Common Male Sexual Problems
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Common Male Sexual Problems
Philip Werthman, FACS (Director, Center for Male Reproductive Medicine) gives expert video advice on: What causes premature ejaculation?; How can premature ejaculation be treated?; What causes low libido? and more...
What is "premature ejaculation"?
Premature ejaculation is a condition where the man has an orgasm before he wants to, or before pleasing his partner. In terms of absolute time, it could be anywhere from under five minutes to specifically under one to two minutes, and it can be distressing to both the male and female partners when this condition occurs.
What causes premature ejaculation?
Premature ejaculation can be caused by a variety of things. It could be a psychological issue, it could be a sensitivity issue. There are probably a variety of reasons that cause it that we don't even know about yet.
What is "retrograde ejaculation"?
Retrograde ejaculation is a condition where, when a man ejaculates, instead of the semen coming out through the end of the penis, it actually runs back into bladder. If you look at the male reproductive tract and its anatomy, the sperm come up through the vas deferens and then run through the ejaculatory ducts and the prostate, which is part of the male urethra. The prostate is right next to the bladder. It's probably about a centimeter or two centimeters from the bladder. The penile urethra is usually six to eight centimeters in length, so the path of least resistance for the semen to go is actually back into the bladder, and that is retrograde ejaculation.
What causes retrograde ejaculation?
The causes of retrograde ejaculation are any issues that affect the function of the sphincter at the neck of the bladder. This could be caused by prostate surgery, as it's common when men have prostate surgery for the neck of the bladder to be scraped to facilitate urination, and while scraping this out, muscles that are part of the sphincter are scraped out as well. It used to be very common for men post-surgery to experience retrograde ejaculation. Retrograde ejaculation can also be caused by neurologic conditions. Anything that affects the nerves of the spinal chord in the sacral and lumbar region, and also the nerves that eminate from the spinal chord and go to the prostate and the bladder. Those conditions most commonly include spinal chord injury, abdominal surgery, colon surgery and surgery for testicular cancer. Some men with diabetes will have the problem of the diabetes causing damage to the nerves that control ejaculation and can therefore end up suffering from retrograde ejaculation.
What is "anorgasmia"?
Anorgasmia is a condition whereby a man is unable to have an orgasm. Usually anorgasmia is psycological condition.
What is "delayed ejaculation"?
Delayed ejaculation is a condition where a man has trouble ejaculating but can ejaculate over a period of time. This can be 15 minutes, a half an hour, an hour, so this is very variable between different men. It's usually due to psychological causes, where the man has decreased sensitivity in the penis and is unable to ejaculate because of that, or through other psychological issues, where they're unable to let go and release and just experience an orgasm.
What causes low libido?
Low libido can be caused by a variety of different things. It can be caused by a low level of the male hormone testosterone which is linked to the idea of the <a href="http://www.videojug.com/interview/andropause-male-menopause-2">male menopause</a>. Testosterone, which is made in the testicles, is really the chemical by which a man has sex drive and is aggressive. If testosterone is low, then a man may experience symptoms of lack of desire for sex and <a href="http://www.videojug.com/interview/male-infertility-2">male infertility</a>. Other things include stress, being tired, being overworked, depression; unhealthy lifestyle, being overweight, obese. Some men, a high level of estrogen in their body, even though their testosterone may be normal, can also cause low libido, because it's the balance between testosterone and estrogen in a man's body that affects both sperm production and also libido issues.
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Tips & Comments
My husband had delayed ejaculation but since he start to buy Generic Viagra everything is different we live better.
How to cure premature ejaculation - a video guide
Erection problems and Viagra:Sildenafil citrate, sold under the name Viagra, is a drug used to treat male erectile dysfunction (impotence), developed by the pharmaceutical company Pfizer The pills are blue with the words "Pfizer" on one side and "VGR xx" (with xx being either 25, 50 or 100 as the dose of that pill in milligrams) on the other. Viagra was initially developed to treat heart disease (angina). In trial studies, the penile erection enhancing effects were noticed. Therefore, men all over the world use viagra when they want to increase their sex drive. The drug was patented in 1996, approved by the FDA on March 27, 1998 (becoming the first pill approved to treat erectile dysfunction in the United States) and offered for sale in the United States later that year. It soon became a smashing success. Even though Viagra is only available by prescription from a doctor, it was advertised directly to consumers on TV (famously being endorsed by Bob Dole). Numerous sites on the Internet offer Viagra for sale after an "online consultation," a mere web questionnaire. It is likely that many men (and some women) experiment with the drug to increase sexual prowess or pleasure. Annual sales of Viagra in the period 1999-2001 exceeded $1 billion. It has been suggested that Viagra would lead to a marked drop in the demand for certain traditional remedies, such as tiger penises and rhinoceros horns and that the drug may therefore help to preserve these endangered species. However, this is unlikely in that these parts of endangered species are not only used to treat impotence. Rhinoceros horns, for example, are used as a treatment for high fever. Further, since Viagra has not been shown to possess aphrodisiac properties, it is unclear that the natural remedies would compete with this new clinical drug. The "Viagra" name has become so well known that many fake aphrodisiacs now call themselves "herbal Viagra" or are presented as blue tablets imitating the shape and colour of Pfizer's product. Pfizer's worldwide patents on sildenafil citrate will expire in 2011 - 2013. The UK patent held by Pfizer on the use of PDE5 inhibitors (see below) as treatment of impotence has been invalidated in 2000 because of obviousness; this decision was upheld on appeal in 2002. A mixture of Viagra and ecstasy, called sextasy, has become popular among rave partygoers. Viagra is also known as Vitamin V. Chemical name: 1-[4-ethoxy- 3-(6,7-dihydro- 1-methyl- 7-oxo- 3-propyl- 1H-pyrazolo [4,3-d]pyrimidin-5-yl) phenylsulfonyl]- 4-methylpiperazine citrate Chemical formula: C22H30N6O4S·C6H8O7 Molecular weight: 666.7 g/mol Part of the physiological process of erection involves the release of nitric oxide (NO) in the corpus cavernosum. This then activates the enzyme guanylate cyclase which results in increased levels of cyclic guanosine monophosphate (cGMP), leading to smooth muscle relaxation in the corpus cavernosum, resulting in increased inflow of blood and an erection. Sildenafil is a potent and selective inhibitor of cGMP specific phosphodiesterase type 5 (PDE5) which is responsible for degradation of cGMP in the corpus cavernosum. This means that, with Viagra on board, normal sexual stimulation leads to increased levels of cGMP in the corpus cavernosum which leads to better erections. Without sexual stimulation and no activation of the NO/cGMP system, Viagra should not cause an erection. Other drugs that operate by the same mechanism include Cialis and Levitra. Viagra is metabolised by hepatic enzymes and excreted by both the liver and kidneys. If taken with a high fat meal, there may be a delay in absorption of Viagra and the net effect might be muted slightly as the plasma concentration will be lowered. Some reports have claimed that Viagra causes enhanced sexual pleasure for women by increasing blood flow to the sexual organs. Contraindications and side effects Contraindications include: When taking other nitric oxide donors, organic nitrites and nitrates (which includes glyceryl trinitrate, sodium nitroprusside, amyl nitrite) In men for whom sexual intercourse is inadvisable due to cardiovascular risk factors Severe hepatic impairment Severe impairment in renal function Hypotension Recent stroke or heart attack (myocardial infarct) Hereditary degenerative retinal disorders (including genetic disorders of retinal phosphodiesterases) Amongst Viagra's serious adverse effects are: priapism, severe hypotension, myocardial infarction, ventricular arrhythmias, sudden death, stroke and increased intraocular pressure. Common side effects include headache, flushing, dyspepsia, prolonged erections, palpitations and photophobia. Visual changes including blurring of vision and a curious bluish tinge have also been reported. Dosage and price As with all prescription drugs, proper dosage is at the discretion of a licensed medical doctor. The dose of Viagra is 25mg to 100mg taken once per day between 0.5 to 4 hours before sexual intercourse. It is usually recommended to start with a dosage of 50 mg and then lower or raise the dosage as appropriate. The drug is sold in three dosages (25, 50, and 100 mg), all three costing about USD$10 per pill. Investing in a pill cutter can therefore be advisable. Some patients may find various degrees of discomfort at the 25 or 50 mg dosage level, including flushing of the face, head pressure, headache, and tachycardia. For these patients a dosage of 10 mg to 12.5 mg may be more appropriate yet effective.
fartoolong, As A clinical psychologist I can assure you, you are going to the wrong people for help. Go to your local Hospital and ask for an appointment with a clinical psychologist. You're problem, if not complicated, will be fixed in a few sessions! Trust me. But make sure the clinical psychologist is experienced in sex therapy.
Hey fartoolong, doctors go to medical school to learn their skills. Medical school needs to teach doctors about problems for doctors to know how to treat them. For med school to teach it to them, they have to know how to treat it and it has to be common enough for treatment to be cost-effective. Do you really think ANY business would provide ANY service that doesn't bring in money? You can't GET funding to research a health problem unless there are a lot of people that have that condition. And since it is rare or so you say, and it's not a life-endangering problem, nobody is going to fund the research.
Hi all. I can't help but add a post here as I do on many of these sites. I've become totaly pissed off with doctors and the entire world concentrating on an apparent problem call Premature. I'm looking for the first person than can for the first time, provide me with generous details on the problem of delayed ejaculation. The world seem either totaly unaware that this is a condition, or simply don't give a s**t because the catagory is a minority. Doctors also are totaly unprofessional in they're approach to the problem. Doctors are only interested in money, and the money only ever comes from issues that live in the majority problems, where they're are endless cases to treat. If your condition lyes in a minority, doctors don't give a s**t. It just makes my skin crawl to constantly in social environment, have to sit a listen to women that carry on, make jokes and laugh, because they beleive they are better and can last longer. It's one of things where you'd just love to take everyone of them aside and make them eat they're words, (And I don't mean that in a rude way). Women are the quick shot wonders, not us blokes. They are the ones that can not last. The best orgasm I ever had took 7 1/2 hours. Makes your eyes water, doesn't it ladies? I've suffered delayed since the day I first had sex. If I'm having a realy good day, I will go off in around 30 to 40 minutes, and yet this bloke above calling himself an expert, Philip E. Werthman, claims dealyed is only around 15 minutes. Horse s**t. Do some more reasearch Dr, before you call yourself a Dr. On an average day, I will take around 40 to 100 minutes. On a bad day, It will last until one of us gives up with exhaustion and I don't orgasm at all. I challenge any one of you reading this, to google delayed and you'll spend countless days reading all about premature instead. When you do find something on delayed, it's about 50 cents worth, and worthless. The only real time medical answers I've uncovered, want thousands of dollars upfront, with no real upfront answers as to how they're going to fix the problem. I've discovered all sorts of apparent remedies, including vitamin supliments, that "possibly" help, but not once in 42 years has an "apparent" doctor been able to show me some conclusive proof of the answers. I don't mind spending money to fix it, I'm just tired of Dr's telling me that it will cost me thousands of dollars for them to have a guess. I challenge both the bloke above, Philip E. Werthman, or any other appparent experts to show me why they should be deservant off being recognised as a true Dr. Ladies of the world, it's you that is the 5 minutes wonders, not me.
Excellent
& yes Ashunn it is possible to get her pregnant,would it really hurt to go & wash your hands after masturbating?? it takes one minute & could stop you from becoming a father,please use your head!!!
Sometimes my guy can think too much about how longhe's lasting & keeps stopping everytime time he comes close to orgasm,& it can go on for hours & hours,how can i tell him that doing this is actually hurting me more than pleasuring me,as i do get dry,without hurting his feelings? i know he only wants to please me :(
lol.. Funny comments. My suggestion seen from somewhere is everytime you go for a piss to stop it and start it. Do it 4 times or so a piss and hold it for 5 seconds. The same muscle used to ejaculate is used to piss so you can strengthen your muscle to hold on longer or stop yourself before you ejaculate. I also suggest taking your time! There is no need to go hammer and tongs right away as you will last a minute. Go slow.. pull out.. put back in... go slow.. go fast.. slow down.. etc..