ASK THE DOCTOR - Unable to sustain an Erection for Long

I am a 51-year-old married man. My erection does not sustain for long. What can I do?
- Kothari

ASK THE DOCTOR - Unable to sustain an Erection for Long

This is a form of Erectile Dysfunction (ED). There are many organic (physical) as well as psychogenic causes for this problem. It is necessary to find out the cause of this problem first, through history taking, examination and investigations. Once the cause (diagnosis) is found, treatment can be advised. Very effective drugs, Sildenafil citrate and Tadalafil, are now available in India for the complaint of inability to ‘sustain’ the erection. Remember, these drugs cannot bring about erection in a flaccid penis. They only help to ‘sustain’ the existing erection longer.

These drugs are useless in those who have difficulty in getting an erection. It helps only those who get an erection ‘on their own’ but cannot sustain it long enough to perform satisfactory sexual intercourse. You could be benefited with these drugs. However, neither can you get these drugs without a proper prescription by a qualified specialist, nor should you take it on your own. There are risks involved in taking them; and unless you are guided by a qualified expert, kindly avoid selfmedication.

ASK THE DOCTOR - Sexual Intercourse Cures Menstrual Pains

I have heard that sex cures menstrual pains. Is it true? Does sex during menses have any relation to developing or contracting Sexually transmitted diseases (STD)?
- A. Nakti

There is no truth what so ever to the rumour that sexual intercourse cures menstrual pains. On the contrary, intercourse during menstruation can heighten the risks of contracting sexually transmitted diseases (STDs), including HIV/AIDS. Menstrual blood is a very rich medium in which micro-organisms can grow very rapidly. If a menstruating female has sexual intercourse with a male who is infected with an STD, she is more likely to get infected than during other times of her monthly cycle. In addition, she is likely to get a more severe infection when she is menstruating. This is because the mouth of the uterus (cervix) is wider than usual at this time so that the menstrual blood can flow out easily. The micro-organisms of STD can travel up into the uterus and fallopian tubes and can cause an infection high up in the female reproductive system. This can result in infertility. For the male, having sexual intercourse with a menstruating female is also very risky. If she is infected with HIV, her menstrual blood will be very rich in viruses (HIV).

ASK THE DOCTOR - Postponing Sexual Intercourse in Teenagers

QUESTION:
As parents, what kind of messages can you give your teenager about postponing sexual intercourse that won’t sound preachy, or like you are living in the dark ages?
- H Pawar

ANSWER:
Most parents hope their teenagers will wait to have sex till they are psychologically mature and are able to have emotional resources to manage relationships. It is important for parents to be able to convey this hope while communicating accurate information about sexual health and consequences. While we may encourage teenagers to postpone intercourse, the present reality is that, most young people become sexually active when they are in the clutches of their hormones. Because of this, they must be prepared to protect themselves when they decide to engage in sexual activity. Information about preventing pregnancy and sexually transmitted diseases is vital to help young people make informed decisions. And parents can help their kids understand the value of selfrespect, assertiveness, and responsible decision-making in postponing sexual activity.

‘Everybody is doing it’ is an age-old pressure tactic that applies to experimenting with drugs and alcohol as much as it does to experimenting with sex. Encourage your children not to be taken in by it. Teenagers often say they have intercourse the first time because they are curious. Open family communication about sexuality can satisfy your teenager’s curiosity, and help him/her behave more responsibly while exploring his/her sexuality.

You can communicate to your teenager that anyone can have good intentions of abstaining from intercourse. However, to translate this intent into responsible behaviour may not be as easy because of the high levels of arousal experienced due to raging hormones. And yet one needs to remember at the right time the consequences of irresponsible sexual behaviour in order to practice responsible sexual behaviour.

ASK THE DOCTOR - ‘How does a vacuum suction device work?’

QUESTION:

For erectile dysfunction (ED), some sexologists advise a ‘vacuum suction device’. How do they work? Are there any side effects of using such a device? 

- Jayant 

ANSWER:

A vacuum suction device (VSD) is also called a ‘penile pump’. It was designed to help those men whose erections are not firm, or not as firm as it used to be earlier, to make it possible for them to penetrate the vagina and perform sexual intercourse. A vacuum suction device is a good option for men in this situation. However, if the device is not used properly, it can cause serious loss of sensations, loss of penile skin, and even gangrene. If you are having difficulty with an erection — and this is a problem for you, I suggest that you consult a qualified sexologist who can assess, among other things, your penile blood flow. The VSD is only a temporary solution to erectile dysfunction. Erectile Dysfunction is a treatable condition in a majority of cases, and you should approach a sexologist for help.

LET’S TALK ABOUT SEX

An unhealthy level of interest in bed can soon land you in rehab. AT tells you how to deal with sex addiction

When Tiger Woods entered rehab after his ‘transgressions’ became public, detractors were quick to pipe ‘sex addiction’ as the reason. Years ago, Michael Douglas took treatment to get over his unhealthy interest in sex. And later, so did Xfiles star David Duchovny. And just recently, it is disgraced footballer, John Terry who’s facing the music for his innumerable flings, even as his wife,
Toni is contemplating leaving him.

Interestingly, the American Psychiatric Association does not list sex addiction as a diagnosable mental disorder with no real statistics to show the magnitude of its prevalence. However, its existence cannot be refuted. Like any other addiction, sexual addiction, too, can be treated.


ADDICTED TO SEX? 
As the term suggests, a person can be called an addict when he/she can’t control his/her sexual behaviour — even with strangers, or in public situations. The need for sex becomes so compulsive that it starts affecting the person’s functioning. Addiction to masturbation or even porn are aspects of sex addiction. In extreme cases, the addict goes against societal norms, engages in unsafe sex and can repeatedly cheat despite being in a committed relationship.


WHY IT HAPPENS 
Personality type 
Often, kids can be seen holding on obsessively to their toys. This may indicate an obsessive personality type. Combined with a dysfunctional family, lack of love from parents makes the child excessively dependent on material factors to compensate for the lack of intimacy. While that doesn’t mean the child, later, might turn out to be a sex addict, it increases the risk.

Genes 
Some times the genetic makeup makes them more susceptible to addictions.

Stress 
If under severe stress, a person may look towards sex for temporary relief — not for intimacy but for the momentary ‘high’.


SIGNS TO WATCH OUT 

• Spending excessive amount of time chasing sex and preparing for the same. 
• Continuously compromising on social activities to make way for sex. 
• Feeling extremely dissatisfied, depressed, even angry citing lack of sex (despite having an active sex life). 
• Dwindling sense of intimacy and satisfaction despite engaging in sex. 
• Engaging in sex with multiple partners. 
• Dependency on pornography. 

THE WAY OUT 

• Set a time-frame challenge of not engaging in the sexual act for a particular number of days, or say only once in X number of days. This exercise will accurately tell you about the degree to which you are hooked. 
• Find an activity that can replace the craving, and channelise your energy towards it. Let it be something you enjoy or sticking to it will be difficult. 
• If you feel the cause of addiction is stress, figure out the source and deal with it. 
• Seek professional help. 

NOTE FOR PARTNER 
Most addicts are known to live in a sense of denial. Hence, if your partner suffers from the syndrome, do not confront with harsh words and most importantly, do not address the problem as an ‘addiction’. This will only backfire and strengthen the sense of ‘denial’. Instead, seek professional help citing lack of intimacy and a relationship problem ‘shared’ by both. Use the ‘our’ problem approach rather than mentioning it as ‘your’ problem. 

ASK THE DOCTOR - My wife lacks an interest in sex?

QUESTION:
I am a 55-year-old man in good physical health and married happily for the last 30 years. I have a good sex drive and desire to have sex as often as I can with my wife of fifty years. However since the last few years, I find that my wife is not taking an interest in sex. After her menopause, she complains of dryness in her vagina which makes it difficult to enjoy sex. Apart from this physical issue, I find that she doesn’t take any initiative in sex and avoids the same on some or the other pretext. As a result, we have sex only once in a fortnight, whereas I desire sex at least twice a week.
- XYZ

ANSWER:
Menopause is invariably wrongly blamed for declining interest in sex in women. The cause for lack of matching interest in sex in partners could be physical, psychological, situational or even out of a so-called religious belief. It is necessary to find out the cause of such sudden loss of interest in sex. Only after knowing the cause, therapy can be planned.

For your information, a woman’s interest in sex depends on the following factors:

Integration of Love and Sex:
A woman operates through her heart. Her sex-life is not separate from the rest of her life. She sees everything in her life as inter-related. As against this, man tends to compartmentalise. He can mentally put aside stressful aspects of his life and separate it from sex. A woman needs good feelings and experiences during the day to have satisfying sex. How her husband treats her out of bed, greatly influences her response in bed. Inattentiveness, harsh language, a rude tone, hurting words, and criticism can make it difficult for a woman to get involved, to feel enthusiastic and to be passionate during sex. It is important for a couple to be loving even when they are not in the sex act. Sexuality and affection cannot be compartmentalised. Good sex is a continuum of affection and closeness during the day.

Lack of Love: This lack of love cannot be blamed on only one partner. Love happens between two sensitive human beings. Both of you need to deeply examine your relationship, either on your own or with the help of a good counsellor. Ask yourself what you can do to bring more depth into your relationship and make it more than sex — a sharing of intimacy.

Satisfaction: The level and frequency of satisfaction that she has experienced in her sexual life. If sex has been a one-sided activity by the man without bothering much about the needs of the woman, then over a period of time, she may lose interest in sex.

Foreplay: If foreplay is not done correctly and adequately, female partners do not feel aroused enough to have intercourse. Many husbands are impatient and want to go for intercourse after a short and hurried foreplay. Such repeated experiences of unsatisfactory sex gradually make the woman lose interest.
It will be better if both of you speak freely on this subject with each other and try to understand each other.

PLEASURE... THE NATURAL WAY

Erectile Dysfunction (ED) is a big issue among modern-day couples. But the solution is easy.

To put it simply, ED is the repeated inability of a man to achieve an erection sufficient for sexual intercourse. The causes could be many, from old age, diabetes and stress to prostate cancer, hypertension, vascular diseases, neurological diseases, pelvic surgery and some other medical conditions. Vacurect is the only non-invasive and safe device to treat the problem. This internationally patented vacuum therapy system is compact, comes in a pleasing design and is easy to use. It gives you complete natural erection every time in less than 60 seconds and can be maintained for 30 minutes without any harmful side effects. The device uses a unique double-sealing tension ring that ensures maximum efficiency, which means that it works much faster, resulting in minimal interference with intimacy. Vacurect is highly recommended to men with erectile dysfunction and premature ejaculation. What’s more, it’s safe and needs no maintenance cost. The complete Vacurect system includes the device, nine pure silicon tension rings, silicon oil for device servicing, lubricating jelly, travel pouch and a manual. 

Erectile Dysfunction after surgery

QUESTION:
I am 62-years-old. I got myself operated for prostate last year. After the operation I have almost lost the ability to get an erection. My erection was satisfactory before this operation. Will I ever get my ability to get erection back? What can be done to get my erectile function as it was before the operation.
- A Shah 

ANSWER:
A prostate removal surgery such as ‘Radical Prostatectomy’ can cause injury to the pelvic nerves resulting into neurogenic erectile dysfunction. The incidence of erectile dysfunction after Radical Prostatectomy depends on whether a ‘nerve-sparing’ surgical procedure was performed. Reported rates of Erectile Dysfunction after bilateral nervesparing radical prostatectomy range from 18 to 82 per cent. Other factors related to disease or surgery can also affect erectile function. It will be worthwhile discussing your post-operative erectile dysfunction status with the surgeon who operated on your prostate. I think your surgeon is the best person to guide you through your present dilemma.