Rev up Your Sex Life, Guys

Men can stay sexually healthy by exercising,

eating right and finding the right remedies

By Deb Rinard

If you watch TV commercials, you might think a man’s sexual issues can be solved—poof!—with a magical blue pill. Unfortunately, only 50 percent of men with erectile dysfunction (ED) benefit from such drugs as Viagra, says Brandon Chastant, N.M.D., R.N., M.S., of the Summit Male Medical Center in Tempe.

“The medications work better with younger men, and the drug’s effectiveness diminishes as the body develops a tolerance,” he says. “If you have heart disease, high cholesterol, diabetes, high blood pressure and/or prostate issues, the chance that Viagra will work is significantly reduced because of all the medicines involved in treating those conditions.”

Chastant defines ED as the inability to consistently get or maintain an erection sufficient for intercourse, and that includes premature ejaculation (PE). “ED is a huge problem,” he notes. “By 2020, it’s estimated that more than 350 men worldwide will suffer from it. ”

Approximately 75 percent of ED originates from blood flow issues, and the vast majority are medical in nature.   

ED Remedies

Suffer from ED? Thanks to a variety of medications and devices, all hope is not lost for your sex life. Dr. Chastant recommends:

A VACUUM ERECTION DEVICE

The pump fits over the penis and pulls blood into it. A restrictor band at the bottom retains the blood. The drawback? The penis can turn blue and feel tight.

“I see thousands of patients, some of whom use the pump, but nobody really likes it,” Chastant says.

A PENILE SUPPOSITORY

Containing prostaglandin, a pellet the size of a rice grain is inserted into the ureter to create an erection. Some men experience a burning sensation, and some are put off by the insertion process.

CAVEJECT

This form of prostaglandin is injected into the base of the penis. “You use an insulin-sized needle that’s only 3/16 of an inch, and the base of the penis is not nearly as sensitive as the head, so it’s not painful,” Chastant says. “Injectables don’t affect the heart or go through the liver and the circulatory system.” But you can’t use them more than three times a week, and you need to space injections a full 24 hours apart.

VIAGRA, CIALIS AND LEVITRA

These ED drugs also come in under-the-tongue form and can be more effective than pills.

Premature Ejaculation

“One in five men in the U.S. suffers from PE,” Chastant says. If a man ejaculates less than two minutes after vaginal penetration, he has the condition.

With PE, the head of the penis is overly sensitive. “Doctors formerly prescribed  antidepressants, which can double the time before ejaculation. But the typical male with PE only lasts 30 seconds to one minute, so the drugs don’t really help,” Chastant says.

What does? Desensitizing sprays containing lidocaine and injectable drugs that sustain an erection past ejaculation.

Low Testosterone

As a man ages, his testosterone levels decline. “Lower levels are starting at an earlier age now, and it’s more pronounced,” Chastant says. Possible causes are a sedentary lifestyle and the environment. But there’s an astonishing 57 percent decrease in mortality with a testosterone level of 1,000 vs. 300. Chastant recommends exercise, lower stress levels and eating right to boost levels.

Using topical testosterone creams, gels and/or injectables can result in increased libido, energy and muscle mass. “But if a man has latent prostate cancer, testosterone can accelerate it, so seeing a doctor first is critical,” he says.

Does it work for everyone? “Some men say they feel fantastic while others don’t notice much difference. It’s a very individual thing,” Chastant says.

Talking about sexual problems can be difficult for most men, but Art Wignant, 52, is glad he sought help. "I thought it was me. My wife thought it was her. Turns out it was my diabetes. Summit guaranteed their medication would work and they were right."

Prostate Problems

The prostate gland plays a main role in a man’s sexual health because:

• It provides the fluid that carries the sperm.
• It helps mature secretions and provide healthy sperm.
• Nerves that stimulate an erection run alongside the prostate.
• The blood supply draining the penis runs along the surface of the prostate.

“All prostate cancer treatments, except for doing nothing (active surveillance), affect sexual function,” says Erik Castle, M.D., a urologist at Mayo Clinic-Scottsdale.

“Each patient has to weigh what they’re looking for—continence, potency—when he decides on surgery, radiation, cryosurgery (freezing) or hormonal therapy. With surgery, if a man is potent going into it, there’s a 50 to 80 percent chance he will preserve erectile function after surgery. A lot depends on how bad the cancer is. If it’s bad, the surgeon will take everything—the gland and the nerves.”

With radiation, there’s no immediate effect on potency. Because radiation affects DNA, men will lose function over time, with the rate of impotency leveling off over five years, Castle says.

The best advice is to talk to your doctor at length and weigh all the factors carefully before making a treatment decision.   

To read more about men's sexual health, including a Q&A with a local "cougar and cub," pick up June's issue of Generation Health AZ, available now.