An active sex life is an enjoyable and important element of a healthy relationship. However, many people encounter sexual problems at some point in their lives.
There are lots of physical and emotional reasons why this can happen, such as stress, tiredness, illness, family and work pressures, even a new baby.
Lots of people find these sexual problems don’t last long. Where a problem does last, there are lots of approaches to start finding a solution.

What is your problem?

Sex therapists see lots of people with sexual difficulties like:

  • Loss of desire
  • Erectile dysfunction
  • Premature ejaculation
  • Pain on intercourse

Some Tests for this Problems

Several tests can be used to evaluate the causes and extent of sexual problems. They include:

  • Blood tests — These tests are done to evaluate hormone levels.
  • Vascular assessment — This involves an evaluation of the blood flow to the penis. A blockage in a blood vessel supplying blood to the penis may be contributing to erectile dysfunction.
  • Sensory testing — Particularly useful in evaluating the effects of diabetic neuropathy (nerve damage), sensory testing measures the strength of nerve impulses in a particular area of the body.
  • Nocturnal penile tumescence and rigidity testing — This test is used to monitor erections that occur naturally during sleep. This test can help determine if a man’s erectile problems are due to physical or psychological causes

Now, let’s focus on one of the most troubling of them, impotence.

Sexual Impotence

Sexual impotence, also defined as erectile dysfunction, is a very common problem which affects most men at least once during their lifetime. The incidence of erectile dysfunction varies with age, and increases in the proportion of affected men, from 7 to 8 %, from 20 to 39 years of age; to 55-60 %, in men older than 70 years; according to a study carried out in the USA. The largest increase is seen in men in the range of 60-69 years. Is is estimated that at least 10 million men suffer from chronic impotence in the USA, and that at least 20 million more men have less severe forms of erectile dysfunction associated to age, chronic health problems or psychological problems.
Although in the past sexual impotence was regarded as having almost exclusively psychic causes, we now know that from 85 to 90 % of all cases of erectile dysfunction have organic causes, such as peripheral vascular diseases, diabetes, imbalances in the sexual hormones, the effect of medications, etc. This has encouraged medical science to discover new forms of treatment, which are available and work well for a large number of patients. These treatments range from oral tablets and vasoactive drugs which can be injected into the penis, to vacuum pumps and implantable penis prostheses. Effectiveness of therapies may range from 40 to 90 %, depending on the proper choice of method.
However, the psychological factor is always important, because erectile dysfunction may severely affect self-esteem, provoke anxiousness and depression, and make the problem even worse, by an interaction of psychic factors with organic ones. These problems may affect indirectly the female partner, particularly when there are marital or interpersonal problems.
Impotence can be caused by physical and psychological reasons, for example:

  • Stress, anxiety and nervousness
  • Problems in relationships
  • Poor health
  • Drinking too much alcohol
  • Some medications
  • Some operations
  • Low levels of the male hormone testosterone.

Diabetes and impotence

The reasons why men with diabetes are more prone to problems with impotence are not fully understood. Some people with diabetes suffer from hardened arteries. This may contribute to impotence by restricting the flow of blood to the penis. Nerve damage, another problem for people with diabetes, may also contribute to impotence. If blood glucose levels are kept in the normal range, it will help reduce the chance of these problems occurring.

Diagnosis of erectile dysfunction

Medical diagnosis

There are no formal tests to diagnose erectile dysfunction. Some blood tests are generally done to exclude underlying disease, such as diabetes, hypogonadism and prolactinoma. Impotence is also related to generally poor physical health, poor dietary habits, obesity, and most specifically cardiovascular disease such as coronary artery disease and peripheral vascular disease.
A useful and simple way to distinguish between physiological and psychological impotence is to determine whether the patient ever has an erection. If never, the problem is likely to be physiological; if sometimes (however rarely), it could be physiological or psychological. The current diagnostic and statistical manual of mental diseases (DSM-IV) has included a listing for impotence.
There are many treatments for erectile dysfunction. Treatments can be grouped according to their level of invasiveness.

  • Non-invasive treatments include oral medications, counseling and external devices, such as vacuum pumps.
  • Minimally invasive treatments include penile injections.
  • Surgical treatments include penile prosthesis and vascular surgery.

It is usual to start with the least invasive treatment, such as tablets, and to recommend more complicated injection treatments or surgery if the tablets fail.

Remember that:

  • Most cases of erectile dysfunction are caused by physical factors.
  • Treatments include oral medications, penile injections, vacuum devices, counseling and implants.

Where to get help

  • Your doctor
  • Sexual health clinic
  • Family planning clinic.

Premature Ejaculation (PE)

Alternative therapies for premature ejaculation

Many alternative therapies are available for the treatment of PE. Caution should be exercised when researching alternative sources of advice however, most treatments have not actually been shown to be effective. Some web sites even advocate the dangerous and antiquated method of pulling the testes downwards when aroused. This is actually a good way to slightly strain the interior of the testes and is associated with reports of injury and weakened/deteriorated erection. For some reason this advice is still widespread on the Internet.
Hypnosis has also proven very effective in the treatment of premature ejaculation. It is believed by some that ejaculation is a subconscious habit and by giving the mind hypnotic suggestions to last longer, the problem can be greatly alleviated if not completely cured. Most men report dramatic improvement after only a few sessions of hypnosis.
The prostate gland plays a very important part in regulating arousal. Pressure in between the engorged prostate and the erection causes most of the pleasurable sensations and it may be emptied manually before sex by prostate massage. This causes the erection to be strong but less sensitive, and increases a patient’s awareness of his physiology.
There is a trend toward the use of nutritional supplements when treating men who suffer from PE. Effective supplements must contain 5HTP which is a precursor to serotonin. A Dr. William Ganong, noted that serum serotonin levels could be increased through dietary means. Increasing the serum level of serotonin helps inhibit the ejaculatory reflex. There are a number of nutritional remedies available primarily on the internet.Sources: Medicine Net, Better Health, Wikipedia

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