What are prostatic calculi (prostate stones)? Do they affect sexual function?
What are prostatic calculi (prostate stones)? Do they affect sexual function?
Tag: ED
What is the refractory period?
What is the refractory period?
After orgasm, both men and women experience a resolution stage. At this time, their bodies “recover” from sexual excitement and return to their normal states. For men, the penis becomes flaccid again and he goes through a refractory period.
During the refractory period, a man doesn’t think about sex or get aroused. His body does not respond to sexual stimulation and he is unable to reach orgasm again until the period is over. The length of the refractory period is different for every man. It may take a half hour or more for his body to perform sexually again.
Younger men may need only a few minutes of recovery time, but older men usually have a longer refractory period, sometimes between 12 to 24 hours. For some men, the refractory period can last a few days.
Experts aren’t sure why the length of refractory periods varies so much among men. But they do know that the length of time needed is not related to potency or testosterone levels.
Some men wonder how they can shorten their refractory period. No drugs have been approved for this purpose, but research has shown that some two drugs used to treat erectile dysfunction - may reduce recovery time.
Women do not have refractory periods the way men do. But fatigue after orgasm can make them lose interest in sex temporarily. This can happen after one orgasm or multiple orgasms.
What lifestyle changes can men make to improve their erectile function?
What lifestyle changes can men make
to improve their erectile function?
There are many things men can do to improve erectile function. Many of them provide other health benefits as well, so it makes sense to give them a try.
Before considering these lifestyle changes, it’s helpful to remember the role of penile blood flow in forming and maintaining an erection.
When a man is sexually stimulated, penile arteries widen and smooth muscle tissue relaxes. As a result, the penis fills with blood, which gives the erection its firmness.
Often, erectile dysfunction occurs when there are problems with blood flow. Many of these suggestions improve blood flow, but there are other factors, like nerve damage, that can be involved.
Exercise
Many men find that their erectile function improves when they exercise regularly. Exercise helps to keep blood flowing smoothly, including blood to the penis. Research has shown that men who are more physically active are at a lower risk of developing erectile dysfunction.
Men should consult their doctors before beginning a regular exercise program to ensure that the type of exercise they choose is appropriate for them.
Maintain a healthy weight
Obesity can damage blood vessels that allow blood into the penis for an erection. Studies have shown that heavier men tend to have more erectile problems, which may improve after the men lose weight.
Weight loss may also help erectile function by decreasing inflammation, increasing testosterone, alleviating depression, and boosting confidence.
Don’t smoke (or quit if you do smoke)
Scientific studies have found that men who smoke are more likely to develop erectile dysfunction than nonsmoking men. This likelihood appears to increase with the amount of cigarettes smoked over time. Men who stop smoking often see an improvement in their erectile function.
Eat a healthy diet
Research has shown that eating a Mediterranean diet may improve erectile function for some men. This diet includes fruits, vegetables, grains, and olive oil. Research has also shown that men without erectile dysfunction were more likely to eat lots of fruits, vegetables, nuts, and fish, and whole grains.
Control blood sugar and manage diabetes
Many men with diabetes have erectile problems. High blood sugar can damage blood vessels, nerves, and erectile tissue.
Blood vessels may be more susceptible to atherosclerosis – hardening of the arteries – in diabetic men. This means that plaques build up in the arteries, making it more difficult for blood to flow freely into the penis and form an erection.
Nerve damage, or neuropathy, can cause signaling problems between the brain and the penis. A man’s brain may register sexual stimulation, but if the “message” doesn’t reach the penis, there will be erectile problems.
High blood sugar can also interfere with the production of chemicals needed for an erection, like the neurotransmitter nitric oxide.
Other chemicals associated with diabetes can stiffen erectile tissue, leading to valve problems and “venous leak.” When this happens, the erection cannot be maintained because blood leaks out of the penis and back into the body.
Manage blood pressure
High blood pressure, or hypertension, is a common cause of erectile dysfunction, as it can interfere with penile blood flow.
While it’s important to manage high blood pressure, medications for this condition may also affect erectile function. It appears that older drugs, such as diuretics and beta-blockers, are more likely to have sexual side effects than newer ones. A man’s physician can help him decide on the best treatment options.
Manage depression
Depression is associated with erectile dysfunction, although it is unclear whether one directly causes the other. A man’s depression may lead to erectile difficulties. However, erectile dysfunction may also make him depressed.
Nevertheless, managing depression may help alleviate erectile dysfunction. It is important to note, however, that some commonly prescribed medications for depression, such as selective serotonin-reuptake inhibitors (SSRIs), have sexual side effects. A man may need to try different medications, with a physician’s guidance, to determine which one works best for him.
Remain sexually active
In a Finnish study of men between the ages of 55 and 75, men who had intercourse less than once a week were twice as likely to have erectile dysfunction than those who had intercourse once a week. The researchers concluded that regular intercourse protects against erectile dysfunction.
Be careful when bike riding
Men put a lot of pressure on their genitals when riding a bike. Compressing the perineum (the area between the scrotum and anus) on a bicycle seat can stop blood flow to this area, causing sexual difficulties. Men are advised to use a noseless bicycle seat, adjust their position on the bicycle so that there is less pressure on the perineum, and limit the time they spent bike riding.
What is venous leakage and how does it cause erectile dysfunction (ED)?
What is venous leakage and how does it cause erectile dysfunction (ED)?
Problems with blood vessels are a common cause of erectile dysfunction (ED). The term venous leakage refers to veins in the penis.
Blood vessels are important for erections. When a man becomes sexually aroused, the arteries in his penis expand to allow blow to flow in, making the erection firm.
However, to keep the erection rigid, blood needs to stay in the penis until the man ejaculates. To accomplish this, veins constrict to trap the blood inside. (This process is called veno-occlusion.) Once the man climaxes, or if sexual stimulation ends, the veins widen and blood flows back into the body.
If the veins do not constrict enough, blood will “leak” back into the body, softening the erection. Many men with this type of ED find that they can get a firm erection at first, but gradually lose the firmness.
Venous leak is often a cause of ED in younger men.
Several factors can contribute venous leak and ED:
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Vascular disease (which affects blood vessels)
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Radiation therapy for cancer treatment
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Diabetes
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Peyronie’s disease
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Nerve disorders
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Anxiety
To diagnose venous leakage, a doctor might conduct the following tests:
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Doppler ultrasound. This procedure uses sound waves to show how blood is flowing in and out of the penis.
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Dynamic infusion cavernosometry. With this test, a doctor can measure the pressure in the penis during an erection to determine the degree of venous leakage. Cavernosometry is used less frequently, usually in men who have already undergone Doppler ultrasound.
A doctor will also assess a man’s overall health and check for conditions related to ED, like vascular disease, diabetes, Peyronie’s disease, and nerve disorders.
Treatments for ED due to venous leakage can vary. Some men have success with oral ED medications, but there are other options, including vacuum devices, self-injections, urethral suppositories, psycho-sexual treatments, and penile implants.
Lifestyle modifications, like getting more exercise and eating a healthier diet, may also help control underlying factors like diabetes and vascular disease.
In some cases, venous ligation surgery, which repairs the leaking veins, might be considered. However, this approach is not typically recommended because it has limited long-term success. More research is warranted in this area.
Does engaging in sex affect personal workouts or sporting performance?
Does engaging in sex affect personal workouts or sporting performance?
The notion that sexual activity before a sporting event affects performance has been a matter of some debate. Some athletes feel that sex before sports is detrimental. For example, boxer Muhammad Ali is believed to have abstained from sex for 6 weeks before a match. But some feel it helps. American football player Joe Namath reportedly had lots of sex before a game.
So which is better? Scientific studies show that sex before a workout usually doesn’t affect energy levels or strength, at least for men. Women’s results have not been widely studied.
Many male athletes who abstain feel that that the sexual frustration makes them more aggressive and gives them endurance. These feelings may or may not be related to testosterone. It is unclear whether abstaining or having sex raises or lowers testosterone levels, and every man is different.
On the other hand, some feel that having sex regularly, even before a sporting event or workout, helps athletes feel relaxed and focused. They can concentrate better because they are not distracted by sexual frustration.
Many experts say that while the actual act of sex will not hurt one’s performance, the circumstances surrounding the encounter might. If athletes are up late and partying, the lack of sleep and effects of alcohol could make them groggy the following day, leaving them with less energy and less ability to concentrate.
Experts have also suggested that athletic performance within a few hours of sex might not be optimal because it takes some time for the heart rate to stabilize. As a result, some athletes tire out more quickly.
Ultimately, the decision to abstain from sex before sports is up to the individual. However, maintaining other healthy habits - like getting enough sleep and following a diet rich in fruits, vegetables, and whole grains - will benefit short-term performance and long-term well-being.
Priapism
Priapism
What causes priapism and how is it treated?
Priapism is a full, rigid erection that lasts for more than 4 hours. It is not necessarily caused by sexual stimulation and it is usually painful.
While priapism isn’t very common, it’s important for men to seek treatment immediately to avoid tissue damage. Left untreated, priapism will lead to erectile dysfunction (ED).
To understand priapism, it helps to review how erections occur.
In normal circumstances, erections are induced by signals from the nervous system – either as a result of sexual stimulation or thoughts or as a reflex during sleep. The signals cause arteries in the penis expand to allow more blood to flow in, causing the erection. Veins constrict to hold the blood in the penis and keep the erection rigid. After the man ejaculates (or if stimulation stops), the extra blood in the penis flows back into the body.
With priapism, there is a problem with this blood flow. Sometimes, too much blood flows into the penis as the erection forms. Or, the blood becomes trapped in the penis, unable to flow back out into the body as expected.
Priapism can have a number of causes, including the following:
• Blood disorders, such as sickle cell anemia and leukemia
• Substance abuse, including alcohol, marijuana, and cocaine
• Injury to the genitals, pelvis, or perineum (the area between the base of the penis and the anus)
• Spinal cord injury
• Carbon monoxide poisoning
• Venom from scorpions or black widow spiders
• Blood clots
Priapism can also be a side effect of certain prescription medications, including
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Antidepressants
• Erectile dysfunction (ED) drugs (oral and injected)
• Mental illness medications
• Blood thinners
• Alpha blockers (sometimes used to treat high blood pressure or an enlarged prostate)
Treatment usually depends on the type of priapism.
Ischemic priapism, in which blood is trapped in the penis and can’t drain out, is an emergency and should be treated as quickly as possible to avoid damage to the penis.
Some common treatments are:
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Aspiration. A small needle and syringe are used to drain the excess blood from the penis. Sometimes, a saline solution is flushed through the penis as well.
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Medication. A drug may be injected into the penis. This drug narrows the blood vessels that let blood in. This makes it easier for the trapped blood to drain out.
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Surgery. A shunt may be implanted so that blood flow can be redirected.
Men with sickle-cell anemia, a common cause of priapism, may be given treatment specifically for that condition.
Nonischemic priapism, when too much blood flows into the penis, may resolve on its own. Some doctors advise putting ice on the perineum. At times, surgery is done to prevent excess blood flow to the penis or to treat damage caused by an injury.
Peyronie’s Disease
What is Peyronie’s disease?
Peyronie’s disease is a disorder that causes areas of hardened scar tissue called plaques to form on the penis, just under the surface of the skin. These plaques make the penis less flexible. As a result, men with Peyronie’s disease have a noticeable curve in their penis. The penis may shorten as well.
Sexual intercourse can be difficult for men with Peyronie’s disease, especially if their curve is severe. Men may also experience pain and have problems with erections.
Experts aren’t sure what, exactly, causes Peyronie’s disease. It is believed to be a wound healing disorder. A man may injure his erect penis, such as through vigorous sex, and not even be aware that he has done so. However, the injury does not heal as it should. Instead, an excessive amount of scar tissue develops and does not break down as it typically would.
It’s also possible that some cases of Peyronie’s disease are inherited.
Peyronie’s disease occurs in two stages. The first is the “active” phase, which occurs during the first twelve to twenty-four months. During this phase, the disease progresses and the penis continues to bend.
Eventually, Peyronie’s disease stabilizes. This is called the “chronic” phase. At this time, pain usually subsides and the curve usually doesn’t worsen.
Not all men with Peyronie’s disease require treatment. For some, the condition goes away on its own. For others, the condition is not severe enough to require treatment.
However, many men decide to have treatment, which may involve surgery. Nonsurgical treatments are also available.
How do plaques cause the penis to bend?
Plaques form on the tunica albuginea, the flexible tissue that surrounds other tissue that fills with blood during an erection. Because the plaques are hardened scar tissue, they cause the tunica albuginea to lose its elastic quality. This makes the penis bend when erect.
Where are the plaques located?
Usually, the plaques are found on the upper side of the penis, but they can be found on the underside, too. Sometimes they look like small dents; other times, they form all around the penis, giving it an hourglass look.
How is Peyronie’s disease treated?
Surgery is the most common method. Tunica albuginea plication involves stitching tissue on the opposite side of the affected area to even out the bend. More severe cases are treated with a plaque incision and grafting procedure. Surgeons cut into the plaque and fill it with human or animal tissue.
How might Peyronie’s disease affect a man’s partner?
Peyronie’s disease is a condition that causes hardened plaques to form just under the skin of the penis. As a result, the penis loses flexibility and develops a distinct curve, sometimes to the point that sexual intercourse is difficult or impossible.
Men with Peyronie’s disease often feel pain and experience erectile dysfunction. But the condition can take an emotional and psychological toll as well. Men may feel depressed that their intimate relationships have changed, frustrated that they can’t perform like they used to, and anxious about satisfying their partner.
Peyronie’s disease can, in fact, have an impact on partners. In 2016, the Journal of Sexual Medicine published a study by Canadian researchers that shed some light on Peyronie’s effects on female partners.
Couples facing Peyronie’s disease are encouraged to keep the lines of communication open, especially in sexual matters. They might need to make some adjustments to their sexual routine, but it’s still possible to be intimate. Some couples in this situation benefit from sex therapy, which can help them express and work through their sexual concerns, needs, and relationship issues.
Are there personal health risk factors associated with Peyronie’s disease?
Peyronie’s disease is characterized by areas of bone-like collagen plaques that form inside the penis. Because these plaques are hard and inflexible, they cause the penis to bend. Peyronie’s disease can be painful and make sexual intercourse difficult.
The exact cause of Peyronie’s disease is unknown, but it is believed to be a wound healing disorder. In other words, the penis is injured and doesn’t heal properly. Peyronie’s disease may also be genetic or linked to certain connective tissue disorders like Dupuytren's contracture.
Personal health risk factors may also be involved. For example, high blood sugar and tobacco use may make it harder for wounds to heal normally. These factors could, indirectly, make a man more likely to develop Peyronie’s disease. Other potential risk factors include diabetes, heart disease, alcohol use, and high cholesterol.
In 2015, a team of Italian scientists investigated erectile dysfunction (ED), smoking, diabetes, and high blood pressure as possible risk factors for Peyronie’s disease. After collecting data from a group of 279 men (97 with Peyronie’s disease, 182 without), they found that cigarette smoking, high blood pressure, and ED were associated with Peyronie’s disease, but diabetes was not.
These results do not mean that any of these conditions cause Peyronie’s disease. The scientists explained that more study is necessary to see if removing a potential risk factor reduces rates of Peyronie’s disease.
How might Peyronie’s disease cause erectile dysfunction?
Scientists aren’t sure exactly some men with Peyronie’s disease also have ED, but the following factors might be involved:
- The plaques may weaken the smooth muscle tissue in the penis, making it more difficult for an erection to occur.
- The plaques may impair blood flow into the penis. As a result, there isn’t enough blood for a firm erection.
- The plaques may cause blood to leave the penis too quickly, making the man lose the erection.
- Men with Peyronie’s disease often feel depressed about their situation and anxious about sexual activity. These psychological issues can lead to erection problems.
If a man has ED along with Peyronie’s disease, he should talk to his doctor. The two conditions can be managed and a doctor can help determine what course of treatment is most appropriate.
Is there any relationship between penile curvature in men with Peyronie’s disease and ED?
One of the hallmarks of Peyronie’s disease is curvature of the penis. Plaques – areas of hardened scar tissue – cause the penis to lose some of its elasticity. This can make it bend when erect. For some men, the degree of curvature is so severe that they cannot have sex at all.
In July 2014, the International Journal of Impotence Research published a study that examined whether the degree and direction of a man’s curvature was associated with erectile dysfunction. They focused on vasculogenic ED, which involves poor blood flow to the penis.
The researchers found that the extent and direction of curvature did not appear to be related to ED.
“The role of [Peyronie’s disease] in the development of ED remains unclear at the present time,” they said.
What surgical treatments are available for Peyronie’s disease?
Surgical treatment for Peyronie’s disease is usually considered when a man is in the stable phase. At this point, the curvature has reached a plateau – not worsening, but not getting better.
Physicians will also consider the type of curvature and degree of erectile function when making decisions about surgery.
The most common surgical treatments for Peyronie’s disease include the following:
Nesbit Procedure (Tunica Albuginea Plication). The tunica albuginea is a thin layer of tissue that envelops the corpora cavernosa – two chambers of spongy tissue that fill with blood during an erection. Plaques caused by Peyronie’s disease form in the tunica albuginea.
During this procedure, the surgeon straightens the penis by folding small portions of the tunica albuginea on the opposite side of the curve. (Sometimes, these small portions are removed.) The surgeon then stitches the area, keeping the penis straight.
- Plaque Incision and Grafting. Men with more severe cases of Peyronie’s disease may benefit from this technique. To straighten the penis, the surgeon cuts into the actual plaque and then fills the space with replacement tissue called a graft. The graft could come from another part of the patient’s body or from another human or animal.
- Penile Prosthesis (Implant). Men who have both Peyronie’s disease and erectile dysfunction may decide to have a penile prosthesis, or implant. This procedure involves removing the corpora cavernosa and replacing them with cylinders, which straighten the penis.
Depending on the type of surgery and the man’s anatomy, there might be some penile shortening or loss of penile sensitivity after these procedures.
For men who have the Nesbit procedure or plaque incision and grafting, problems with erections could develop.
Concerned patients should ask their doctors about these issues. Resulting erectile dysfunction (ED) is usually treatable.
Men who are in the “active” stage of Peyronie’s disease, when the condition is still progressing, may choose nonsurgical treatments. Such treatments could include the following:
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Intralesional Therapy.
In some cases, medication is injected directly into the plaques themselves. Verapamil and interferon are two such substances, which are hypothesized to stop the development of collagen, the protein from which the plaques are made. They are also suggested to help “remodel” the scar tissue, making the plaques smaller as the area heals. However, there are conflicting reports regarding the efficacy of these therapies in the treatment of Peyronie’s disease.
In December 2013, the U.S. Food and Drug Administration (FDA) approved the use of an injectable medicine called Xiaflex to treat Peyronie’s disease in the United States. Xiaflex is given in a treatment course of four cycles by a healthcare professional, many men reported better erections and improved sexual satisfaction.
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Traction.
This technique involves wearing a special device designed to straighten the penis. This device pulls the penis straight. Wearing the traction device between six and nine hours a day (with thirty minute breaks every two hours) appears to have the best results, according to recent research. Traction therapy may also help restore some lost penile length. Apparently, more research is required to elucidate whether this therapy is a viable option for patients with Peyronie’s disease.
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Vacuum Erection Devices (VEDs).
VEDs are sometimes used by men with erectile dysfunction (ED). But there are some studies demonstrating that it might also help men with Peyronie’s disease. To use a VED, a man places a clear plastic cylinder over his penis. The cylinder is connected to a pump, which, when activated, creates a vacuum. Once an erection has formed, a constriction ring is placed at the base to keep it strong for whatever duration is needed.
What is orgasmic anhedoniapleasure dissociative orgasmic dysfunction?
What is orgasmic anhedoniapleasure dissociative orgasmic dysfunction?
The word “anhedonia” refers to the inability to experience pleasure from an activity that is normally considered pleasurable. People with orgasmic anhedonia (also called pleasure dissociative orgasmic dysfunction or PDOD) are unable to feel pleasure when they climax.
Orgasmic anhedonia/PDOD doesn’t affect sex drive. People with this rare condition still feel driven to have sex. Men still ejaculate. And women still know they’re reaching orgasm. The difference is that the pleasure is missing.
The situation can be quite frustrating for couples. People with orgasmic anhedonia/PDOD may be embarrassed or feel like they’re missing out. Partners may feel inadequate, like they are doing something wrong. Some partners are unaware of the situation.
Experts believe that orgasmic anhedonia/PDOD occurs because of a problem with neurochemicals in the brain, particularly dopamine. Patients may receive sexual stimulation, but there is a disconnect between the sensation and the part of the brain that recognizes that sensation as pleasurable.
It’s possible that the orgasmic anhedonia/PDOD is linked to psychological issues like depression or addiction. But it could also be connected to medications, high prolactin levels, low testosterone, or physical conditions like spinal cord injury.
If the cause of orgasmic anhedonia/PDOD can be identified, treating that issue may solve the problem. Sometimes, a combination of medical treatment and sex therapy is necessary.
People who do not feel pleasure during orgasm are encouraged to see their doctor.
Does long term anabolic androgenic steroid use lead to heart problems?
Does long term anabolic androgenic steroid use lead to heart problems?
THE USE (abuse) of anabolicandrogenic steroids (AAS), such as synthetic testosterone and other androgens, has increased markedly in recent years.
The majority of AAS users do so to ‘improve’ physical appearance and body building rather than competitive sport.
Many users become dependent on these drugs. The side-effects of AAS abuse include acne, weight gain, mood changes (especially aggressive behaviour), decreased testes size and low sperm counts leading to infertility.
There is some evidence that longer term effects include prostate cancer and heart disease but good quality studies are lacking.
A recent American study1 from the journal Circulation assessed three different measures of cardiovascular disease (CVD) in weight-lifters aged 34 to 54 who had used AAS for at least two years compared to those who had not used AAS.
This cross-sectional study showed that users of AAS had significantly worse outcomes on the three CVD measures, although one measure was normal in those who had previously used AAS but were not using at the time of the study, suggesting some recovery after stopping the AAS.
However, the other two measures indicated long-term damage to heart function and atherosclerosis (build-up of plaques leading to clogging of the artery connected to the heart). Although this study had some limitations it adds to the evidence that there are serious health implications for men who do not have testosterone deficiency but are using steroids for other purposes.
The risks may be difficult to quantify as the drugs available from suppliers at the local gym or on the internet are not regulated.
They may contain unknown substances, have varying concentrations or may contain hormones mixed with other drugs or dietary supplements (mixing drugs can be dangerous as they may interact with each other).
Painful Orgasm
What causes painful orgasm in men, and how can it be treated?
Painful orgasm (painful ejaculation) is commonly described as a pain or burning sensation that happens when a man ejaculates. He may feel pain between his anus and genitals or in his testes. He may also feel it in the urethra, the tube that semen passes through. Pain may be mild or severe.
A man may become so frustrated by this pain that he starts to avoid sex. His relationship with his partner may suffer as a result. Many men with painful ejaculation experience depression and anxiety.
Painful orgasm can have a number of causes:
Inflammation and Infections
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Prostatitis - inflammation of the prostate gland, which is involved with semen production
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Orchitis - inflammation of one of both testes, the glands that make sperm
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Urethritis - inflammation of urethra, the tube that semen passes through when a man ejaculates.
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Sexually-transmitted infections – such as trichomoniasis
Pelvic Conditions and Treatments
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Prostate cancer
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Pelvic radiation
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Lower pelvic surgery– such as radical prostatectomy (removal of the prostate)
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Nerve damage in the penis– such as from an injury or complications of diabetes.
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Chronic pain in the pelvis
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Blockages in the ejaculatory system- from cysts or stones