The Health Blog

Learning to have pleasurable sex without intercourse is a good way to expose some myths about sex. Many men think that an erection is necessary for a woman’s sexual pleasure, but in fact it is not. A woman can experience much joy and achieve orgasm without an erect penis being in the picture. That does not mean that a woman won’t enjoy intercourse, just that ifs not always necessary. Like many of us, Caroline felt that intercourse was “real sex,” and other pleasures didn’t quite qualify. Learning otherwise made her feel better and enjoy sex more. And realizing that sex and pleasure don’t require an erection is reassuring—and re-energizing—to many men.

Once genital touching is permitted, the therapist might explain that the woman should gently caress the man’s penis until he gets an erection. Then she stops touching until the erection goes away—without the man ejaculating. The lovers can then repeat the exercise. Doing this several times gives the man practice in getting, losing and regaining an erection. It’s reassuring to both partners to realize that an erection once lost is not gone forever.

Or the man might caress the woman. Some men have always been the more active partner in sexual encounters, and they may find it difficult to relax and let their partner give pleasure to them, as the exercises require. One way around this is for the man to caress and stroke his lover first. Initiating the exercise may make it easier for him to then let his companion take the lead.

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To diagnose leaky veins you often need to have a cavernosogram. This test has been around for a while, but recently if s become more widely used to check out vein problems. It can provide important information which just isn’t available any other way.

The cavernosogram test takes about 20 minutes, and while it involves sticking a small needle in your penis, it is an otherwise painless procedure. You are given an artificial erection with a penile shot. The doctor then injects some dye into the penis which makes any leaky veins show up on an X-ray. If everything is normal, the dye should just stay in the erect penis. But if a man has leaky veins, the dye will leave the penis and show up in the veins. With this test, your doctor can determine the size and location of the leak.

Another test, the xenon wash-out, gives some of the same information but unfortunately can’t pinpoint the location of the leak. Because the cavernosogram gives more information, if s usually preferred.

The crucial thing about vein abnormalities is that they can be exceedingly difficult to diagnose. If a doctor doesn’t look for them, vein problems are easy/to miss. Any leak in the system may be a lifelong problem, or it may develop after years of satisfactory erections. Eric, a 40-year-old fisherman, had always enjoyed sex very much. He never had problems with erections. A large and very strong man, he prided himself on his health and the effort he put into keeping physically fit. But two years ago, Eric developed a problem maintaining his erections. He didn’t know what was wrong and neither did his steady girlfriend, Margie. As time went on, Eric’s difficulty increased. He went to several doctors, but no one could find anything wrong with him. Finally, Eric was referred to a urologist who specialized in potency problems.

Sure enough, Eric checked out fine on every test—but one. That test showed that he could blame his veins for the change in his potency. At this point, we don’t know just what makes some veins fail after functioning well for years. Fortunately, Eric didn’t have to resign himself to the situation. He had a choice between having the veins repaired, or having a penile prosthesis.

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There are lots of self-help sexual aids on the market, many of which are sold with the claim of fantastic powers. While some of them do work for some men, you should never use any of these devices without first consulting your physician. You need to find out if your potency problem is caused by a medical condition, which in itself requires treatment. Consulting a doctor before you buy anything might also save you a lot of money, disappointment and even harm to your health.

Cock Rings

One common aid used to boost potency is the cock ring— and it does work for some men. After a man has attained the best erection he can, the cock ring will hold the blood in the penis to keep it erect. These rings may be helpful for men who can get an erection but have difficulty maintaining it. But used improperly, they can cause pain and even permanent damage. A man who cannot become erect at all usually will not find them helpful.

Cock rings are sold in sex shops and by mail order houses. They are often made of thick rubber like material, which stretches easily so the ring can be slipped around the base of the penis once an erection is present. The rings come in different types of designs; some even have bumpy areas to stimulate the woman’s clitoris.

If, after consulting your physician, you decide to try a cock ring, it is essential that you observe precautions. You should use the ring only for short periods of time—never over 30 minutes. This is very important, because otherwise the penis can swell and make removal difficult and painful. Think of how your finger swells if a too-tight ring is left on.

So, clearly, being able to get the ring off easily is of prime importance. Some rings stretch easily for removal, others have snaps which you have to unfasten. Only use rings which can easily and quickly be removed or cut off. If you can’t get a ring off, it can cut off the blood supply, which can cause gangrene and possibly require amputation of the penis. Therefore, plastic, wood or metal rings, or thin elastic or rubber bands which can be lost in the skin and difficult to remove, are absolutely not recommended. One man kept a metal cock ring around his penis for several days. When this unfortunate fellow finally came into a hospital emergency room, the ring was literally cutting into his penis, causing profuse bleeding. It took a special saw to cut the metal and remove the ring.

If you have pain, your penis feels tender or you see any type of discoloration on the organ, remove the ring immediately. And if any of the symptoms or discomfort persist after removal, see your physician without delay.

And we hasten to add that a man with poor sensation in his penis should never use a cock ring, because he won’t feel the warning signs that tell when a ring is causing damage.

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It’s important to know that after either type of prostate surgery, a man will retain his ability to feel an orgasm, but he won’t ejaculate any fluid. Because the prostate produces part of the fluid a man ejaculates, after surgery he has less fluid to discharge; what does come out goes back into the bladder. This isn’t harmful, and the ejaculated fluid simply mixes with urine and is discharged when the man voids.

Some research suggests that just knowing what to expect after prostate surgery can help a man keep his potency. So here’s our advice for prostate patients.

• Be sure you understand why the doctor is recommending prostate surgery.

• Specifically, ask how it will affect your sexual functioning. Make sure you get a clear and comprehensive answer.

• If you’re having a radical prostatectomy, make sure your doctor is familiar with the new nerve-sparing methods. Some large tumors cannot be treated this way; if your physician advises against the new techniques, be sure you understand the reasons, Make sure you understand the pros and cons of any alternative treatment.

• Make sure your wife understands the procedure and the amount of time it will take you to recover. Encourage herto discuss with you and the doctor any concerns she may have.

For those patients who do lose potency after prostate surgery, penile prostheses or penile shots (discussed in chapters 7 and can enable a man to get and maintain an erection.

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Many drugs can interfere with erection. Here is a list of the more common troublemakers. In some cases doctors aren’t sure if the drug is really causing the problems; with almost all of these drugs, some men may experience potency problems while others remain unaffected. If you think one of them may be contributing to your erection problem, consider switching to another drug or type of treatment. But be sure to talk over any change with your doctor first. Stopping a drug treatment on your own can be dangerous.

Fortunately, the negative effects of drugs on potency are almost always reversible, though it may take some time for your system to get back in gear after you quit taking the drug.

Generic Name Brand Name

Blood pressure medicines and

diuretics

Thiazides Diuril, Esidrix,

Hygroton and

others

Spironolactone Aldactone

* Hydralazine * Apresoline

* Minoxidil * Loniten

Methyldopa Aldomet

Clonidine Catapres

Reserpine Serpasil, Sandril

Guanethidine Ismelin

Bethcmidine

Pargyline Eutonyl

Phenoxybenz- Dibenzaline

amine

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