The Opposite of Premature Ejaculation: Delayed Ejaculation (from The Ultimate Guide To Male Enhancement)

The following is a chapter taken from the book: The Ultimate Guide To Male Enhancement.

Our Takeaways:

· Delayed Ejaculation (DE) can be caused by a number of factors

· Poor masturbation habits in conjunction with pornography use appears to be a chief contributing factor to DE

· There are methods for mitigating and even reversing DE- to include exercises

Another less common, less understood but still notable issue is delayed (or impaired) ejaculation. This is a problem on the opposite end of the sexual spectrum from premature ejaculation. Delayed ejaculation is when an inordinate amount of intense stimulation and/or time is required to ejaculate. An extreme version of this problem can manifest itself in a condition known as anorgasmia- or the inability to orgasm. The clinical definition of delayed ejaculation is when you suffer from this condition for six months or greater.

Causes of Delayed Ejaculation

The most common cause of delayed ejaculation among younger men is due to poor masturbation habits. As men age, delayed ejaculation becomes more common. For men over the age of 50, the chance of experiencing delayed
ejaculation increases significantly, even without negative masturbatory conditioning.

A high frequency of ejaculations can also lead to temporary delayed ejaculations, as well as exhaustion and lowered libido. This becomes more notable as men age, as it’s common for the refractory period to lengthen. The remedy for delayed ejaculation caused by ejaculating too frequently is simply to avoid ejaculating for a few days to ensure full recovery.

The causes of age-related delayed ejaculation may be related to lowered androgen levels, though some men with
normal levels of androgens still appear to suffer these effects. If this is the case, specific treatments, as prescribed by a medical professional, or supplementation may be of assistance with this.

Certain medications can induce delayed ejaculation. Most notable among these are anti-anxiety medications, selective serotonin reuptake inhibitors (SSRIs), painkillers, and blood pressure medications. If your delayed ejaculation is caused by medication, please consult with your doctor to see if a change in dosage or medication is possible.

Lifestyle choices can also result in delayed ejaculation. Alcohol can cause a dulling of sensation, which can lead to temporary delayed ejaculation. Drinking daily can result in a chronic case of delayed ejaculation as well as lower your libido. The easiest way to correct this problem is to stop drinking completely. Even one beer can negatively affect your ability to orgasm. Getting daily exercise and eating a healthy diet can also help improve your orgasm responsiveness, as your body will feel better and your cardiac health will improve.

Low testosterone levels and libido may also case delayed ejaculation. This is often accompanied by erectile
dysfunction. To determine if your testosterone levels are abnormally low, your doctor can perform a simple blood test.

How to Combat Delayed Ejaculation

Viagra has been prescribed with good success for the treatment of delayed ejaculation. Some prescription medications may also improve the effect as well, notably those for Parkinson’s and certain anti-allergy drugs. Speak with your doctor about these options, to see if any of them are right for you.

The herb piper auritum kunth (hoja santa) has been promoted as an aphrodisiac in traditional medicine, but it has also been shown to be an effective agent at improving sensory thresholds. It’s also shown to be effective in improving electromyographic activity of pelvic floor. Ensuring you are getting necessary levels of zinc in your diet can go a long way toward minimizing sexual dysfunctions and ensuring optimal genitourinary health and function.

If your delayed ejaculation is due to poor masturbation habits and the desensitization of your penis, a great exercise to alleviate delayed ejaculation and to reset your sensory threshold is the “Reverse” Stop and Starts movement. The Reverse Stop and Starts is very simple to perform.

How to Perform the Reverse Stop and Start

Using an extremely light grip, attempt to ejaculate as quickly as possible.

Time yourself on this, and attempt to bring yourself to the 10-minute mark. From here, you should have reset your sensory threshold and can revert to the standard Stop and Starts for training. It won’t take many of these sessions to reset your sensory threshold!

The Emotional Component of Delayed Ejaculation

As with all stamina and other male enhancement exercises, it’s important to cultivate an emotional backdrop of confidence and a feeling of being unencumbered. Some cases of delayed ejaculation may have an emotional
component to it. In cases like these, repeated use of emotional visualizations during training can be effective at improving the timing of your ejaculations.

Stress and anxiety are huge factors in emotional delayed ejaculation. Worrying about other aspects of your life can result in a difficulty in orgasming. This then increases stress and anxiety while having sex, which exponentially can compound the problem and even lead to other sexual dysfunctions, like erectile dysfunction.
Speaking to a mental health professional can help if there’s an emotional component to your delayed ejaculation. They can help you address the underlying issues affecting you. They can also give you cognitive behavior exercises.

Communication is the Key When Dealing with Delayed Ejaculation

It’s important to note open communication with your partner when contending with any type of sexual dysfunction or less than satisfactory performance is vital. Communication and understanding can go a very long way in helping to resolve many of these issues, as emotional stress can often make them worse.

Delayed ejaculation can be just as devastating to a relationship as any other sexual dysfunction. For the man, it can be an ego crusher, when he can’t orgasm. It can also be physically frustrating and tiring. This often results in a reduced libido.

For their partner, it can also be equally ego-crushing. Your partner may worry they are doing something wrong. They may worry you’re no longer physically attracted to them. Perhaps the most destructive worry is the concern you’re being unfaithful. Be 100% up front with your partner about what’s going on, no matter how embarrassing and uncomfortable it may be. Reassure your partner the problem isn’t with them, and continue this reassurance, while you work on your delayed ejaculation.

Vaginal Laxity as a Contributor to Delayed Ejaculation

Communication becomes really important in cases where you may not have negative conditioning or even any
functional problems with ejaculation but are still experiencing delayed orgasm due to vaginal looseness in their sexual partner. The Kegel exercise is recommended for toning the vaginal walls and can also improve the intensity of orgasms for women. In extreme cases, surgery may be required or preferred to Kegels as a solution for vaginal laxity.

Broaching this sensitive subject can be difficult and requires great tact. One effective way of introducing the Kegel to women in cases of vaginal looseness is for the man to suggest vaginal contractions to his partner during penis-in- vagina (PIV) sexual contact. Repeated sessions of this type of activity should lead to increased tone and vaginal response in just a few weeks.

Another version of conditional delayed ejaculation is when your sexual partner can’t withstand long bouts of sexual activity due to health-related issues. As with the above, communication and alternate arrangements during sexual activity can go a long way toward creating better sexual harmony.

 

The Ultimate Guide to Male Enhancement

Erectile Dysfunction: Signs & Ways To Eliminate Its Risk

How To Detect The Early Signs Of Erectile Dysfunction & Eliminate The Risk Once And For All

Updated on May 04, 2021, 18:00 IST · 4 min read

By Snehal Sharma

This article is a repost which originally appeared on MENSXP

Edited for content.

It’s not easy to talk about sex, especially if you’re grappling with insecurities.

For the longest time, erectile dysfunction was ascribed to psychological origins. Most ancient cultures, including Ayurveda, believed that ED can be treated with the help of natural herbs such as Indian ginseng, sesame powder, Safed Musli and more.

Today, we know more about its causes and have treatments to address the issue. But before we talk about eliminating the condition, we need to dispel the stigma associated with ED.

Studies have clarified that ED is not just “in your head”. According to a 2017 study by the Department of Urology Tulane University School of Medicine, New Orleans, 20% of men across all age groups battle ED in India and 30% of them are younger than 40.

Most of the times, it is experienced due to an underlying cause that can be treated.

But no cure is possible until men accept the problem and stop shying away from asking for help.

What Is Erectile Dysfunction?

Erectile Dysfunction (ED), also known as impotence, is a condition in which a man experiences difficulty in getting or maintaining an erection during sexual performance.

The symptoms may also include reduced sexual desire or libido. If the condition lasts for more than a few weeks or months, your doctor is likely to diagnose you with ED.

Signs Of Erectile Dysfunction

Every piece of the body—including your emotions, hormones, brain, nerves, muscles and blood vessels—plays an intricate role in male arousal. When any of these isn’t aligned, it results in some kind of dysfunction.

Your mental health impacts your sexual ability equally. Stress, anxiety and other mental health concerns can worsen erectile dysfunction.

Experiencing minor or occasional sexual problems don’t necessarily mean you’re dealing with erectile dysfunction. But lookout for the consistency of these symptoms.

● Reduced or no desire for sex.

● Inability to get an erection.

● Inability to maintain an erection.

Who Is At The Risk?

The risk of ED increases as you age, especially if you have lived a sedentary lifestyle. It can worsen if you:

● Have a psychological condition like anxiety, depression or stress.

● Have an injury that might damage the nerves and arteries that contribute to erections.

● Use tobacco, drugs or alcohol.

● Are overweight.

● Are undergoing radiation treatment for cancer.

● Are taking antidepressants or high blood pressure medications.

● Have heart disease or diabetes.

How To Prevent Erectile Dysfunction

The healthier you are, the easier it’ll be to fight erectile dysfunction. There’s no one-size-fits-all way to prevent ED but you can avoid persistent problems by taking care of its causes and yourself. The following measures may help:

● Reduce stress.

● Take care of your mental health.

● Exercise daily.

● Limit alcohol consumption.

● Quit smoking and stop using recreational drugs.

● Manage diabetes and heart disease.

How Can You Treat Erectile Dysfunction

The causes of ED vary and so does the treatment. Work with your doctor to create a plan that’s best for you.

1. Counselling

If you feel anxious, depressed or have any other mental health concern, seek therapy. Along with consulting a professional, indulge in relaxing activities such as music, painting, poetry or aromatherapy. Geranium oil helps those with low libido.

2. Ayurveda to the rescue

It’s not feasible for everyone to collect and consume the recommended herbs for sexual wellness. But you can always rely on natural supplements that provide men with the right nutrients optimised for better and stronger erections.

3. Lifestyle changes

Manage weight, exercise or do yoga consistently, stop smoking, avoid alcohol and illicit drugs and manage your health with the help of a doctor.

4. Prescribed medication

If the above treatments don’t work, your doctor may prescribe oral medications—like Viagra, Levitra, Aronix, Tadalafil, Stendra and Cialis, self-injection such as an Alprostadil or testosterone replacement.

5. Physical treatments

Penis pump or penile implants. However, these aren’t generally considered until every other treatment has failed.

Final Thoughts

Recognise the symptoms and consult a professional. If you’re diagnosed with erectile dysfunction, your doctor will help you figure out the cause of ED.

Work on the treatment options and before you know it, you’ll start seeing the results.

Vaseline in Place of Viagra: Is It Safe and Effective?

Can You Use Vaseline in Place of Viagra?

Medically reviewed by Matt Coward, MD, FACS — Written by James Roland on March 17, 2021

This article is a repost which originally appeared on Healthline

Edited for content.

If you experience erectile dysfunction (ED), you may be willing to try just about anything to restore healthy sexual function.

However, there are plenty of potentially dangerous options that people have tried, including the injection of Vaseline or other petroleum jelly products into the penis.

For many years and in many cultures, the practice of injecting or inserting something into the penis to make it larger or to improve sexual stamina has been done, often without the guidance of medical experts.

If you’re tempted to use Vaseline in place of Viagra or any other approved treatment for ED, don’t waste your time or take the risk. There are plenty of safer and more effective options available.

You may also have heard of topical gels or essential oils for ED, but there has yet to be any evidence to suggest that applying Vaseline as a topical treatment to your penis will have any effect on sexual function.

The science

Numerous studies have shown that injecting Vaseline into your penis is a danger, rather than a cure. The practice can lead to:

  • infections
  • serious skin and tissue injury
  • other medical complications

In a small 2008 study of 16 people who were treated for Vaseline injections, researchers found that “urgent surgery” was necessary to prevent further injury.

A 2012 case report concluded that Vaseline injections are usually done without medical supervision and can lead to severe complications if the petroleum jelly or other foreign objects aren’t removed promptly.

Clinical treatments

Instead of trying risky self-help solutions for ED, consider proven medications and other treatments that have a track record of success.

Oral medications

While Viagra, known clinically as sildenafil, may be the best known ED pills, there are other FDA-approved medications. They all vary somewhat in their:

  • potency
  • how quickly they take effect
  • duration of effectiveness
  • side effects

Other ED medications on the market include:

  • Tadalafil (Cialis). It’s available in a generic form and can be taken daily at low doses or as needed in higher doses.
  • Vardenafil (Levitra). It’s available in brand-name and generic versions. it tends to remain effective a little longer than sildenafil.
  • Avanafil (Stendra). It’s not yet available in generic form, Stendra is unique among ED medications in that it can become effective in about 15 minutes, while others take between 30 and 60 minutes to take effect.

Your lifestyle may help determine the best ED medication for you.

Vacuum pumps

This treatment involves the use of a tube that fits over your penis and attaches to a pump that withdraws air from the tube to create a vacuum.

The vacuum created around your penis helps draw blood to fill the blood vessels within and produce an erection. An elastic ring is also placed around the base of your penis to help maintain the erection.

A 2013 research review noted that the use of vacuum devices to treat ED is usually safe and effective, particularly when combined with ED drugs known as PDE-5 inhibitors, which include:

  • tadalafil
  • sildenafil
  • other standard medications

Penile injections

Certain medications can be injected into your penis to increase blood flow and create a firmer erection for intercourse. Those include:

  • papaverine
  • phentolamine
  • prostaglandin E1 (PGE1) or alprostadil (Caverject, Edex)

There are also combinations of the above medications available.

Penile implants

Some people choose to treat ED with surgically-implanted, flexible, or inflatable rods that you can activate on demand.

Penile implants are generally reserved for individuals who have not had success with other traditional ED treatments.

Alternative treatments

Many safer and more effective alternatives to Viagra are available, including several prescription medications and over-the-counter (OTC) supplements, as well as complementary therapies, such as acupuncture, according to a 2016 research review.

Some people have had success using herbal supplements to treat ED. Some OTC products that have been supported by research include:

  • Korean red ginseng. It’s a plant that grows in Asia and may help both ED and alertness with relatively few side effects.
  • L-arginine. It’s an amino acid that serves as a building block for certain proteins. A small 2019 research review of 10 studies found that L-arginine used in doses of 1,000 to 1,500 milligrams significantly improved ED symptoms compared with placebo.
  • Yohimbe. It’s an herbal supplement commonly used in West African cultures, proved to be at least partially effective in treating ED in about one-third of people who participated in an old 1989 study.

Lifestyle changes

In addition, improving your health may improve ED symptoms and provide other benefits, including:

  • more energy
  • better sleep
  • greater cardiovascular fitness

The following lifestyle changes may pay dividends in terms of sexual health:

  • regular aerobic exercise, at least 150 minutes per week
  • maintaining a manageable weight
  • no smoking
  • consuming little or no alcohol
  • maintaining a healthy blood pressure
  • getting 7 to 8 hours of sleep each night
  • managing stress through meditation, yoga, or other strategies

When to talk with a doctor

The first step in finding the solution that’s right for you is to talk with your primary care physician or a urologist.

And while ED can be an embarrassing and frustrating topic to discuss with anyone, understand that ED is a common condition, affecting an estimated 1 in 3 adults with penises.

In other words, you won’t be the first person to ask your doctor for advice or treatment in this department.

Occasional concern

If ED occurs occasionally, then you may not need any treatment at all. In this case, it may usually be chalked up to:

  • stress
  • fatigue
  • relationship concerns
  • a side effect of misusing alcohol

Keep in mind that ED can be a symptom of many physical and emotional health conditions, including:

  • cardiovascular disease
  • obesity
  • hypertension
  • diabetes
  • depression
  • anxiety

Sometimes treating an underlying condition can lead to improved sexual function.

Persistent concern

If ED is a persistent concern, then a conversation with your doctor is recommended. Your concerns may be an inability to:

  • achieve an erection at all
  • achieve an erection that is firm enough for satisfactory intercourse for you and your partner
  • maintain an erection for the duration necessary for satisfactory intercourse
  • become erect at certain times or with certain partners

Regardless of the nature of your ED, there is a range of treatments that may be helpful. Psychotherapy and relationship counseling may be very helpful too, so you may want to talk with your doctor about referrals for therapy.

But because medications are generally tolerated, the first approach may be a prescription for Viagra or any of the other approved ED medications.

The bottom line

ED can affect several aspects of your life, including self-esteem and relationships, so it’s not something to ignore — especially when viable treatments are available.

And rather than rely on unproven and potentially very harmful treatments on your own — such as injecting Vaseline or any foreign substance into your penis — address this common medical condition with your healthcare professional.

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

The Economic Impact of Erectile Dysfunction

The Economic Impact of Erectile Dysfunction

It starts in the bedroom, moves to the workplace, and ends with plummeting GDPs. Yes, erectile dysfunction has economic implications. Is that so hard to believe?

This article is a repost which originally appeared on Fatherly

Edited for content

Eric developed erectile dysfunction after he started taking the medication he needed to in order to manage symptoms of bipolar disorder. Far more concerned with his mental health than sex life, it took him a while to realize it was a problem. When he did, he thought it was only impacting his relationship with his wife. Then, like a cruel and flaccid Whac-a-Mole game, it started popping up in other places. It impacted his sleep, affected his appetite, and killed his motivation at the gym. Finally, it met him at work. Eric manages a substance abuse recovery facility and has the kind of mentally intense job that people tend to bring home with them. But when his ED started causing problems, the opposite happened — he unintentionally started to bring the stress of his home life into work. With less energy and competitive drive, he struggled to be present and available for his clients when he felt so vulnerable himself.

“It’s really hard to support others when you’re feeling vulnerable,” says Eric (he asked that his real name be held). “We at the center often speak openly and honestly, but erectile dysfunction (ED) is not something I bring up during group sessions. That is such an intimate detail might cloud how clients view me.“

At 36-year-old, Eric may seem young, but he represents the new face of ED. More men in their thirties and forties are developing ED, although the reasons for the uptick are not entirely clear. Whether it’s a side effect of psychotropic medications or other lifestyle factors like smoking and obesity, the fact is, ED is on the rise for younger men, and the costs incurred are just now being calculated. The clearest impacts are economic. Men with ED take more sick days and are generally less productive at work all around, compared to men who do not struggle sexually. Conservative estimates suggest that treatment costs upwards of $3 million in healthcare costs in the U.S. alone, but studies in America have not accounted for the loss of work. Studies in the UK suggest that ED more accurately costs $67.71 million annually when productivity losses are figured in. Adjusted for a larger population in the U.S. amounts to over $330 million. This is a very rough estimate that does not account for cultural differences, but it still likely adds up to a lot of dollars, a lot of dysfunctional dicks, and a lot of other, unknown costs.

“The unseen element of cost is the psychological toll that erectile dysfunction takes on men and their partners and their families,” says urologist Dr. Judson Brandeis. “ED causes depression which decreases productivity at work.  It also increases stress on marriages, relationships and families, the cost of which is massive.” How massive? Brandeis estimates the economic cost of ED is well over $5 billion.

And yet, on the other side of ED is a large and burgeoning cross-section of the pharmaceutical industry pedaling generally effective short-term drug solutions like Viagra to older and younger men alike. The global ED drug market was valued at $4.82 billion in 2017 and is projected to grow to $7.10 by the end of 2024. Experts attribute much of this growth to younger men with chronic conditions such as diabetes, cardiovascular disease, neurogenic diseases, and like Eric, psychological disorders, causing an uptick in sexual dysfunction diagnosis. Clearly, ED costs some men money, while it makes others a shit load of it. But the economic impact of ED is farther-reaching than the billions of dollars that surround the drug industry. The function of nearly half the penises in the world is inextricably linked to global economics. Call it the curved economy of dysfunctional dicks. Like it or not, it may impact us all.

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In the past, the most common cause of erectile dysfunction was getting old. As people age, cells in their heart muscle degenerate, valves that control blood flow become thicker and stiffer, and circulation generally slow. Heart health declines, therefore erection health does too, so it has always made medical sense why this would be an issue for retired men in their seventies, rather than men who make up 66 percent of the workforce. However, ED is diagnosed mostly primarily based on patient reports, meaning it’s an honor system, and that’s how a lot of secondary ED diagnoses in younger men are made. Secondary ED, or mild to moderate ED, affects roughly 10 percent of men per decade of life, meaning 30 percent of men in their thirties, 40 percent of men in their forties, 50 percent of men in their fifties, and so on.

Erections depend on blood flow and are inescapably linked with cardiovascular health, so when younger men are unhealthy, they’re more likely to experience ED. In the past, lost productivity at work has been linked to those health problems, and ED was just considered another symptom of an unhealthy lifestyle. A recent study of 52,697 men indicates there may be more to it. Researchers analyzed data from the 2015 and 2016 National Health and Wellness Surveys, which included men ages 40 to 70 from Brazil, China, France, Germany, Italy, Spain, the UK and the U.S. who experienced some form of erectile dysfunction within the past six months of the study. While there was an expected correlation between ED and other health problems like hypertension, dyslipidemia, diabetes, and depression, when scientists controlled for this, men with ED were still worse at their jobs compared to men who felt fine about their sexual performance. Men who experienced symptoms missed more work (7.1 percent compared to 3.2 percent), went to work sick more often (22.5 percent compared to 10.1 percent), experienced greater levels of productivity impairment (24.8 percent compared to 11.2 percent), and scored lower on tests that measure overall mental and physical performance.

“It’s destructive in a workplace situation because men are competing over things that actually have nothing to do with their productivity. Your masculinity being threatened makes you less productive.”

If men’s physical health wasn’t the reason they were struggling at work, then there is something about their professional prowess that is connected to their sexual one. Unsurprisingly, experts suspect a person’s views of masculinity may be responsible for this. Research shows men who cannot perform sexually report a diminished sense of being a man, increased depression, decreased self-worth, embarrassment, and fear of being stigmatized, and the more they believe in traditional masculine norms, the worse they feel as a result of ED.

“This can lower their self-esteem and motivation, even causing physical symptoms such as headaches and lowered immunity,” couples therapist Elisabeth Goldberg explains. When ED goes untreated some men end up feeling worthless. “This is a serious risk factor for depression, leading to missed work days, inability to stick to deadlines, and anger management difficulties with coworkers.”

In the workplace, economist and author Marina Adshade thinks this low self-esteem can take a different turn. Rather than being demotivated by their ED, men become aggressive — in a sense motivated to make up for what they perceive as a masculine failure with a ratcheted-up sense of (usually male on male) competition in the workplace.

“It’s destructive in a workplace situation because men are competing over things that actually have nothing to do with their productivity,” says Adshade. This manifests in ways that may sound familiar: Not being willing to ask for help, not being able to work as part of a team, and not being able to negotiate and compromise. “In the modern workplace, these are real assets. If those are compromised because your masculinity is being threatened, it would make you less productive.”

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It’s impossible to entirely separate men’s health from erectile dysfunction. Even when studies control for a number of health conditions that cause ED, they do not rule out the possibility that smoking, drinking too much, gaining weight, and being generally unhealthy contributed to missed days and lost productivity for men who did not have diagnosable illnesses.

“It’s a chicken or the egg thing,” says urologist Dr. Jamin Brahmbhatt. “Is it the lifestyle choices that lead to erectile dysfunction or is it erectile dysfunction that lead to the lifestyle choices?” This is a question that may have unsatisfying answers. If lifestyle factors cause ED, it could take years to course-correct — losing weight, quitting smoking, getting back on track health-wise.

Why wait when you can take a little blue pill? While men patiently address varying degrees of underlying health issues, drugs like Viagra represent the closest thing to a catchall solution to a widespread problem. The very success of Viagra may come from the fact that, pending no pre-existing heart conditions, these medications are a generally effective and low-risk solution in the short-term. Aggressive advertising campaigns and direct to consumer healthcare companies that discreetly deliver erection pills door to door have helped reduce stigma and educate men on their ED treatment options. And when Pfizer lost exclusive rights to making Viagra in 2017, this gave rise to a number of generic options and market competition that brought costs down, making it even more affordable and accessible for consumers. ED drugs are a temporary but very effective workaround while men address other underlying health problems that cause sexual dysfunction. Of course, they come with hidden costs.

Everyone might be better off if guys are just fine with whatever they’re working with, even if it doesn’t work every time.

Ironically, medically-induced erections may lead to infidelity. ED is linked with a significantly higher risk of infidelity for men, because they blame their current partner for their performance issues, instead of underlying health, psychological, or relationship problems. “They turn to someone new in a frantic effort to prove their manliness, and rationalize that if they can perform with someone other than their spouse, then it must be the spouse’s fault,” says Goldberg. When it doesn’t, damage done, men can ignore the obvious and use ED drugs like Viagra to help make this warped reality a reality.

Infidelity has economic consequences. The affair itself costs about $450 a month, or $2,700 an affair total, which lasts about 6 months on average. It doesn’t sound like much, but that doesn’t account for time lost to the affair and, of course, the fact that many affairs lead to divorce. While infidelity does not cause divorce directly, it does remain one of the most commonly cited reasons for splitting, about 37 percent of the time. In Goldberg’s clinical experiences, ED can cause marriage problems that lead to divorce without causing infidelity as well.

The average divorce in the U.S. costs $15,000 per person but can vary depending on how drawn out and contentious it is. Research shows divorced men tend to have higher rates of smoking, substance abuse, depression, and worse health overall following divorce, all of which lead to increased absences and decreased productivity at work, which slows economic growth overall. Other studies estimate that the family income of parents who divorce and stay divorced for at least six years falls up to 45 percent.

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The various impacts of erectile dysfunction can be boiled down to this: Men have unhealthy expectations for how they should perform sexually. “It’s every day in my office, and you can thank the adult film industry for that,” says Brahmbhatt who admits that he spends more time managing men’s impractical sexual expectations than he does writing prescriptions for Viagra.

In a strange way, this psychology echoes in Adshade’s economic research. In her work she stumbled on a global penis size distribution map, a dataset compiled by a doctoral student to look at how a country’s average penis sizes related to their Gross Domestic Product. Although the findings were not published in a peer-reviewed journal, they indicated that there was a u-shaped relationship between penis size and economic growth. The slowest growing and least developed countries had both the biggest and smallest penis sizes on average, but the fastest-growing economies had average ones. Adshade suspects that this was because these were the men who had less to prove in terms of their masculinity, and lead more productive, economically rich lives as a result. While this does not speak to erectile dysfunction directly, it says everything about the economic impact of how men feel about their dicks. Men don’t need to have the biggest or best penises in the world to succeed — in fact, that may be bad for the economy too. But everyone might be better off if guys are just fine with whatever they’re working with, even if it doesn’t work every time.

“ED causes depression which decreases productivity at work.  It also increases stress on marriages, relationships and families, the cost of which is massive.”

“It really comes down to how men measure their self-worth,” Adshade says. “Men tend to measure their self-worth by their ability to not only perform sexually but please their partner,” Goldberg adds. “Low-self worth has major consequences”

For Eric, a man who is deep in erectile dysfunction and working on finding a way out, this is easier said than done. For him, Viagra has not been the quick fix it can be for some and he’s working with a urologist to figure out a solution without disrupting his medication regimen. He’s doing pretty much everything he’s supposed to, and it’s still not easy.

“Being a newly-single male back on the dating scene, dealing with ED has been tumultuous, to say the least,” he says. “The toll it takes on men’s confidence is quite drastic. It’s almost as if our masculinity is taken away.”

Understanding male sexual health: More men now reporting low sex drive, Peyronie’s disease, finds study

Understanding male sexual health: More men now reporting low sex drive, Peyronie’s disease, finds study

Scientists found that earlier, more men were diagnosed with erectile dysfunction and premature ejaculation.

Myupchar July 20, 2020 22:17:59 IST

This article is a repost which originally appeared on Firstpost.

Edited for content

Male infertility is a topic that is rarely discussed. However, doctors have seen an increase in the number of male patients coming to sexual health clinics to seek help in recent years. Doctors have seen that different sexual health problems are being reported by men which were not prevalent before, also indicating more awareness and openness regarding male sexual health.

Different male sexual health problems

A study published in the journal International Journal of Impotence Research on 1 July 2020 stated that there has been a switch in the sexual problems which males complain about now.

The scientists accumulated complete data of 2,013 patients who were continuously evaluated by a sexual medicine expert between the years 2006 to 2019. The scientists found that 824 patients were assessed for erectile dysfunction, 369 patients were diagnosed with curvature of the penis (Peyronie’s disease), 322 patients had premature ejaculation, 204 suffered from low sex drive and the remaining 294 had other sexual dysfunctions.

In this study, the scientists found that earlier, more men were diagnosed with erectile dysfunction and premature ejaculation. However, more recently, men have been diagnosed with low sexual desire and Peyronie’s disease.

With the successful treatment options for erectile dysfunction such as Viagra and Cialis and awareness, men have been reporting more about other sexual dysfunctions as well.

Cap-Score: A test to find out sperm quality

Male infertility is one of the major reasons behind the increasing numbers of in-vitro fertilization (IVF) cases throughout the world. Earlier tests like semen analysis, also called seminogram, were done to find out the quality and ability of sperm to fertilize. However, due to the lack of an appropriate diagnostic test for evaluating the fertilizing ability of men, most of the infertility cases get classified as idiopathic or unexplained.

In a recent research article in the journal Reproductive BioMedicine Online, scientists from various universities in the US used Cap-Score to test the sperm capacitation of males.

Sperm capacitation is a natural process where the spermatozoa (motile male sex cell) changes its shape to be able to penetrate and fertilize the female egg. The Cap-Score is a test which determines the percentage of sperm that undergoes capacitation in a certain amount of time. Usually, 35 percent of sperms of a man with normal fertility would undergo capacitation.

In this study, the scientists took the sperm samples from 292 patients and tested their ability to reproduce with the help of traditional sperm analysis test and Cap-Score. Out of these patients, 128 couples became pregnant after three cycles of Intrauterine Insemination (placing sperm inside a woman’s uterus to facilitate fertilisation).

The scientists found that those with high Cap-Score were able to fertilize more efficiently and resulted in a higher number of pregnancies. The scientists also found that men who constantly questioned their fertility showed impaired or reduced capacitation ability.

Benefits of Cap-Score over traditional sperm analysis

Scientists found that traditional semen analysis is unable to identify impairments in fertilising ability, which typically leads to a diagnosis of idiopathic infertility. The scientists found that unlike the traditional semen analysis, capacitation is a better test which helps in determining whether or not there would be a successful generation of pregnancy.

Both these studies indicate that with better awareness of male sexual health issues, men choosing to report as well as get treatment for these diseases, and with the widespread adoption of better sperm analysis tests like the Cap-Score by the medical community, male sexual dysfunction and infertility can be better addressed globally.

For more information, read our article on Low Sperm Count.

Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.

Nitroglycerin Gel for ED: Pros, Cons, & Practical Information

About Nitroglycerin Gel for Erectile Dysfunction

Medically reviewed by Matt Coward, MD, FACS — Written by Sara Lindberg on December 16, 2020

This article is a repost which originally appeared on Healthline

Edited for content

Erectile dysfunction (ED) may affect as many as 30 million men in the United States. People with ED experience an inability to get or keep an erection firm enough for sex.

You may be familiar with some of the more common treatments for ED, including lifestyle modifications, oral medications that include phosphodiesterase type 5 inhibitors (PED5 inhibitors), and penis pumps.

But a study published in the Journal of Sexual Medicine also looked at the use of nitroglycerin gel or cream as a topical treatment for ED. Although results look promising, it’s important to note that nitroglycerin gel or cream isn’t approved by the Food and Drug Administration (FDA) to treat ED.

Here’s what you need to know about nitroglycerin as a topical treatment for erectile dysfunction.

What is nitroglycerin?

Nitroglycerin is part of a class called vasodilators, which widen the blood vessels and improve blood flow to allow oxygen-rich blood to reach the heart.

It comes in a variety of forms, including sublingual (under-the-tongue), topical cream or gel, and as a transdermal patch. Nitroglycerin is most often used to prevent angina or attacks of chest pains.

Nitroglycerin for ED

“The idea of treating ED with topical nitroglycerin is not new and was first described in the 1980s,” says Dr. Joseph Brito, a urologist at Yale New Haven Health, Lawrence + Memorial Hospital. Brito is also a member of Healthline’s clinical review network.

In general, Brito says nitroglycerin works by dilating the blood vessels, which is why it’s traditionally used for patients with angina or chest pain due to poor cardiac vessel blood flow.

The concept is the same for ED, although Brito says it may have a dual mechanism of action:

  • It widens blood vessels helps blood flow.
  • It relaxes penile smooth muscle, which in turn compresses penile veins and impedes blood flow out of the penis, which causes rigidity.

How does nitroglycerin gel work?

According to Brito, nitroglycerin gel or cream differs from other ED treatments such as oral medications:

“[Topical nitroglycerin] acts as a nitrogen donor to increase local levels of nitric oxide, which works through molecular signaling (cGMP pathway) to cause this response,” he says.

On the other hand, Brito says PDE5 inhibitors (like tadalafil and sildenafil) work at a later step in the chain by inhibiting the breakdown of cGMP.

Nitroglycerin for ED doesn’t have enough research

That said, Brito points out that nitroglycerin gel or cream is currently not approved by the FDA to treat ED.

Moreover, Brito points out that the American Urological Association guideline on erectile dysfunction published in 2018 didn’t include topical nitroglycerin as a suggested treatment for men with ED.

“Though this therapy was not specifically mentioned, the authors did state ‘the use of these treatments may preclude the use of other treatments known to be effective,’ and felt more research was needed,” he explains.

And there’s another factor to consider: Nitroglycerin cream on the outside of the penis might be transferred to your partner.

Why are people interested nitroglycerin gel for ED?

“Nitroglycerin may have some benefits over standard oral ED medications,” Brito says.

The onset of topical nitroglycerin is between 10 and 20 minutes, which Brito says is better than the quickest acting oral agents, with sildenafil taking at least 30 minutes.

In fact, the 2018 study published in the Journal of Sexual Medicine found that 44 percent of patients saw erection beginning within 5 minutes of application. Seventy percent of the men noticed an erection within 10 minutes.

The randomized, double-blind, placebo-controlled study included 232 men with ED who participated in two 4-week trials. One trial used a 0.2 percent glyceryl trinitrate topical gel before sex, and the other used a placebo gel.

“This may help with spontaneity, which can be an issue for couples using oral agents,” Brito explains.

Another benefit, Brito says, is that unlike other ED treatments like oral agents, nitroglycerin doesn’t need to pass through the gastrointestinal (GI) tract.

“Since absorption of oral agents like sildenafil is strongly affected by food intake, the medications are much more effective when taken on an empty stomach,” he says. This requires more planning and doesn’t always allow for spontaneity.

Where to buy nitroglycerin for ED

Nitroglycerin gel or cream is currently not approved by the FDA to treat ED.

If you have questions about this topical treatment, you need to talk with a doctor who knows your medical history. A prescription is needed for nitroglycerin.

How to take nitroglycerin gel for ED

Nitroglycerin use is managed by your doctor. Don’t use or apply this topical treatment without guidance.

According to the Journal of Sexual Medicine, the concentration studied was 0.2 percent, which Brito says likely explains why the effect was best for men with mild ED.

He also points out that other studies used concentrations of 0.2 to 0.8 percent for patients with more severe ED, who likely needing higher concentrations.

In general, Brito says people prescribed nitroglycerin by their doctor should apply a small amount (pea-sized) to the head of the penis.

Side effects and contraindications

Nitroglycerin is certainly not for everyone. According to a 2018 review, taking nitroglycerin-based medications with certain PDE5 inhibitors like Viagra is contraindicated. Using them together can result in a sudden and serious decrease in blood pressure and potentially death.

According to Brito, some drawbacks of topical nitroglycerin include possible transmission to the partner, which can lead to the partner sharing in side effects, especially low blood pressure. This can lead to headache and nasal congestion.

Other treatments for ED

There are several treatments available for ED, including:

  • oral medications that include PDE5 inhibitors such as sildenafil (Viagra) and tadalafil (Cialis). Other oral medications include vardenafil HCL (Levitra), and avanafil (Stendra)
  • erectile dysfunction pump (penis or vacuum pump)
  • penile injections
  • inflatable penile prosthesis
  • psychotherapy (talk therapy) for emotional or psychological issues related to ED
  • suppositories (Alprostadil)
  • counseling
  • diet modifications
  • exercise
  • stress reduction

The takeaway

Although some research points to the effectiveness of nitroglycerin gel or cream for improving the symptoms of ED, it’s currently not approved by the FDA as a treatment for erectile dysfunction.

If you have ED or think you may have ED, it’s important that you talk with a doctor about any treatment options. They can talk with you about the range of options, including lifestyle modifications, counseling, oral agents, penis pumps, surgery, and implants.

Premature Ejaculation

Premature Ejaculation

What Is It?

Published: February, 2020

This article is a repost which originally appeared on Harvard Health

Edited for content

Premature ejaculation occurs when a man reaches orgasm and ejaculates too quickly and without control. In other words, ejaculation occurs before a man wants it to happen. It may occur before or after beginning foreplay or intercourse. Some men experience a lot of personal distress because of this condition.

As many as one in five men experience difficulty with uncontrolled or early ejaculation at some point in life. When premature ejaculation happens so frequently that it interferes with the sexual pleasure of a man or his partner, it becomes a medical problem.

Several factors may contribute to premature ejaculation. Psychological problems such as stress, depression and other factors that affect mental and emotional health can aggravate this condition. However, there is growing evidence that biological factors can make some men more prone to experience premature ejaculation.

Rarely, premature ejaculation can be caused by a specific physical problem, such as inflammation of the prostate gland or a spinal cord problem.

Symptoms

The key symptoms of premature ejaculation include:

  • Ejaculation that routinely occurs with little sexual stimulation and with little control
  • Decreased sexual pleasure because of poor control over ejaculation
  • Feelings of guilt, embarrassment or frustration

Diagnosis

Premature ejaculation is diagnosed based on typical symptoms. To understand your problem, your doctor will need to discuss your sexual history with you. Be frank and open. The more your doctor knows, the better he or she can help you.

If your sexual history fails to reveal significant mental or emotional factors that may contribute to premature ejaculation, your doctor may want to examine you. Your doctor may examine your prostate or do neurological tests (tests of your nervous system) to determine if there is a physical problem that could be causing premature ejaculation.

Expected Duration

Sometimes, premature ejaculation goes away on its own over weeks or months. Working to relieve stress or other psychological issues may help the situation to improve.

Other men have lasting difficulties with premature ejaculation, and require professional help. Some men respond to treatment promptly, while others struggle with this problem over a prolonged period. Effective treatment is available.

Prevention

There is no known way to prevent premature ejaculation. However, you should consider the following advice:

  • Maintain a healthy attitude toward sex. If you experience feelings of anxiety, guilt or frustration about your sex life, consider seeking psychotherapy or sexual therapy.
  • Keep in mind that anyone can experience sexual problems. If you experience premature ejaculation, try not to blame yourself or feel inadequate. Try speaking openly with your partner to avoid miscommunication.

Treatment

Behavioral therapy is one possible approach for treating premature ejaculation. Most commonly, the “squeeze technique” is used. If a man senses that he is about to experience premature orgasm, he interrupts sexual relations. Then the man or his partner squeezes the shaft of his penis between a thumb and two fingers. The man or his partner applies light pressure just below the head of the penis for about 20 seconds, lets go, and then sexual relations can be resumed. The technique can be repeated as often as necessary. When this technique is successful, it enables the man to learn to delay ejaculation with the squeeze, and eventually, to gain control over ejaculation without the squeeze. Behavioral therapy helps 60% to 90% of men with premature ejaculation. However, it requires the cooperation of both partners. Also, premature ejaculation often returns, and additional behavioral therapy may be needed.

Another possible treatment is prescription medication that helps to delay ejaculation. Delayed orgasm is a common side effect of certain drugs, particularly those used to treat depression. This is true even for men who are not depressed. When this type of medication is given to men who experience premature ejaculation, it can help to postpone orgasm for up to several minutes. Drugs used for this type of treatment include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), paroxetine (Paxil) or sertraline (Zoloft); and tricyclic antidepressants, such as clomipramine (Anafranil).

Some men with premature ejaculation may benefit from drugs called phosphodiesterase inhibitors, such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). A phosphodiesterase inhibitor can be used alone or in combination with an SSRI. One drug should be started at a time, preferably at a low dose.

Some men with premature ejaculation also benefit from reducing the stimulation they experience during sex. A number of creams are available that can partially anesthetize (numb) the penis and reduce the stimulation that leads to orgasm. Another option is to use one or more condoms. However, these techniques may interfere with the pleasure experienced during sex.

When To Call a Professional

Speak with your doctor if you consistently ejaculate before you want to. Remember, one instance of premature ejaculation does not mean that you have a condition that requires treatment. Your doctor may refer you to a sex therapist if premature ejaculation is causing major problems in your sex life or personal relationships or if you would like to consider behavioral therapy.

Prognosis

Many men experience a brief period of premature ejaculation, then improve on their own. Even for men who require medical treatment, the outlook is usually good.

10 Natural Ways to Boost Your Libido

Boost Your Libido with These 10 Natural Tips

Medically reviewed by University of Illinois — Written by Alexia Severson — Updated on May 11, 2019

This article is a repost which originally appeared on Healthline

Edited for content

The natural approach

Looking to spice up your sex life? There are a variety of things you can do in your everyday life that can help boost your libido and enhance your sex life.

1. Try eating certain fruits

Little evidence supports the effectiveness of certain foods, but there’s no harm in experimenting.

Figs, bananas, and avocados, for example, are considered libido-boosting foods, known as aphrodisiacs.

But these foods also provide important vitamins and minerals that can increase blood flow to the genitals and promote a healthy sex life.

2. Try eating chocolate

Throughout history, chocolate has been a symbol of desire. Not just because of its delicious taste, but because of its power to improve sexual pleasure.

According to one study, chocolate promotes the release of phenylethylamine and serotonin into your body. This can produce some aphrodisiac and mood-lifting effects.

According to another study, the effects of chocolate on sexuality are probably more psychological than biological.

3. Take your daily herbs

Next time you decide to sit down for a romantic dinner, add a little basil or garlic to your dish. The smell of basil stimulates the senses. Garlic contains high levels of allicin, and increases blood flow.

These effects may help men with erectile dysfunction.

Ginkgo bilobaTrusted Source, an extract derived from the leaf of the Chinese ginkgo tree, is another herb found to treat antidepressant-induced sexual dysfunction.

4. Take a tip from Africa

Yohimbine, an alkaloid found in the bark of the West African evergreen, has been known to work as a natural Viagra.

Some studies suggest that Yohimbine bark can help you maintain an erection. It will also enhance the quality of an erection. However, researchers say there is no natural equivalent to match Viagra.

5. Boost your self-confidence

The way you feel about your body affects the way you feel about sex. An unhealthy diet and lack of exercise may cause you to have a poor self-image. These things can discourage you from having and enjoying sex.

You can boost your self-esteem and your sex drive by shifting the focus from your flaws to your attributes. You can also focus on the pleasure experienced during sex.

6. Stick to one glass of wine

Two glasses of wine might be one too many. Drinking one glass of wine can put you at ease and increase your interest in becoming intimate. But too much alcohol can ruin your ability to perform by affecting erectile function. Too much alcohol can also inhibit your ability to orgasm.

7. Take time to meditate and relieve stress

No matter how healthy you are, being stressed out is going to affect your sex drive. Women are particularly susceptible to the effects stress can have on one’s sex life.

Men, on the other hand, sometimes use sex to relieve stress. And sometimes differences in the approach to sex may cause conflict.

To relieve stress, participate in sports activities, practice tai chi, or take a yoga class.

8. Get plenty of sleep

Those with a hectic lifestyle don’t always have the time to get the right amount of sleep. Being busy also makes it difficult to make time for sex.

People who balance work with caring for aging parents or young children are often left exhausted, which can lead to a reduced sex drive.

Boost your energy and sex drive by taking naps when you can and eating a healthy diet high in protein and low in carbohydrates.

9. Keep your relationship in check

After you’ve had an argument with your partner, chances are you’re not in the mood to have sex. For women, sensing emotional closeness is important to sexual intimacy. That means unresolved conflicts can affect your sexual relationship.

Communication is essential for building trust. It’s important to prevent resentments from building up.

Consult a doctor

Even if you’re taking a natural approach to boosting your sex drive, it still might be a good idea to talk with your doctor. They can help you identify underlying problems.

Your doctor may suggest some strategies for enhancing sexual health.

These may include communicating with your partner, making healthy lifestyle choices, and treating underlying medical conditions. Knowing the root of the problem affecting your sex life will make it easier to find a solution.

10. Trial and error

There are a variety of different approaches that may enhance your sex drive naturally. However, it’s important to remember that every couple is different. It may take a little experimentation to find out what works best for you.

If you do decide to turn to prescription drugs, remember that desire is at the core of sex. It’s important to remember that a little blue pill may not be the answer if emotional issues are affecting your libido.

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Male Sexual Worries: Trends in the Post-Viagra Age

Male Sexual Worries: Trends in the Post-Viagra Age

This article is a repost which originally appeared on SciTechDaily

Edited for content

Trends in reasons for visiting a the San Raffaele sexual health clinic. Credit: This diagram appears with the permission of the authors and the International Journal of Impotence Research. The EAU thanks the authors, and the journal for their cooperation.

Scientists report a change in why men seek help for sexual problems, with fewer men complaining about impotence (erectile dysfunction) and premature ejaculation, and more men, especially younger men, complaining about low sexual desire and curvature of the penis (Peyronie’s disease).

Presenting the work at the European Association of Urology (virtual) Congress, after recent acceptance for publication, research leader Dr. Paolo Capogrosso (San Raffaele Hospital, Milan, Italy) said:

“Over a 10 year period we have seen a real change in what concerns men when they attend sexual health clinics. This is probably driven by greater openness, and men now accepting that many sexual problems can be treated, rather than being something they don’t want to talk about.”

The success of erectile dysfunction treatments such as Viagra and Cialis, and the availability of new treatments, means that men facing sexual problems have now have treatments for sexual problems which weren’t available a generation ago. Now researchers at San Raffaele Hospital in Milan have studied why men come to sexual health clinics, and how this has changed over a 10-year period.

In what is believed to be the first research of its kind, the scientists questioned 3244 male visitors to the San Raffaele Hospital Sexual Health Clinic in Milan over a 10 year period (2009 to 2019), and classified the main reason for the visit. They found that the number of patients visiting with erectile dysfunction problems increased from 2009 to 2013, then started to decrease.

There were comparatively few patients complaining of low sex drive or Peyronie’s disease in 2009, but complaints about both of these conditions grow from 2009 to the end of the study. In 2019 men were around 30% more likely to report Peyronie’s disease than in 2009, and around 32% more likely to report low sexual desire.

The amount of men complaining of premature ejaculation dropped by around 6% over the 10-year period. The average age of first attendance at the clinical also dropped, from a mean of 61 to 53 years.

“Erectile dysfunction is still the main reason for attending the clinic, but this number is dropping, whereas around 35% of men attending the clinic now complain of Peyronie’s disease, and that number has shown steady growth,” said Paolo Capogrosso. “Our patients are also getting younger, which may reflect a generational change in attitude to sexual problems.”

Dr. Capogrosso continued “We need to be clear about what these figures mean. They do not indicate any change in the prevalence of these conditions, what they show is why men came to the clinic. In other words, it shows what they are concerned about. The changes probably also reflect the availability of treatments; as treatments for sexual conditions have become available over the last few years, men are less likely to suffer in silence.”

These are results from a single centre, so they need to be confirmed by more inclusive studies. “Nevertheless there seems to be a growing awareness of conditions such as Peyronie’s disease, with articles appearing in the popular press*. In addition, we know that the awareness of this condition is increasing in the USA and elsewhere, so this may be a general trend,**” said Dr. Capogrosso.

Commenting, Dr Mikkel Fode (Associate Professor of Urology at University of Copenhagen), said:

“Although these data are somewhat preliminary as they stem from single institution they are interesting because they allow us to formulate several hypotheses. For example the drop in men presenting with erectile dysfunction may mean that family physicians are becoming more comfortable addressing this issue and that the patients are never referred to specialized centers. Likewise, the simultaneous drop in age at presentation and increase in Peyronie’s disease and low sex drive could indicate that both men and their partners are becoming more mindful to optimizing their sex lives. I will be very interesting to see if these trends are also present in other centers around the world.”

Dr. Fode was not involved in this work, this is an independent comment.

References:

* “Trends in reported male sexual dysfunction over the past decade: an evolving landscape” by Edoardo Pozzi, Paolo Capogrosso, Luca Boeri, Walter Cazzaniga, Rayan Matloob, Eugenio Ventimiglia, Davide Oreggia, Nicolò Schifano, Luigi Candela, Costantino Abbate, Francesco Montorsi and Andrea Salonia, 1 July 2020, International Journal of Impotence Research.

** “The Prevalence of Peyronie’s Disease in the United States: A Population-Based Study” by Mark Stuntz, Anna Perlaky, Franka des Vignes, Tassos Kyriakides and Dan Glass, 23 February 2016, PLOS ONE.
DOI: 10.1371/journal.pone.0150157
PMCID: PMC4764365

Male Sexual Worries: Trends in the Post-Viagra Age

Male Sexual Worries: Trends in the Post-Viagra Age

This article is a repost which originally appeared on SciTechDaily

Edited for content

Trends in reasons for visiting a the San Raffaele sexual health clinic. Credit: This diagram appears with the permission of the authors and the International Journal of Impotence Research. The EAU thanks the authors, and the journal for their cooperation.

Scientists report a change in why men seek help for sexual problems, with fewer men complaining about impotence (erectile dysfunction) and premature ejaculation, and more men, especially younger men, complaining about low sexual desire and curvature of the penis (Peyronie’s disease).

Presenting the work at the European Association of Urology (virtual) Congress, after recent acceptance for publication, research leader Dr. Paolo Capogrosso (San Raffaele Hospital, Milan, Italy) said:

“Over a 10 year period we have seen a real change in what concerns men when they attend sexual health clinics. This is probably driven by greater openness, and men now accepting that many sexual problems can be treated, rather than being something they don’t want to talk about.”

The success of erectile dysfunction treatments such as Viagra and Cialis, and the availability of new treatments, means that men facing sexual problems have now have treatments for sexual problems which weren’t available a generation ago. Now researchers at San Raffaele Hospital in Milan have studied why men come to sexual health clinics, and how this has changed over a 10-year period.

In what is believed to be the first research of its kind, the scientists questioned 3244 male visitors to the San Raffaele Hospital Sexual Health Clinic in Milan over a 10 year period (2009 to 2019), and classified the main reason for the visit. They found that the number of patients visiting with erectile dysfunction problems increased from 2009 to 2013, then started to decrease.

There were comparatively few patients complaining of low sex drive or Peyronie’s disease in 2009, but complaints about both of these conditions grow from 2009 to the end of the study. In 2019 men were around 30% more likely to report Peyronie’s disease than in 2009, and around 32% more likely to report low sexual desire.

The amount of men complaining of premature ejaculation dropped by around 6% over the 10-year period. The average age of first attendance at the clinical also dropped, from a mean of 61 to 53 years.

“Erectile dysfunction is still the main reason for attending the clinic, but this number is dropping, whereas around 35% of men attending the clinic now complain of Peyronie’s disease, and that number has shown steady growth,” said Paolo Capogrosso. “Our patients are also getting younger, which may reflect a generational change in attitude to sexual problems.”

Dr. Capogrosso continued “We need to be clear about what these figures mean. They do not indicate any change in the prevalence of these conditions, what they show is why men came to the clinic. In other words, it shows what they are concerned about. The changes probably also reflect the availability of treatments; as treatments for sexual conditions have become available over the last few years, men are less likely to suffer in silence.”

These are results from a single centre, so they need to be confirmed by more inclusive studies. “Nevertheless there seems to be a growing awareness of conditions such as Peyronie’s disease, with articles appearing in the popular press*. In addition, we know that the awareness of this condition is increasing in the USA and elsewhere, so this may be a general trend,**” said Dr. Capogrosso.

Commenting, Dr Mikkel Fode (Associate Professor of Urology at University of Copenhagen), said:

“Although these data are somewhat preliminary as they stem from single institution they are interesting because they allow us to formulate several hypotheses. For example the drop in men presenting with erectile dysfunction may mean that family physicians are becoming more comfortable addressing this issue and that the patients are never referred to specialized centers. Likewise, the simultaneous drop in age at presentation and increase in Peyronie’s disease and low sex drive could indicate that both men and their partners are becoming more mindful to optimizing their sex lives. I will be very interesting to see if these trends are also present in other centers around the world.”

Dr. Fode was not involved in this work, this is an independent comment.

References:

* “Trends in reported male sexual dysfunction over the past decade: an evolving landscape” by Edoardo Pozzi, Paolo Capogrosso, Luca Boeri, Walter Cazzaniga, Rayan Matloob, Eugenio Ventimiglia, Davide Oreggia, Nicolò Schifano, Luigi Candela, Costantino Abbate, Francesco Montorsi and Andrea Salonia, 1 July 2020, International Journal of Impotence Research.

** “The Prevalence of Peyronie’s Disease in the United States: A Population-Based Study” by Mark Stuntz, Anna Perlaky, Franka des Vignes, Tassos Kyriakides and Dan Glass, 23 February 2016, PLOS ONE.
DOI: 10.1371/journal.pone.0150157
PMCID: PMC4764365