What is sex abuse?
Sex abuse is anything that makes you feel uncomfortable or anything somebody tries to do to you sexually that you don't have a choice in or don't want to happen. It can be somebody looking at you and making you feel very uncomfortable. It can be somebody forcing you to have sexual intercourse and it can be anything in between, from unwanted touching, from somebody looking at you and making you feel that maybe you're unsafe.
What should I do if I or someone I know has been abused?
It's really important that you tell somebody, because all abuse is wrong and it needs to stop. Child Line can help you by talking about the feelings, by looking at options of how you can, hopefully, stop the abuse. If you want to report somebody, then you need to go to the police, but it's important that you get some support with that because it's a very difficult thing to do, especially if it's within your family and you're telling, for example, about an uncle, or somebody close to your family, that's sexually abusing you.
What should I do if I suspect someone is an abuser?
It's important you tell somebody that you think that person is an abuser because they may well be abusing more than one person. You can ring the NSPCC Child Protection hotline or you could tell your local police station. You could report the abuser to the people you live with. If you're a child, the important thing is that you get support and that you keep yourself safe as well. You can also talk to Child Line about the feelings that this discovery has brought out for you.
What is rape?
Rape can be either a rape of a man, or rape of a woman. It is when somebody forces you to have sex for sexual intercourse against your wishes , often using violence.
What should I do if I have been raped?
There's lots of things that you should do. First of all seek medical advice. You may well be hurt. You'll also need to get a full check to see if you've contracted any sexually transmitted diseases, and also to see if maybe you are pregnant if you are a woman. You also need to tell somebody. Hopefully, if you'll tell somebody, they will make sure that you are protected but it's important that that person doesn't go on to rape other people.
What should I do if someone I know has been raped?
It's important that you listen to them and that you're there to give them support. If they want to tell somebody, for example, the police, you should offer to go along with them and encourage them to get help medically. It may be that they're pregnant, if they're a woman, or it may be a man that has contracted some sexually transmitted disease. They may or may not choose to report it to the police. You can encourage them to do that or to Crime Stoppers in confidence. It is important that they get medical help.
Showing posts with label Sexual Problems. Show all posts
Showing posts with label Sexual Problems. Show all posts
Sunday, July 27, 2008
Safe Sex
What is a condom?
A condom is a thin latex sheath which goes over the male penis. It stops two things. It stops a female getting pregnant but it also stops sexually transmitted diseases being passed from one partner to another.
Where can I buy condoms?
He doesn't want to wear a condom. What should I do?
What I would suggest you do is to talk to him about the implications of him not wearing a condom. It isn't just about not getting pregnant, it's also about passing on sexually transmitted diseases. And it's important again, that both of you feel comfortable with whatever you choose.
Should I take the pill?
It's important that you seek professional, medical advice about that. You can see your school nurse, you can see your GP, or you can go to family planning clinic. But it's important that you do seek medical advice about that.
What is family planning?
Family planning is planning when you want to start a family, so you would talk to somebody about whether or not you wanted to get pregnant and it's important that both people feel the same way.
How can I find my nearest family planning centre?
You could look it up on the Internet. It should be available in your local GP or your local hospital, or you could ring directory inquiries.
What should I do if I'm pregnant?
You could go to your GP, you could go to your school nurse, but that may not be confidential if you go to your school nurse. Or, you could get a pregnancy test, but they tend to be quite expensive. But it is really important that you take a professional test, because they can be quite difficult to read.
I'm in a relationship. Can we stop using a condom?
Obviously that's a matter of choice between the two of you but it relies on not just on whether or not you use a condom. It's about trust. Do you trust each other not to sleep with anybody else? As long as you're both happy with the decision, then that's the important thing.
What are STD's?
STDs are sexually transmitted diseases. Some of them are very difficult to spot because they don't have particularly many symptoms, for example Chlamydia. So what you need to do is, if you are having sex, and especially if you're having sex with lots of different partners, it's really important to get a regular check up in a family planning clinic, or a gynaecologist clinic at a local hospital.
When should I get STD tested?
If you know that you've had unsafe sex. If, for example, you've gone out and got a little bit drunk and had unprotected sex. It's not just about getting pregnant, it's about checking that you haven't caught anything, like an STD.
A condom is a thin latex sheath which goes over the male penis. It stops two things. It stops a female getting pregnant but it also stops sexually transmitted diseases being passed from one partner to another.
Where can I buy condoms?
He doesn't want to wear a condom. What should I do?
What I would suggest you do is to talk to him about the implications of him not wearing a condom. It isn't just about not getting pregnant, it's also about passing on sexually transmitted diseases. And it's important again, that both of you feel comfortable with whatever you choose.
Should I take the pill?
It's important that you seek professional, medical advice about that. You can see your school nurse, you can see your GP, or you can go to family planning clinic. But it's important that you do seek medical advice about that.
What is family planning?
Family planning is planning when you want to start a family, so you would talk to somebody about whether or not you wanted to get pregnant and it's important that both people feel the same way.
How can I find my nearest family planning centre?
You could look it up on the Internet. It should be available in your local GP or your local hospital, or you could ring directory inquiries.
What should I do if I'm pregnant?
You could go to your GP, you could go to your school nurse, but that may not be confidential if you go to your school nurse. Or, you could get a pregnancy test, but they tend to be quite expensive. But it is really important that you take a professional test, because they can be quite difficult to read.
I'm in a relationship. Can we stop using a condom?
Obviously that's a matter of choice between the two of you but it relies on not just on whether or not you use a condom. It's about trust. Do you trust each other not to sleep with anybody else? As long as you're both happy with the decision, then that's the important thing.
What are STD's?
STDs are sexually transmitted diseases. Some of them are very difficult to spot because they don't have particularly many symptoms, for example Chlamydia. So what you need to do is, if you are having sex, and especially if you're having sex with lots of different partners, it's really important to get a regular check up in a family planning clinic, or a gynaecologist clinic at a local hospital.
When should I get STD tested?
If you know that you've had unsafe sex. If, for example, you've gone out and got a little bit drunk and had unprotected sex. It's not just about getting pregnant, it's about checking that you haven't caught anything, like an STD.
Losing Your Virginity
When should I start having sex?
In this country, 16 is the legal age. Below that if you have sex, it's against the law. If somebody is having sex with you or you are having sex with somebody younger than you, you can actually get into trouble with the law. Having said that, the important thing is, for both parties, that it feels right for both of you, and that nobody feels pressurized either to have sex or to have the kind of sex that is suggested.
I'm afraid to have sex for the first time What shall I do?
It's very common to have fears around something you have never done before, for example, a lot of young people ringing ChildLine and asked how to kiss. So what is important is that you talk about those fears maybe even with the person you are considering having sex with or that you get professional help and talk out what you're frightened of with either your GP. You can go to a family planning clinic or you could talk to a trusted older person, adult or an older sibling.
I'm being pressured into having sex but I'm not ready. Should I do it anyway?
If you're not ready, it's important that you don't feel pressurized. And that's the main thing, that you feel happy and ready to have sex. Maybe talk to your boyfriend about this, and if he really is interested in your well being then he shouldn't want you to have sex against your will. Boys and girls can feel pressurized to have sex. Often it will be because all their mates, girls and boys, are bragging about the amount of partners they've had, the amount of conquests they might put it. Don't believe the hype basically, not everything that people say is necessarily factual. And it's very important if you're a boy or a girl, that it's the right time for you. In fact, it doesn't mean you're less of a man, or less of a woman if you don't feel that it's right at the moment. It's actually showing that you're an individual and a free thinker.
All my friends have had sex and I haven't Is there something wrong with me?
There's nothing wrong with you and just because people say they're having sex doesn't mean necessarily they are having sex. But even if they were, if you're not ready to have sex or you haven't found the right person yet, then it is important that you wait until it does feel right.
Should I drink or take drugs before having sex for the first time?
Do I have to tell him or her I never had sex before?
You might choose to tell them that, but it very much your own judgement whether you tell them that or not.
I don't want my parents to talk about sex with me What should I do?
I think it is probably true a lot of parents are still very nervous about talking about sex with their children. What is important is that young people get correct and informative sex education. So as long as you have sex education in school or you go to respectable websites, for example, that have to a lot of information on sex. That is Ok, it does not have to be your parents, you might want to just drop in conversations, for example, that you have sex education, so they do not feel to have to talk to you about it.
In this country, 16 is the legal age. Below that if you have sex, it's against the law. If somebody is having sex with you or you are having sex with somebody younger than you, you can actually get into trouble with the law. Having said that, the important thing is, for both parties, that it feels right for both of you, and that nobody feels pressurized either to have sex or to have the kind of sex that is suggested.
I'm afraid to have sex for the first time What shall I do?
It's very common to have fears around something you have never done before, for example, a lot of young people ringing ChildLine and asked how to kiss. So what is important is that you talk about those fears maybe even with the person you are considering having sex with or that you get professional help and talk out what you're frightened of with either your GP. You can go to a family planning clinic or you could talk to a trusted older person, adult or an older sibling.
I'm being pressured into having sex but I'm not ready. Should I do it anyway?
If you're not ready, it's important that you don't feel pressurized. And that's the main thing, that you feel happy and ready to have sex. Maybe talk to your boyfriend about this, and if he really is interested in your well being then he shouldn't want you to have sex against your will. Boys and girls can feel pressurized to have sex. Often it will be because all their mates, girls and boys, are bragging about the amount of partners they've had, the amount of conquests they might put it. Don't believe the hype basically, not everything that people say is necessarily factual. And it's very important if you're a boy or a girl, that it's the right time for you. In fact, it doesn't mean you're less of a man, or less of a woman if you don't feel that it's right at the moment. It's actually showing that you're an individual and a free thinker.
All my friends have had sex and I haven't Is there something wrong with me?
There's nothing wrong with you and just because people say they're having sex doesn't mean necessarily they are having sex. But even if they were, if you're not ready to have sex or you haven't found the right person yet, then it is important that you wait until it does feel right.
Should I drink or take drugs before having sex for the first time?
Do I have to tell him or her I never had sex before?
You might choose to tell them that, but it very much your own judgement whether you tell them that or not.
I don't want my parents to talk about sex with me What should I do?
I think it is probably true a lot of parents are still very nervous about talking about sex with their children. What is important is that young people get correct and informative sex education. So as long as you have sex education in school or you go to respectable websites, for example, that have to a lot of information on sex. That is Ok, it does not have to be your parents, you might want to just drop in conversations, for example, that you have sex education, so they do not feel to have to talk to you about it.
How To Cope With Enlarged Prostate
A Medical condition referred to as Benign Prostatic Hyperplasia (aka. Enlarged Prostate), affects nearly 50% of the men in their sixties and nearly 90% in their seventies and eighties.The condition can make it extremely difficult and painfull for one to urinate. There are several steps you can take to minimize the pain.
Steps
1. Wear loose clothing so that the genital area is not too cramped.
2. Avoid drinking liquids close to bed time
3. Go to the washroom often and completely empty the bladder
4. Prostate massage may alleviate symptoms. Prostate massage is a healthy and pleasurable activity that you can learn with your partner.
5. You can put a stop to this harmful prostate problem from occurring by merely adjusting the things you do today in your life will make a huge difference tomorrow like changing your diet and exercising to deal with enlarged prostate.
Tips
* Visit your doctor and follow his/her advice
Steps
1. Wear loose clothing so that the genital area is not too cramped.
2. Avoid drinking liquids close to bed time
3. Go to the washroom often and completely empty the bladder
4. Prostate massage may alleviate symptoms. Prostate massage is a healthy and pleasurable activity that you can learn with your partner.
5. You can put a stop to this harmful prostate problem from occurring by merely adjusting the things you do today in your life will make a huge difference tomorrow like changing your diet and exercising to deal with enlarged prostate.
Tips
* Visit your doctor and follow his/her advice
Male Genitourinary Disorders
What is "cryptorchidism"?
Cryptorchidism is a term that we use to describe a condition known as an undescended testicle. When boys are born, about one percent of the time, one or both testicles won't be descended down into the sac. Many times, during the first six to eight months of life, the testicles would descend by themselves spontaneously as the child grows. But in certain individuals, this won't happen. The testicle will remain either in the abdomen or it will remain in the inguinal canal, which is the area where men get hernias. If that's the case, then a minor surgery needs to be performed to free up the testicle and place it in the scrotum to preserve fertility.
How is cryptorchidism treated?
Cryptorchidism is treated through two means. Number one is through injections of a hormone called HCG, which can help testicles descend. Or number two, through surgery, where a minor surgical procedure is performed to locate the testicle, free it up, and bring it down into its appropriate position inside the scrotum.
What is "hypospadias"?
Hypospadias is a condition where the penile meatus or the pee hole is not located at the tip of the penis, it's actually located some where on the underside of the glands, in the shaft or at the junction of the penis and scrotum.
How is hypospadias treated?
Hypospadias is treated with surgery. There are a variety of different techniques that have been developed to advance the hole, elongate the urethra, such that the tip of the urethra known as the meatus or the pee hole is positioned at the tip of the glans. Some of these surgeries are actually quite complex and need to be performed by doctors who specialize in these techniques. Usually it is a pediatric urologist and recontructive surgeons who are best able to perform some of these advanced types of surgeries.
What is "orchitis"?
Orchitis is a condition where the testicle is inflamed, and that can be secondary to an infection or another inflammatory condition, but certainly infection is the most common reason for an infection of the testicle.
How is orchitis treated?
Orchitis is treated by, number one, making the correct diagnosis, making sure the testicle is not torsed or twisted. A urine sample is preformed to make sure that there are no bacteria growing. Usually orchitis is treated with antibiotics, with anti-inflammatories such as ibuprofen, with bed rest, with elevation of the scrotum, and with ice.
What is "prostatitis"?
Prostatitis is a condition that describes inflammation of the prostate gland. The prostate gland, which is the gland that sits under the bladder in men, and actually encircles the urethra, can become infected with numerous types of bacteria or it can become inflamed, and when this happens, it can cause pain, discomfort when one urinates, burning on urination, difficulty urinating, low back pain, a feeling of pressure around the rectum and underneath the testicles, and this can happen in an acute or chronic form.
What are the symptoms of prostatitis?
The symptoms of acute prostatitis are fever, pain in the prostate, pain in the bladder, pain upon urination, pain in the testicle, pain in the low back, difficulties urinating.
How is prostatitis treated?
Prostatitis is treated usually by antibiotics and sometime with a technique known as prostate massage where the doctor pushes on the prostate gland to express fluid to drain the prostate.
Cryptorchidism is a term that we use to describe a condition known as an undescended testicle. When boys are born, about one percent of the time, one or both testicles won't be descended down into the sac. Many times, during the first six to eight months of life, the testicles would descend by themselves spontaneously as the child grows. But in certain individuals, this won't happen. The testicle will remain either in the abdomen or it will remain in the inguinal canal, which is the area where men get hernias. If that's the case, then a minor surgery needs to be performed to free up the testicle and place it in the scrotum to preserve fertility.
How is cryptorchidism treated?
Cryptorchidism is treated through two means. Number one is through injections of a hormone called HCG, which can help testicles descend. Or number two, through surgery, where a minor surgical procedure is performed to locate the testicle, free it up, and bring it down into its appropriate position inside the scrotum.
What is "hypospadias"?
Hypospadias is a condition where the penile meatus or the pee hole is not located at the tip of the penis, it's actually located some where on the underside of the glands, in the shaft or at the junction of the penis and scrotum.
How is hypospadias treated?
Hypospadias is treated with surgery. There are a variety of different techniques that have been developed to advance the hole, elongate the urethra, such that the tip of the urethra known as the meatus or the pee hole is positioned at the tip of the glans. Some of these surgeries are actually quite complex and need to be performed by doctors who specialize in these techniques. Usually it is a pediatric urologist and recontructive surgeons who are best able to perform some of these advanced types of surgeries.
What is "orchitis"?
Orchitis is a condition where the testicle is inflamed, and that can be secondary to an infection or another inflammatory condition, but certainly infection is the most common reason for an infection of the testicle.
How is orchitis treated?
Orchitis is treated by, number one, making the correct diagnosis, making sure the testicle is not torsed or twisted. A urine sample is preformed to make sure that there are no bacteria growing. Usually orchitis is treated with antibiotics, with anti-inflammatories such as ibuprofen, with bed rest, with elevation of the scrotum, and with ice.
What is "prostatitis"?
Prostatitis is a condition that describes inflammation of the prostate gland. The prostate gland, which is the gland that sits under the bladder in men, and actually encircles the urethra, can become infected with numerous types of bacteria or it can become inflamed, and when this happens, it can cause pain, discomfort when one urinates, burning on urination, difficulty urinating, low back pain, a feeling of pressure around the rectum and underneath the testicles, and this can happen in an acute or chronic form.
What are the symptoms of prostatitis?
The symptoms of acute prostatitis are fever, pain in the prostate, pain in the bladder, pain upon urination, pain in the testicle, pain in the low back, difficulties urinating.
How is prostatitis treated?
Prostatitis is treated usually by antibiotics and sometime with a technique known as prostate massage where the doctor pushes on the prostate gland to express fluid to drain the prostate.
Penis Enhancement
Are there medications and herbs one can take to increase penis size?
To be very clear about it there is really nothing that effectively increases penis size. All the ads on television and in the magazines that say if you take this herbal medication that it will add inches to your penis are all lies and bogus. If that was the case, I would be taking them. They don't work.
Are there "penis augmentation" surgeries that can increase penis size?
There are certain surgeries that can be done to try to lengthen the penis. Although there's nothing that can be done to actually lengthen the penis, these surgeries make the penis appear longer. These surgeries can have a verity of complications, and most men having these surgeries are not happy with the result.
To be very clear about it there is really nothing that effectively increases penis size. All the ads on television and in the magazines that say if you take this herbal medication that it will add inches to your penis are all lies and bogus. If that was the case, I would be taking them. They don't work.
Are there "penis augmentation" surgeries that can increase penis size?
There are certain surgeries that can be done to try to lengthen the penis. Although there's nothing that can be done to actually lengthen the penis, these surgeries make the penis appear longer. These surgeries can have a verity of complications, and most men having these surgeries are not happy with the result.
Curvature Of The Penis
What is "Peyronie's disease"?
Peyronie's disease is a disease described by François de la Peyronie, a French physician to the court of one of the French kings in the 17th century. And it's a condition to describe a curvature of the penis.
What causes Peyronie's disease?
Peyronie's disease is caused by one of two things. Either it's a congenital problem where someone is born with a curvature of the penis, or more specifically, it's a scar that forms in the aligning of the penis that causes the penis to bend toward the side of the scar. The penis is comprised of elastic cylinders, or actually, they're semi-elastic, where they'll grow to a certain point and then they'll become rigid. If there's a scar in one of these areas, then that area loses its elasticity, so that site can't grow, so it results in a curvature of the penis.It's almost like if you took one of those long children's water balloons and you were to fill it up, it would get longer and longer and longer, and then it would get to a certain point and then it would stop getting longer. If you were to put a piece of Scotch tape on one side, all of a sudden, when you fill it up, that side won't expand, so it's going to curve to the side where the scar, or in this scenario, the Scotch tape is.
What are the symptoms of Peyronie's disease?
The symptoms of Peyronie's disease are, number one, a man notices his penis has become curved and this can be disturbing to him for several reasons. Number one is he may not like the way it looks. Number two is it might cause him pain. Sometimes the scarring inside the lining of the penis can actually be painful. It may be painful to his partner during intercourse or it may be so deformed such that it might not be possible for him to achieve penetration.
How is Peyronie's disease treated?
Peyronie's disease is treated with a variety of different things: with either medical therapy, injection therapy, or with surgery. There are several prescription and non-prescription medications which can decrease the inflammation that occurs in the lining of the penis, although they're not very effective. Some doctors have advocated injecting shots of anti-inflammatories right into the area where the scar is in the penis. But these also have not been exceptionally effective, and actually injecting the needle into this lining can cause it to scar.The most effective treatment for Peyronie's disease is to perform a surgery where the plaque, or area of scarring, is actually incised and allowed to spring open, and then that is covered with a patch of either vein or some other substance.The other treatment for Peyronie's disease is a procedure where the opposite side of the curvature is actually ratcheted down with sutures to straighten the penis. But because men lose length with that procedure, most men who are undergoing surgical procedures want the procedure where the plaque is opened up, because that helps to preserve the length of the penis.
Peyronie's disease is a disease described by François de la Peyronie, a French physician to the court of one of the French kings in the 17th century. And it's a condition to describe a curvature of the penis.
What causes Peyronie's disease?
Peyronie's disease is caused by one of two things. Either it's a congenital problem where someone is born with a curvature of the penis, or more specifically, it's a scar that forms in the aligning of the penis that causes the penis to bend toward the side of the scar. The penis is comprised of elastic cylinders, or actually, they're semi-elastic, where they'll grow to a certain point and then they'll become rigid. If there's a scar in one of these areas, then that area loses its elasticity, so that site can't grow, so it results in a curvature of the penis.It's almost like if you took one of those long children's water balloons and you were to fill it up, it would get longer and longer and longer, and then it would get to a certain point and then it would stop getting longer. If you were to put a piece of Scotch tape on one side, all of a sudden, when you fill it up, that side won't expand, so it's going to curve to the side where the scar, or in this scenario, the Scotch tape is.
What are the symptoms of Peyronie's disease?
The symptoms of Peyronie's disease are, number one, a man notices his penis has become curved and this can be disturbing to him for several reasons. Number one is he may not like the way it looks. Number two is it might cause him pain. Sometimes the scarring inside the lining of the penis can actually be painful. It may be painful to his partner during intercourse or it may be so deformed such that it might not be possible for him to achieve penetration.
How is Peyronie's disease treated?
Peyronie's disease is treated with a variety of different things: with either medical therapy, injection therapy, or with surgery. There are several prescription and non-prescription medications which can decrease the inflammation that occurs in the lining of the penis, although they're not very effective. Some doctors have advocated injecting shots of anti-inflammatories right into the area where the scar is in the penis. But these also have not been exceptionally effective, and actually injecting the needle into this lining can cause it to scar.The most effective treatment for Peyronie's disease is to perform a surgery where the plaque, or area of scarring, is actually incised and allowed to spring open, and then that is covered with a patch of either vein or some other substance.The other treatment for Peyronie's disease is a procedure where the opposite side of the curvature is actually ratcheted down with sutures to straighten the penis. But because men lose length with that procedure, most men who are undergoing surgical procedures want the procedure where the plaque is opened up, because that helps to preserve the length of the penis.
Andropause Male Menopause
What is "andropause"?
Andropause is the name we give to what is commonly known as male menopause, or the male biological clock. As men get older, their level of testosterone decreases. Their level of sperm decreases. It probably reaches a peek in the teens and early twenties and then in the late twenties or early thirties, there is a gradual decline in the level of testosterone and testicular function. So as men experience this decrease in testosterone, they start undergoing some changes such as decreased desire, decreased drive, decreased lean body mass, decreased energy, decreased ability to focus, lack of mental concentration that go on with normal ageing.
Do all men experience andropause?
Andropause is experienced by different men to different degrees. I have met young men in their thirties who have a drop in their testosterone level as they've gotten older and I've seen men in their seventies and eighties who have absolutely no drop in their testosterone, they're vigorous, they're vital. Those are usually men who take very good care of themselves, who exercise regularly, who continue to work. So while all women experience menopause by the age of 45 to 50, not all men will experience andropause.
How is andropause treated?
Andropause is treated by replacing the male hormones that are now low. And that usually means giving testosterone supplementation. This can be done through a shot of testosterone on a monthly basis. It can be done through a patch that goes on the skin. It can be done through creams or jells that are applied to the hands. It's important for men to know that if they want to have children in the future, they can't take testosterone on a long term basis because it will lower their sperm counts. For those men, there are other ways of increasing testosterone. There are taking shots of the precursor to testosterone, HCG. And that causes the testicle to make more testosterone. There are also other ways of doing this using pills, although those are not really great for long term treatment of this problem.
What are symptoms of andropause?
The symptoms of andropause vary, but the most concerning to men is a symptom of descreased sex drive -- a low libido. It can also result in problems with erection. It can cause depression. It can be a lack of energy or a lack of a sense of well-being. Andropause can be lack of mental acuity or inability to focus at work or doing difficult tasks. So all these things can be due to low testosterone. It can also manifest as low lean muscle mass, or men can put on weight in the midsection and decrease their lean muscle mass in their upper body. This will happen as men go through andropause.
Andropause is the name we give to what is commonly known as male menopause, or the male biological clock. As men get older, their level of testosterone decreases. Their level of sperm decreases. It probably reaches a peek in the teens and early twenties and then in the late twenties or early thirties, there is a gradual decline in the level of testosterone and testicular function. So as men experience this decrease in testosterone, they start undergoing some changes such as decreased desire, decreased drive, decreased lean body mass, decreased energy, decreased ability to focus, lack of mental concentration that go on with normal ageing.
Do all men experience andropause?
Andropause is experienced by different men to different degrees. I have met young men in their thirties who have a drop in their testosterone level as they've gotten older and I've seen men in their seventies and eighties who have absolutely no drop in their testosterone, they're vigorous, they're vital. Those are usually men who take very good care of themselves, who exercise regularly, who continue to work. So while all women experience menopause by the age of 45 to 50, not all men will experience andropause.
How is andropause treated?
Andropause is treated by replacing the male hormones that are now low. And that usually means giving testosterone supplementation. This can be done through a shot of testosterone on a monthly basis. It can be done through a patch that goes on the skin. It can be done through creams or jells that are applied to the hands. It's important for men to know that if they want to have children in the future, they can't take testosterone on a long term basis because it will lower their sperm counts. For those men, there are other ways of increasing testosterone. There are taking shots of the precursor to testosterone, HCG. And that causes the testicle to make more testosterone. There are also other ways of doing this using pills, although those are not really great for long term treatment of this problem.
What are symptoms of andropause?
The symptoms of andropause vary, but the most concerning to men is a symptom of descreased sex drive -- a low libido. It can also result in problems with erection. It can cause depression. It can be a lack of energy or a lack of a sense of well-being. Andropause can be lack of mental acuity or inability to focus at work or doing difficult tasks. So all these things can be due to low testosterone. It can also manifest as low lean muscle mass, or men can put on weight in the midsection and decrease their lean muscle mass in their upper body. This will happen as men go through andropause.
Vasectomy
What is a "vasectomy"?
A vasectomy is a minor procedure performed on men desiring permanent sterilization, permanent contraception. They have made the decision that they no longer want to father a child. A small incision used to be made, but nowadays, it is done without an incision. It's done with a tiny little hole made in the skin of the scrotum right above the vas. The vas is grabbed in a little clamp and it's pulled up, a couple of titanium clips are placed on the ends of the vas and a small cut is made between them, the two ends are dumped back in, and the hole is so small that it seals up on its own. Men don't even need a stitch any more. It's all done under local anesthesia. It's just like going to the dentist and getting a tiny little shot in the skin with some Novocain. It's a very affective technique of permanent male contraception.
When should a man consider having a vasectomy?
A man should consider having a vasectomy as part of family planning discussing with his wife that they do not desire children and he doesn't want to wear condoms and she, for whatever reason, doesn't want to take the birth control pill or for health reasons can't take the birth control pill. A vasectomy is a much easier procedure than a tubal ligation, which is the female counterpart of vasectomy, blocking the woman's fallopian tubes. That's an interabdominal procedure that has to be done under general anesthesia, whereas a vasectomy is a quick office procedure. So when a man is sure that he no longer wants to have children, then a vasectomy is an appropriate procedure for him.
Are there any risks associated with vasectomies?
The risks to a vasectomy--any time you make a cut, poke anywhere on the body you can have pain, you can have bleeding, you can get an infection. Specifically, the risks to a vasectomy are it can fail. They are not 100% fool-proof. The ends of the Vas can grow back together. We've developed some techniques to prevent that from happening. It's possible that years and years and years down the line the vasectomy site grows back together. That happens maybe 1 in 200 times, so it's very, very low.
Why would a couple choose vasectomy over tubal ligation?
The reasons to choose vasectomy over tubal ligation are numerous. Number one, a vasectomy is a safer procedure for a man to undergo than a tubal ligation is for a woman to undergo. The vas is sitting in the scrotum outside of the body. It's just sitting right under the skin. So to perform a vasectomy the doctor just needs to make a tiny little poke hole in the skin to access the vas, which can be done under local procedure. It takes roughly about 10 to 15 minutes to perform a vasectomy and the man walks out of the office, rests for a few days and then goes back to life as usual. For a woman to have a tubal ligation, it is a procedure that is done with her asleep. So she has have general anesthesia and the risks of anesthesia. One has to enter the abdomen. It's usually done through laproscope these days. So several tiny holes are cut in the abdominal wall and through belly button surgery and video camera the fallopian tubes are accessed and they are blocked. This is usually more costly than a vasectomy because it is more intense.
Can a vasectomy be reversed?
Vasectomies can be very effectively reversed. In the hands of a trained micro-surgeon who has lots of experience, vasectomy reversal for men who still have sperm in the vas at the time of the reversal will have probably upwards of 90-95% -- and close to 98% in the top specialists – chance of having sperm come through the tubes again through a reversal. For men who have other blockages after they've had a vasectomy, and a little bypass procedure needs to be performed, it's about 60-70% chance that they'll have sperm coming through again.The overall chances of conceiving after having a vasectomy are upwards of 50%. So that's very good and it's really up from years ago, as the techniques and the skills of the surgeons have gotten better.
Do vasectomies sometimes fail to prevent pregnancy?
Vasectomies can fail to prevent pregnancy. It is very important for men, after they've had a vasectomy, to provide sperm samples until the sperm are absent from the ejaculation; Until they become asospermic. It can take awhile. Sperm live upstream in the vas from where the doctor makes the cut, and it can take six weeks to three months, sometimes longer, for all that sperm to get flushed out or die. If you were to do a vasectomy on someone and do a sperm count the next day, the sperm count would be completely normal. So it is important for men to realize that until they have gone back and done the appropriate follow up testing, they need to use contraception, otherwise the vasectomy will fail to prevent pregnancy.
A vasectomy is a minor procedure performed on men desiring permanent sterilization, permanent contraception. They have made the decision that they no longer want to father a child. A small incision used to be made, but nowadays, it is done without an incision. It's done with a tiny little hole made in the skin of the scrotum right above the vas. The vas is grabbed in a little clamp and it's pulled up, a couple of titanium clips are placed on the ends of the vas and a small cut is made between them, the two ends are dumped back in, and the hole is so small that it seals up on its own. Men don't even need a stitch any more. It's all done under local anesthesia. It's just like going to the dentist and getting a tiny little shot in the skin with some Novocain. It's a very affective technique of permanent male contraception.
When should a man consider having a vasectomy?
A man should consider having a vasectomy as part of family planning discussing with his wife that they do not desire children and he doesn't want to wear condoms and she, for whatever reason, doesn't want to take the birth control pill or for health reasons can't take the birth control pill. A vasectomy is a much easier procedure than a tubal ligation, which is the female counterpart of vasectomy, blocking the woman's fallopian tubes. That's an interabdominal procedure that has to be done under general anesthesia, whereas a vasectomy is a quick office procedure. So when a man is sure that he no longer wants to have children, then a vasectomy is an appropriate procedure for him.
Are there any risks associated with vasectomies?
The risks to a vasectomy--any time you make a cut, poke anywhere on the body you can have pain, you can have bleeding, you can get an infection. Specifically, the risks to a vasectomy are it can fail. They are not 100% fool-proof. The ends of the Vas can grow back together. We've developed some techniques to prevent that from happening. It's possible that years and years and years down the line the vasectomy site grows back together. That happens maybe 1 in 200 times, so it's very, very low.
Why would a couple choose vasectomy over tubal ligation?
The reasons to choose vasectomy over tubal ligation are numerous. Number one, a vasectomy is a safer procedure for a man to undergo than a tubal ligation is for a woman to undergo. The vas is sitting in the scrotum outside of the body. It's just sitting right under the skin. So to perform a vasectomy the doctor just needs to make a tiny little poke hole in the skin to access the vas, which can be done under local procedure. It takes roughly about 10 to 15 minutes to perform a vasectomy and the man walks out of the office, rests for a few days and then goes back to life as usual. For a woman to have a tubal ligation, it is a procedure that is done with her asleep. So she has have general anesthesia and the risks of anesthesia. One has to enter the abdomen. It's usually done through laproscope these days. So several tiny holes are cut in the abdominal wall and through belly button surgery and video camera the fallopian tubes are accessed and they are blocked. This is usually more costly than a vasectomy because it is more intense.
Can a vasectomy be reversed?
Vasectomies can be very effectively reversed. In the hands of a trained micro-surgeon who has lots of experience, vasectomy reversal for men who still have sperm in the vas at the time of the reversal will have probably upwards of 90-95% -- and close to 98% in the top specialists – chance of having sperm come through the tubes again through a reversal. For men who have other blockages after they've had a vasectomy, and a little bypass procedure needs to be performed, it's about 60-70% chance that they'll have sperm coming through again.The overall chances of conceiving after having a vasectomy are upwards of 50%. So that's very good and it's really up from years ago, as the techniques and the skills of the surgeons have gotten better.
Do vasectomies sometimes fail to prevent pregnancy?
Vasectomies can fail to prevent pregnancy. It is very important for men, after they've had a vasectomy, to provide sperm samples until the sperm are absent from the ejaculation; Until they become asospermic. It can take awhile. Sperm live upstream in the vas from where the doctor makes the cut, and it can take six weeks to three months, sometimes longer, for all that sperm to get flushed out or die. If you were to do a vasectomy on someone and do a sperm count the next day, the sperm count would be completely normal. So it is important for men to realize that until they have gone back and done the appropriate follow up testing, they need to use contraception, otherwise the vasectomy will fail to prevent pregnancy.
Stress And Male Fertility
Is male fertility affected by stress?
I believe male infertility can be impacted by stress. We see that sperm counts can fluctuate over time, and fluctuate with the environment the man is in, with what he ingests, with the condition of his sleep cycle, so certainly stress can affect sperm production in some way. What it is not is consistent among different men, because different men handle stressors differently, and their bodies handle sperm production differently.
Does stress actually reduce sperm counts?
Depends on what the actual stress is as to whether it reduces sperm count. Is there only the stress of an infection, or the stress of surgery, or is the body mounting it's resources to try to heal some other area or to fight off an infection? If it is any of those things, the body will not be paying its greatest attention to making sperm at that point. This is part of the fight or fight response, where the body, smart enough to know when it is in danger, needs to go into protective mode. So all non-essential functions are reduced in their efficiency. I think that can happen with sperm production as well.
What are the emotional consequences associated with infertility and impotence?
There are a variety of emotional responses that men can have to either being diagnosed as infertile or being impotent or having inability to perform when needed. Those go from anywhere of denial to feelings of low self worth to feelings of not being what we consider a man. Or not being able to satisfy or please his partner or not being able to give his partner a child. It can lead to depression; it can lead to problems with relationships, a strain on a marriage, a strain on a sexual relationship. So, all these things really affect a man's sense of well-being, a man's sense of worth, the happiness of a relationship, they can have profound effects. But the good thing about this is that many of these problems are easily treated and men don't have to suffer silently with any of these conditions.
I believe male infertility can be impacted by stress. We see that sperm counts can fluctuate over time, and fluctuate with the environment the man is in, with what he ingests, with the condition of his sleep cycle, so certainly stress can affect sperm production in some way. What it is not is consistent among different men, because different men handle stressors differently, and their bodies handle sperm production differently.
Does stress actually reduce sperm counts?
Depends on what the actual stress is as to whether it reduces sperm count. Is there only the stress of an infection, or the stress of surgery, or is the body mounting it's resources to try to heal some other area or to fight off an infection? If it is any of those things, the body will not be paying its greatest attention to making sperm at that point. This is part of the fight or fight response, where the body, smart enough to know when it is in danger, needs to go into protective mode. So all non-essential functions are reduced in their efficiency. I think that can happen with sperm production as well.
What are the emotional consequences associated with infertility and impotence?
There are a variety of emotional responses that men can have to either being diagnosed as infertile or being impotent or having inability to perform when needed. Those go from anywhere of denial to feelings of low self worth to feelings of not being what we consider a man. Or not being able to satisfy or please his partner or not being able to give his partner a child. It can lead to depression; it can lead to problems with relationships, a strain on a marriage, a strain on a sexual relationship. So, all these things really affect a man's sense of well-being, a man's sense of worth, the happiness of a relationship, they can have profound effects. But the good thing about this is that many of these problems are easily treated and men don't have to suffer silently with any of these conditions.
Male Fertility Therapies
What therapies are available to improve male fertility?
There are a variety of different things that someone can do to improve their fertility, but before you start with improving your fertility we need to test fertility by doing several semen analyses, and if those are abnormal there are a variety of other tests that could or should be done to try to diagnose the problem. So, number one diagnosis, number two treatment for the specific problem, and number three general therapy, which includes modification of lifestyle: staying out of hot tubs and jacuzzis, it means eating healthy, it means taking certain supplements that can help improve the sperm, so it's a variety of different things. It means stopping smoking, it means limiting alcohol intake; all these things are potentially bad for sperm.
What is "assisted reproduction"?
Assisted reproduction is any technique or technology that we use short of natural conception, and it includes intrauterine insemination or sperm washing or IUI, or the turkey baster as it's commonly known. Other assisted reproductive technologies include in vitro fertilization, which means the fertilization is not done in the woman's body, it's done in the lab in a Petri dish.
What is "electroejaculation"?
Electroejaculation is a technique that's used to treat men with a condition called anejaculation, where they're unable to have an orgasm and an ejaculation. This is usually due to a few different types of conditions. Number one, it could be due to a spinal cord injury, where a man had, his spinal cord is severed so the signal from the brain to get to the testicles and the penis to tell them to ejaculate does not go through. It, it's also seen in some men with diabetes, or men who've had different types of surgery and, and the retroperineum, the area behind the abdomen, where the nerves that control ejaculation are, some surgeries can damage those nerves. So in men who can't ejaculate, what happens is, there is a device that is an electrostimulator that is applied to the back of the prostate and by passing current to those muscles it actually causees those muscles to contract in an ejaculation to ensue.
What is "sperm retrieval"?
Sperm retrieval describes a series of techniques used to obtain sperm from the testicle in men who are azoaspermic, or don't have sperm in the ejaculate.
What is "sperm washing"?
Sperm washing is a technique that we use in the laboratory, where a man provides a semen sample and we go ahead and let that liquefy because semen comes out as a gel like substance and over a half an hour to 45 minutes, enzymes that are derived from the prostate, actually cause that gel to liquefy. We let the sperm swim out and we're able to separate the moving sperm from the non moving sperm. We then put it in a centrifuge. To do that we decant off the dead sperm, we take the live moving sperm and we suspend it in a very small amount, a half a cc or a half a milliliter of culture media that supports the sperm with nutritional fluids. That half a cc is then loaded up into a little catheter and is placed inside a womans uterus.
What is "Intracytoplasmic sperm injection"?
Intracytoplasmic sperm injection or ICSI as it is known, is a technique of advanced reproductive technology, and it's a technique of in vitro fertilization. The sperm are taken into the lab, the eggs are retrieved from a woman's ovaries after she goes to a series of fertility treatments, and under a microscope a single sperm is picked up in a very, very tiny needle and is then directly injected directly into the cytoplasm inside of the egg, allowing it to fertilize.
What types of drugs are used to treat male infertility?
Most of the drugs are hormonal based therapies. Meaning if a man has a hormone problem those hormones can be supplemented or replaced to try and improve their sperm counts and the quality of their sperm. In some men we try a medicine called clomid which women frequently use for fertility problems and sometimes that helps improve the numbers of sperm they produce many times it does not. There are a variety of other medications that can be used but they are also situational specific if a man has a prostate infection or a urinary tract infection that can be causing damage to the sperm then treating that person with the appropriate antibiotics can help.
What surgeries are performed to treat male infertility?
There are a variety of different surgeries designed to treat male infertility, but they're based on, and broken down into, three different categories. Number one is the treatment of varicocele or varicose veins around the testicle, and there are several different procedures to block those veins; to block the abnormal blood flow and stop damage to the testicle, so that the testicle can make sperm that are in bigger quantities. The other type of surgery that is done for male infertility is microsurgery to relieve a blockage in either a man who has had a vasectomy and wants it reversed, or in someone who has a blockage either in their epididymis, or in their vas, from either an infection or other types of surgery. The last types of surgery that we do to treat male infertility are sperm retrieval techniques for men who have a condition called azoospermia, where we're able to go into the testicle or the epididymis and get the sperm directly out from there by doing a small, outpatient, microsurgical procedure. Those sperm are then used in combination with in vitro fertilisation and ICSI, where we take the sperm, and then we inject the sperm directly into an egg.
There are a variety of different things that someone can do to improve their fertility, but before you start with improving your fertility we need to test fertility by doing several semen analyses, and if those are abnormal there are a variety of other tests that could or should be done to try to diagnose the problem. So, number one diagnosis, number two treatment for the specific problem, and number three general therapy, which includes modification of lifestyle: staying out of hot tubs and jacuzzis, it means eating healthy, it means taking certain supplements that can help improve the sperm, so it's a variety of different things. It means stopping smoking, it means limiting alcohol intake; all these things are potentially bad for sperm.
What is "assisted reproduction"?
Assisted reproduction is any technique or technology that we use short of natural conception, and it includes intrauterine insemination or sperm washing or IUI, or the turkey baster as it's commonly known. Other assisted reproductive technologies include in vitro fertilization, which means the fertilization is not done in the woman's body, it's done in the lab in a Petri dish.
What is "electroejaculation"?
Electroejaculation is a technique that's used to treat men with a condition called anejaculation, where they're unable to have an orgasm and an ejaculation. This is usually due to a few different types of conditions. Number one, it could be due to a spinal cord injury, where a man had, his spinal cord is severed so the signal from the brain to get to the testicles and the penis to tell them to ejaculate does not go through. It, it's also seen in some men with diabetes, or men who've had different types of surgery and, and the retroperineum, the area behind the abdomen, where the nerves that control ejaculation are, some surgeries can damage those nerves. So in men who can't ejaculate, what happens is, there is a device that is an electrostimulator that is applied to the back of the prostate and by passing current to those muscles it actually causees those muscles to contract in an ejaculation to ensue.
What is "sperm retrieval"?
Sperm retrieval describes a series of techniques used to obtain sperm from the testicle in men who are azoaspermic, or don't have sperm in the ejaculate.
What is "sperm washing"?
Sperm washing is a technique that we use in the laboratory, where a man provides a semen sample and we go ahead and let that liquefy because semen comes out as a gel like substance and over a half an hour to 45 minutes, enzymes that are derived from the prostate, actually cause that gel to liquefy. We let the sperm swim out and we're able to separate the moving sperm from the non moving sperm. We then put it in a centrifuge. To do that we decant off the dead sperm, we take the live moving sperm and we suspend it in a very small amount, a half a cc or a half a milliliter of culture media that supports the sperm with nutritional fluids. That half a cc is then loaded up into a little catheter and is placed inside a womans uterus.
What is "Intracytoplasmic sperm injection"?
Intracytoplasmic sperm injection or ICSI as it is known, is a technique of advanced reproductive technology, and it's a technique of in vitro fertilization. The sperm are taken into the lab, the eggs are retrieved from a woman's ovaries after she goes to a series of fertility treatments, and under a microscope a single sperm is picked up in a very, very tiny needle and is then directly injected directly into the cytoplasm inside of the egg, allowing it to fertilize.
What types of drugs are used to treat male infertility?
Most of the drugs are hormonal based therapies. Meaning if a man has a hormone problem those hormones can be supplemented or replaced to try and improve their sperm counts and the quality of their sperm. In some men we try a medicine called clomid which women frequently use for fertility problems and sometimes that helps improve the numbers of sperm they produce many times it does not. There are a variety of other medications that can be used but they are also situational specific if a man has a prostate infection or a urinary tract infection that can be causing damage to the sperm then treating that person with the appropriate antibiotics can help.
What surgeries are performed to treat male infertility?
There are a variety of different surgeries designed to treat male infertility, but they're based on, and broken down into, three different categories. Number one is the treatment of varicocele or varicose veins around the testicle, and there are several different procedures to block those veins; to block the abnormal blood flow and stop damage to the testicle, so that the testicle can make sperm that are in bigger quantities. The other type of surgery that is done for male infertility is microsurgery to relieve a blockage in either a man who has had a vasectomy and wants it reversed, or in someone who has a blockage either in their epididymis, or in their vas, from either an infection or other types of surgery. The last types of surgery that we do to treat male infertility are sperm retrieval techniques for men who have a condition called azoospermia, where we're able to go into the testicle or the epididymis and get the sperm directly out from there by doing a small, outpatient, microsurgical procedure. Those sperm are then used in combination with in vitro fertilisation and ICSI, where we take the sperm, and then we inject the sperm directly into an egg.
Andrology Basics
What is "andrology"?
Andrology literally is the study of man and it encompasses several different things. Mostly it encompasses male sexual health and then it encompasses male fertility. It also can encompass male aging because as men get older, they can have a drop in hormone function and andrology would deal with anything that has to do with male hormones as well.
What are the main areas of andrological medicine?
The main areas of andrological medicine, if broken it down into several branches, are many. One is sexual medicine, dealing with problems such as erectile dysfunction, or EDS as it is popularly called, premature ejaculation, and difficulties with orgasm. Another area of andrological medicine is more endocrinologic, dealing with male hormones and aging because as men get older, they have hormonal changes, not exactly like women do but somewhat similar and many men experience symptoms as they get older. So andrology deals with the aging male and also encompasses fertility. Any time a man has issues with sperm count or things aren't working in terms of a woman falling pregnant, conception, as quick as they should, then andrology covers that as well.
What is "male infertility"?
The definition of infertility is a couple who have been trying to conceive for a year and has not met with success. Male infertility relates to any problem on the male side of things which includes anything that has to do with sperm numbers or function, anything that has to do with male hormones as it applies to testicular function. What's interesting about male infertility and what's really not known by many people is that the male contributes almost 40 to 50 percent of the cases of infertility. When you look at a break down of contributing factors to infertility, the male is there almost 40 percent of the time as a problem. Almost everybody thinks that fertility is a female issue and that's really not true.
What is "contraception"?
Contraception is birth control. So it is essentially being able to have intercourse without initiating a pregnancy.
What are "genitourinary disorders"?
Genitourinary disorders are a group of disorders that are covered by the field of urology. It is basically any disorder from the adrenal glands on down. The adrenal glands sit on top of the kidneys and they produce certain types of hormones. The kidneys obviously make urine and also produce hormones. The ureters take the urine from the kidney and drain it into the bladder, which is a storage site for urine. Then, in the female, you have the urethra and the vagina, and in the male, there is the prostate, the penis and the testicles. So the field of urology encompasses all those organs.
Andrology literally is the study of man and it encompasses several different things. Mostly it encompasses male sexual health and then it encompasses male fertility. It also can encompass male aging because as men get older, they can have a drop in hormone function and andrology would deal with anything that has to do with male hormones as well.
What are the main areas of andrological medicine?
The main areas of andrological medicine, if broken it down into several branches, are many. One is sexual medicine, dealing with problems such as erectile dysfunction, or EDS as it is popularly called, premature ejaculation, and difficulties with orgasm. Another area of andrological medicine is more endocrinologic, dealing with male hormones and aging because as men get older, they have hormonal changes, not exactly like women do but somewhat similar and many men experience symptoms as they get older. So andrology deals with the aging male and also encompasses fertility. Any time a man has issues with sperm count or things aren't working in terms of a woman falling pregnant, conception, as quick as they should, then andrology covers that as well.
What is "male infertility"?
The definition of infertility is a couple who have been trying to conceive for a year and has not met with success. Male infertility relates to any problem on the male side of things which includes anything that has to do with sperm numbers or function, anything that has to do with male hormones as it applies to testicular function. What's interesting about male infertility and what's really not known by many people is that the male contributes almost 40 to 50 percent of the cases of infertility. When you look at a break down of contributing factors to infertility, the male is there almost 40 percent of the time as a problem. Almost everybody thinks that fertility is a female issue and that's really not true.
What is "contraception"?
Contraception is birth control. So it is essentially being able to have intercourse without initiating a pregnancy.
What are "genitourinary disorders"?
Genitourinary disorders are a group of disorders that are covered by the field of urology. It is basically any disorder from the adrenal glands on down. The adrenal glands sit on top of the kidneys and they produce certain types of hormones. The kidneys obviously make urine and also produce hormones. The ureters take the urine from the kidney and drain it into the bladder, which is a storage site for urine. Then, in the female, you have the urethra and the vagina, and in the male, there is the prostate, the penis and the testicles. So the field of urology encompasses all those organs.
Common Male Sexual Problems
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.
How can premature ejaculation be treated?
There are several techniques to treat premature ejaculation. For some men it's decreasing the sensativity, so it's, perhaps, wearing a condom may delay ejaculation. For other men it's using a numbing jelly like lidocaine cream that can decrease sensation of the glans and prolong ejaculation. For other men it's using what's called the sqeeze technique, when they feel like they're about to ejaculate, they pull out and they squeeze and that can delay ejaculation. But, right now, the main stay of premature ejaculation therapy is really using medications. There are a number of medications that belong to the class of drugs known as anti-depressants that can delay or retard ejaculation and thereby it may actually prolong or double the time that someone who ejaculates prematurely can maintain an erection for intercourse.
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.
How is retrograde ejaculation treated?
There are several different ways of treating retrograde ejaculation. One is to have the man urinate the sperm out of the bladder. And then the sperm are washed. They're taken out of the urine. The urine is alkalinized by having the man take something like Alka Seltzer or bicarbonate prior, because very acidic urine will kill the sperm. And once those sperm are washed, they can be used for insemination. Certain drugs can be used to help close that sphincter. Certainly in men who have diabetes, and some men who have spinal cord injuries, we use a medication like Sudafed, and that causes those muscles to contract, closing the sphincter. In severe cases of retrograde ejaculation where sperm of good quality can't be obtained through these other means, we can go into the testicle, take the sperm out, and use those sperm with in vitro fertilization.
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.
How is anorgasmia treated?
Anorgasmia is usually treated with psychological counseling or sex therapy.
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. 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. 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.
How is low libido treated?
Low libido is treated in a variety of different ways. Number one is to assess a man's hormone levels, hormonal status and check his testosterone level and his free testosterone level--which is the part of the testosterone that we call bio-available that's seen by the actual cells in the body. These are two different measurements. If a man has low testosterone then there are a variety of different ways of supplementing testosterone to raise his back to the normal level which should increase his desire and sex drive. For men who have unhealthy lifestyles. . . smoke too much, who are obese, clearly making lifestyle changes, changing their their bad habits can help affect a man's libido. Certainly, we know that when men start working out their testosterone levels increase, their level of estrogen decreases and that can give them a sense of well-being, a sense of better body image and also a sense of sexual desire and increased drive.
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