Sexual issues men must discuss with their urologist


Sexual issues men must discuss with their urologist

Sometimes it’s just easier to stick your head in the sand pretending everything is okay.  This may be the approach some men choose when sexual performance issues have gone awry.  But any man, who wants to keep bringing his A-game to the bedroom, will sooner or later need to broach the topic with an expert – his urologist. 

When sexual issues come up, men naturally want to resolve them as soon as possible.  However sometimes sexual issues may signal more serious health conditions.  In most cases, these can be treated.  But until a man makes an appointment and has a thorough discussion with his doctor about his concerns, the problem could become worse. 

Here are the five most common sexual problems men may face and how they can be addressed:

1.  Erectile dysfunction

Erectile dysfunction (ED) or impotence is the inability to get and then maintain an erection sufficient enough for sexual intercourse.  Up to 30 million American men get ED but most men usually are reluctant to talk about their ED problem with other men or their doctor.

Other than putting a strain on a couple’s sex life, ED can also be the first sign of significant cardiac or vascular disease.  To sustain an erection, the penis requires good blood flow and men with heart disease usually do not have good blood flow.  Studies have shown that the majority of men seen in the emergency room for a heart attack or stroke, suffered from ED three to five years earlier. 

Any man who is experiencing ED for more than a month should seek the advice of a doctor such as a urologist who specializes in the treatment of erectile dysfunction.   This will be his best option for successfully treating ED to get back his sex life. 

To treat ED, the underlying cause must first be determined.  From there, man most likely will be told to lose weight, quit smoking, eat a healthier diet, and increase exercise.   Besides lifestyle modifications, medications to treat ED may also be used which include Viagra, Levitra, and Cialis.

2.  Priapism or prolonged erection

 Priapism is when a man has an abnormal erection in which blood that engorges the penis fails to drain out. Every year emergency rooms see thousands of men with this distressing condition that if an erection lasts too long – more than 4 hours - can do permanent damage to the penis.  In fact, priapism is considered a medical emergency as it could result in a man’s ability to ever have an erection again. 

One cause of priapism is medication used to treat ED.  It’s a rare side effect but can happen.  Other possible causes can include the use of certain psychiatric medications, cocaine use, or sickle cell disease. 

To treat a prolonged erection, a doctor may drain the excess blood from the penis with a needle, use medication to limit blood flow into the penis, or do surgery.

3. Peyronie’s disease

Peyronie’s disease is when scar tissue or plaque forms in the penis.  It can occur at any age but men over the age of 40 are who it affects the most.  A thick, elastic membrane called the tunica albuginea is where the plaque builds up inside the tissues of this membrane.  Either the top or bottom of the penis is the most common areas where plaque buildup occurs. 

If the condition is severe enough, it can cause a curve in the penis when erect and be painful enough to prevent a man from having sex.   The deformation of the penis is caused by scar tissue that appears as a hard lump, usually on the upper side of the penis.  In most cases, pain during an erection goes away after one or two years even though the curvature may remain.

In the past, surgery has been the main treatment option.  However, new methods are being tested such as compounds that can be injected into the scar tissue to straighten the penis.

4.  Hypogonadism or testosterone deficiency

Male hypogonadism is when the testes also called the testicles are not making normal levels of the male sex hormone, testosterone.   A deficiency of testosterone not only can affect sexual performance but also a man’s bone health, energy level, muscle strength, and mood.

Any man having difficulty achieving or maintaining erections, needs to see his doctor who will order a simple morning blood test to rule out low testosterone as the underlying cause.  To treat low testosterone, testosterone replacement therapy – such as with a gel or patch – will help prevent symptoms.  All men using testosterone replacement therapy will need regular follow-ups to make sure they are within a reasonable range of testosterone. 

5.  Premature ejaculation

Premature ejaculation occurs when a man ejaculates sooner during sexual intercourse than he or his partner would like.  It is estimated as many as one out of every three men experiences it at some time in their lives.  If it happens infrequently, it’s not a cause for concern.  However if it is frequently happening negatively affecting a man’s sex life, he need to bring this up with his doctor.

Premature ejaculation is actually more common in men across all age groups than ED and is considered the most common sexual dysfunction in men under the age of 40. 

There are several methods of treating premature ejaculation which include behavioral techniques, topical anesthetic creams applied to the penis right before sex to reduce sensation helping to delay ejaculation, and certain oral medications.