Sexual Health Clinic

Erectile Dysfunction is a condition that highlights the inability to achieve and or maintain an erect penis adequate for sexual function. This condition is one of the most common sexual problems for men and mainly increases with age. According to research around 42% of the men get affected by ED at the age of 52. However ED is not just age related or psychological, there are a number of medical reasons for the same. Research and medical exposure has shown that there can be a number of factors responsible for ED. Most men have difficulty with erections from time to time, yet in some men, it is a regular and more severe problem. It can cause low self-esteem, performance anxiety, depression and stress. ED may affect the quality of a marriage or intimate relationships. However, there are many safe and effective ED treatments available.

• Lifestyle Changes – ED can be treated by making small lifestyle changes like adding daily exercise to your routine. Exercise boosts blood circulation to the penis which in turn may help in improving the problem of ED. Also a good diet of fruits, vegetables, proteins, whole grains is important. A combination of exercise and proper diet can limit the chances of having erectile dysfunction. Adequate sleep is necessary to support a healthy level of testosterone. Smoking and alcohol have also shown to decrease full functioning of the penis by constricting the blood vessels and inability to maintain an erection.
• Use of Oral Medications – known as phosphodiesterase-5 inhibitors (PDE-5), Sildenafil Citrate (Viagra), Vardenafilhcl (Levitra), Tadalafil (Cialis).
  Men with ED take these pills before starting any sexual activity and these drugs boost natural signals that are generated during sex and improve and prolong the erection. The mechanism of the drug is by relaxation of muscle cells in the penis allowing for better blood flow which provides a rigid erection. These medications are highly effective, and improvement is seen in most men on usage. The drugs are effective regardless of race and age. Studies have shown that these medications can be taken by heart patients, but men taking medication like nitrates should consult with their doctors before them. The commonly seen side effects are headache, stuffy nose, flushing and muscle aches. In some rare instances, sildenafil may cause temporary blue-green shading of vision. No long term risks are seen. The proper instructions for these medications should be taken for best results.
• Penile injections – Alprostadil is approved for use. This drug comes in two forms: injections that the patient places directly into the side of the penis and an intra-urethral suppository. This drug has shown that men can achieve a firm erection viable for sexual intercourse with self-injection. Modifying alprostadil to allow intra-urethral delivery avoids the need for a shot, but reduces the likelihood of successful treatment. The commonly seen side effect is a burning sensation in the penis and a prolonged erection (over four hours).
• Use of an External Vacuum Device – This device combines a plastic cylinder or tube that is slipped over the penis and makes a seal with skin of the body. A pump present on the opposite end of the cylinder creates a low-pressure vacuum around the erectile tissue, resulting in an erection. To keep the erection firm after removal of the plastic cylinder a rubber constriction band goes around the base of the penis. With proper instruction, it is seen that 75 percent of men can achieve a functional erection.
• Reconstructive Prosthetic Surgery – (placement of a penile prosthesis or “implant”) can be done, with patient satisfaction rates up to 90 percent. Prosthetic placement can be performed in an outpatient setting or with overnight hospital observation. These are recommended only in patients who have tried all other means of treatment.

The Sexual Health Clinic specializes in providing counseling, management and treatment for male reproductive issues.

Sexual health is important at any age. As age increases, our bodies undergo changes that can affect sexual desire enjoyed at a young age. Sex at an older age is more than physical intimacy; it involves both the physical and emotional act. Understanding what your partner requires from you and try and fulfill those desires. Also practicing safe sex is important at all ages.

There are a number of conditions that affect sexual drive at an older age:

Low Testosterone: Older men have lower levels of testosterone which can affect sexual activity as it takes more time to achieve full arousal. Also erectile dysfunction is more common in older age.  In older women the levels of estrogen become low leading to lack of pleasure, decreased lubrication causing pain during intercourse. Menopause can also affect sexual desire as the body undergoes a number of changes.

Medical Conditions: Medical complications can affect your sexual health. Example diabetes, stroke, high blood pressure, hormonal problems, depression/anxiety can affect overall well being.

Some medications can inhibit sexual response like decreased desire for sex, problems in achieving climax. If such side effects are seen you can consult your physician to change your medication. Surgery can also affect sexual activity. You have to be patient and give your partner time to heal.

There are a number of hurdles that are faced by people of older age. But these have to be taken in stride and you and your partner have to optimize your body’s response to sexual desire by being patient and loving towards each other.

Books are available on how to maintain your sexual health as you grow older. Also your doctor can refer you to specialists in sexual health.

The Sexual Health Clinic specializes in providing counseling, management and treatment for male reproductive issues.

Retarded ejaculation or delayed ejaculation or inhibited ejaculation is the inability or difficulty in achieving orgasm despite sexual stimulation. It is a common medical condition in men.

Causes:

Include psychological problems, health issues/systemic disorders or prolonged use of certain medication.

Psychological and lifestyle problems can result due to a traumatic experience, anxiety about relationship and satisfying sexual partner, depression or work stress. These problems can result in making retarded ejaculation worse. These men can ejaculate during masturbation but not during intercourse with their partner.

Medical conditions that are related to retarded ejaculation are thyroid disorders, pituitary disorders like Cushing’s disease, hypogonadism. Certain medications like antidepressants, antipsychotics, high blood pressure medication, diuretics.

Certain Surgeries and Trauma can cause Delayed Ejaculation:

• Pelvic surgery resulting in trauma to pelvic nerves responsible for orgasm
• Prostate surgeries injuring nerves
• UTI
• Stroke
• Low level of hormones like testosterone, thyroid

Diagnosis of Retarded Ejaculation or Delayed Ejaculation:

• Proper history
• Physical examination
• If an underlying disorder is detected than blood and urine tests maybe done.

Treatment of Retarded Ejaculation or Delayed Ejaculation:

• Counseling/therapy: the patient can undergo counseling for depression, anxiety and any fears that he may have from past experiences that lead to Retarded Ejaculation. Sex therapy can also help in resolving the underlying cause of sexual dysfunction.
• Drugs: some medications may help, but these are not specifically approved for treating retarded ejaculation. These include – cyproheptadine, amantadine, and buspirone.

Retarded ejaculation is a condition which can be treated in the long run through psychological and physical support and talking to your doctor without any inhibitions.

The Sexual Health Clinic specializes in providing counseling, management and treatment for male reproductive issues.

Inhibited sexual desire is a condition in which the individual has low sexual desire. It can be either primary (a person who has never felt much sexual desire or interest) or secondary (in which the person used to feel sexual desire, but no longer does).

It can also be situational, in which the person feels no sexual desire for his partner but is interested in other people or it could be general in which the person lacks any sexual desire and maybe averse to sex altogether.

Causes of Inhibited Sexual Disease :

Common relationship problems that can result in ISD are –

• Conflicts and Criticism between partners
• Infidelity
• Lack of emotional connection

There are also Medical and Psychological Problems which can lead to ISD:

• Pain during intercourse
• Erectile dysfunction
• Retarded ejaculation
• Pregnancy
• Menopause
• Depression/anxiety
• Stress
• Chronic illness
• Alcohol and drugs usage
• Systemic diseases like high blood pressure, diabetes, STDs, stroke, arthritis

Diagnosis of  Inhibited Sexual Disease:

A person who has low sexual desire which causes distress in their personal relationship has ISD. A brief history, physical examination, blood tests, hormone tests, blood pressure check may be prescribed by the doctor.

If there is no underlying condition, the doctor will refer you to a sex therapist for counseling.

Treatment of Inhibited Sexual Disease:

• Counseling – psychological and sexual counseling is foremost treatment in ISD. Communication is the key in any relationship, the therapist helps the couple to resolve their anger issues and treat each other with love and empathy. Sexual therapy also helps in bringing sexual intimacy in the relationship.
• Hormone therapy –testosterone or estrogen therapy can be given, but it is not yet approved as there are many side effects like excessive hair growth, acne and mood swings.
• Lifestyle changes – certain changes can improve sexual health as well as overall health. Work related stress should be managed better. Exercise and yoga can improve mood and increase stamina.

The Sexual Health Clinic specializes in providing counseling, management and treatment for male reproductive issues.