Senior Sex: How to Maintain or Improve Intimacy

Sex in the Senior Years

By Mark Stibich, PhD | Updated on August 13, 2023
Medically reviewed by Isaac O. Opole, MD, PhD

This article is a repost which originally appeared on verywell health

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key takeaways:

People in their 70s and 80s and beyond can continue to enjoy sex.

Striving for optimal physical and mental health can allow one to continue to enjoy sex in older age.

Issues you cannot resolve on your own should be brought to the attention of a qualified medical professional.

Many people in their 70s and 80s are not only sexually active, but satisfied with their senior sex lives.1 Though the frequency or ability to perform sexually may decline with age due to physiological changes, these don’t necessarily affect how a person experiences or enjoys sex.

Aging-related problems like erectile dysfunction (ED), vaginal dryness, or urinary incontinence can affect sex. But their impact can also be minimized by using medication, managing chronic conditions, seeking individual or couples counseling, and changing sexual practices.2

This article explores the sex lives of adults 65 and over and the problems that can interfere with sex as the body ages. It also discusses the various treatment options and ways to maintain—or even jumpstart—your senior sex life.

Sexual Activity in Older Adults

Studies suggest that men are almost twice as likely as women to still have sex or masturbate in their later years. A British study found close to 60% of men ages 70 to 80 and 31% of men ages 80 to 90 are still sexually active. In women, those figures drop to 34% and 14%, respectively.3

This lower rate of sexual activity in older women may be due to a lack of opportunity rather than a lack of desire. Research shows that older women are less likely to have partners (due in large part to the fact that they often outlive their partners). This is sometimes referred to as “the partner gap.”1

Sexual Health Problems in Older Men

It is common for men to experience sexual problems after age 40. Reasons include a natural decline in testosterone levels, heart disease, and prostate problems. The inability to achieve or sustain an erection or reach orgasm or ejaculation are common concerns.4

Erectile Dysfunction

Erectile dysfunction (ED), formerly known as impotence, is the inability to achieve or maintain an erection firm enough for sexual penetration and long enough to achieve orgasm.

While ED is more common in older men, aging itself does not cause the problem. ED is related to conditions, sometimes several at once, that directly or indirectly interfere with erections.

Risk factors include high blood pressure, diabetic nerve damage, smoking, obesity, Peyronie’s disease, depression, and even certain medications. An accurate diagnosis is needed to ensure the right treatment.5

ED drugs like Viagra (sildenafil), Levitra (vardenafil), and Cialis (tadalafil) are often the first-line treatments for ED. Lifestyle changes and counseling can also help. For some men, hormonal therapy, penis pumps, and penile implants may be recommended.
Is There a Female Viagra?

Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is a non-cancerous enlarged prostate and one of the most common health problems in older males.6 BPH can cause symptoms like difficulty urinating, frequent urination, or waking up in the middle of the night to urinate (nocturia).

On top of this, BPH can cause sexual problems like low libido (low sex drive) and delayed ejaculation (difficulty reaching orgasm).

Among the treatment options, testosterone therapy may help restore libido. There are also certain drugs used off-label that may help with delayed ejaculation, including cabergoline (originally marketed as Dostinex) and Wellbutrin (bupropion).7

Because some BPH medications can also cause sexual dysfunction, a change in the dose may help resolve these concerns.8

Sexual Health Problems in Older Women

More than a third of older women experience sexual problems. These are typically due to menopause, when estrogen levels steeply decline. Hormonal changes can lessen sexual desire and make it harder to become aroused.9

Sexual organs also change as a person gets older. A woman’s vagina will shorten and narrow. The vaginal walls become thinner and less flexible, tearing more easily. Vaginal lubrication decreases, making vaginal intercourse more painful.10

Hypoactive Sexual Desire Disorder

Hypoactive sexual desire disorder (HSDD) is diagnosed when an absence of sexual fantasies, thoughts, and desires causes personal distress. It is a problem that is common among many older women.

A medication known as Addyi (flibanserin) is used to treat HSDD in women. It is currently only approved for premenopausal women, but research shows that it can also improve libido in older women as well.11

Vaginal Dryness

Vaginal dryness is uncomfortable and can make sex painful. Over-the-counter (OTC) remedies that can help relieve irritation and itching from vaginal dryness include lubricants such as K-Y Jelly or vaginal suppositories like Replens.

If OTC remedies don’t help, your doctor may prescribe estrogen cream as well as estrogen-containing vaginal rings and vaginal suppositories.

There are also plant-based products, like black cohosh, that have estrogen-like effects. These should be used with caution in women who have had or are at risk of breast cancer.12

Pain With Sex

Painful intercourse is more likely in older women as vaginal tissue tends to thin and tear easily after menopause. Standard treatments for vaginal dryness can often help ease pain during sex.

If that is not effective, prescription drugs like Osphena (ospemifene) and Intrarosa (prasterone) can treat thinning vaginal tissues and help relieve moderate to severe vaginal dryness.12

Pelvic Organ Prolapse

The pelvic floor muscles and tissues hold the bladder, uterus, cervix, vagina, and rectum in place. Pelvic organ prolapse (POP) occurs when the pelvic floor weakens, causing the pelvic organs to drop and bulge (prolapse) in the vagina. This can cause pelvic pain and pressure, pain with sex, and urinary incontinence.13

POP is often treated with pelvic floor physical therapy to strengthen the supporting muscles. In some cases, surgery may be needed.14

Other Health Concerns

Chronic medical conditions become more common as a person ages. Many of these can interfere with an older person’s sex life.
Arthritis and Chronic Pain

Arthritis and other chronic pain conditions are common among older adults and can make sex very difficult. Depending on the cause, doctors may recommend physical therapy to strengthen muscles and improve flexibility.

Nonsteroidal anti-inflammatory drugs (NSAIDs), both over-the-counter and prescription, can be taken before sex to help ease the pain. Opioid drugs, while effective as a pain reliever, can cause a drop in testosterone and contribute to ED.15

If the pain only occurs in certain sexual positions, let your partner know and try different positions. Bolstering your bodies with pillows and cushions can also help.

Diabetes

In the United States, almost one-third of adults over 65 have diabetes. Approximately half of these are undiagnosed.16

Diabetes can cause sexual dysfunction in both men and women. This can be due to circulation problems, medication side effects, or nerve damage. Problems include:17

  Low libido
Difficulty with arousal
Erectile dysfunction
Painful intercourse
Reduced genital sensation
Urinary tract infections
Yeast infections

The best way to reduce the impact of diabetes is to gain control of your blood sugar. Speak with your doctor if you have difficulty managing your blood sugar, and be sure to mention any sexual health problems you may be having. It’s important for your doctor to know.

Heart Disease

Older age is the greatest risk factor for heart disease.18 Heart disease causes problems as arteries start to narrow and harden (referred to as atherosclerosis). This reduces blood flow throughout the body, including the pelvis and genitals, resulting in sexual dysfunction in both men and women.

Heart disease is one of the leading causes of erectile dysfunction in men. It can also cause women to have difficulty achieving orgasm due to the decreased blood flow to the genitals.

There is no one way to resolve these issues, but there is evidence that statin drugs used to reduce the risk of heart disease can improve erectile dysfunction in some men.19 Some studies suggest that similar approaches may improve sexual function in women with heart disease.20

People with heart disease may also be nervous about sex due to fear of a heart attack. While sexual activity is generally safe, talk to your health provider if you are concerned.21

Obesity

Today, more than 40% of adults over 65 meet the definition of obesity.22 Research shows that women who are obese are more likely to experience sexual dysfunction than non-obese women.23 In addition, obesity increases the odds of erectile dysfunction in men.20

These issues may be directly related to higher rates of diabetes among people who are obese as well as reduced blood circulation due to atherosclerosis.24

Weight loss, achieved with a healthy diet and routine exercise, is considered the best strategy to overcome obesity. It may also improve a person’s self-image and sense of well-being while making sex easier to navigate.

Urinary Incontinence

Urinary incontinence is the loss of bladder control. This becomes more common with age, especially in women.

Incontinence can be embarrassing and make sex awkward. Women who experience stress incontinence may be afraid to orgasm. Extra pressure on the abdomen during intercourse can also cause urinary leakage.

If you have incontinence, empty your bladder before sex. Changing sexual positions can help prevent urinary leakage by avoiding the compression of the bladder. Pelvic floor exercises can also help strengthen the muscles that aid with urine control.

Medications

Some medications used in older adults can cause sexual dysfunction in both men and women. These include:25

  Antidepressants
  Antihistamines
  Chemotherapy
  Diuretics (“water pills”)
  High blood pressure medicines
  Opioid painkillers

If you are having sexual difficulties, let your doctor know and advise them of any drugs you are taking, including over-the-counter, prescription, or recreational.

Lifestyle and Mental Health

Lifestyle and mental health issues can also contribute to sexual problems in older adults. These issues can be just as difficult—and sometimes even more difficult—to overcome than physical ones. If you are faced with any of these issues, there are things you can do to turn them around.
Alcohol

For some people, drinking a glass of wine helps them relax and get in the mood. However, too much alcohol can end up impairing sexual function. According to the National Institute on Drug Abuse, alcohol is the most-used drug among older adults, with 65% of people 65 and older reporting high-risk drinking.26

Alcohol can impair a man’s ability to get an erection, cause premature ejaculation, or delay orgasm.27 In women, too much alcohol can make it difficult to climax.2

Reducing the amount you drink can help, but if you are unable to control your alcohol use, speak to your doctor about treatment options.

Depression

In the United States, between 5% and 10% of adults over 65 are estimated to be depressed.28 This can lead to many health concerns, including sexual dysfunction.29

In people with depression, neurotransmitters—chemical messengers that send signals between the brain and body—are out of balance. This can affect sexual desire, arousal, and orgasm. Ironically, medications used to treat depression can have the same effects.

While the benefits of antidepressants often outweigh the risks, therapy and counseling may offer a reasonable option for those with mild depression.

Stress

Stress can be a contributing factor to sexual dysfunction. Financial worries and health concerns are just some of the common stresses affecting older adults.

To relieve stress (and the effect it has on your sex life), consider stress management techniques like mindful breathing, tai chi, yoga, and meditation. Research shows practicing mindfulness and meditation can ease the effects of stress and improve overall feelings of well-being.30 This alone may help improve sex.

In addition, seek professional assistance from financial advisors, health advocates, and social workers to help better deal with the other stresses in your life.

Relationship Issues

Lack of sexual intimacy is often related to relationship problems. If you are and your partner are not connecting emotionally, it can lessen your desire to be intimate.

On the flip side, studies show that older couples who engage in sexual intercourse with their partner are likely to share a closer relationship. Moreover, closeness to one’s partner has been shown to increase overall well-being.31

While this issue is not unique to older couples, many people find talking to a marriage counselor can help them work through relationship issues and rekindle sexual feelings and attraction.

Self-Image

With age can come weight gain and other body changes that may affect one’s sense of physical attractiveness. Self-consciousness can spill over into the bedroom and affect a person’s confidence during sex.

A 2019 study among older women found that those who were self-conscious about their bodies reported less sexual satisfaction. By contrast, those who had greater self-acceptance of their bodies irrespective of weight or aging-related changes had a more satisfying sex life.32

Self-acceptance is ultimately the key. Working with a therapist, either alone or as a couple, can help you discuss your feelings openly and find a way to embrace a more positive self-image.

How to Maintain a Healthy Sex Life

The benefits of maintaining your sex life as you age are physical and emotional. Being sexually active is associated with a lower risk of medical conditions and a longer life. It’s also associated with a greater sense of happiness and overall well-being.3

If your sex life has become stagnant and you’d like to rev it back up, here are a few things you can do.

Communicate

Good sex begins with good communication. Couples who have been together a long time often think they know what the other is thinking. But no one is a mind reader.

Talk to your partner about any concerns you have. You may feel as though your mate is no longer attracted to you because sex has become infrequent, when in fact they are experiencing a decline in sexual interest.

In addition, as sex organs change with age, what felt good before may no longer feel good or may even be painful. Be open with your partner about these changes.

Communicating about sex can be challenging at any age, however. If you and your partner struggle to talk about sex, consider seeing a sex therapist.

Redefine Sex

Sex, as you get older, may need to change. But different can still be good, if not better. With an empty nest and possibly retirement, there’s more time and privacy to explore.

Research shows older adults have a broader definition of sexual activity than younger adults.33 In other words, they better understand that there is more to sex than just intercourse. Foreplay on its own can be quite satisfying.

Be creative and willing to try new things.

Rethink Intimacy

Sex isn’t just physical. It’s an emotional expression of intimacy. As you grow older, sexual intimacy changes. What this means to you and your partner may need to be redefined.

Emotional intimacy can be expressed through non-sexual physical touch. Examples of non-sexual physical touch include:

  Back rubs
  Cuddling
  Holding hands
  Hugging
  Placing your hand on your partner’s shoulder or arm
  Playful nudges
  Sitting next to each other
  Touching feet under the table

Another non-sexual way to build emotional intimacy is spending quality time together. Things you can do:

  Go out on dates with other couples.
  Look through old photos and reminisce.
  Play cards, board games, or word games.
  Read aloud to each other.
  Play music together.
  Travel, explore new places.
  Visit with friends or family.

Just Do It

Instead of waiting for the desire to strike, experts recommend that older adults just go for it. This is because sex has physical and emotional benefits. Orgasms release oxytocin, a hormone that induces a state of calm and improves sleep.

Even if you’re not in the mood, having sex can set the stage for more sex in the future. This is especially true for women. Having sex regularly helps increase natural lubrication and vaginal elasticity. It may also improve erections in men.

Summary

Older age can lead to sexual problems in different ways. Age alone increases the risk of erectile dysfunction, delayed ejaculation, low libido, vaginal dryness, and pelvic organ prolapse. Medical conditions like arthritis, diabetes, heart disease, obesity, and incontinence can also directly or indirectly interfere with sex.

Lifestyle and emotional issues that can impair sexual function in all ages can become even more profound in adults 65 years and older. These include stress, depression, negative self-image, relationship problems, and alcohol abuse.

By working with a doctor or therapist, you can overcome many of these concerns and improve not only your quality of life but your sex life as well. Keeping open lines of communication and embracing change as a natural part of life can also help keep your sex life fresh as you approach your later years.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. University of Michigan Institute for Healthcare Policy and Innovation. Let’s talk about sex.

2. National Institute on Aging. Sexuality in later life.

3. Lee DM, Nazroo J, O’Connor DB, Blake M, Pendleton N. Sexual health and well-being among older men and women in England: findings from the English longitudinal study of ageing. Arch Sex Behav. 2015;45(1):133-144. doi:10.1007/s10508-014-0465-1

4. Shigehara K, Kato Y, Iijima M, et al. Risk factors affecting decreased libido among middle-aged to elderly men; Nocturnal voiding is an independent risk factor of decreased libido. Sex Med. 2021 Oct;9(5):100426. doi:10.1016/j.esxm.2021.100426

5. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of erectile dysfunction.

6. National Institute on Aging. Prostate problems.

7. Abdel-Hamid IA, Elsaied MA, Mostafa T. The drug treatment of delayed ejaculation. Transl Androl Urol. 2016;5(4):576-591. doi:10.21037/tau.2016.05.05

8. National Cancer Institute. Understanding prostate changes: a health guide for men.

9. Harvard Health Publishing. Yes, you can have better sex in midlife and in the years beyond.

10. Szymański J, Słabuszewska-Jóźwiak A, Jakiel G. Vaginal aging—What we know and what we do not know. Int J Environ Res Public Health. 2021 May;18(9):4935. doi:10.3390/ijerph18094935

11. Portman DJ, Brown L, Yuan J, Kissling R, Kingsberg SA. Flibanserin in postmenopausal women with hypoactive sexual desire disorder: Results of the PLUMERIA study. J Sex Med. 2017;14(6):834-842. doi:10.1016/j.jsxm.2017.03.258

12. Naumova I, Castelo-Branco C. Current treatment options for postmenopausal vaginal atrophy. Int J Womens Health. 2018;10:387-395. doi:10.2147/IJWH.S158913

13. Department of Health and Human Services: Office on Women’s Health. Pelvic organ prolapse.

14. Duralde ER, Rowen TS. Urinary incontinence and associated female sexual dysfunction. Sex Med Rev. 2017;5(4):470-485. doi:10.1016/j.sxmr.2017.07.001

15. Marudhai S, Patel M, Valaiyaduppu Subas S, et al. Long-term opioids linked to hypogonadism and the role of testosterone supplementation therapy. Cureus. 2020;12(10):e10813. doi:10.7759/cureus.10813

16. Kalvani RR, Golden SH, Cefalu WT. Diabetes and aging: unique considerations and goals of care. Diabetes Care. 2017 Apr;40(4):440–3. doi:10.2337/dci17-0005

17. American Diabetes Association. Sex and diabetes.

18. Steenman M, Lande G. Cardiac aging and heart disease in humans. Biophys Rev. 2017 Apr;9(2):131–7. doi:10.1007/s12551-017-0255-9

19. Kosti JB, Dobrzynski JM. Statins and erectile dysfunction. World J Mens Health. 2019 Jan;37(1):1–3. doi:10.5534/wjmh.180015

20. Nascimento ER, Maia ACO, Pereira V, Soares-Filho G, Nardi AE, Silva AC. Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence. Clinics (Sao Paulo). 2013 Nov;68(11):1462–8. doi:10.6061/clinics/2013(11)13

21. Penn Medicine. Sex and your heart: What to know about intimacy and heart disease.

22. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity and severe obesity among adults: United States, 2017-2018. NCHS Data Brief. 2020;360.

23. Mozafari M, Khajavikhan J, Jaafarpour M, et al. Association of body weight and female sexual dysfunction: a case control study. Iran Red Crescent Med J. 2015;17(1):e24685. doi:10.5812/ircmj.24685

24. Ho JH, Adam S, Azmi S, et al. Male sexual dysfunction in obesity: the role of sex hormones and small fibre neuropathy. PLoS One. 2019;14(9):e0221992. doi:10.1371/journal.pone.0221992

25. Conaglen H, Conaglen J. Drug-induced sexual dysfunction in men and women. Aust Prescr. 2013;36(1):42-45. doi:10.18773/austprescr.2013.021

26. National Institute on Drug Abuse. Substance use in older adults DrugFacts.

27. Prabhakaran DK, Nisha A, Varghese PJ. Prevalence and correlates of sexual dysfunction in male patients with alcohol dependence syndrome: a cross-sectional study. Indian J Psychiatry. 2018;60(1):71-77. doi:10.4103/psychiatry.IndianJPsychiatry_42_17

28. Cheruvu VK, Chiyaka ET. Prevalence of depressive symptoms among older adults who reported medical cost as a barrier to seeking health care: findings from a nationally representative sample. BMC Geriatr. 2019;19(1):192. doi:10.1186/s12877-019-1203-2

29. National Institute of Aging. Depression and older adults.

30. Goyal M, Singh S, Sibinga EM, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357–68. doi:10.1001/jamainternmed.2013.13018

31. Smith L, Yang L, Veronese N, Soysal P, Stubbs B, Jackson SE. Sexual activity is associated with greater enjoyment of life in older adults. Sex Med. 2019 Mar;7(1):11–8. doi:10.1016/j.esxm.2018.11.001

32. Gillen MM, Markey CH. A review of research linking body image and sexual well-being. Body Image. 2019;31:294-301. doi:10.1016/j.bodyim.2018.12.004

33. Hinchliff S, Tetley J, Lee D, Nazroo J. Older adults’ experiences of sexual difficulties: Qualitative findings from the English longitudinal study on ageing (ELSA). J Sex Res. 2018;55(2):152-163. doi:10.1080/00224499.2016.1269308

 

 

 

 

 

 

Does Sex Hurt for Men? – 10+ Causes

Why Sex Could Hurt for Men

By Jerry Kennard
Updated on July 12, 2023
Medically reviewed by Jamin Brahmbhatt, MD

This article is a repost which originally appeared on verywell health

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key Points

‧ There may be one or more causes to pain during sex for men.

‧ Refrain from sexual activity if you suspect you have an injury which needs attention.

‧ STIs can interfere with sexual performance and pleasure.

Pain during sex happens to both males and females, regardless of gender identity. When sex hurts, it can cause anxiety and affect sexual pleasure.

Sex can hurt for men for a variety of reasons, including sexually transmitted infections, foreskin problems, and being allergic to chemicals in birth control methods (such as latex condoms).

This article explores some common reasons sex can hurt for men. It also offers guidance for when to seek medical care.

For the purpose of this article, “male” refers to people born with penises, irrespective of whether they identify with one or more genders or no gender at all.

Why Does Sex Hurt for Males?

Some of the reasons sexual intercourse can hurt for men include:

Sexually Transmitted Infections

Some sexually transmitted infections (STIs) can cause pain during sex. Infections such as herpes and gonorrhea can cause burning and itching if left untreated. They can also cause sores, bumps, or blisters on the penis or anus.

If you think you may have been exposed to an STI, visit your healthcare provider or a clinic to get tested.

The sooner you know if you’re infected, the sooner you can get treatment. Early treatment can limit or prevent some effects of these infections.

Foreskin Problems

Uncircumcised men can develop tight foreskin, or phimosis. When you pull back the foreskin, or when your penis is erect, it can tear, bleed, get inflamed, or be painful.

This problem can usually be treated with an ointment. In some cases, adult circumcision can resolve the problem. Talk to your healthcare provider about your options.

Why Does Sex Hurt For Females?

In general, women are more prone to experience painful sex than men. Here are some of the reasons sex can hurt for females:

‧ Losing their virginity

‧ STIs

‧ Vaginismus

‧ Vulvodynia

‧ Endometriosis

‧ Uterine fibroids

‧ Ovarian cysts

‧ Cervical cancer

Curved Penis

Normal penises vary in length, girth, and shape from one person to the next. Sometimes, a curved penis can cause painful erections or make sex difficult.

Some penises curve because of conditions like hypospadias. That’s where the urethra opens away from the tip of the penis.

In some cases, a curve can develop over time. One cause of this is Peyronie’s disease, which causes scar tissue to form in the penis. Scars from previous traumas or infections can make sex painful, too.

Lesions and Growths

Sometimes a growth on the penis is what’s causing the pain. Some cancers cause growths. Cysts and lesions can also form on the penis or in the ducts and tubes that carry sperm.

If your prostate is enlarged, you may have pain when you ejaculate. It’s also possible that an infected pocket called an abscess can form on the penis.

Any of these growths can cause pain when you’re having sex or ejaculating.

Priapism

Most of the time, erections go away after sex. Sometimes a non-sexual erection lasts much longer than it normally would. This condition is called priapism, and it is often painful.

An Allergy

Some men have an allergic reaction to vaginal fluids or the chemicals in birth control methods. A medical professional can help you find out if you’re allergic to latex condoms or another substance.

Hypersensitivity

The penis can become very sensitive after orgasm and ejaculation. If you keep having sex after that point, it may be painful. This may mean you need to limit how many times you have sex with your partner on a given day or find other ways to experience pleasure together.

A rare condition called pudendal neuralgia affects a nerve in the pelvic region and may cause pain during sex as well.

Medications

Some antidepressants and muscle relaxers can cause pain when you ejaculate.4 It’s important to talk to your healthcare provider if you think a medication may be causing this kind of pain.

However, you should not stop taking your medication without discussing it with your healthcare provider first, because serious health problems can arise if you do.

Skin Disorders

Some skin conditions can lead to painful sex. These include:

‧ Zoon’s balanitis, an inflammation of the foreskin

‧ Erosive lichen planus, which causes an itchy rash or blisters

‧ Lichen sclerosus, which causes itchy white patches

‧ Genital psoriasis, an itchy inflammation of the skin

‧ Penile cancer

Other Causes of Painful Sex

Other possible reasons that a man or woman might find sex painful include:

Sex positions: Some sexual positions are more uncomfortable than others. This can be due to a variety of reasons, including someone’s overall health, weight, flexibility. Some health conditions, such as back pain, can also make some positions painful. Work with your partner on finding the positions that are most comfortable for you. There are also other ways to enjoy sex that don’t involve intercourse.

Lack of lubrication: Vaginal dryness can cause pain for a woman during sexual intercourse. This can also affect men and women during anal sex. Using a lubricant designed to be used during sex can help with this.

Losing your virginity: Having sexual intercourse for the first time can be painful for women. Women are born with a hymen, thin, fleshy tissue that stretches across part of the opening of your vagina. When this tissue is penetrated, it may cause pain or bleeding. Men typically do not experience pain when they have sex for the first time.

Postorgasmic illness syndrome: Postorgasmic illness syndrome (POIS) is a rare condition in which a person develops flu-like and allergy symptoms after orgasm. It is much more common in men than in women. Symptoms typically develop shortly after an orgasm, and can last for up to seven days before going away. It is not known what causes POIS.

When to See Your Healthcare Provider

It is important to see a healthcare provider if you are experiencing pain during sex so it can be treated as soon as possible.

If you don’t feel comfortable talking about it with your current provider, try to find a healthcare professional you can talk. The right diagnosis and treatment can improve your health and your sex life.

Summary

Pain during sex can be a sign that you have an STI, a skin disorder, an allergy, or another health condition. It could also be that the shape of your penis, a medication, a long-lasting erection, or post-orgasm sensitivity could be the reason.

Some conditions that cause this kind of pain can be serious. It’s vital that you seek medical care when sex hurts so that you can protect your own health and your partner’s.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Urology Care Foundation. What are sexually transmitted infections (STIs) or diseases (STDs)?

2. National Health Service. Tight foreskin (phimosis and paraphimosis). Updated July 26, 2018.

3. The American College of Obstetricians and Gynecologists. When sex is painful.

4. Waqar M, Omar K, Moubasher A, Brunckhorst O, Ahmed K. Painful ejaculation: An ignored symptom. Cureus. 2020;12(10):e11253. Published 2020 Oct 30. doi:10.7759/cureus.11253

5. Muneer A, Alnajjar HM, Ralph D. Recent advances in the management of priapism. F1000Res. 2018;7:37. doi:10.12688/f1000research.12828.1

6. Marfatia YS, Patel D, Menon DS, Naswa S. Genital contact allergy: A diagnosis missed. Indian J Sex Transm Dis AIDS. 2016;37(1):1-6.

7. Turley KR, Rowland DL. Evolving ideas about the male refractory period. BJU Int. 2013;112(4):442-52. doi:10.1111/bju.12011

8. Genetic and Rare Diseases Information Center. Pudendal Neuralgia.

9. American College of Obstetricians and Gynecologists. Vulvovaginal health.

10. NIH. Genetic and Rare Diseases Information Center. Postorgasmic illness syndrome.

 

What Causes Morning Wood?

By Brandon Peters, MD Updated on March 23, 2023
Medically reviewed by Jamin Brahmbhatt, MD

This article is a repost which originally appeared on verywell health

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key Points

‧ Morning erections are not necessarily associated with sex dreams.

‧ During sleep, REM sleep cycles affect erectile activity.

‧ Subtle contact of the penis with bedsheets can induce erections.

“Morning wood” is when the penis engorges with blood and you wake up with an erection. This is a perfectly normal occurrence. Most morning erections tend to last for a few minutes after awakening but can persist for longer.

Despite what some think, these erections are not so much associated with “sex dreams” as they are certain parts of the sleep cycle—namely, REM sleep.1 Changes in hormone levels, a full bladder, and even physical stimulation from a bedsheet can also cause morning wood.

This article explains the causes of morning erections, clinically known as nocturnal penile tumescence. It also reviews factors that independently contribute to morning wood in people with penises.

Erections and Your Sleep Cycle

Morning erections correspond to the timing of rapid eye movement (REM) sleep. Because REM sleep effects neurological stimulators that increase blood flow to the penis, penile erection is more likely during this part of the sleep cycle.1

Everybody has different sleep patterns. But since there are usually four or five stages of REM sleep during the night, people with penises may have four or five erections during the night, too. Each erection can last 25 to 35 minutes, though this doesn’t necessarily happen every night.

People stay in REM stage sleep for longer as morning approaches. By the time they wake, they are often still coming out of REM sleep. This is why you may experience morning wood, which typically subsides within a few minutes of awakening.

It seems that the body is doing what healthcare providers refer to as “testing systems” during sleep. This is a normal and healthy phenomenon in people with penises. In fact, it can also happen in those without them: The clitoris can become engorged with blood and erect during REM sleep as well.

Hormones Levels in the Morning

The sex hormone testosterone plays a central role in the sexual functions of people with penises. Research has shown that testosterone helps facilitate nearly every facet of an erection, from the activation of nerves that stimulate smooth muscles of the penis to the engorgement of blood in the spongy interior of the penis.

Testosterone levels also fluctuate and tend to be higher early in the morning than in the afternoon or evening.

This incidental increase can also be one of the contributing factors to a morning erection.

Even Subtle Touch Can Cause Erections

Physical touching of the penis can, on its own, cause an erection in the absence of sexual stimulation. Research has shown that physical stimulation sends sensory signals directly to the lower part of the spinal cord which functions at the body’s “erection center.”

Even when half-asleep or half-awake, these sensory nerves can be alert to even subtle changes in the environment. As such, the tactile sensation of a bedsheet or pajama fabric against the penis may be enough to provoke a morning erection.

Effect of a Full Bladder

Men who don’t get up to urinate during the night will have a full bladder in the morning. A full bladder can press on the sacral nerve, which is a group of five nerves in the lower back.

Your nervous system helps keep your body running while you sleep. Because the sacral nerve is responsible for erections while you’re asleep or half-asleep, stimulation of the nerve from a full bladder can cause an erection.

Morning erections can be a reassuring sign that your nerves, blood supply, and circulation are healthy.

What If Morning Erections Stop or I Never Have Them?

If you do not wake with an erection, it is not necessarily abnormal. It could be that you did not wake from REM sleep. It is also possible that the erection began to fade prior to waking completely.

In general, sleep-related erections decrease with age. But if you’re not waking at least occasionally with an erection, if may be time to visit your healthcare provider for a check-up.

Adolescents, teens, and young adults tend to have morning wood more often than older adults.

A complete lack of morning erections may suggest a problem with the blood vessels or nerves. It can also indicate erectile dysfunction, a common condition in which a person is unable to get or keep an erection firm enough for satisfactory sexual intercourse.

See your healthcare provider. They will probably want to do a full health history and eliminate other possibilities, such as obstructive sleep apnea, which is just one condition that can affect erections. A diagnostic sleep study called a polysomnogram may be recommended.

What If a Morning Erection Doesn’t Go Away?

Persistent erections may occur in a condition called priapism. With this uncommon condition, either blood flow through the penis is not as it should be (nonischemic or high-flow priapism) or blood gets trapped in the penis after it becomes erect (ischemic or low-flow priapism).

Priapism can result in erections that last hours. With nonischemic cases, the shaft of the penis may lose some rigidity and you likely won’t experience pain. With ischemic priapism, the shaft is rigid, the tip is soft, and there is pain that worsens with time.

Give the erection some time to resolve. If it goes away, but long-lasting and/or painful erections keep happening, see your healthcare provider.

If your erection lasts for more than four hours, go to the emergency room.

Summary

Morning erections correspond to the timing of rapid eye movement (REM) sleep, which you may still be coming out of when you wake up. They can also be caused by hormone fluctuations, a full bladder, and subtle touch.

These erections typically resolve within minutes of you waking up.

Morning wood is not only common, but normal. If you don’t ever experience these erections, they stop, or they last several hours, see a healthcare provider.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Youn G. Why do healthy men experience morning erections? Open Psychol J. 2017;10(1). doi:10.2174/1874350101710010049

Isidoria AM, Buvat J, Corona G, et al. A critical analysis of the role of testosterone in erectile function: from pathophysiology to treatment—a systematic review. Eur Urol. 2014 Jan;65(1):99-112. doi:10.1016/j.eururo.2013.08.048

Crawford ED, Poage W, Nyhuis A, et al. Measurement of testosterone: how important is a morning blood draw? Curr Med Res Opin. 2015;31(10):1911-4. doi: 10.1185/03007995.2015.1082994

Boston University School of Medicine. The central mechanisms of sexual function.

Leungwattanakij S. Erectile dysfunction. Bangkok Med J. 2016;11:57-. doi:10.31524/bkkmedj.2016.02.012

Urology Care Foundation. What is Priapism?

 

 

 

 

 

 

 

 

Common and Uncommon Threats to Men’s Sexual Health

3 Common—and 4 Uncommon—Risks to Men’s Sexual Health

You might know some of these threats to your sexual well-being. Others might surprise you.

Author: Kurtis Bright
Published: March 22, 2023

This article is a repost which originally appeared on Giddy

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key Points

‧ Sexual health information is more abundant and easier to access than ever.

‧ Ironically, men are at a greater risk of diseases caused by excess and poor lifestyle choices than ever.

‧ ED is a notorious side effect of common ailments like diabetes and poor cardiovascular health.

Sexual health information is everywhere these days, both quality info and the not-so-high-quality kind that’s widespread on social media platforms. Even with all this access to so much information, though, certain lesser-known threats to our sexual health and fertility may slip under the radar.

At the same time, the seriousness of certain sexual health risks that “everyone knows about” may go ignored.

Here are three of the more common risks to men’s sexual health and fertility, as well as a handful of risks that aren’t always recognized as threats.

What are the biggest risks to men’s sexual health?

When we talk about threats to sexual health, we’re often talking about systemic problems. That is to say, if you’re having a problem with how your penis works, it’s not necessarily about your penis.

In modern society, we tend to view medicine as slapping on a bandage or taking a pill to alleviate the most obvious symptom we can see. In reality, lots of problems you might have in other parts of your body can affect how your penis functions.

“Sexual health is health,” said Justin Dubin, M.D., a urologist and men’s health specialist with Memorial Healthcare System in South Florida. “So sexual health problems, in general, can be a warning sign or a result of other health issues: diabetes, heart issues, infections, depression, anxiety, testosterone issues, obesity, other lifestyle issues—you name it. Having ED is the canary in the coal mine.”

Common sexual health issues

Three of the most common issues that can affect sexual health are cardiovascular disease, obesity and diabetes. They work against us in different ways.

Cardiovascular disease

Heart disease and vascular problems are strongly associated with erectile dysfunction (ED). A vital component of getting an erection is good blood flow to the penis, and issues such as atherosclerosis and high blood pressure hamper it.

Obesity

Obesity is a big risk factor for ED. One study indicated 79 percent of men who presented with ED were clinically obese, and obesity hampers your heart’s ability to pump blood. Plus, it’s a comorbidity for another risk factor, diabetes.

Diabetes

Diabetes causes a condition called diabetic neuropathy, which affects nerve endings and can result in numbness, tingling and loss of sensation. Along with blood flow, nerves are crucial for the penis to receive the signals from the brain and nervous system to get erect.

“You need to have good nerves in your penis,” Dubin said. “People [with diabetes] who have bad sensation in their feet or fingers or their eyesight, well, the nerves in the penis are very small as well, and poorly controlled diabetes can cause ED.”
Less common risks to sexual health

Four of the less obvious issues that can affect your sexual health include smoking, sexually transmitted infections (STIs), Peyronie’s disease and mental health.

Smoking

The dangers associated with smoking often focus on the lungs and heart, and rightly so. However, a lesser-known effect of smoking is that it’s associated with ED.

“Smoking and ED are linked to overall cardiovascular health,” said Neel Parekh, M.D., a men’s fertility and sexual health specialist with Cleveland Clinic. “It’s associated with cardiovascular disease, so that’s another reason why it can make it more difficult to achieve an erection. It can even affect fertility; smoking has a negative effect on how well the sperm swim.”

Indeed, according to some studies, smoking has a negative impact on semen parameters. Luckily, other studies show that quitting can greatly improve them in a short amount of time.

STIs

When it comes to fertility, another little-known issue some guys may encounter is that sexually transmitted infections can affect your sperm. An STI can travel up the urinary tract and cause problems in the rest of your reproductive system in ways that may affect you long after you’ve taken your antibiotics and the symptoms have gone away.

“Chlamydia and different bacterial infections can lead to epididymitis—the inflammation of the epididymis—which is where sperm is stored,” Parekh said. “These STDs can cause scarring of the epididymis or vas deferens and cause blockages for guys, preventing sperm from traveling through.”

Peyronie’s disease

Another issue that can fly under the radar is Peyronie’s disease. It’s a buildup of fibrous plaque or scarring in the penis that may result in a lump or new curvature that wasn’t there before. It’s thought to affect 1 in 10 men and may come on suddenly due to overenthusiastic sexual activity or over time through buildup. It can also cause erections to be painful during the acute phase.

“Peyronie’s disease is another uncommon disease that some guys will let go unchecked,” Parekh said. “A painful lump in the penis can lead to worsening curvature to the point where they can’t penetrate. Some guys will kind of ignore it for a while; maybe they’re embarrassed by it and they don’t want to tell anybody.”

Mental health

It’s an old trope: The biggest sex organ in the body is the brain. If your emotional state isn’t good, it can have a profound impact on sexual function.

Don’t forget that some antidepressants have a negative effect on sexual function, too, so it’s important to talk with your healthcare provider and make sure you address both mental health and sexual health.

“Mental health is health, too, just like sexual health,” Dubin said. “Depression, anxiety and medications that treat depression and anxiety can cause ED. I always quote the great Robin Williams: ‘God gave man a brain and a penis, and only enough blood to control one at a time.’ So if you’re up in your head, your penis is just not going to work. It’s just not.”

Conclusions

A wide variety of health issues can affect your sexual health and fertility. But perhaps the main takeaway should be that instead of trying to list all the possible factors that could specifically affect your penis, try to remember that the penis is just one part of the intricate and complex machine that is your body. Mess with one part of the network and it’s likely to have downstream effects. Take care of your body, and it’ll take care of you.

If your overall health is solid but erectile dysfunction is an issue, even intermittently, a wearable device free of the side effects of popular medications can restore sexual function. Eddie® is an FDA-registered Class II medical device designed to treat erectile dysfunction and improve male sexual performance. Its urologist-designed shape and fast-acting results allow you to treat your ED with more control. With Eddie, you don’t need to wait for a pill to kick in, use an awkward pump or subject yourself to painful injections.

In 2021 clinical trials, 95 percent of men who used Eddie reported a positive effect on their sex life.

How Men Can Take Care of Their Sexual Health

What Men Can Do to Ensure Their Sexual Health Is Strong

Mental and physical care are both critical to a man’s libido and reproductive well-being.

Author: Helen Massy
Published: March 06, 2023

This article is a repost which originally appeared on Giddy

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key Points

‧ Maintaining good sexual health is important for men.

‧ Mental health will have a large impact on sexual well-being.

‧ 20-30% of men in their 20s and 30s experience some form of ED.

Sexual health is an essential part of every man’s life. As well as protecting yourself from sexually transmitted infections (STIs) and diseases (STDs) or preventing unwanted pregnancies, sexual health is about having safer, satisfying sex and a positive and respectful approach to sexuality and relationships.

Understanding how to look after your sexual health benefits both you and your partner.

The best place to start is by getting to know your body and your reproductive system, and what’s normal and what’s not normal. This way, you can quickly identify any problems and seek medical support to address them.

There are multiple aspects to men’s sexual health, including physical health and mental health. Lifestyle factors influence all of these elements, either in a positive or negative way.

Men’s health and sexual health

A few of the essential aspects of a male’s sexual health are desire, erections and endurance, explained James J. Elist, M.D., a urologist in Beverly Hills, California, who specializes in impotence and male sexual dysfunction.

Being sexually healthy enables a man to fully participate in and enjoy sexual activity.

The body can’t just rely on physical health to create desire, erections and endurance, though. Physiology, mental health and emotional health can affect both libido and sexual function.

Male sexual health isn’t just about the ability to enjoy sex. It’s also about preventing STIs/STDs and identifying any problems with fertility. It’s about understanding how to prevent unwanted pregnancies and ensuring sex is consensual, respectful and safe for both partners.

Mental health and men’s sexual health

Mental health can directly impact sexual health and vice versa.

“Low libido, erectile dysfunction [ED] and premature ejaculation can all be exacerbated by negative mental health experiences, whether that’s traumatic experiences, relationship or professional workplace stress, depression or anxiety,” Elist said.

He explained that those negative mental health experiences can lead to worsened sexual performance, which in turn leads to more strains on mental health, driven by decreased self-confidence and self-worth as a result of poor performance in bed.

This leads to a negative cycle in which one feeds into the other.

“As such, it’s important to seek solutions early on to prevent any issues from worsening. Taking care of one’s mental health through therapy, meditation, etcetera can often improve sexual health issues as well,” Elist said.

If you find your mental health is affecting your sexual health, or problems with sex or sexuality are affecting your mental health, you can explore a number of options with your healthcare provider to address either issue.

Physical health and men’s sexual health

“It all begins with male libido,” Elist said of the connection between physical health and sexual health. “A man must have the desire to engage in sexual activity in the first place.”

Unfortunately, he said, as guys get older, libido tends to decrease as testosterone decreases. Obviously, for a man to be able to perform sexually, he must be able to achieve and maintain an erection. You can take steps to address this issue.

“As with testosterone and libido, erectile function also relies on staying healthy, particularly maintaining cardiovascular health, avoiding cigarettes and exercising frequently to get the blood pumping,” Elist said.

Once a man achieves an erection, he must maintain the erection and be able to last long enough to enjoy a sexually satisfying experience for both himself and his partner.

“Often, premature ejaculation can get in the way, which is why it’s important to limit stress and practice pelvic floor exercises if that’s an issue an individual deals with,” he said.

There is no need to suffer in silence if you have any problems with your libido, erection, ejaculation or performance. Seek help from your healthcare provider if you are experiencing problems, as many treatment options are available to help you feel comfortable and satisfied when having sex.

What’s a ‘normal’ sex drive?

Sex drive varies depending on a man’s age. Elist explained what happens to libido across the stages of life:

‧ In his early 20s, an individual can desire sex almost daily.

‧ Starting in his mid-30s, an individual’s testosterone levels begin to decrease by approximately 1 percent per year.

‧ Upon reaching his 60s, sexual desire may lessen even further for many men.

While there’s no “normal” level of sex drive for men, Elist stressed it is normal for levels to decrease over time.

“However, that trend can be partially mitigated and offset through regular exercise, eating healthy and maintaining a consistent sleep schedule,” he said.

Sexual health and reproductive health

“There are various issues that can impact an individual’s reproductive health and fertility, from stress to smoking to excessive testosterone use,” Elist explained.

To look after reproductive health, men should undertake a testicular self-exam routinely to ensure that there are no signs of lumps or tumors. Cancer is obviously a concern here, but fertility comes into the picture, too.

Testicular self-exams and examinations by a physician can help men identify the presence of a varicocele, a dilated vein inside the scrotum that can increase the temperature of the testicles and negatively affect sperm development, according to Elist.

Sperm counts decrease by an estimated 40 percent for every degree the testicles rise in temperature.

Elist also highlighted that the excessive use of testosterone or androgens could damage the testicles. Tobacco and frequent marijuana use can also decrease sperm count. All of these factors should be considered if a man is experiencing fertility issues.

Your healthcare provider can use various tests to help establish fertility problems, including the following:

‧ STI/STD testing
‧ Semen analysis
‧ Urinalysis
‧ Hormone testing
‧ Ultrasound scans
‧ Testicular biopsies

Complications and related conditions

The most common male sexual dysfunctions men should be aware of, according to Elist, include:

‧ Low testosterone
‧ Low libido
‧ Erectile dysfunction
‧ Premature ejaculation

ED is an issue that impacts more than half of all men at some point in their lives.

“While many think erectile dysfunction is an issue that only affects older men, it can actually impact 20 percent to 30 percent of men in their 20s and 30s,” Elist said.

Premature ejaculation is an issue that impacts nearly 40 percent of all men.

“It is characterized by sexual activity that often lasts one minute or less and sexual experiences which cause stress and frustration,” Elist explained.

You can address premature ejaculation issues with a combination of solutions that could include meditation, pelvic floor exercises, supplements, lidocaine sprays or prescription SSRIs, or selective serotonin reuptake inhibitors.

“Other issues, such as delayed ejaculation, retrograde ejaculation and Peyronie’s disease, are less common, but if an individual is experiencing any of those issues, then it’s important to discuss them with a urologist,” he added.

 

Depression and erectile dysfunction: The link, causes, and treatment

What to know about depression and erectile dysfunction

Medically reviewed by Nicole Washington, DO, MPH — By Mary West on November 14, 2022

This article is a repost which originally appeared on MEDICAL NEWS TODAY.

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Our takes:

‧ There are many potential causes of Erectile Dysfunction (ED).

‧ Anxiety and emotional stress appear to be common underlying factors.

‧ Medical professional assistance is available for treating ED.

Research has shown that there is a link between the two conditions. If a person has depression, they have a higher risk of developing erectile dysfunction (ED).

The above information comes from a 2018 review published in The Journal of Sexual Medicine.

Researchers do not fully understand the connection. However, theories suggest the underlying causes may include sexual performance anxiety or antidepressant side effects.

If a person with depression experiences ED, their doctor may prescribe a medication such as sildenafil (Viagra). Alternatively, they may recommend trying a different antidepressant.

Read on to learn about the symptoms of ED, how depression can cause it, treatment options, and more.

Signs and symptoms of erectile dysfunction

The signs of ED include‧:

‧ ability to get an erection only sometimes, despite a desire to have sex

‧ inability to get an erection at any time

‧ ability to get an erection, but being unable to sustain it throughout sex

Can depression cause erectile dysfunction?

Research from 2018 evaluates 49 studies to determine the relationship between depression and ED. It finds that a person with depression was 39% more likely to have ED than a person without depression.

Experts do not fully understand the factors that underlie how depression may cause ED. However, the current theories include:

‧ Behavioral: Depression involves negative thoughts and low mood. Either or both can lead to performance anxiety that hinders erectile function.

‧ Antidepressants: Many people with depression take antidepressant medications to manage their symptoms. However, these medications can cause low libido and inhibit the ability to have or maintain an erection.

‧ Low testosterone: The male hormone, testosterone, plays a key role in sexual performance. As such, low levels often correlate to ED. There is an association between depression and low testosterone levels in men.

The previously mentioned 2018 review also finds that people with ED are 192% more likely to have depression. This means that the link between depression likely goes both ways. For example, a person with depression may have ED for the reasons listed above. Similarly, a person with ED may also be more likely to experience depression.

Low self-esteem, self-consciousness about sexual performance, and other negative thoughts could contribute to depression in people with ED.
Other causes

There are a wide variety of factors besides depression that can cause ED. They include:

physical health conditions, such as:

‧ type 2 diabetes

‧ high blood pressure

‧ heart and blood vessel disease

‧ multiple sclerosis

‧ Peyronie’s disease (curvature of the penis)

‧ chronic kidney disease

‧ surgery for bladder cancer

‧ injury to the penis or pelvic area

certain medications, including:

‧ antidepressants, such as fluoxetine (Prozac)

‧ blood pressure drugs, such as atenolol (Tenormin)

‧ tranquilizers, such as diazepam (Valium)

‧ antiandrogens (medications that block the effects of testosterone), such as bicalutamide (Casodex)

‧ appetite suppressants, such as phentermine (Adipex-P)

Mental health factors can also increase a person’s likelihood of ED. In addition to depression, these include:

‧ anxiety

‧ low self-esteem

‧ fear of sexual failure

‧ stress

‧ guilt about certain sexual activities

Treatment options

Treatment for ED and depression includes medication, lifestyle changes, and psychotherapy. The treatment a healthcare professional recommends depends on the underlying cause of a person’s symptoms.

Medications for erectile dysfunction

Older research from 2001 explains when depression and ED occur simultaneously, treating one condition may improve the other. The findings indicate that treating ED with Viagra can alleviate the issue and lead to a notable reduction in depression.

Despite this, the research did not investigate how long the improvement lasts.

Doctors commonly prescribe Viagra for ED. It works by relaxing the muscle and increasing blood flow to the penis during sexual arousal. Other medications in the class include:

‧ vardenafil (Levitra)

‧ avanafil (Stendra)

‧ tadalafil (Cialis)

Additionally, if a person has low testosterone, a doctor may prescribe supplemental hormones.

Another treatment option that can trigger an erection is alprostadil. This comes in the form of an injection (Caverject) or a suppository (Muse).

Medication change for depression

A study from 2017 notes that sexual dysfunction is a common side effect of many antidepressants. For that reason, changing medication can help. Low libido and difficulty maintaining an erection are common side effects of antidepressants. However, some medications are less likely to have these effects.

The study’s authors recommend the following antidepressants for people who consider sexual functioning important:

‧ desvenlafaxine (Pristiq)

‧ trazodone

‧ vortioxetine (Trintellix)

‧ vilazodone

Lifestyle changes

Lifestyle changes may also reduce symptoms‧ of ED. These changes include:

‧ stopping smoking, if applicable

‧ eating a nutritious diet

‧ exercising regularly

‧ maintaining a moderate weight

‧ limiting or stopping recreational drug use, if applicable

Psychotherapy

The following psychotherapy interventions may help a person manage the emotional and psychological effects of depression and ED.

‧ Sex therapy: This involves counseling partners about their relationship or sex-related concerns.

‧ Cognitive behavioral therapy (CBT): This helps a person identify unhelpful thoughts and develop healthier ways of responding to challenges.

‧ Mindfulness therapy: This mental exercise consists of focusing on the present moment.

When to contact a doctor

If a person thinks they may have ED, it is a good idea to make an appointment with a doctor.

Additionally, people should seek medical attention if they have symptoms of depression. The sad feelings associated with depression last weeks and months, not days.

If they have suicidal thoughts, they should get immediate medical attention.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

Ask the tough question: “Are you considering suicide?”
Listen to the person without judgment.
Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
Stay with the person until professional help arrives.
Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

Summary

People with depression are more likely to have ED, and ED is also associated with higher rates of depression. Symptoms of ED include being unable to attain and sustain an erection long enough to have sex.

If a person has both depression and ED, treating one condition is likely to improve the other. Medication and psychotherapy interventions, such as mindfulness, may help someone manage both conditions.

Sources:

Chokka, P. R., et al. (2017). Assessment and management of sexual dysfunction in the context of depression.
https://journals.sagepub.com/doi/10.1177/2045125317720642
Liu, Q., et al. (2018). Erectile dysfunction and depression: A systematic review and meta-analysis.
https://www.jsm.jsexmed.org/article/S1743-6095(18)31007-5/fulltext
Lue, T. (n.d.). Erectile dysfunction (ED).
https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction
Overview – clinical depression. (2019).
https://www.nhs.uk/mental-health/conditions/clinical-depression/overview/
Seidman, S. N., et al. (2001). Treatment of erectile dysfunction in men with depressive symptoms: Results of a placebo-controlled trial with sildenafil citrate.
https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.158.10.1623
Walther, A., et al. (2019). Association of testosterone treatment with alleviation of depressive symptoms in men.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2712976

Men Should Check Their Testosterone Levels by Age 30, Urologist Says

Men should know their testosterone levels by age 30 to prevent health issues like weight gain and muscle loss, says top urologist

Gabby Landsverk
Oct 11, 2022, 12:31 PM

This article is a repost which originally appeared on INSIDER.

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Early testing can help identify low testosterone.

‧ Low testosterone levels can cause side effects ranging from low libido and mood to muscle loss.

‧ A urologist said more men should get tested so their doctors can see how their hormone levels change over time.

‧ There is some evidence that higher testosterone levels may prevent illness like prostate cancer, not increase the risk.

Testosterone is a crucial hormone for men’s health, and a top urologist says more men should know their levels earlier in life.

Low testosterone can cause loss of energy, muscle, and libido, and can contribute to chronic illnesses such as heart disease, diabetes, and obesity, according to research.

But diagnosing low testosterone can be tricky, because natural testosterone levels can vary.

If you don’t already know your baseline, and you start experiencing these symptoms, you may not be able to trust the results of a testosterone test, said Dr. Ananias C. Diokno, former chief medical officer and chair of urology at Beaumont Hospital, Royal Oak.

“If you ask men what their testosterone levels are, they’ll scratch their heads. They don’t know and doctors aren’t testing for this. You should know what your level is by the time you hit 30 to 35,” Diokno told Insider.

What we think of as ‘normal’ testosterone, and why it’s not a perfect barometer

Testing for low testosterone is simple, using a blood test.

In healthy men, testosterone levels can range between 260 nanograms per deciliter (ng/dL) and more than 900 ng/dL, depending on age.

Low testosterone is typically defined as less than 250-300 ng/dL, according to the Cleveland Clinic.

However, since natural testosterone levels can vary widely, Diokno said many men can be misdiagnosed for hormone deficiencies.

For example, a person with testosterone levels of 400 or 500 ng/dL won’t be diagnosed with low testosterone because it’s higher than the defined standard, but if his initial levels were 700 or higher, the drop is significant and may warrant treatment.

“Many practitioners close their minds. Someone may be having symptoms but according to the guidelines, does not have low testosterone. It’s frustrating among men and among doctors who can’t help them,” Diokno said.

One solution is more routine hormone testing so men can establish what a healthy baseline looks like for them, similar to other markers of health like cholesterol, blood pressure, and blood sugar, Diokno said.

Low testosterone can cause low energy, low libido, and loss of muscle

Over time, men’s testosterone levels dwindle as a common side effect of aging. However, younger men can also have low testosterone, causing them to experience similar symptoms to much older men.

Telltale symptoms of low testosterone can be mental, physical, and emotional, including:

‧ Decreased sex drive

‧ Brain fog

‧ Depression and mood changes

‧ Fatigue

‧ Difficulty building or maintaining muscle

“The lower the testosterone, the more symptoms,” Diokno said.

Testosterone therapy may not be as risky as previously believed

For men who have had sudden dips in hormone levels, testosterone therapy can help restore quality of life, energy, and libido, Diokno said.

Previously, testosterone therapy has been carefully regulated, in part because high testosterone has been linked to a higher risk of prostate cancer in some studies.

Diokno said the opposite may be true, according to some observational studies, and healthy testosterone levels may protect prostate health.

Loss of muscle linked to low testosterone can cause other problems, too, including a decreased metabolism that can lead to weight gain and associated health issues.

Available evidence suggests that testosterone therapy, done correctly and with medical supervision, is a safe and effective way to raise hormone levels, and more research is needed to see who could benefit, Diokno said.

“It’s a Pandora’s Box, I think there are many questions that are still unanswered,” he said.

Get a Stronger, Healthier Penis – Penis Health Plan

The Ultimate Training Plan for a Stronger, Healthier Penis

Power up your package and sexual performance.

By Jon Irwin

Published: Oct 25, 2022

This article is a repost which originally appeared on Men’s Health.

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Our Takeaways:

· Exercises can be performed for better penile function.

· Regular, productive sexual activity is excellent for optimizing penile function.

· If you suffer from serious negative effects, please seek out medical professional assistance.

“Fitness Routine” usually conjures up whatever gets you more endurance or stronger muscles. But devoting a little time to a few routines and developing new habits can also result in a stronger, healthier penis. Think of it as Third Leg Day.

Peak-performing junk (penis, balls, prostate, and pelvis—the whole enchilada) puts bathroom breaks under your control and houses sperm that are both plentiful and swift. Whether you think your package is working great, struggling, or doing something in between, these tips will help you get your gear in gear.

How to optimize your package if you are basically fine

That means everything is working okay—you just want to keep it that way.

Raise the frequency

Men who had sex less than once a week had a higher risk of erectile dysfunction than guys who did it at least once a week, according to a study in The American Journal of Medicine, making it one of the most useful (and fun!) ways to keep your penis strong. Even better, DIY sex is good, too. If you’ve noticed that you have a hard time maintaining an erection or reaching orgasm without, say, watching certain videos on the Internet, then you might want to try an orgasm ban during sex, even for a day, says sex educator Lawrence A. Siegel. This shifts the focus away from the endpoint and toward pleasure in the moment.

Find the right stuff for your stuff

When jock itch is driving you nuts, bypass online advice to apply apple–cider vinegar, cocoa butter, or Vicks VapoRub—they can leave you more uncomfortable without helping—and start with an OTC antifungal cream (like Lotrimin). Then avoid repeat infections: Put those boxer briefs on carefully at the gym and treat athlete’s foot and sweaty shoes with an antifungal powder, says MH dermatology advisor Corey L. Hartman, M.D.

Wrap it

Rates of the most reportable sexually transmitted infections have surpassed prepandemic levels, according to the CDC. At last estimate, one in five people in the U. S. has an STI. If you’re convinced condoms are still nothing but barriers to pleasure, you haven’t checked out the market for a while. P. S. condoms are known for feeling as if there’s nothing there. Skyn condoms have a soft texture and are nonlatex.

How to optimize if you are sort of fine

“Sort of fine” meaning you have problems getting or keeping it up—and maybe bladder leakage. Things may also look slightly . . . off?

Add a daily workout

Treat your pelvic floor like the muscles it’s made of and do isometric contraction sets. These Kegels improve bladder control and “have been shown to allow men to control ejaculations and enhance orgasm,” says Jamin Brahmbhatt, M.D., an assistant professor of urology at UCF College of Medicine. Tighten the muscles that stop your pee midstream for 3 seconds, relax them for 3, and repeat 10 times. Aim for 3 sets a day.

Get that checked out

Pimples? Bumps? Rashes? Go to a doctor to figure out what’s going on. Yes, there are apps out there where you can take a photo of your stuff and get a diagnosis of what’s up, but MH urology advisor Elizabeth Kavaler, M.D., says that using an app to detect an STI is “totally crazy.” You can order an at-home STI test kit (LetsGetChecked.com, Everlywell), but if what you have isn’t an STI, the kit can’t tell you what the trouble actually is. Only a real live doctor can do that.

How to optimize if you are not fine

In other words, “not fine” is when you can’t maintain an erection. And the urge to urinate is all the time.

Bolster your bladder

If “drip” describes your latest bathroom trip, you may have benign prostatic hyperplasia, a usually innocuous yet annoying enlarged prostate gland. The good news is that there are many treatments after diagnosis. Talk to your doctor about saw-palmetto extract, a supplement that can reduce urinary symptoms for some men, says Dr. Kavaler. Prescription drugs and minimally invasive surgeries can also help.

Eliminate the negative

Having a hard time staying hard? Maybe it’s your attitude. Men with higher levels of suspicious jealousy concerning their mate tend to have higher levels of erectile dysfunction, according to research by Gavin Vance at Oakland University. One way to cut through the envy is with sensate-focus therapy, a technique that uses touch, like holding hands, to decrease anxiety and increase intimacy.

Seek treatment for ED

If you’ve ruled out pills due to side effects or preexisting conditions, consider injectables. Sounds scary, but intracavernosal injections do the same thing as pills—increase blood flow—and people who use them consistently have high satisfaction rates, according to a 2019 study. Just stay skeptical of shock-wave therapy, says Dr. Kavaler. Using high-frequency ultrasound to irritate the penis lining as a way to help new cells grow and increase blood flow is being investigated, but its marketing may be stronger than the evidence—at least right now.

This story originally appeared in the November 2022 issue of Men’s Health.

Reference: Recent advances in the understanding and management of erectile dysfunction: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348436/

Penises are shrinking because of pollution, warns environmental scientist

It may sound like a joke, but this research shows the full extent of how much we are damaging reproductive health.

By Marthe de Ferrer • Updated: 13/12/2021

This article is a repost which originally appeared on euronews.green

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Our Takeaways:

· Pollution is proving to causing penis shrinkage and decreasing fertility worldwide.

· Some scientists believe the trend of infertility and smaller penises will qualify humans as becoming an endangered species.

· Phthalates which are now found in the environment are disrupting endocrine systems.

Pollution is causing human penises to shrink, according to one scientist.

A leading epidemiologist and environmental expert has published a book that examines the link between industrial chemicals and penile length.

Dr Shanna Swan’s book, Count Down, argues that our modern world is altering humans’ reproductive development and threatening the future of our species.

The book outlines how pollution is leading to higher rates of erectile dysfunction, fertility decline, and growing numbers of babies born with small penises. Though the headline fact about shrinkage may sound like a laughing matter, the research paints a bleak portrait of humanity’s longevity and ability to survive.

“In some parts of the world, the average twenty-something today is less fertile than her grandmother was at 35,” Dr Swan writes, dubbing the situation a “global existential crisis” in the book.

“Chemicals in our environment and unhealthy lifestyle practices in our modern world are disrupting our hormonal balance, causing various degrees of reproductive havoc.”

According to the book, humans meet three of the five possible criteria used to define whether or not a species is endangered. “Only one needs to be met,” writes Dr Swan, “the current state of affairs for humans meets at least three.”

How is pollution causing problems with fertility?

According to Dr Swan’s research, this disruption is caused by phthalates, chemicals used in plastic manufacturing, which can impact how the hormone endocrine is produced.

This group of chemicals is used to help increase the flexibility of a substance. They can be found in toys, food packaging, detergents, cosmetics, and many more products. But Dr Swan believes that these substances are radically harming human development.

“Babies are now entering the world already contaminated with chemicals because of the substances they absorb in the womb,” she says. Much of Dr Swan’s recent work has focused on the effects of phthalates, initially looking at phthalate syndrome in rats.

In 2000, however, there was a breakthrough in the field, and it became possible to measure low doses of phthalates in humans.

Since then Dr Swan has authored papers on how these chemicals can pass between parents and their offspring, the impact on female sexual desire, and – most recently – on penile length.

One of her most famous studies examined the intersection between sperm count and pollution in 2017, in ground-breaking research which looked at men’s fertility over the last four decades. After studying 185 studies involving almost 45,000 healthy men, Dr Swan and her team concluded that sperm counts among men in Western countries had dropped by 59 per cent between 1973 and 2011.

But there is some good news. Since the creation of the European Environment Agency, European citizens are exposed to 41 per cent less particulate pollution than we were two decades ago. It’s believed that these regulations have gifted Europeans an extra nine months of life expectancy, on average.

“A demand for change from citizens and subsequent strong policies have helped to clear the air in parts of Europe before, and can continue to do so to ensure that high pollution today does not need to be tomorrow’s fate,” says Michael Greenstone, director of the Energy Politics Institute at the University of Chicago.

So if pollution reduction measures can be properly implemented, there is still hope for the future and humanity’s fertility.

 

Should you be exercising your penis?

Should you be exercising your penis?

Rumours relating to hacking your sex life with the likes of ‘penis gyms’ and ‘penis training programs’ have been doing the rounds in recent weeks. So far so curious. But are these practices really a thing and if so, who is doing them and do they actually work?

Are penis workouts going to be incorporated into your normal gym routine? / Jesper Aggergaard

21 January 2020

This article is a repost which originally appeared on Evening Standard

You are by now probably familiar with the concept of biohacking, namely the self-improvement trend started by a handful of individuals who, venturing into the unknown, made it their mission to find whatever means, from microdosing to eccentric exercise trends and extraordinary diets to enhance their physical, cerebral and even spiritual function.

Five or so years later Silicon Valley caught on with the likes of Twitter founder Jack Dorsey and former Facebook president Sean Parker joining the brigade and forking out tens of thousands of dollars to improve everything from their productivity to muscle condition. Often they turned to the world’s biohacking ‘gurus’, self-experimenting guinea pigs and lifestyle enhancers such as Ben Greenfield, Tim Ferriss and Gwern, as their guides, eschewing traditional medical professionals, presumably preferring the more macho and unconventional approach. It’s perhaps worth mentioning that approximately 90% of biohackers are men…

Washington State based Greenfield is an elite biohacker who says he has a biological age of nine and makes a successful living documenting his quest for the world’s most effective means of physical and cerebral enhancement. While his practice is vast and varied, covering everything from microdosing LSD to supplementation and a process described as a ‘full-body stem-cell local’ whereby every joint in the body is injected with stem cells, it is arguably his reporting on sexual performance technologies and comments on penis gyms (he wrote a blog post entitled ‘how to make your penis stronger with a Private Gym’), which have garnered most attention. On day one of the 30-day Private Gym program Greenfield wrote, ‘I start round one of my training: contract, relax, contract, relax, five rounds done. 20 rapid flexes, done. 20 second hold, done. My penis quivers (oh geez, did I just write that?) under the weight towards the end.’ It’s undeniably attention-grabbing stuff.

And before those of you with a better-than-average anatomical knowledge flag – correctly – that contrary to popular belief the so-called love muscle contains no muscle and therefore can’t be trained, we know. And so does Greenfield. What he colloquially refers to in this way is in fact – less thrillingly – known as pelvic floor training.

Long considered a woman’s work, pelvic floor exercises tone the muscles that support the uterus. Done daily they can ease childbirth, prevent incontinence and even improve your sex life. Now however, experts are keen to flag that men have the same network of muscles as women. Extending like a hammock from the tailbone to the pubic bone they support the back, abdomen, bladder and bowel helping to maintain faecal and urinary continence. In male bodies these muscles also surround the base of the penis and are activated during erection, orgasm and ejaculation, as well as being responsible for the surge of blood flow to the penis.

Medical evidence suggests that done correctly male pelvic floor exercises taught by the likes of Professor Grace Dorey a professor emeritus of physiotherapy and urology at The University of West England can improve pelvic floor control, urinary function (particularly after radical prostatectomy surgery to treat prostate cancer) and sometimes even sexual function. Doctors explain that like all muscles, pelvic ones weaken with age, but can be strengthened by tightening the muscles used to cut off a flow of urine midstream. Held for a few seconds this contraction is then released and the motion repeated 10 to 15 times.

There is unsurprisingly, a budding market of systems to aid men with such ‘exercises’. Greenfield’s preferred Private Gym for example, includes an instructional DVD and small, ultralight weights on a silicone band that fits around the penis and is intended for men who want to add a little resistance training to their routines. The KegelPad meanwhile is another tool designed to aid good practice. Of the former Professor Dorey, has gone as far as to say ‘ It’s as good as Viagra, without the costs and the side effects…the pelvic floor muscles provide the base for the erection — for the penis to sit on, if you will.”

That said Karl Monahan of London’s The Pelvic Pain Clinic recommends that patients practice due diligence when purchasing such items, taking the time to identify companies that are legitimate and well intentioned. ‘Choose those which offer sound, medically supported programs and clinical trials,’ he says. Moreover, many of the symptoms associated with poor pelvic health actually have separate root causes that should be professionally diagnosed and treated. ‘Working with an experienced specialist is the best way for men suffering with pelvic floor related symptoms,’ he explains. ‘Unguided programs can also lead to patients overdoing their pelvic floor exercises, which can in turn, have dramatic effects on their pelvic health.’

Greenfield too warns against seeing biohacking and hacking technologies as quick fix. ‘A negative implication of the proliferation of these self-improvement methods is that people are inherently lazy and so in many cases [think] these biohacks can be used as a shortcut,’ he tells us. ‘But biohacking is not a shortcut. It’s the use of science or technology to enhance human biology, but always needs to be paired with actual hard work and dedication.’