers, and Ali had two. Later, after a dip in the pool, they headed to the bedroom, but he couldn’t get an erection. Dina said not to worry about it, but he hated disappointing her.

Did something change with the meds?

Not necessarily. Sometimes, foods and beverages affect the way ED drugs work.

What are PDE5 inhibitors?

PDE5 inhibitors are a class of drugs designed to treat ED. They work by increasing blood flow into the penis when a man is sexually stimulated. Good blood flow is essential for a firm erection.
Four of the most commonly-prescribed PDE5 inhibitors are sildenafil, avanafil, tadalafil, and vardenafil. Viagra is now available in generic form as well.
Men who take PDE5 inhibitors still need to be sexually stimulated for an erection to occur.

How might foods interact with PDE5 inhibitors?

Foods might limit the effectiveness of PDE5 inhibitors in two ways.

First,

the type of food might delay the erection. Some men find that their ED drugs take longer to work after they have eaten fatty foods, like Ali’s two cheeseburgers mentioned above.

Second,

ED drugs, like Sildenafil and Vardenafil, work better on an empty stomach. If a man takes them with food, the stomach needs to do double duty: digest the meal and process the pill.
Men might consider taking their pill and enjoying their sexual activity before they eat. But all men are different, so it might take some trial and error to figure out what you can eat – and how much – around that time.

What about alcohol?

Lots of men have trouble getting erections after consuming alcohol, especially in excessive amounts. Some people even call it “brewer’s droop.” Alcohol can dehydrate you, which interferes with blood flow to the penis.
The effect can be similar for men who take ED drugs. Even though PDE5 inhibitors are meant to help with blood flow, using alcohol can work against the process.
If you discover that you have trouble with erections after alcohol, even when taking an ED drug, you might want to reconsider your alcohol intake.

When should I seek help?

If your ED medications aren’t working as well as you thought they would – and you’re taking them exactly as prescribed – call your doctor. You might need to change medications or adjust the dose. Also, remember that not all men respond to ED drugs. Fortunately, there are other ED treatment options, so don’t give up hope. Patience is key; eventually, you will find the solution that works best for you and your partner.

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Coping with Mismatched Sex Drives

  June 9, 2019
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You and your partner probably have a lot in common. Or if you’re not partnered, you likely seek common traits in a prospective mate. Whether it’s a love of baseball, camping, or rock concerts, these commonalities help keep you close as a couple.

So, what happens if your sex drives don’t sync?

Having mismatched sex drives is a frequent problem for couples, especially as their relationship matures. One partner might want sex all the time. The other might not be as interested. Does that mean there is a problem with the relationship?
Not necessarily. Some people are just wired to have higher sex drives than others. And that’s okay – until a mismatch happens. Partners who want more sex may take their partner’s rejection personally and feel frustrated and angry. Partners who don’t want sex may feel guilty about disappointing their partner or annoyed and pressured if they are constantly approached about sex.
If you find yourself in this situation, first consider whether one partner’s libido has changed over time.

Medical Problems

Sometimes, a medical issue causes sex drive to drop:

Hormones.

Sexual desire is driven largely by hormones, and hormone production – for both men and women – changes over time. As men get older, their bodies start making less testosterone, and some find themselves less interested in sex. A woman’s libido may also decline during and after menopause, when her estrogen levels drop.

Medications.

Some medications, like antidepressants, have sexual side effects that can include a dip in sex drive.

Hypoactive sexual desire disorder (HSDD).

Women with HSDD develop a lack of sexual interest, along with distress, that can’t be easily explained by other factors.
A doctor’s visit and treatment could be all that’s needed to bring one’s sex drive back into the usual range.

Relationship Problems

When people are hurt or angry with each other, they can feel less inclined to have sex. Working out the conflict with a trained counselor or therapist can help couples better communicate with each other and decide on their goals, including sexual goals.

Making Compromises

Sometimes, mismatched libidos have nothing to do with hormones or relationships. Some people are just more sexual than others.

Understanding this is the key to compromising.

With that clear, couples can talk together about meeting each other in the middle. Some strategies might include:

Asking questions.

Many couples sweep sexual incompatibility under the rug. But chances are, if you’re sensing a mismatch in sex drive, your partner is too. Have an open discussion about the situation at a time when you’re not feeling angry or frustrated. Ask each other what you want and need. Then try framing a plan.

Understanding exactly what your partner’s needs are.

It can be easy to say that one partner needs more sex than the other. But it might also be that the less sexual partner needs more non-sexual intimacy to feel sexually inclined. Try working on your friendship and romance. Think of activities that can bring you together and nurture your relationship. You might play games together, cook a great meal, take walks after dinner. This time can reinforce your emotional bond and, eventually, your sexual relationship. You can nurture this bond even when you’re not together. If you’re thinking of your partner during the work day, send a romantic email or text. Or pick up his or her favorite dessert on the way home.

Expanding your sexual definitions and repertoire.

Touching, massage, and cuddling while watching TV are other ways to be intimate, which may satisfy the more sexual partner. Some people masturbate, either alone or with their partner watching, kissing, or massaging them. In this way, both partners can still be involved in an intimate act.

Staying honest.

In some cases, partners feel that ending or straying from the relationship (as opposed to negotiating an open one) is the only solution to sexual incompatibility. They should be honest about their feelings and give their partner a chance to respond and make changes, if possible.
Remember that communication and respect are key aspects of compromise. Staying open with your partner and working out a plan together can keep your relationship strong, even if your sex drives are different.

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High Blood Pressure and Sexual Problems

  May 4, 2019
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You probably know it’s important to keep your blood pressure under control. High blood pressure (also called hypertension) can lead to all sorts of health problems, including coronary heart disease, heart failure, stroke, and kidney failure.
But did you know that high blood pressure can cause problems in your sex life, too?

What is High Blood Pressure and How Can it Affect Sex?

As blood travels through your arteries, it exerts a certain amount of force along the arterial walls. This force is blood pressure. The higher your blood pressure, the more force your blood exerts against these walls.
Over time, high blood pressure can damage the linings of your blood vessels, leading to plaque buildup and atherosclerosis – hardening of the arteries. When this happens, blood has a harder time flowing to essential parts of the body.
Since blood flow to the penis is an important mechanism for erection, many men with high blood pressure develop erectile dysfunction, which means they can’t get or keep an erection firm enough for sex.

Men with high blood pressure might have problems with ejaculation and desire, too.
Reduced blood flow to the genitals can also be an issue for women, interfering with desire, arousal, vaginal lubrication, and orgasm.
Anxiety over high blood pressure and its associated health problems can affect with the sex lives of both men and women, especially if it weakens relationships. Couples may have less desire for sex. Or they may not feel sexually satisfied.

Sexual Side Effects of Blood Pressure Medications

Unfortunately, medications used to treat high blood pressure can cause sexual problems themselves. For example, diuretics (water pills) can reduce blood flow to the penis and lower levels of zinc, which a man’s body needs to make testosterone. Beta blockers are another type of blood pressure drug that can have sexual side effects.
If you think your medication is causing sexual problems, don’t hesitate to talk to your doctor. It might be possible to adjust your dose or change the drug you take. Don’t make any changes without a doctor’s guidance, however.

Manage Your Blood Pressure

There are many steps you can take to lower your blood pressure and keep it at a healthy level. Sometimes, all it takes is changing your lifestyle a bit:
Eat a healthy diet that includes fruits, vegetables, and whole grains. You might also consider fat-free or low-fat dairy products, fish, and nuts. Keep red meat, added sugars, and alcohol to a minimum.
Cut back on salt and sodium. The National Heart, Lung, and Blood Institute recommends no more than one teaspoon of salt each day. Check the sodium content of the foods you eat. Remember, processed foods tend to be high in sodium.
Keep your weight under control. Being overweight increases your risk for high blood pressure.
Exercise regularly. Talk to your doctor about a fitness plan that’s right for you.
If you smoke, quit. Avoid secondhand smoke as well.
Reduce your stress levels. Blood pressure can rise when we’re excited or stressed. Find ways to relax and try not to overextend yourself with commitments. Ask your friends and family for help if you need to.
Your doctor can help you with these strategies and suggest others tailored to you. If you need medication, be sure to take it as directed.

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What is platelet-rich plasma (PRP) therapy, and can it benefit sexual health or performance?

  April 21, 2019
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Platelet-rich plasma (PRP) therapy refers to injections used to reduce inflammation and promote tissue healing. Athletes sometimes have PRP to speed up the healing of sports injuries. PRP has also been used for hair loss, cosmetic surgery, and osteoarthritis.
Some practitioners claim that PRP injections into the penis or the vagina can improve sexual function and satisfaction. This use is considered experimental and has not been widely studied.

P Shots and O Shots

For men, the injection is called the “Priapus shot” or “P shot” and is thought to improve erections and increase penis size.
For women, PRP therapy is called the “Orgasm shot” or “O Shot.” Practitioners claim that the shot leads to heightened libido, better vaginal lubrication, and more intense orgasms. Again, these claims are not evidence based.
The process involves separating platelets from a patient’s own blood and injecting them directly into the genitals.

What are platelets?

When a person has a cut, scrape, or other type of bleeding wound, platelets – small blood cells – work to stop the bleeding by clotting the blood. Proteins in platelets also contribute to wound healing.
Some scientists believe that injecting platelets from a patient’s own blood into a wounded area could help it heal more quickly.
In 2017, researchers reported on a small study of nine men with erectile dysfunction (ED). Each participant received one PRP injection in addition to a standard ED treatment (medication or vacuum therapy). The men’s scores on an ED assessment did get better, and none of the men had serious side effects.
The authors wrote that “PRP may represent a safe and viable option as a supplementary therapy for penile rehabilitation.” But they added that more research is needed.
This small study had no control group. Therefore, the only true result was that PRP therapy did not cause significant harm because all patients underwent typical erection therapies in addition to the PRP.
Currently, regulatory agencies have not approved PRP therapy for the treatment of sexual dysfunction.
Nevertheless, some practitioners market PRP therapy with promises of better sex. These claims should be considered with caution. There have been no large randomized controlled trials to show efficacy.
In 2018, the Sexual Medicine Society of North America (SMSNA – an ISSM-affiliated society) released a position statement on ED restorative therapies, including PRP therapy. The organization encourages further research so that clinicians can fully understand the pros and cons of therapy, as well as its long term safety.
People considering PRP therapy for sexual dysfunction are encouraged to see their healthcare provider for advice on standard treatments that are backed with solid scientific evidence. In some cases, patients see sexual improvements by making lifestyle changes, addressing an existing health condition (such as diabetes or heart disease), changing medications, counseling, or communicating more openly with a partner.

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Are Men Satisfied with Penile Implants?

  April 19, 2019
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Bill took a deep breath, looked at his wife Judy, and finally told his urologist, “Okay. I’ll get the implant.”
It wasn’t something he necessarily wanted to do. But he had been dealing with erectile dysfunction (ED) for a few years now and no other treatments seemed to be working out. Because he took heart medication, he couldn’t take the pills he saw advertised on TV. And the vacuum device, which was far from romantic, didn’t seem right for him either.
He didn’t like the word “prosthesis” when it referred to his manhood. It made him think of artificial limbs. But he knew that an implant was just that – a device designed to give him an erection when he wanted.
He and Judy were in their fifties - still young - and still had a long sex life in front of them. He wanted to be more spontaneous with their lovemaking. He wanted to feel confident, like he did early in their marriage. And he wanted to keep Judy satisfied. She was patient, but he knew he was disappointing her every time.
Bill had heard that penile implants had a high satisfaction rate. He’d also heard that sex would probably still feel the same as it did before he had ED. But he was nervous. He knew that after getting the implant, there was no turning back. So he wanted to make sure he was doing the right thing.
Many men getting implants share Bill’s concerns. Penile implantation is a big decision. Today, we’ll talk about men’s experiences with implants and some things to keep in mind if you’re considering one.

What kind of implant?

Bill’s urologist recommended a 3-piece inflatable implant, which is currently the most common type. These implants have three components:
  • Cylinders that are surgically implanted into the shaft of the penis. These cylinders replace the corpora cavernosa – the spongy tissue that typically fills with blood and gives an erection its firmness.
  • A reservoir filled with saline fluid. This fluid fills the cylinders on demand, similar to the way blood once filled the corpora cavernosa.
  • A pump placed in the scrotum. When a man wants an erection, he can activate the pump by squeezing it, sending the saline fluid into the cylinders. Similarly, when he no longer desires an erection, he can deactivate the pump, returning the saline fluid to the reservoir until next time.
Another type of implant, but less commonly used, involves malleable rods placed in the shaft. The man can move his penis to an erect position as he chooses.

Why do men like their implants?

In December 2015, The Journal of Sexual Medicine published a study on men’s satisfaction and dissatisfaction with penile implants. The researchers interviewed 47 men with an average age of 61 years and asked them to share their thoughts.
Overall, 79% of the men were “fairly” or “very” satisfied. The main reasons they gave were:
  • Improved sexual performance. Men could get erections, penetrate their partners, and feel sexually satisfied.
  • Improved self-esteem, confidence, and male identity. “It was a giant step I took in my life, and I'm glad I took it,” one man said.
  • Improved relationships. One participant remarked, “My general relationship with my wife is much better now.” Others said they were happy that they could please their partners.
  • Improved urination. Some men said their urinary function was better with the implant.

Why are men dissatisfied?

While the majority of men were satisfied, there were some who were not. Here are some of their reasons
  • Unmet expectations. Some men found that the implant did not “feel” the way they thought it would.
  • Shortening of the penis. In some cases, the penis was shorter than it was before. Two men were not able to have intercourse. [Note: A small 2014 study of penile shortening showed that 70% of men experience some degree of shortening after penile implantation, usually in the range of 0.5 centimeters to 1.5 centimeters. However, over half the men in the study didn’t notice.]
  • Feeling “artificial.” One man said, “It is always artificial. It takes time to inflate, it always disturbs.”
Malfunction. After a while, some men with inflatable implants had trouble activating their devices. It is possible for pumps to malfunction, although this is rare. A urologist should give instructions on how to keep the device in good working order.
Should you get an implant?
That’s a question only you, your partner, and your doctor can answer. As the study suggests, the majority of men are satisfied with their choice. But men should be prepared – and have realistic expectations – before surgery. If you have any questions or concerns, be sure to let your andrologist know.

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