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''Men's Health // Sexual health for men-- ''Sexual health is a source of concern for many men. Yet some men are not comfortable talking to their doctors about sex. Others wrongly think that sexual problems are a normal part of aging. But treatment can help with many sexual health issues. No matter what your age, talk to your doctor if you have: •Problems getting an erection •Problems keeping an erection •Less interest in sex •Other problems that keep you or your partner from enjoying sex ---------------------------------- Male infertility More information on male infertility Lots of couples have trouble conceiving a child. About 30 percent of the time, the cause of their infertility is from the man. The male fertility process involves making mature sperm and getting the sperm to reach and fertilize the egg. For this process to happen, a man must be able to have and keep an erection, have enough sperm, have enough semen to carry the sperm to the egg, and have sperm that are the right shape and move in the right way. A problem in any part of this process can lead to problems conceiving. Many factors can affect male fertility. Some include: •Age •Stress •Smoking •Drinking too much alcohol •Some illegal drugs, like anabolic steroids or artificial testosterone taken to increase muscle mass •Undescended testicles or damage to the testicles •Too much heat, like from hot tubs or, possibly, from tight underwear •Certain medications, such as cancer medications (chemotherapy) •Exposure to radiation •Environmental toxins, like pesticides, at work or at home •Genetic conditions •Other health problems, including obesity If your partner has not become pregnant after one year of frequent sex without birth control (or after six months if your partner is 35 or older), talk to your doctor. A semen test, which looks at the health of a man's semen and sperm, can be a good first step for couples facing fertility problems. That's because it is much easier and costs less than tests for female fertility. Many couples with fertility problems go on to have healthy pregnancies and babies. ''Connect with other organizations •American Society for Reproductive Medicine •Association of Reproductive Health Professionals •Hormone Foundation, •RESOLVE: The National Infertility Association •Yale Fertility Center -- |
Men's Health Sexual problems Premature ejaculation Erection problems Loss of sexual interest Low testosterone More information on sexual problems-- KNOWLEDGEFINANCIAL. COM Sexual problems are not unusual among men. Many men have problems getting or keeping an erection. Some men have problems with ejaculation. The good news is that treatment often can help sexual problems. Premature ejaculation A lot of men sometimes ejaculate sooner than they would like. Estimates vary, but around 1 out of 3 men experience premature ejaculation at some time. Usually, premature ejaculation does not need treatment. But if you often ejaculate prematurely — like before starting intercourse or just a minute or two after starting — you can get help. Premature ejaculation has several possible causes, including: •Emotional issues like guilt or anxiety •Low levels of certain brain chemicals •Being very aroused or stimulated •Infection of the prostate or urethra Talk to your doctor if you are concerned. There are several treatments for premature ejaculation. You first might try techniques like stopping sexual stimulation briefly and then restarting it. You also could try using topical creams or condoms to lessen excitement. The U.S. Food and Drug Administration has not approved any medications for premature ejaculation, but your doctor may prescribe antidepressants because a possible side effect is delaying ejaculation. Open communication with your partner can help with any stress between you. And it can help you figure out ways that you can both achieve satisfaction. Working with a therapist or counselor, either by yourself or as a couple, can be very effective. Erection problems ED drugs are not safe for everyone Many men now take medications like Viagra, Levitra, and Cialis to treat erection problems. These medications are not safe for everyone. Before taking drugs to treat ED, talk to your doctor about the benefits and risks involved. Never take Viagra, Levitra, or Cialis if you take heart medicines called nitrates. Doing so could cause a sudden — and dangerous — drop in blood pressure. Also, tell your doctor if you take any drugs called alpha-blockers, which are used to treat prostate enlargement or high blood pressure. Some men have problems getting or keeping an erection. (An erection is when blood fills up the penis, making it firmer and larger.) This problem is called erectile dysfunction, or ED, and sometimes is called impotence. ED is fairly common. In fact, between 15 million and 30 million U.S. men are affected by it. ED can be very upsetting. It can affect self-esteem and cause frustration, anger, and sadness. But there are effective treatments for ED. And counseling can help you and your partner cope with any emotional effects of ED. Causes of ED include: •Clogged blood vessels, high blood pressure, and high cholesterol •Nerve damage from diabetes •Certain medicines, including some used to treat depression or high blood pressure •Low testosterone •Unhealthy habits like smoking, drinking too much alcohol, overeating, and not exercising •Emotional factors, such as stress or depression As men get older, ED becomes more common. By age 65, almost 25 percent of men have this problem at least one out of every four times they have sex. But ED is treatable at any age. Your doctor can offer a number of ways to treat ED. If treatment solves your ED, though, you still need to take care of any health issues that may have caused it. Some men need to try two or three options before they find an ED treatment that works for them. Medication is one popular way to treat ED. Drugs like Viagra increase blood flow to the penis, which helps make an erection possible. Injections to the penis and medicine you put into the tip of your penis also can increase blood flow to it. Other treatments for ED include a vacuum cylinder and pump you put on your penis to pull blood into it or inflatable rods that are put into the penis through surgery. You may have heard of herbal products or dietary supplements that claim to treat ED or improve sexual performance. You should beware of these products even if they claim to be "natural." They can contain dangerous ingredients, including prescription medications that are not identified on the product's label. Loss of sexual interest Your interest in sex, also called libido, can vary over the course of your life. Some men may lose interest in sex during times of stress or illness. Also, your interest might not match that of your partner at times, which is normal in long-term relationships. Reduced interest in sex can have a number of causes, including: •A health problem •Certain medications •Reduced levels of male hormones •Emotional or relationship problems As men age, it is natural to be less interested in sex. But for a healthy man, having no interest in sex is not normal. If you have less interest in sex, talk frankly with your doctor. Treatment can help. It could include medicine, counseling, or both. Low testosterone Testosterone is the most important male hormone. It helps maintain sex drive, sperm production, pubic and body hair, muscle, and bone. Lower than normal levels of testosterone can affect a man's body and mood. Signs of low testosterone in adult men can include: •Less interest in sex •Erection problems •I•Hot flashes •Problems with memory and concentration •Mood problems, like irritability and depression •Smaller and softer testicles •Loss of muscle strength and weakened bones Low testosterone levels can have a number of causes, including injury, disease, and certain medications. A gradual decline in testosterone is normal in men as they get older. This is sometimes called aging male syndrome (or andropause) and can cause erection problems and less sex drive. But it is not normal for healthy older men to have no interest in sex. There could be other reasons for these changes. If you have symptoms of low testosterone, talk to your doctor. You can get your testosterone level checked with a simple blood test. If you do have low testosterone, your doctor will want to find out the underlying cause. Finding the cause can involve many tests. You might want to see a specialist, such as an endocrinologist or urologist. Some men with low testosterone take testosterone replacement therapy, which they get through a skin patch or other method. But testosterone therapy is not right for everyone, and its use is controversial. One reason is that testosterone therapy has certain risks. Another reason is that experts don't know exactly what testosterone levels are "normal" as men age. If you have low testosterone, your doctor can help you understand the benefits and risks of treatment so you can decide what's right for you. More information on sexual problems---KNOWLEDGEFINANCIAL.COM Connect with other organizations •Administration for Children and Families •Adopt America Network //•AdoptUSKids •American College of Obstetricians and Gynecologists •Child Welfare Information Gateway, ACYF, ACF, HHS •Children Awaiting Parents, Inc. •Ferre Institute, Inc. •Intercountry Adoption, Office of Children's Issues, US Department of State •International Council on Infertility Information Dissemination •National Adoption Center •National Foster Parent Association •RESOLVE: The National Infertility Association •Society for Assisted Reproductive Technology ••U.S. Food and Drug Administration |
Erectile Dysfunction - (Impotence, ED) What is erectile dysfunction? Erectile dysfunction (ED), also known as impotence, is the inability to achieve or sustain an erection for satisfactory sexual activity. Erectile dysfunction is different from other conditions that interfere with male sexual intercourse, such as lack of sexual desire (decreased libido) and problems with ejaculation and orgasm (ejaculatory dysfunction). This article focuses on the evaluation and treatment of erectile dysfunction. How common is erectile dysfunction? Erectile dysfunction (ED, impotence) varies in severity; some men have a total inability to achieve an erection, others have an inconsistent ability to achieve an erection, and still others can sustain only brief erections. The variations in severity of erectile dysfunction make estimating its frequency difficult. Many men also are reluctant to discuss erectile dysfunction with their doctors due to embarrassment, and thus the condition is underdiagnosed. Nevertheless, experts have estimated that erectile dysfunction affects 30 million men in the United States. While erectile dysfunction can occur at any age, it is uncommon among young men and more common in the elderly. By age 45, most men have experienced erectile dysfunction at least some of the time. According to the Massachusetts Male Aging Study, complete impotence increases from 5% among men 40 years of age to 15% among men 70 years and older. Population studies conducted in the Netherlands found that some degree of erectile dysfunction occurred in 20% of men between ages 50-54, and in 50% of men between ages 70-78. In 1999, the National Ambulatory Medical Care Survey counted 1,520,000 doctor-office visits for erectile dysfunction. Other studies have noted that approximately 35% of men 40-70 years of age suffer from moderate to severe ED, and an additional 15% may have milder forms. What is normal penis anatomy? The penis contains two chambers, called the corpora cavernosa, which run the length of the upper side of the penis (see figure 1 below). The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora cavernosa. Filling the corpora cavernosa is a spongy tissue consisting of smooth muscles, fibrous tissues, spaces, veins, and arteries. A membrane, called the tunica albuginea, surrounds the corpora cavernosa. Veins located in the tunica albuginea drain blood out of the penis. |
How does erection occur? Erection begins with sexual stimulation. Sexual stimulation can be tactile (for example, by touching the penis) or mental (for example, by having sexual fantasies). Sexual stimulation or sexual arousal generates electrical impulses along the nerves going to the penis and causes the nerves to release nitric oxide, which in turn increases the production of cyclic GMP (cGMP) in the smooth muscle cells of the corpora cavernosa. The cGMP causes the smooth muscles of the corpora cavernosa to relax and allow rapid blood flow into the penis. The incoming blood fills the corpora cavernosa, making the penis expand. How is erection sustained? The pressure from the expanding penis compresses the veins (blood vessels that drain the blood out of the penis) in the tunica albuginea, helping to trap the blood in the corpora cavernosa, thereby sustaining erection. Erection is reversed when cGMP levels in the corpora cavernosa fall, causing the smooth muscles of the corpora cavernosa to contract, stopping the inflow of blood and opening veins that drain blood away from the penis. The levels of the cGMP in the corpora cavernosa fall because it is destroyed by an enzyme called phosphodiesterase type 5 (PDE5). What are some of the risk factors for erectile dysfunction? The common risk factors for ED include the following: What are the causes of erectile dysfunction? The ability to achieve and sustain erections requires 1.a healthy nervous system that conducts nerve impulses in the brain, spinal column, and penis, 2.healthy arteries in and near the corpora cavernosa, 3.healthy smooth muscles and fibrous tissues within the corpora cavernosa, 4.adequate levels of nitric oxide in the penis. Erectile dysfunction can occur if one or more of these requirements are not met. The following are causes of erectile dysfunction: Aging: There are two reasons why older men are more likely to experience erectile dysfunction than younger men. First, older men are more likely to develop diseases (such as heart attacks, angina, cardiovascular disease, strokes, diabetes mellitus, and high blood pressure) that are associated with erectile dysfunction. Second, the aging process alone can cause erectile dysfunction in some men, primarily by decreasing the compliance of the tissues in the corpora cavernosa, although it has been suggested, but not proven, that there is also decreased production of nitric oxide in the nerves that innervate the corporal smooth muscle within the penis. Diabetes mellitus: Erectile dysfunction tends to develop 10-15 years earlier in diabetic men than among nondiabetic men. In a population study of men with type I diabetes for more than 10 years, erectile dysfunction was reported by 55% of men 50-60 years of age. Diabetes mellitus also causes erectile dysfunction by damaging both sensory and autonomic nerves, a condition called diabetic neuropathy. Smoking cigarettes, obesity, poor control of blood glucose levels, and having diabetes mellitus for a long time further increase the risk of erectile dysfunction in diabetes. In addition to atherosclerosis and/or neuropathy causing ED in diabetes, many men with diabetes also develop a myopathy (muscle disease) as their cause of ED in which the compliance of the muscles in the corpora cavernosa is decreased, and clinically this presents as an inability to maintain the erection. Hypertension (high blood pressure): People with essential hypertension or arteriosclerosis have an increased risk of developing erectile dysfunction. Essential hypertension is the most common form of hypertension; it is called essential hypertension because it is not caused by another disease (for example, by kidney disease). It is not clearly known how essential hypertension causes erectile dysfunction; however, those with essential hypertension have been found to have low production of nitric oxide by the arteries of the body, including the arteries in the penis. High blood pressure also accelerates the progression of atherosclerosis, which in turn can contribute to erectile dysfunction. Scientists now suspect that the decreased levels of nitric oxide in patients with essential hypertension may contribute to erectile dysfunction. Cardiovascular diseases: The most common cause of cardiovascular diseases in the United States is atherosclerosis, the narrowing and hardening of arteries that reduces blood flow. Atherosclerosis typically affects arteries throughout the body and is aggravated by hypertension, high blood cholesterol levels, cigarette smoking, and diabetes mellitus. When coronary arteries (arteries that supply blood to the heart muscle) are narrowed by atherosclerosis, heart attacks and angina occur. When cerebral arteries (arteries that supply blood to the brain) are narrowed by atherosclerosis, strokes occur. Similarly, when arteries to the penis and the pelvic organs are narrowed by atherosclerosis, insufficient blood is delivered to the penis to achieve an erection. There is a close correlation between the severity of atherosclerosis in the coronary arteries and erectile dysfunction. For example, men with more severe coronary artery atherosclerosis also tend to have more erectile dysfunction than men with mild or no coronary artery atherosclerosis. Some doctors suggest that men with new onset erectile dysfunction should be evaluated for silent coronary artery diseases (advanced coronary artery atherosclerosis that has not yet caused angina or heart attacks). Cigarette smoking: Cigarette smoking aggravates atherosclerosis and thereby increases the risk for erectile dysfunction. Nerve or spinal cord damage: Damage to the spinal cord and nerves in the pelvis can cause erectile dysfunction. Nerve damage can be due to disease, trauma, or surgical procedures. Examples include injury to the spinal cord from automobile accidents, injury to the pelvic nerves from prostate surgery for prostate cancer (prostatectomy), radiation to the prostate, surgery for benign prostatic enlargement, multiple sclerosis (a neurological disease with the potential to cause widespread damage to nerves), and long-term diabetes mellitus. Substance abuse: Marijuana, heroin, cocaine, methamphetamines, crystal meth, and alcohol abuse contribute to erectile dysfunction. Alcoholism, in addition to causing nerve damage, can lead to atrophy (shrinking) of the testicles and lower testosterone levels. Low testosterone levels: Testosterone (the primary sex hormone in men) is not only necessary for sex drive (libido) but also is necessary to maintain nitric oxide levels in the penis. Therefore, men with hypogonadism (diminished function of the testes resulting in low testosterone production) can have low sex drive and erectile dysfunction. Medications: Many common medicines produce erectile dysfunction as a side effect. Medicines that can cause erectile dysfunction include many used to treat high blood pressure, antihistamines, antidepressants, tranquilizers, and appetite suppressants. Examples of common medicines that can cause erectile dysfunction include propranolol (Inderal) or other beta-blockers, hydrochlorothiazide, digoxin (Lanoxin), amitriptyline (Elavil), famotidine (Pepcid), cimetidine (Tagamet), metoclopramide (Reglan), indomethacin (Indocin), lithium (Eskalith, Lithobid), verapamil (Calan, Verelan, Isoptin), phenytoin (Dilantin), and gemfibrozil (Lopid). Depression and anxiety: Psychological factors may be responsible for erectile dysfunction. These factors include stress, anxiety, guilt, depression, widower syndrome, low self-esteem, posttraumatic stress disorder, and fear of sexual failure (performance anxiety). It is also worth noting that many medications used for treatment of depression and other psychiatric disorders may cause erectile dysfunction or ejaculatory problems. |
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