Live long enough and your sex life is likely to be stalled by some dysfunction, but seek treatment and your odds are good — 70 percent, to put a number on it — to be restored to healthy sexual function, says Irwin Goldstein, M.D., professor of urology and gynecology with Boston University's Institute for Sexual Medicine. "Men and women who have sexual health concerns shouldn't need to live with them," Goldstein says. "If a sexual problem is causing distress, it's time to seek help."
Men's Multiple Options
The elusive erection is a top sexual trouble point for men. Popular options for impotence include:
- PDE-5 Inhibitors. Popularly known as Viagra (sildenafil), Levitra (vardenafil) and Cialis (tadalafil), the phosphodiesterase-5 inhibitors are proven effective in promoting erection and restoring satisfactory intercourse. They support an erection by helping the arteries in the penis to dilate and blood flow to increase when a man is sexually stimulated. One of the three might work better for you, so see a doctor to discuss the best choice. (See "The Little Blue Pill ... Plus Other Impotence Options.")
- Penile Self-Injection. Injection therapy with alprostadil (Caverject), papaverine, or alprostadil with papaverine and phentolamine (Tri-Mix) can take a penis from flaccid to full readiness within a few minutes by engorging the penis with blood. With proper training in use of the injecting syringe, the success rate is relatively high, but pain from the injections causes many men to stop using them. Other side effects are possible, including dangerous prolonged erection, known as priapism.
- Vacuum-Assisted Erection Devices. The device, which uses vacuum pressure to draw blood to the penis and rings to help keep the blood there, can create erections in most men. Click here for more on vacuum devices.
- Penile Prosthesis. A flexible rod or inflatable prosthesis can be surgically implanted into the penis, but other treatments, such as Viagra, injection or vacuum-based therapy, are typically favored as less invasive.
Premature ejaculation (the inability to wait with ejaculation for both partners' enjoyment) is another major troublemaker for men. In addition to the "squeeze technique" — in which pressure is applied to the penis, where the glans meets the shaft, on the brink of ejaculation — some drug therapies have been used successfully, such as:
- Selective Serotonin Reuptake Inhibitor. This class of antidepressants is blamed for negative sexual side effects, but sometimes the problem can be turned into a positive by delaying ejaculation until it's desired.
- Tricyclic antidepressant. The drug clomipramine has been shown to be effective in delaying ejaculation, but side effects including dry mouth can occur.