What is a penile rehabilitation program (PRP)?
What is a penile rehabilitation program (PRP)?
Tag: erectile dysfunction
Should men stop taking erectile dysfunction (ED) drugs before having surgery?
Should men stop taking erectile dysfunction (ED) drugs before having surgery?
Yes. The American Association of Nurse Anesthetists recommends that men avoid taking erectile dysfunction (ED) drugs like Viagra and Cialis for a full 24 hours before surgery.
When patients receive anesthesia, they are often given drugs to control high blood pressure that might occur during surgery. Such drugs contain a substance called nitric oxide.
ED drugs also contain nitric oxide, which helps men achieve erections by relaxing muscles and widening arteries so that more blood can flow into the penis and make it firm for intercourse. These medications usually take 24 hours to leave the body.
Combining ED drugs with anesthesia can lessen the effects of the blood pressure drugs. It can also lead to poor circulation to the kidneys, heart failure, and other side effects.
Men should be up front with their doctors about any medications they use, including complementary and alternative medicines, like dietary supplements, ginseng, and ginger. It’s important for anesthesiologists – or any doctor - to know exactly what a patient is taking so that dangerous drug interactions can be avoided.
Vit D and Erection
Do vitamin D levels have any impact on a man’s erections?
Vitamin D is an important nutrient for our overall health. And some experts believe vitamin D deficiency might interfere with a man’s erections.
Sometimes called the “sunshine vitamin,” vitamin D helps the body process calcium to strengthen bones. It’s also important for nerves, muscles, and the immune system.
The body makes vitamin D when the skin is exposed to sunlight. Vitamin D can also be found in certain foods, such as fish and fortified cereals. Some people also take vitamin D supplements.
In 2016, the journal Atherosclerosis published a study by American researchers examining the relationship between vitamin D deficiency and erectile dysfunction (ED). The research team collected data from 3,390 men between the ages of 20 and 85. The men were considered to have vitamin D deficiency if their levels were below 20 ng/mL. Almost a quarter of the men had ED.
The scientists determined that the prevalence rates of vitamin D deficiency were 36% for men with ED and 29% for men without ED. Men with ED tended to be older, less active, and in poorer health.
It was unclear why vitamin D deficiency was linked to ED in this way. It’s possible that low levels of vitamin D could lead to damage in the blood vessels of the penis. Such damage could lead to atherosclerosis (hardening of the arteries), which would make it more difficult for blood to flow into the penis for an erection.
Another theory involves nitric oxide, an important element for erections. Vitamin D helps the body make this compound, but if a man is deficient, less nitric oxide can be produced.
More research is needed to determine if increasing vitamin D levels would improve erections for men with ED. In the meantime, men with erection problems are encouraged to see their doctor. Many factors can contribute to ED, and a full checkup can determine the cause and, in turn, the appropriate treatment.
What is postcoital dysphoria (“post-sex blues”)?
What is postcoital dysphoria (“post-sex blues”)?
Sometimes, people feel deep sadness or agitation after consensual sex. The medical term for these feelings is postcoital dysphoria (PCD), but some call it the “post-sex blues.”
In some cases, people become tearful or depressed after orgasm. In others, they become argumentative with their partner. These feelings occur even if the sexual encounter has been satisfying and enjoyable.
Not much is known about PCD, but research published in the journal Sexual Medicine in 2015 has revealed how common it is among women.
Researchers from the Queensland University of Technology (QUT) in Australia asked 230 female university students to participate in a survey about their experiences with PCD. The women ranged in age from 18 to 55 with an average age of 26 years.
Forty-six percent of the women said they’d experienced PCD in the past. About 5% said they’d had symptoms over the past month. And about 2% reported having PCD “always” or “most of the time.”
However, PCD was not linked to intimacy in close relationships, the researchers reported.
Experts aren’t sure why PCD happens. It may be that the bonding with a partner during sex is so intense that breaking the bond triggers sadness. Childhood sexual abuse may play a role as well.
The QUT researchers noted that their findings may not apply to other groups, as their participants were heterosexual, mostly Caucasian, and university students.
Additional studies with larger, more diverse groups may provide more clues. It is also uncertain to what extent postcoital dysphoria affects men.
People who are concerned about the post-sex blues are encouraged to talk to their doctor or a sex therapist.
Soft Drinks & ED
Soft Drinks
Can consuming soft drinks lead to erectile dysfunction (ED)?
It’s possible. Soft drinks, which include sweetened carbonated beverages like soda, are usually high in sugar, refined carbohydrates, and calories. Consuming too much of these ingredients can contribute to the development of metabolic syndrome, which can then lead to erectile dysfunction (ED).
Metabolic syndrome is actually a group of conditions that include obesity, high triglycerides, low HDL (“good”) cholesterol, high blood pressure, and high blood sugar. Many people with metabolic syndrome eventually develop diabetes.
In 2015, research published in the Journal of Sexual Medicine found that men with metabolic syndrome are 2.6 times more likely to have ED compared to healthy men. And in 2010, a study in the British Medical Journal reported that obese men were two and a half times more likely to have ED than men who were not obese.
In addition, men with diabetes are about four times more likely to develop ED compared to non-diabetic men. They are more likely to start having erection problems at earlier ages, too.
There are many ways the components of metabolic syndrome can lead to ED.
Penile Prosthesis
Penile Prosthesis
When should a man consider a prosthesis?
Usually, a prosthesis is considered a last resort. Men with erectile dysfunction (ED) are encouraged to try all other possible treatments (such as pills, injections, and vacuum devices) before getting an implant. However, some treatments are not suitable for all men. For example, men who take nitrates cannot take certain ED medications.
What types of prostheses are available?
Generally, there are two different types:
Semi-rigid positionable rods have an inner core made of stainless steel or interlocking plastic joints. A man can bend the penis up when he wants an erection and bend it back down when he’s finished with sexual activity.
Inflatable implants use a pump system. When a man wants an erection, he activates a pump placed in the scrotum. This action sends fluid (usually a saline solution) into inflatable cylinders placed in the penis.
Inflatable implants can have 2 or 3 parts. With 2-part implants, the fluid is held in the back part of the inflatable cylinders. With 3-part versions, the fluid is contained in a separate reservoir.
Nowadays, 3-part inflatable implants are the most common.
Both semi-rigid rods and inflatable implants are completely concealed within the body. Nobody can see them.
What are some of the drawbacks of a penile prosthesis? Can the device malfunction?
Infection is one risk. If the implant becomes infected, it will need to be replaced. Sometimes the implant damages surrounding tissue.
It’s possible for an implant to malfunction. This is more common with inflatable devices, which can leak saline fluid into the body. The fluid itself shouldn’t cause problems, but the device should be replaced or repaired.
What is the implant procedure like?
For some men, an implant procedure is same-day surgery. Others need to spend one night in the hospital. Men receive general anesthesia and incisions are made in the penis, lower abdomen, or scrotum. Afterward, many men need to take oral medications for pain. Sexual activity should be avoided for about a month after surgery.
Can the prosthesis wear out?
Yes. Normally, the device will function for about 12 to 15 years. After that, it will probably need replacement, if the patient wishes.
What is the satisfaction rate for penile prostheses?
The satisfaction rate is very high. For men with implants, the rate can reach 85%. For their partners, it can be as high as 90%.
Will sex still feel the same with a prosthesis?
Most men feel sensation, reach orgasm, and ejaculate just as they did before getting an implant.
What if I don’t like the implant? Can the operation be reversed?
No. The implant replaces the corpora cavernosum, the spongy tissue that typically fills with blood during an erection. So, it’s important that men discuss the pros and cons with their physician before getting an implant. Usually, other treatments for erectile dysfunction (such as oral medications or vacuum devices) are tried before an implant is considered.
Are certain foods helpful in addressing erectile dysfunction (ED)?
Are certain foods helpful in addressing erectile dysfunction (ED)?
It’s possible. Research published in January 2016 found that men who ate foods high in antioxidants called flavonoids had a lower risk of erectile dysfunction (ED) than those who didn’t eat a flavonoid-rich diet.
Flavonoids can be found in certain plant-based foods like citrus fruits, blueberries, strawberries, apples, pears, cherries, blackberries, radishes, and blackcurrant. Some teas, herbs, and wines also have flavonoids in them.
Past studies have shown that consuming flavonoids could reduce a person’s risk for diabetes and heart disease, both of which can lead to ED.
Eating a healthy diet overall, particularly a Mediterranean diet, can go a long way in preserving erectile function, however.
This type of diet includes fruits, vegetables, whole grains, and olive oil. Nuts and fish are good additions.
What does diet have to do with erections?
When a man is sexually-aroused, his penis fills with blood, giving it the firmness it needs for sex. Many men with ED have poor blood flow to the penis. Some medical conditions, like diabetes and heart disease, can damage blood vessels and nerves that are critical for this process.
Eating a healthy diet keeps the body in good working order. It can help men maintain a healthy weight, keep their blood sugar under control, and reduce the risk of blood vessel damage, which can impair blood flow.
Diet isn’t the only path to good erections, however. Other lifestyle habits, like regular exercise, quitting smoking, and managing depression are important too.
A man’s doctor can help him decide which dietary changes to make. However, men who are having trouble with erections should be sure to mention it. Many factors can contribute to ED and it’s best to have a complete medical checkup.
What is penile ultrasound?
What is penile ultrasound?
An ultrasound is an imaging test that uses sound waves to produce pictures of internal organs, giving doctors a more detailed view.
Penile ultrasound can be used to evaluate many conditions affecting the penis, including erectile dysfunction (ED), plaques (such as those caused by Peyronie’s disease), fibrosis, lumps, and even cancer.
Doppler Ultrasound
Men with erection problems often have a Doppler ultrasound, which can show the way blood flows in and out of organs. In a Doppler ultrasound, the sound waves bounce off circulating red blood cells. A change in pitch signals the movement of blood.
Blood flow is critical for a man’s erections. When a man is sexually stimulated, the arteries in his penis widen and the penis fills with blood. This blood is what gives the penis the firmness it needs for sex. Veins in the penis constrict, holding the blood in. When the stimulation stops, or when the man ejaculates, the veins widen again and allow blood to flow back into the body.
Many men with erectile function have problems with this blood flow. The arteries might not widen enough for sufficient blood to flow in. Or, the veins might not constrict enough to keep the blood from flowing out. Both situations can lead to weak erections.
The test begins with an injection of medicine, which causes an erection by widening arteries and increasing blood flow. From there, a doctor moves a small device called a transducer over against the skin of the penis. The transducer sends data to a computer so that the doctor can tell how fast blood is flowing in and out.
A Doppler ultrasound is noninvasive and the test itself shouldn’t hurt. Some men have pain or bruising at the injection site. Men might also feel dizzy for a few minutes. If the induced erection lasts longer than the test, the doctor might give another injection so the penis will become flaccid again.
Men are usually advised not to take any erectile dysfunction medications (such as Viagra, Levitra, or Cialis) for a day or two before the test. They might also be instructed not to have sex or masturbate the day of the ultrasound.
Congenital Penile Curvature
Congenital Penile Curvature
Patients with congenital penile curvature will have noticed this problem during their entire post puberty adult life. Erections will have always shown the abnormal curvature, which most often is downward. There will not be any history of penile injury. No scar or "plaque" can be felt in the penis during examination.
In terms of treatment, if this curvature is significant and very disturbing to the patient and/or his sexual partner, it may be corrected by relatively simple outpatient surgery. Slowly absorbing stitches are placed in the opposite side of the penis to cause the curve to be neutralized. Recovery is rapid and the results most often quite gratifying and long lasting. The stitches do not change penile feeling or interfere with one's ability to have erections. Penile length is not significantly changed.
A Man’s Penis Changes with Age
A Man’s Penis Changes with Age
As we get older, it’s inevitable that our bodies change. Our hair might turn gray, our skin may become wrinkled, and we might put on a little weight. These are changes we can usually expect.
Some men might be surprised to learn that their penis and testicles change with age, too. Why does this happen? And should men be concerned? We’ll look at these questions today.
Men might be surprised to learn that their penis and testicles change with age
Testosterone Levels Gradually Fall
Testosterone is an important hormone for men’s health, as it gives them their masculine traits and contributes to sex drive.
As men get older, their testosterone levels naturally decline. Some experts call this process “andropause” or “male menopause” to compare it to female menopause, when estrogen levels drop. However, it is not the same. Once men are in their 40s, their testosterone levels decrease about 1% each year. For women, the hormonal drop is much more dramatic.
Still, it helps to understand this decline in testosterone and the role it plays in the aging man.
Changes in Penis Appearance
Men might notice that their penis starts to look different:
- It might change color. Good blood flow to the penis is important for genital health. But with age, atherosclerosis – hardening of the arteries – becomes more common. When this happens, the blood supply decreases and the tip of the penis becomes lighter in color.
- It might look smaller. Some older men worry that their penis is shrinking, but this can be an optical illusion. If a man has gained abdominal weight, the extra fat can hide part of the shaft, making the penis look shorter than it actually is.
- It might actually become smaller. Sometimes, the penis does actually shorten, due to reduced blood flow and testosterone levels. A buildup of scar tissue can also contribute to the problem. This “shrinkage” could be as much as an inch over time. Keep in mind that the change is gradual and that for many partners, penis size is not important.
- It might start to curve. Peyronie’s disease, a condition marked by a distinct bend in the penis, becomes more likely with age. In some cases, the curve becomes so great that intercourse is impossible. Men in this situation should see their urologist for treatment.
- Testicles may become smaller. Over time, the size of a man’s testicles may decrease by as much as a third.
- Pubic hair may diminish. As testosterone levels decrease, so might the amount of a man’s pubic hair.
Functional Changes in the Penis
Aging can affect the way a man’s penis performs, too:
- Men may need more time. With their testosterone levels falling, older men often need more stimulation to become sexually aroused, get an erection, and reach orgasm. They may also need more time before they can have sex again. It can be frustrating, but it’s normal. Keep in mind that female partners may need more time, too.
- Erectile dysfunction (ED) may develop. ED – being unable to get or keep an erection firm enough for sex – is quite common in aging men, especially if they have developed atherosclerosis in penile blood vessels. Fortunately, there are a variety of treatments for ED, including pills and vacuum devices. If you are having trouble with erections, be sure to see your doctor. ED can be a sign of other medical conditions, like heart disease or diabetes, so it’s important to have it checked out.
- Urinary problems may occur. Older men are likely to have an enlarged prostate, also called benign prostatic hyperplasia (BPH). When this occurs, the prostate gland grows inward. The urethra – the tube that carries semen and urine out of the body – runs right through this gland. When prostate tissue enlarges, it can squeeze the urethra, making it more difficult for men to urinate. Men with urinary problems are encouraged to see their doctors as well.
What Can Men Do?
While none of us can turn back the clock, there are a number of ways men can keep the penis healthy as they get older.
- See a doctor when you have concerns. It might be awkward to discuss your private parts and even more awkward to acknowledge that you’re having a problem. But talking to your doctor is the first step toward better penis health, better sexual health, and better overall health.
- Develop healthy habits. Ask your doctor about dietary changes and fitness plans that are right for you. You might consider having fruit for dessert instead of cake, going to the gym, or taking a walk around the block after dinner. Maintaining a healthy lifestyle can reduce your risk of heart disease and diabetes, which can contribute to erection problems. And losing some weight might bring back some of that penis length you “lost.”
- Communicate with your partner. If you’re worried about changes in your penis, be open with your partner. Most likely, he or she will be glad you brought it up, supportive in your search for answers, and understanding if your performance isn’t what it used to be. Your partner may also have ideas for adjustments the two of you can make in the bedroom.
By accepting the course of aging and maintaining healthy habits, you and your partner can still enjoy an active sex life for many more years.