MALE PRIME FERTILE YEARS
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In these videos Sally will give you an introduction to the blog about aging male prime fertile years
Did you know …
- Fertility is classified as the ability to conceive a healthy pregnancy within 6 to 12 months while having unprotected sex
- Peak male fertility is around 25-35 years old.
- Sperm quality begins to decline at 30.
- At 45, men begin to experience a significant decrease in semen volume.
- Older men can also take longer to conceive
- Infertility is often considered a “women’s issue.”
- But when it comes to having a baby, sperm is 50% of the equation
- And people who produce sperm are just as likely to experience fertility challenges as people who produce eggs.
- Approximately 1 in 8 heterosexual couples face infertility,
- Of which approx. 33% of these cases are due to the male partner’s inability to create and ejaculate healthy sperm.
- Known as “male factor infertility.”
- Fertility experts estimate that:
– 33% of cases are due to female factor infertility, such as polycystic ovary syndrome, endometriosis, or diminished ovarian reserve
– 33% of cases are a result of male factor infertility, such as low sperm count
– The final 33% are due to a combination of subfertility factors from both partners, or are unexplained
- To put those figures into context, about 15% of couples are unable to conceive after 1 year of having unprotected sex. After 2 years, 10% still can’t conceive
- Several recent studies have indicated that average sperm count and quality has declined significantly — up to 50% — in the Western world
- One study looked at over 42,000 semen analyses performed between 1973 and 2011. They found that sperm count had declined, on average, 1.4% per year, with a total decline of 52.4% in just 38 years.
- Additional studies of sperm count, motility, and fertility outcomes support the idea that something is affecting male fertility on a population level.
- Most men who experience infertility don’t have a problem having sex or ejaculating
- But sperm quality declines measurably with age
– Sperm motility at 55 is less half what it was at 30
– Couples in which the male partner is over 35 are 52% less likely to get pregnant, compared to couples with younger male partners.
– The genetic health of sperm declines with age, too
– Damaged (fragmented) DNA was 33% higher in men over 50, compared to men under 30
– DNA fragmentation can contribute to infertility, miscarriage, and adverse health outcomes for the child
- Sperm freezing is an option for men and sperm-producing individuals who want to have kids someday, but not just yet.
Prime Time Ages for Men
- Prime time for what must be the question?
- Is it all about sex drive and testosterone, or
- Feeling fulfilled with the things you bring to the table, or
- The legacy you’re leaving, or
- Your kids, loved ones, and employees.
Everything has its ‘time’
- Sex drive and physical prowess, size matters – the 20s
- Wealth, health, and family, whether or not you’ll have sex again – the 30s and 40s
- Whether you can keep it up like you used to – the 50+’s
Men in Their 20s are Sexual Prime
- For many this age is all about how to take a good dick pic.
- Testosterone levels are typically at their highest late teens and early 20s.
- That means
– Quick response to sexual arousal
– Healthy appetite for all things sexual
– Physically fit and high metabolism
- BUT there’s a lot of learning and maturing to do
– Sex is more than an erection.
- Sexually attracted to women and other men in their 20s
Men in Their 30s are Comfortably Prime
- By many metrics, men in their 30s have it all together, such as
– A good career or a job they love
– A spouse and kids or a circle of great friends
– Mental and physical abilities to handle their partners’ needs, as well as their own
– Physical endurance for long sensual and sexual nights
– Knowledge of how to be a well-groomed man
– Know who they are, what they want.
– Focused, grounded, yet still willing to explore life’s great unknowns
– Sexually attracted to women or men in their mid-20s to 40’s
Men in Their 40s are Financially Prime
- For some body mass starts to take a different turn
- Metabolism slows down turning six-packs into keg barrels – the famous dad bod
- For others it’s the continuation of the 30s.
- Many men have solidified their careers
- Family guys are enjoying watching their kiddos growing up..
- Men between 45 and 64 are also earning the most money they’ll make during their working years.
- Sexually attracted to women or men in 30’s to 40’s.
Men in Their 50s are at their Peaceful Prime
- Kids are grown and more independent
- Still have sex drives, and sex may even be better
- Probably sexually attracted to younger men and women
Men in Their 60s are at Their Prime
- The Golden Years begins.
- This age is a happy prime in which the worries that occurred earlier in life are no longer relevant.
- Sexually attracted to women of a similar age
Men in Their 70s Are Enjoying The Prime Of Their Senior Years
- Enjoying their senior years in the comfort of knowing they did everything they could to create a happy, healthy family to follow behind them.
- Probably more friendships, loving, caring than sexual.
Age and Male Fertility
- The impact of age on male fertility hasn’t received the same focus as its impact on female fertility
- Age can significantly affect sperm quality
- 25 – 29 years of age – Peak male fertility
- 30 years of age – Sperm quality begins to decline.
- 36 – 37 years of age – Damage to sperm DNA begins to increase and risk for genetic disease increases slightly
- 45+ years of age – Significant decrease in semen volume
- Older men – Can also take longer to conceive a child and an increase in the risk for genetic disease in offspring, such as Down syndrome.
- As men age:
– Testosterone production begins to decline, impacting sexual function and sperm quality.
– Sperm motility, or movement, is impacted making it more difficult for sperm to reach a woman’s egg.
– Increase in abnormal sperm morphology, which can affect sperm’s ability to fertilize an egg.
Causes of Male Factor Infertility
Most of the time, it’s multifactorial.
- Effects the quality of the sperm, including
- Fertility starts to decline for men in late 40s
- One study suggested that conceiving during a 12-month period was 30% less likely for men who were over the age of 40 compared to men who were under 30 years old
- Another study of intrauterine artificial insemination found that after six cycles, men who were 35 or under had a fertility rate of 52%, whereas men over the age of 35 had a fertility rate of 25%
- Other fertility-related issues that may arise as men get older include:
– genetic abnormalities of the sperm
– erectile dysfunction
– changes in the reproductive organs and tissues.
– shifts in health, such as high blood pressure.
- Low sperm count – too few sperm in the semen
- Low sperm motility – too few moving, “swimming” sperm
- Poor sperm morphology – too many abnormally shaped sperm
- High sperm DNA fragmentation – too many sperm that carry damaged DNA
- A combination of the above abnormal semen parameters, which often occur together
- Read more in the article Sperm Disorders in this blog
- Swollen veins in the scrotum that can harm sperm growth
- The semen goes back into the body instead of out of it
- Antibodies that attack the sperm
- A blockage somewhere where the sperm travel
- Otherwise known as low sex drive, describes a person’s desire to have sex.
- Foods or supplements that claim to increase libido are called aphrodisiacs.
- Also known as impotence, ED is when a man is unable to develop or maintain an erection
- Low levels of testosterone, the male sex hormone, may be responsible for infertility in some men
- Due to poor growth of sperm and low libido
- Certain medication can impact the growth, function and delivery of sperm, such as:
– Prostate medication
Symptoms that may indicate Male-Factor Infertility
Often, there aren’t any symptoms – aside from the inability to conceive after a year of unprotected intercourse.
Erectile dysfunction (ED)
- Most infertile people don’t have any problems with sexual function, and most people with ED are fertile.
- However, ED is more common in men with infertility.
- This may be due to an underlying hormone imbalance, such as low testosterone levels.
Low testosterone levels
- Also known as hypogonadism, low T can manifest in weight gain, difficulty getting or maintaining an erection, and tiredness.
- The process of making sperm doesn’t require high testosterone levels, so many people with low T are still fertile.
- However, low testosterone may be a result of an overall hormonal imbalance that also affects fertility.
- Look out for symptoms like
– low sex drive
– getting and/or maintaining an erection
– man boobs
Dry orgasm or low semen volume
- If someone isn’t producing much semen — or any semen at all — when they orgasm, that could indicate a blockage or issue with ejaculation.
Tests for Male Fertility
- Physical exam
- Review of medical history, such as
– childhood illnesses
– medications taken currently and in the past
– previous surgeries
– prior exposure to radiation, pesticides or heavy metals
– lifestyle, including use of alcohol and drugs.
- Semen Analysis to determine
– sperm volume
– sperm count
– sperm shape
– sperm movement
- Hormone Blood Test including:
– Free and total testosterone
- General blood test
– ruling out other major health issues.
- Scrotal Ultrasound
– To check for any structural issues.
– Placing a probe in the rectum, which then sends soundwaves to the ejaculatory ducts nearby.
– Reveals any blockages or malformations in the seminal vesicles or ejaculatory duct.
- Semen analysis can provide a decent snapshot of sperm health.
- The test examines semen parameters under a microscope to determine
– Quantity – the number of sperm
– Motility – how they’re swimming
– Morphology – whether they’re the right shape and size
- A semen analysis isn’t stamped “fertile” or “infertile”
- Fertility is diagnosed based on a couple’s inability to get pregnant
- Plenty of couples can conceive a child naturally, even with sperm that has one or more poor semen parameters.
- However, this analysis can alert a person to issues with their sperm production that may affect their ability to conceive, such as low sperm count.
- A measure of the number of spermatozoa per ejaculation or per measured amount of semen,
- Used as an indication of a man’s fertility
- Normal sperm densities range from 15 million to greater than 200 million sperm per ml of semen.
- You are considered to have a low sperm count if you have fewer than 15 million sperm per ml or less than 39 million sperm total per ejaculate
- Fertility is most likely if the semen discharged in a single ejaculation (ejaculate) contains at least 15 million sperm per ml.
- Low sperm count – too few sperm in the semen
- Low sperm motility – too few moving, “swimming” sperm
- Poor sperm morphology – too many abnormally shaped sperm
- High sperm DNA fragmentation – too many sperm that carry damaged DNA
- A combination of the above abnormal semen parameters, which often occur together
The underlying cause(s) may be linked to:
- Hormonal imbalances
- Genetic factors
- Advanced age – after 40
- Lifestyle factors such as:
– Poor diets high in sugar and trans fats/seed and plant oils
– Sedentary lifestyle
– Lack of sleep
- Exposure to chemicals that damage fertility, such as pesticides or chemotherapy
- Exposure to EDC’s endocrine-disrupting chemicals, chemicals that disrupt the hormone, system:
– EDCs are commonly found in plastics, like the plastic in water bottles and food packaging, as well as pesticides and chemicals used in manufacturing.
– Job exposure to EDCs
– Exposure through eating food or drinking from plastic containers.
Sperm Quality and Daily Habits
- The testes constantly make sperm— about 1,500 sperm per heartbeat – through a process that takes about 72 days.
- Sperm quality is reflective of the past 2 to 3 months of someone’s health and habits.
- Everything that affects a person’s overall body function will also affect their sperm.
Regular Aerobic Exercise
– One study found an improvement was seen after just 12 weeks of moderate-intensity cardiovascular exercise, 3 to 4 times per week.
- The American Society for Reproductive Medicine (ASRM) estimates that infertility rates are about twice as high in smokers, (male or female) compared to non-smokers.
- Smoking is associated with decreased sperm count, motility, morphology, and genetic health.
- Physicians and researchers are also examining the impact of smoking cannabis on male infertility, and suggest staying away from it while trying to conceive.
- A diet rich in vitamins, minerals, and antioxidants has been associated with better male fertility.
- Eating trans-fat, seed oils, processed meats, and added sugars has been associated with lower numbers of moving sperm.
- Men who sleep less than 7 hours per night on average, or those who have interrupted or low-quality sleep, are at a higher risk of sperm health issues.
Options for Male Infertility
In addition to sperm freezing, there are several fertility technologies that can help people and couples diagnosed with male-factor infertility.
- To improve sperm production, hormone imbalances, testosterone levels or infections and to address retrograde ejaculation.
- Such as correcting varicoceles, or removing blockages
- Frozen sperm from a donor
Intrauterine insemination (IUI)
- In this process, the semen is washed to isolate the sperm, then inserted directly into the uterus to give it a “kickstart.”
- IUI is done on the day the female is ovulating, to maximize chances of fertilization.
- IUI can help people with moderately low sperm count or motility and requires 10 million motile sperm.
In vitro fertilization (IVF) with intracytoplasmic sperm injection – ICSI
- IVF is a process in which eggs are removed from the ovaries and fertilized with sperm in a lab.
- ICSI is an IVF technique in which a single sperm is injected directly into an egg, improving chances of fertilization even in cases of severe male-factor infertility or very low count.
Testicular sperm extraction
- Some patients produce sperm, but the sperm can’t get to the ejaculate
- Maybe because the sperm count is too low
- Maybe there’s a problem with the vas deferens, the duct that transports sperm out of the testes.
- A testicular sperm extraction is a procedure in which sperm are retrieved directly from the testicular tissue; these sperm can then be used in IVF with ICS.
Boosting Male Fertility
- Fertility refers to the ability to reproduce without medical assistance
- Infertility affects about 1 in 6 couples, and researchers estimate about 1 in 3 is due to fertility problems in the male
- Male fertility usually depends on the quality of sperm cells, sometimes is linked to sexual function, and other times it could be linked to semen quality
- While infertility is not always treatable, there are some things you can do to boost fertility
Lose excess weight
- Carrying extra weight is associated with infertility.
- Smoking impairs blood flow
- Smoking decreases sperm quality with lower numbers of sperm and sperm’s ability to move and increased numbers of abnormally shaped sperm
Limit your alcohol intake
- Heavy alcohol consumption, as it may reduce testosterone levels and impair semen quality
- Heavy alcohol consumption hinders sexual performance.
- Is vital to maintaining your health.
- Restricted or excessive sleep has also been linked to poor semen quality
- Soy is rich in isoflavones, which are associated with lower semen quality
- Maybe due to the Estrogen-like effects
- Can boost testosterone levels and improve fertility.
- However too much exercise may have the opposite effect and potentially reduce testosterone levels.
Relax and minimize stress
- It’s hard to get in the mood when you’re feeling stressed
- Stress may reduce your sexual satisfaction and impair your fertility
- Prolonged stress raises levels of cortisol, which has strong negative effects on testosterone.
- When cortisol goes up, testosterone levels tend to go down
- Stress management can be as simple as taking a walk in nature, meditating, exercising, or spending time with friends
- Severe stress and anxiety may need medication.
Supplements for Male Fertility
D-aspartic acid / D-AA
- A form of aspartic acid
- Not be confused with L-aspartic acid, which is far more common than D-AA.
- D-AA is mainly present in certain glands, such as the testicles, as well as in semen and sperm cells.
- Researchers believe that D-AA is implicated in male fertility.
- In fact, D-AA levels are significantly lower in infertile men than fertile men
- Studies show that D-AA supplements may increase levels of testosterone
- Some evidence suggests that coenzyme Q10 improves semen quality
- 100mg daily
- Some evidence indicates that taking antioxidant supplements, such as vitamin C, may improve fertility by reducing oxidative stress, which in turn decreases tissue damage and inflammation
- There is also some evidence that vitamin C supplements may improve semen quality,
- Also an improved sperm count and motility, and reduced number of deformed sperm cells
- Important for testosterone levels.
- One observational study showed that vitamin-D-deficient men were more likely to have low testosterone levels
- High vitamin D levels are linked to greater sperm motility
- But the evidence is inconsistent
- Also known as puncture vine, is a medicinal herb frequently used to enhance male fertility.
- May work as an aphrodisiac enhancing the libido-promoting effects of testosterone
- Fenugreek is shown to significantly increase testosterone levels, strength, and fat loss, improve libido, sexual performance and strength, improved erectile function and the frequency of sexual activity.
- Important to use fenugreek extracts.
- It’s unlikely that whole fenugreek, which is used in cooking and herbal tea, is as effective.
- Zinc is an essential mineral found in high amounts in animal foods, such as meat, fish, eggs, and shellfish.
- Getting enough zinc is one of the cornerstones of male fertility.
- Low zinc status or deficiency is associated with low testosterone levels, poor sperm quality, and an increased risk of male infertility
- Taking zinc supplements increases testosterone levels and sperm count in those who are low in zinc
- May reduce the decreased testosterone levels associated with excessive amounts of high-intensity exercise
- May improve male fertility by boosting testosterone levels.
- May improve sperm counts, sperm motility, and antioxidant status
- May improve libido, as well as fertility and sexual performance.
- Low intake of folate may impair semen quality
NB! – There’s no guaranteed fix, but if nutrient deficiencies or low testosterone levels are contributing factors, chances are that the above mentioned nutrients will lift levels
- Defined as the persistent inability to achieve or maintain penile erection sufficient for satisfactory sexual performance.
- Also known as impotence
- It was estimated that, in 1995, over 152 million men worldwide experienced ED.
- For 2025, the prevalence of ED is predicted to be approximately 322 million worldwide.
- In fact more than 50% of men between the ages of 40 and 70 experience some form of ED
- In the past, erectile dysfunction was commonly believed to be caused by psychological problems.
- It is now known that, for most men, erectile dysfunction is caused by physical problems, usually related to the blood supply of the penis.
- Many advances have occurred in both diagnosis and treatment of erectile dysfunction.
- Since ED can be a forewarning symptom of progressive coronary disease, doctors should be more direct when questioning patients about their health, such as directly asking them about their sexual function through conversation or a questionnaire during a check-up
- In this way doctors may be able to detect more serious health conditions sooner.
- According to the NIH, erectile dysfunction is also a symptom that accompanies many disorders and diseases
Direct risk factors
- Prostate problems
- Type 2 diabetes
- Hypertension / high blood pressure
- Vascular disease and vascular surgery
- High blood cholesterol
- Low levels of HDL / high-density lipoprotein
- Chronic sleep disorders – obstructive sleep apnoea, insomnia
- Prescription drugs
- Neurogenic disorders
- Peyronie’s disease – distortion or curvature of the penis
- Priapism – inflammation of the penis
- Alcohol use
- Lack of sexual knowledge
- Poor sexual techniques
- Inadequate interpersonal relationships
- Many chronic diseases, especially renal failure and dialysis
- Smoking, which exacerbates the effects of other risk factors, such as vascular disease or hypertension
Indirect risk factor
- Age appears to be a strong indirect risk factor in that it is associated with increased likelihood of direct risk factors, some of which are listed above.
Different types (and causes) of ED
- Abnormalities the penile arteries, veins, or both and is the most common cause of ED, especially in older men.
- When the problem is arterial, it is usually caused by arteriosclerosis, or hardening of the arteries, although trauma to the arteries may be the cause.
- Risk factors for arteriosclerosis
- being overweight
- lack of exercise
- high cholesterol
- high blood pressure,
- cigarette smoking
- These factors can cause erectile failure often before progressing to affect the heart.
- Partial or complete wasting or excess smooth muscle tissue around the veins in the body of the penis triggers problems with being able to maintain a firm erection and or losing an erection too quickly
- This is also believed to be an early manifestation of atherosclerosis and vascular disease.
- Common in people with diabetes.
- An estimated 2.5 million adult men in the UK have diabetes, of which 35 to 75% struggle with ED.
- Diabetes involves premature and unusually severe hardening of the arteries.
- Peripheral neuropathy, involving the nerves controlling erections, is commonly seen in people with diabetes.
- Chronic alcoholism
- Multiple sclerosis
- Heavy metal poisoning
- Spinal cord and nerve injuries
- Nerve damage from pelvic operations.
- A great variety of prescription drugs, such as
– blood pressure medications
– antianxiety medication
– glaucoma eye drops
– cancer chemotherapy agents
and many more.
- Hormonal abnormalities, such as
– increased prolactin
– steroid abuse by bodybuilders
– too much or too little thyroid hormone
– hormones administered for prostate cancer
– low testosterone can contribute to ED but is rarely the sole factor responsible for ED.
- Performance anxiety – often caused by stress
- Patient medical and sexual history
– reveal conditions or diseases that lead to impotence
– distinguish among problems with erection, ejaculation, orgasm, and or sexual desire.
- Physical examination
– problem in the nervous system – penis does not respond as expected to touch
– Secondary sex characteristics, such as hair pattern, can point to hormonal problems, which involve the endocrine system.
– Circulatory problems
– Unusual characteristics of the penis itself could suggest the basis of the impotence.
- Laboratory tests
– blood counts
– lipid profile
– measurements of creatinine and liver enzymes
– measurement of testosterone in the blood is often done in men with ED, especially with a history of decreased libido or diabetes.
- Psychosocial examination
– revealing psychological factors that may be affecting performance.
– the sexual partner may also be interviewed to determine expectations and perceptions encountered during sexual intercourse.
Early warning signs of ED
- Trouble in getting an Erection – this is the first sign and symptom of ED
- Inability to maintain an Erection
- Not having the desire for sex
- Loss of sensitivity in the penis
- Lack of early morning erections.
Simple Solutions for Early Stage ED
- Smoking impacts blood circulation in many ways, leading to a host of related health problems including heart disease, heart attack, stroke, and ED.
- An erection occurs when blood vessels in the penis enlarge and fill with blood.
- The blood vessels of the Penis are impacted by smoking
- In fact, smoking is capable of causing ED in men as young as 20.
Reduce or stop alcohol intake
- Alcohol acts as a depressant on the central nervous system.
- Alcohol creates a sedating effect on the brain and body.
- However, alcohol also brings as lack of inhibition, and a decline in motor skills.
- This effect is also called ‘whiskey dick’ where a person is not able to get an erection after heavy boozing.
- Alcohol affects some of the critical systems involved in sexual arousal, erection, blood circulation, and nerve sensitivity.
- But not all alcohol is bad
– 1–2 drinks per day, may help you to get a better erection, possibly by decreasing performance anxiety and increasing sexual desire.
– However, heavy drinking leads to a loss of penis nerve sensitivity, lower libido, sexual dysfunction, and other similar effects.
– Shakespeare said ‘alcohol increases desire but takes away performance’ – Macbeth
- Some specific exercises help increase the blood flow in the abdominal area and in private parts, which may help reverse early-stage erectile dysfunction.
Kegel – pelvic floor exercise
- These important muscles do three jobs:
– allows the penis to engorge with blood during erection,
– pumps during ejaculation,
– helps empty the urethra after urination.
- A few Yoga Asanas ( exercises/positions) are very helpful to stimulate the pelvic muscle and increase the blood flow in the abdominal and pelvic area and help ED
- Positions include:
– Baddha Konasana
– Janu Sirsasana
Abdominal and Pelvic Floor Muscles
- Hollow Hold.
- Make healthy lifestyle choices
- Manage any existing health conditions
- Stop smoking
- Limit or avoid alcohol
- Stop illegal/recreational drugs
- Exercise regularly
- Reduce stress
- Get help for anxiety, depression or other mental health concerns.
Treatment for ED will be determined by you and your medical professional based on:
- Your age, overall health, and medical history
- Extent of the disease
- Tolerance for specific medications, procedures, or therapies
- Expectations for the course of the disease
- Opinion or preference
Address underlying health conditions
- Heart disease
- High blood pressure
- Viagra, Cialis, Levitra, Staxyn, or Stendra
- These pills boost blood flow to the penis during sexual arousal, making it possible to achieve an erection that is firm enough for satisfactory sexual intercourse.
Testosterone Replacement Therapy
- TRT may improve
– Bone density
– Increase muscle mass
– Heighten sexual interest in older men who may have deficient levels of testosterone.
- Testosterone supplementation is not recommended for men who have normal testosterone levels for their age group due to the risk of prostate enlargement and other side effects.
- Testosterone replacement therapy is available as a cream or gel, topical solution, skin patch, injectable form and pellet form placed under the skin.
- Not recommended as a first-line, single treatment for ED
- May be used in combination with another ED treatment option, depending on the individual symptom profile.
- Hair loss
- Enlarged prostate
VED (Vacuum Erection Device)
- Often called a penile pump
- Works by manually pulling blood into your penis using suction.
- Once the erection is formed, a tension ring is slipped to the base of the penis, which helps maintain an erection for about 30 minutes.
- Mild bruising
- Restriction of ejaculation
- The penis feels cold to the touch when used for an extended period
- Intraurethral therapy involves inserting a small drug pellet into the tip of the penis.
- It only takes about 10 minutes for an erection to form
- Which can then last anywhere from 30 to 60 minutes.
- A burning sensation
- Minor bleeding from the tip of the penis
- The medicine is injected at the base of the penis using a very small needle
- Improve penile blood flow much better than the oral alternatives.
- This is a self-injection, of course,
- Minor pain or bleeding at the injection site
- Prolonged erection that can last longer than desired
- Formation of scar tissue within the deeper tissues of the penis, primarily seen in long-term users of this therapy.
- Involves a 30- to 45-minute surgical procedure that places a water-based device into the erection chambers of the penis,
- There are two basic types of penile implants:
- The non-inflatable implant is a single rod that can be shaped by hand to create an erection.
- The inflatable implant has two rods filled with fluid from a reservoir located near the bladder.
- When you desire an erection, you use the pump to fill the rods with pressurized fluid.
- As the rods fill, the penis becomes erect and broader.
- The prosthesis leaves the penis completely deflated when there is no fluid in the rods, making the penis implant unnoticeable.
- The procedure allows for control of when and how long an erection lasts.
- Ideal if your penile blood vessels have been damaged by severe diabetes or during radical prostatectomy
- Possibly the closest option to a cure for ED.
- More than 90% of men and their partners report great satisfaction with this procedure.
Coping with ED
- The loss of erectile capacity can have a profound effect on a man.
- Many times, men will avoid sexual situations due to the emotional pain associated with ED, causing their partner to feel rejected and or inadequate.
- ED can put a strain on a relationship.
- Communication is essential.
- Seek treatment for ED together
- A lack of communication is the primary barrier for seeking treatment and can prolong the suffering.
- Feeling embarrassed about sexual health problems may prevent many men from seeking the medical attention they need, which can delay diagnosis and treatment of more serious underlying conditions.
- The good news – ED can usually be treated safely and effectively.
- Erectile Dysfunction itself is often related to an underlying problem, such as heart disease, diabetes, liver disease, or other medical conditions.
Premature Ejaculation (PE)
- PE is a male sexual dysfunction characterized by:
– Ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration
– In other words the inability to delay ejaculation on all or nearly all vaginal penetrations
– Also known as rapid ejaculation, premature climax or early ejaculation
- Is a common sexual complaint – as many as 1 out of 3 people say they have it at some time
- It can be lifelong or acquired
– Lifelong premature ejaculation – since first beginning coitus
– Acquired premature ejaculation – previous successful coital relationships.
- Can create:
– Makes sex less enjoyable
– Impacts relationships
– Avoidance of sexual intimacy
– Fertility problems
- The exact cause of premature ejaculation isn’t known.
- It was once thought to be purely psychological.
- Today it is considered a complex interaction of psychological and biological factors.
- Poor early sexual experiences
- Sexual abuse
- Poor body image
- Worrying about premature ejaculation
- Guilty feelings causing the person to rush through sex
– Erectile dysfunction – problems with maintaining an erection can form a pattern of rushing to ejaculate
– Sexual performance
– Relationship issues
- Irregular hormone levels
- Irregular levels of brain chemicals
- Swelling and infection of the prostate or urethra
- Inherited traits
- Erectile dysfunction
- Stress can limit the ability to relax and focus during sex.
Diagnosis based on
- Always or nearly always ejaculate within 1 to 3 minutes of penetration
- Inability to delay ejaculation during sex all or nearly all the time
- If your premature ejaculation is caused by a biological/physical condition – treat the underlying condition, talk with a medical professional about the options.
- If your premature ejaculation is caused by psychological factors treatment can be more challenging.
- Masturbating 1 to 2 hours before having sex
- Using a thick condom to help decrease sensation
- Taking a deep breath will briefly shut down the ejaculatory reflex
- Have sex with your partner on top, allowing them to pull away when you’re close to ejaculating
- If you’re in a long-term relationship, you may benefit from having couples therapy.
– explore issues that may be affecting your relationship and be given advice on how to resolve them
– shown techniques that can help you “unlearn” the habit of premature ejaculation.
- Strengthening pelvic floor muscles may help control ejaculation.
- Magnesium deficiency may increase premature ejaculation
Selective serotonin reuptake inhibitors (SSRIs)
- Can be used if self-help techniques do not improve the problem
- SSRIs are mainly used to treat depression, but one of their side effects is delaying ejaculation.
- Take SSRIs for 1 or 2 weeks before gaining the full effects.
- An SSRI specifically designed to treat premature ejaculation.
- It can be used “on demand”.
- Usually to be taken between 1 – 3 hours before sex, no more than once a day.
- If dapoxetine does not work, your GP may recommend trying another SSRI on an “off-label” basis.
- Off label means the medication is used for a different purpose than it was licensed for.
- Doctors can prescribe an off-label medicine if they decide it’s in the patient’s best interest.
Other SSRIs include
Anaesthetic creams and sprays
- Such as
- Can make the penis less sensitive
- Using an anaesthetic cream with a condom can be particularly effective.