Category: Erection Concerns

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‘Grower’ or ‘Shower’

— Scientists Define Categories for Penis Erections

Scientists say categorizing penis erection size could be helpful in certain surgeries.

By Bob Curley

  • In a new study, researchers are categorizing penises in terms of how much they grow during erections.
  • They label penises that are relatively large when flaccid as “showers” while those that are smaller at first and then grow substantially during erections as “growers.”
  • They say the classifications could be useful in some surgeries.

Size isn’t everything.

And, according to new research, when it comes to erections, where men start isn’t necessarily an indication of where they finish.

Some men are considered “showers” — having a visibly larger penis when flaccid — while others are “growers” — appearing smaller at first, but exhibiting a larger penis size when erect.

European researchers are actually defining the terms scientifically to see how many men fall into each category.

Their findings were presented at the European Association of Urology (EAU) Congress in Milan, Italy. The study hasn’t been published yet in a peer-reviewed journal.

Urologists from three hospitals in Madrid, Spain, studied 225 men, taking ultrasound scans of their flaccid and erect penises.

They concluded that men whose penis increased in size by more than 56% when erect can be considered “growers” while those whose penises increased by less than 31% should be categorized as “showers.”

However, less than half of the men studied fit either definition.

Researchers led by Dr. Manuel Alonso-Isa of University Hospital HM Puerta del Sur in Madrid found that 24% of men were “growers” while 25 percent were “showers.”

The rest fell in the middle.

“This study gives credence to the concepts of the fact that some patients will have more of enlargement of their penis than others with an erection,” said Dr. Stanton Honig, the director of male urology at Yale University in Connecticut.

”It does not comment as to whether men who have shorter penises are more likely to grow than men with longer penises, so further work is necessary here,” he told Healthline.

Why the study is important

The study had a serious purpose.

The researchers said that the findings could help physicians make surgical decisions.

“It is important to be able to predict if a patient is a grower or a shower as when we see them, they are usually in a flaccid state,” said Alonso-Isa. “If they grow a lot when they get an erection, it might mean they need a different surgical approach compared to someone who doesn’t grow much.”

Men who had longer penises when flaccid were more likely to be “showers,” the study found, while growers tended to have thinner layers of the tissue known as tunica albuginea, which surrounds the spongy erectile tissue inside the penis.

“This makes sense as the tissue is being stretched further,” said Alonso-Isa.

However, researchers were unable to establish any relationship between shower/grower tendencies and factors such as age, weight, or smoking status.

Experts said having a baseline definition of penile-growth characteristics could have medical and mental health benefits for men.

“This is a frequent area of concern for our patients and the emphasis should be on normalizing baseline and erectile length for all,” said Maarten Albersen, a urologist at the University of Leuven in Belgium.

How men may view the research

Dr. Nicole Prause, a sexual psychophysiologist whose expertise includes genital physiology, said the classifications in the study are “purely clinical judgment.”

“They are not tied to any other meaningful physiological, psychological, or relationship characteristic,” she told Healthline. “To me, the distinction appears to be just physiological: those with a shorter penis when they are flaccid are much more likely to have a larger relative increase.”

“What is interesting is that men are more likely to express dissatisfaction with their flaccid size,” she said. “This suggests that men, since they tend to be shorter when they are flaccid, are focusing on the ‘worst case’ rather than being excited to have such a large increase.”

Penis size not connected to sexual performance

From a human sexuality standpoint, the question of whether a man is a “shower” or a “grower” is largely irrelevant, Nancy Sutton Pierce, a California-based clinical sexologist, told Healthline.

That penis size is still a primary concern for men reflects “the false pretense the sexual gratification of women relies on the measurement of the penis,” said Pierce.

“If the women’s clitoris isn’t being stimulated in some way, shape, or form, she isn’t going to be having a lot of fun no matter how big or how small the penis is,” she said.

She advised men that “you are more than your penis size.”

Complete Article ↪HERE↩!

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5 Facts All Men Should Know About Sexual Problems and Dysfunction

Male sexual dysfunction can include a wide variety of problems, ranging from low libido, erectile dysfunction (ED), premature ejaculation, and other issues. While many men know that these issues are common, they can be difficult to talk about. In fact, many men wait several months, or even years, before raising the issue with their primary care physician.

Thankfully, both normal and abnormal male sexual function are now better understood medically than ever before. Dr. Sharon Parish, Professor of Medicine in Clinical Psychiatry at Weill Cornell Medicine, maintains an active faculty practice specializing in sexual medicine. “I use an integrated, holistic approach, looking at the whole man,” explained Dr. Parish. “Often, men will first see a urologist and then are referred to me for a more detailed evaluation and discussion of their overall health.”

Here, Dr. Parish shares her insight as to the connection between male sexual, physical, and mental health.

Sexual problems may signal a cardiovascular or other medical issues

“Any man that experiences a change in libido, erection, or ejaculation should bring this up to their primary care physician,” said Dr. Parish. Any issue that lasts for several months may indicate a more serious medical issue that should be addressed:

  • Early ejaculation can develop because of medication, nerve damage, or other direct urinary conditions
  • A change in libido or erection may be the first sign of diabetes
  • Problems with libido or erection may be related to a hormonal imbalance
  • Problems with erection may be a sign of a cardiovascular issue or prostate cancer

There is a strong link between sexual function and mental health

Mental health issues — including depression, anxiety, and other psychiatric illnesses — can lead to many different types of sexual disorders. “It’s clear that there is a strong connection between ED and depression,” asserted Dr. Parish. “Women, on the other hand, who experience depression are more likely to see a decrease in libido. It’s very important to diagnose the psychiatric illness first to improve sexual function.”

Sexual function is often improved by addressing, managing, and alleviating anxiety and depression. “There are many helpful therapies,” Dr. Parish explained, “including mindfulness, cognitive behavioral therapy, and relaxation techniques to help one be more present in the experience and enjoy it more fully.”

Medications for mental illness may cause sexual function changes, to varying degrees

“There is a wide misconception that the medications for mental illness cause sexual problems, but the data is clear that sexual function is more likely to improve when the mental illness is treated,” said Dr. Parish. “It’s not a good idea to avoid the medication because of the potential side effects.”

Fifty to 70 percent of men do not experience any sexual side effects from medications, and men taking medications for serious psychiatric disorders are more likely to experience a sexual side effect.

“If you do experience sexual problems as a result of a medication,” Dr. Parish explained, “work with your doctor to manage the side effects. Several drugs are known to produce lesser side effects.”

Again, Dr. Parish emphasized the importance of mental health for sexual health. “The key,” she stated, “is to treat the mental disorder and then the sexual disorder. It’s best to get the condition treated and work with the doctor to manage the side effects.”

With age, some changes in sexual function are normal

Some changes in sexual drive, performance, and function are normal parts of aging. “As men get older,” said Dr. Parish, “they may need more time for foreplay or direct stimulation. If this isn’t enough to improve normal age-related changes in sexual function, sex therapy can be very beneficial.”

However, if the changes are dramatic or difficult to work through, Dr. Parish suggested talking to a primary care physician. “Your doctor can help you differentiate normal changes from more problematic issues, including medical issues,” she said. “Don’t assume it’s a normal change that comes from getting older.”

Improving overall health can improve sexual performance

Dr. Parish ascribes to the “biopsychosocial model” for overall and sexual health. “There is so much interconnectivity when it comes to our health,” she explained. “It’s important to take a holistic view.”

Indeed, cardiovascular, neurological, hormonal, and psychological systems all interact together for sexual performance. A healthy lifestyle can significantly help improve sexual function — improving diet, achieving and maintaining a healthy weight, and exercising regularly all help promote greater overall health and, therefore, greater sexual health.

Complete Article ↪HERE↩!

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The Life-Changing Magic of a Urologist

— Here are three issues you may want to address with a professional.

By Jancee Dunn< Urologists often deal with health problems that arise from two very intimate functions: peeing and sex. Because of this, “most urologists tend to have a lot of brevity and a bit of humor, because we know these are hard topics for our patients,” said Maria Uloko, a urologist at UC San Diego Health and assistant professor of urology at the University of California, San Diego School of Medicine.

In my experience (as both a patient and a health journalist), urologists will happily discuss the subjects that some of us laypeople tend to avoid: erectile problems, peeing too much, peeing too little, painful sex, dwindling or nonexistent orgasms, urinary tract infections and the list goes on.

Rachel Rubin, a urologist and sexual health specialist based outside Washington, D.C., said many people don’t share these issues with their doctor even if they are ongoing; they simply learn to live with discomfort. “They’ll tell themselves, ‘Well, that’s just aging. Suck it up,’” Dr. Rubin said. But, “if it bothers you and it matters to you, then it’s a medical problem with medical solutions.”

There are two parts of a urologist’s job. “There’s the serious illness stuff, like cancers,” said Nelson Bennett, a professor of urology at Northwestern University Feinberg School of Medicine, who specializes in male sexual function. “But there’s a big chunk of our practice that is basically quality of life. I tell my patients that no one dies of not having an erection, but they’re still suffering.” All of this may be why people who have seen a urologist (present company included) sometimes say the results are life altering.

Here are three issues you may want to address with a professional.

Erection problems

If you have erectile dysfunction, Dr. Rubin said: “Don’t be embarrassed. So do your friends.” Erectile dysfunction affects as many as 30 million men in the United States, according to the American Urological Association.

There are treatment options for almost every erectile problem, including oral medications, injectable medications, surgery and cognitive behavioral therapy, Dr. Bennett said.

Although it can be tempting to furtively order medications such as Viagra on direct-to-consumer websites, a practice that Dr. Bennett found, in a 2021 study, is dramatically increasing, he said there are several reasons to see a specialist instead. “We can actually begin to figure out why you’re having the problem, as opposed to just taking medication to cover it up,” he said. Some medications can also affect erections, such as antidepressants, which can cause orgasms to be delayed, or vanish altogether. And a urologist can screen for those, he said.

What’s more, erection problems can be a sign of heart problems down the road. Penis arteries, which are one millimeter in diameter, are very small, compared with heart arteries, which are 3 millimeters. “So if you’re clogging your small pipes first, you may have erectile dysfunction before you have your first heart attack,” Dr. Rubin said.

“Those are the guys you need to start looking at,” said Dr. Bennett, “because we know that erectile issues will predate cardiovascular issues by about 10 years.”

Painful sex

For older women, painful sex is a leading sign of genitourinary syndrome of menopause, or G.S.M., a term that in 2014 replaced the dispiriting phrase “vulvovaginal atrophy.” During perimenopause and beyond, as estrogen leaves a woman’s body, the tissues in the vulva, vagina and urinary tract become dryer, less supple and more sensitive. This process can cause recurrent urinary tract infections and incontinence, and sex can become excruciating, which takes many women by surprise, Dr. Rubin said. G.S.M. may affect up to half of postmenopausal women, according to a 2019 review, and is “unlikely to improve without treatment.”

What has been shown to work for conditions like G.S.M., Dr. Rubin said, are treatments like inserts with DHEA, a steroid that mimics hormones, lubricants and moisturizers; ospemifene, an oral medication that is approved by the Federal Drug Administration to treat G.S.M.; vaginal dilators; and low-dose topical vaginal estrogen.

“There’s not a cocktail party or children’s birthday party where I don’t recommend vaginal hormones,” Dr. Rubin said. (It is important, however, that you discuss any of these treatments with your own doctor first.)

Pelvic floor therapy is another option, Dr. Rubin added. “Pelvic floor therapists rehab your muscles, just like you would do rehab after a knee replacement.” And you don’t have to do it forever, she added. “Physical therapists are there to optimize your pelvis and send you out the door.”

Then there’s the D.I.Y. approach: a 2023 review found that vibrators were considered “an accepted modality” to treat vulvar pain. “I think doctors should be prescribing vibrators, which are health aids, just like eyeglasses or hearing aids,” Dr. Rubin added. “The more we normalize them and educate patients in exam rooms about them, the better.”

Bladder issues

You may know that bladder control loss afflicts women at various hormonal stages in their lives — pregnancy, after giving birth and during menopause — but “men are plagued by urinary incontinence, too,” Dr. Bennett said. A quarter to a third of Americans have incontinence, according to the American Urological Association.

There are two main types: “stress incontinence,” which means sudden leaking brought on by activities like coughing, sneezing or exercise, and “urgency incontinence,” a strong and immediate urge to pee, which sends you on a mad dash to the bathroom.

Some male patients will visit the bathroom 10 times a night because of a prostate issue, which leads to sleep deprivation, Dr. Bennett said.

Some treatments for urinary incontinence include medication, and for women, vaginal estrogen, but urologists also teach patients Kegel exercises, use electrical stimulation and employ pelvic floor physical therapy. (Men have a pelvic floor, too.)

Urologists, Dr. Uloko said, “are really glorified plumbers. We know how to fix the leaks.”

Complete Article ↪HERE↩!

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Walk Your Way to Better Erections

— Taking a stroll for as little as 30 minutes a day can improve sexual health.

By Lauren Dodd

Seeking to improve your sex life as the new year kicks into gear? This one isn’t all that difficult. Resolve to walk your way to better erections.

Men who experience erectile dysfunction (ED), the consistent inability to get or maintain an erection satisfactory for sexual intercourse, may benefit from incorporating more heart-pumping physical activity—as little as a 30-minute walk—into their 2023 routine.

More than 30 million men in the United States experience ED, which can lead to higher rates of depression and anxiety. ED is generally seen as a growing public health concern. But a portion of ED sufferers may be able to improve their condition by simply adding extra steps to their daily life.

Medical conditions such as cardiovascular disease, the leading cause of death in men, produce changes to the penis’s blood flow and are common causes of ED, as blood flow is necessary to achieve and sustain an erection. Without the need of a doctor or a prescription, better sexual health may literally be around the corner for men who resolve to lace up their sneakers and head outdoors.

Better erections could be just a few steps away

Walking, one of the most popular forms of exercise in the world, is also one of the cheapest. No gym membership required.

Increasing your daily steps can be as easy as parking farther away from entrances or opting to take the stairs rather than the elevator. As little as 40 minutes of moderate to vigorous exercise four days a week—a grand total of 160 minutes—sustained over the course of six months can improve ED caused by physical inactivity, obesity, hypertension, metabolic syndrome and/or cardiovascular disease, according to a 2018 systematic review that looked at a decade of erectile dysfunction research.

Moderate exercise can be achieved by walking briskly at a pace of 4 mph or bicycling at a pace of 10 to 12 mph, according to Harvard research. Another Harvard study found walking 30 minutes a day was linked with a 41 percent decline in risk for ED.

Considering the leading causes of ED are atherosclerosis (hardening of the arteries) and diabetes, additional physical activity may improve more than just erectile function.

People who took 12,000 steps a day had a 65 percent lower risk of dying over the course of 10 years compared with those who took 4,000 steps a day, one 2020 study found.

“Higher step counts were also associated with lower rates of death from heart disease and cancer,” the study stated.

Quitting smoking or vaping and reducing alcohol consumption in the new year may also lead to better performance in the bedroom. Heavy smokers, even younger ones, are twice as likely to develop ED than their nonsmoking peers.

Heavy drinking doesn’t help, either. One study found men’s “episodic erectile failure” occurred at “significantly higher” rates in those consuming more than three standard units of alcohol a day. (One standard unit is any drink that contains 14 grams of alcohol, according to the National Institute on Alcohol Abuse and Alcoholism.)

Maintaining a healthy weight is essential

The risk of developing ED and losing sexual function increases along with a man’s waistline, according to Harvard research. A man with a 42-inch waist is 50 percent more likely to have ED than one with a 32-inch waist.

Regular physical activity such as walking can aid vascular health. It helps arteries by boosting nitric oxide production, thereby increasing blood flow to the penis and making it easier to get an erection.

One of the first suggestions Susan MacDonald M.D., a urology specialist at Penn State Health in Hershey, Pennsylvania, offers her male patients is to lose a little weight.

“There is an obesity epidemic in America, so odds are most of your readers have five to 10 pounds to lose,” MacDonald said. “If they were to start walking, that would help.”

Quitting smoking is another one of her top recommendations for men experiencing ED.

“If we’re making New Year’s resolutions here, stopping smoking is a huge one,” MacDonald explained. “I think if you’re smoking, you’re paying double, because you’re paying for the cigarettes and you’re paying for [medication] to fix the erectile dysfunction it’s causing.”

Symptoms of erectile dysfunction should be taken seriously because a man’s penile dysfunction may be the first red flag of other illnesses and disorders, she said.

“In most cases, it’s the disease process leading to the ED,” MacDonald said. “In cardiovascular disease, we see the ED before we see the heart attack.”

Walking can curb more than erectile dysfunction

Walking has been proved to lower blood pressure, ease joint pain, curb sweet-tooth cravings and improve sleep. It can also help ward off breast cancer, heart disease, stroke, and early onset Alzheimer’s disease and dementia.

During peak flu and cold seasons, walking is another way to boost your immune system to fend off germs. It can increase bone health and bone density in osteoporosis patients and improve a person’s balance.

In addition to physical benefits, walking can offer mental health perks, such as improving feelings of sadness, anxiety, anger and depression.

But as with anything, the trick to picking up a new exercise habit is to do so safely.

Anyone taking to the streets should map out a path in advance, use sidewalks when possible, choose a well-lit area, be aware of major changes in the weather, stay hydrated and wear bright, reflective clothing. If sidewalks are unavailable, public school tracks and indoor shopping malls can be additional areas to squeeze in a little extra physical activity.

Be sure to consult a primary doctor before making changes to your diet and exercise routine.

If lifestyle and diet changes improve your overall health but erectile dysfunction persists, even intermittently, a wearable device free of the negative side effects of medication may help restore sexual function. Eddie® is an FDA-registered Class II medical device designed to treat erectile dysfunction and improve male sexual performance. Its specific shape optimizes blood flow as it puts pressure on the veins of the penis but not the arteries.

Complete Article ↪HERE↩!

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Anxiety and Erectile Dysfunction

— Is there a connection?

 

By Jana Abelovska

It may surprise you that your genitals are not your primary sex organ; your brain is! The brain plays a significant role in your ability to feel aroused. If you find it difficult to relax, it will be challenging to get aroused or reach orgasm.

Having trouble maintaining an erection isn’t always linked with age. Men often experience ED at some point. The good news is that you can now identify the cause of ED, which will usually go away with treatment.

Anxiety refers to feelings of nervousness, worry, or unease about something with an uncertain outcome. Anxiety means continuous stress or fear after the source of this stress or concern has passed. Anxiety is the most prevalent mental health condition in the Uk, and 20% of men will likely experience anxiety at some stage. You may get Viagra pills online from a trusted pharmacy if you have ED.

The causes of ED may be both psychological and physical. The success of treatment for physical reasons depends on your condition. Studies reveal that psychological factors are the most significant cause of ED. Psychological factors, like emotional and environmental factors, are usually curable. It includes stress and anxiety.

Anxiety plays a significant role in erectile dysfunction (ED) development. Psychological and behavioral responses to erectile dysfunction may lead to a heinous cycle of increased uneasiness, distance and conflicts. It, in turn, leads to fewer sexual encounters, less time spent together and a lack of communication between partners.

You might wonder how something you experience in your mind may cause erectile dysfunction. A number of key factors play a role when it comes to achieving an erection. Your nervous system, muscles, blood vessels, hormones, and emotions play a role in erection.

  • Stress and anxiety may trigger an increase in the production of stress hormones and a decrease in testosterone levels, which plays a role in the sex drive.
  • Stress and anxiety may trigger how the brain sends signals to your penis to allow for better blood flow.
  • Stress and anxiety may affect your self-esteem and feelings of desire.

Increased stress and anxiety may also increase your risk for other health conditions that may cause ED, like:

  • High blood pressure
  • High cholesterol levels
  • Heart disease
  • Obesity
  • Excessive alcohol consumption

How does anxiety cause erectile dysfunction?

Men experience three types of erections:

  • Reflexive erection due to physical stimulation
  • Psychogenic erection due to visual or mental associations
  • Nocturnal erection during sleep

These types of erections involve vital bodily systems and processes. A disruption in any of these processes may cause ED. These include:

  • Nervous system
  • Blood vessels
  • Muscles
  • Hormones
  • Emotions

Mental health conditions like stress and anxiety may also affect how the brain signals the body’s physical response. Stress and anxiety may affect how the brain sends messages to your penis to allow extra blood flow.

Stress and anxiety about erectile dysfunction may also contribute to a cycle of ongoing ED. Experiencing ED may lead to behavioral changes that contribute to anxiety and incidences of ED.

Reasons for erectile dysfunction

Men of all ages may experience ED in some shape or form caused by stress.

  • Psychological erectile dysfunction (mainly nervousness and anxiety) affects about 90% of teenagers and young men. This form of psychological erectile dysfunction is normally short-lived.
  • Men over 30 are more likely to deal with personal and professional stress, leading to erectile dysfunction. Personal and professional stress, such as relationship trouble, is the primary reason for ED in middle-aged men.
  • Impotence is the most prevalent cause for older men. Life circumstances, such as losing a partner or adjusting to retirement, may cause stress and anxiety, which can, in turn, cause erectile dysfunction.

How do you know if erectile dysfunction is psychological?

Whether you have discussed it with your healthcare professional, a few signs may suggest that erectile dysfunction is psychological. Ask yourself these questions:

  • Are you interested in sex and love your partner but have difficulty performing?
  • Do you experience morning erections?
  • Are you under much stress or have immense anxiety?
  • Do you get anxious about satisfying your partner?

An affirmative answer to any of the above questions doesn’t necessarily indicate that ED is psychological. Still, it may tell that one or several psychological factors affect your symptoms. It’s imperative to talk to your healthcare provider if you think ED may have something to do with your mental health issues, such as anxiety or major depression.

How to beat psychological erectile dysfunction?

Erectile dysfunction may occur for various reasons, from physical issues like high blood pressure and heart diseases to psychological ones like anxiety and depression. To treat psychological erectile dysfunction in the best way is to focus on the root of the problem, whether it is some mental illness or simply feelings of guilt about sex.

Cognitive-behavioural therapy (CBT) is a standard treatment for psychological issues, including depression and anxiety. The therapy helps to identify and change unhealthy thought patterns and behaviour that may contribute to erectile dysfunction and sexual health issues.

This kind of treatment relies on the idea that the situation (your inability to get or maintain an erection) isn’t the core problem; instead, your reaction to it is. If you learn to understand your thought patterns better, you may positively change them to resolve the issues.

The next option is psychosexual therapy or sex therapy. It is a specialized form of counseling that helps you (and your partner) to overcome sexual issues like erectile dysfunction. However, it is essential to realize that discussing erectile dysfunction with your healthcare provider and partner is integral to the healing process.

What should you do if you are having issues?

Whether in a relationship or single, changes in the sex drive and your ability to get an erection may be confronting issues. If you are in a relationship, speak with your partner about how you feel. A problem shared is a problem halved. Understanding between you and your partner will help you work through the sexual issues you are having.

If you are single, consider talking to someone you trust, like your friend or a doctor, about changes in your sex drive. Talking through this may help you better understand the next best steps.

Remember that it is normal to feel stressed during this time. It is normal not to feel like having sex. If your sex drive remains low and you have issues with ED for a couple of weeks or more, you should visit your doctor. The doctor may do a physical examination to help understand the causes of your ED and set up a treatment plan.

Conclusion

Stress is an underlying factor in erectile dysfunction. But over time, stress may cause anxiety, which triggers more stress, creating a heinous cycle that’s bad for your mental health and sex life.

Accepting the issue and being honest with your partner takes some weight off your shoulders. If you’re experiencing ED and think it may be psychological, it’s always best to talk to your healthcare provider. He will try to identify the cause of the erectile dysfunction and recommend an appropriate treatment, like medication or therapy.

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The Most Effective Erectile Dysfunction Treatments for Older Adults

By James Roland

Erectile dysfunction (ED) is very common. Although it can affect men of all ages, it occurs more often in older adults and those with certain medical conditions, like diabetes.

Older research estimates that about 70 percent of men ages 70 and older report being “sometimes able” or “never able” to achieve an erection adequate for satisfactory intercourse, compared with just 30 percent of older men who report being “usually able” or “always or almost always able.”

Though it isn’t inevitable for everyone, ED is considered a normal part of aging as its risk factors include conditions common among older adults, such as:

  • cardiovascular disease
  • diabetes
  • reduced levels of testosterone
  • use of medications that treat conditions including:
    • high blood pressure
    • chronic pain
    • prostate disorders
    • depression
  • long-term, heavy substance use, including alcohol and tobacco
  • psychological conditions, including stress, anxiety, and depression
  • overweight or obesity

Sometimes treating an underlying condition can cure or reverse ED. However, most ED treatments are designed for temporary symptom relief, so an erection can be achieved that’s satisfactory for both the person with ED and their partner.

Best ED treatment for 70s and over

A variety of ED treatments are currently available. Researchers continue to develop new medications and other therapies.
For older adults, treating ED may require a two-prong approach:

  1. treat underlying conditions that contribute to ED, such as cardiovascular disease and diabetes
  2. address ED symptoms with oral medications or other alternatives

Medications

The most commonly used ED medications among older adults are from a class of drugs called phosphodiesterase-5 (PDE5) inhibitors.

PDE5 inhibitors block the activity of an enzyme in the walls of blood vessels. As a result, blood vessels are able to relax. In the penis this means more blood can fill the blood vessels, producing an erection.

The main PDE5 inhibitors available with a prescription are:

  • sildenafil (Viagra)
  • tadalafil (Cialis)
  • vardenafil (Levitra)
  • avanafil (Stendra)

Except for avanafil, all of those medications are available in both brand-name and generic versions. (As of 2020, avanafil is still only sold as the brand-name drug Stendra.)

More ED medications are in the testing and approval process. In the United States, PDE5 inhibitors require a prescription. None are available over the counter.

Side effects from these medications are usually temporary and minor. More serious reactions such as priapism (a painful, prolonged erection) may occur in some cases.

Typical side effects include:

  • headache
  • flushing
  • congestion
  • stomach and back pain

ResearchTrusted Source indicates that PDE5 inhibitors are appropriate for most older adults.

Each medication works a little differently. For example, vardenafil usually works faster than the other medications, while tadalafil’s effects last longer.

Tadalafil is often a good choice for older adults who also have an enlarged prostate because it can be prescribed for daily dosing.

Sildenafil should be taken on an empty stomach and may require dose adjustments to get it right.

Talk with your doctor to find the right ED medication for you and your lifestyle.

Who shouldn’t take these meds

People who have certain health conditions, including heart disease, shouldn’t take these medications.

People who take certain medications to manage another health condition shouldn’t take PDE5 inhibitors either. This includes nitrates and alpha-blockers.

Older men are more likely to have heart disease or take nitrates for blood pressure.

Your doctor will take into consideration your overall health and lifestyle when prescribing an ED medication.

Injections

For older adults who find that PDE5 inhibitors don’t produce the results they want or who don’t like their side effects, self-administered penile injections may be a preferred option.

The three most widely used medications for penile injection therapy include:

  • papaverine
  • phentolamine
  • prostaglandin E1 (PGE1) or alprostadil (Caverject, Edex, MUSE)

To use these, you inject the medication into the penis with a syringe before intercourse. While this approach often results in some minor, temporary pain, research shows that about 90 percentTrusted Source of men who used alprostadil were satisfied with the results.

These medications are often used in combination with other treatments and require dosing adjustments. Your first injection should be done in your doctor’s office so they can make sure you do it correctly and safely.

Who shouldn’t use these

Older adults who feel they or their partner can’t carefully administer an injection should consider other options, whether due to lack of dexterity or other reasons.

Taking blood thinner medications is another reason to avoid injectables.

Inflatable prosthesis

If oral or injected medications can’t be used or don’t provide desired results, another ED treatment is an inflatable prosthesis surgically implanted in the penis.

In a 2012 studyTrusted Source of men ages 71 to 86, researchers found that an inflatable penile prosthesis was well tolerated and largely effective in treating ED.

Because it’s a surgical procedure, it carries the slight risks of infection or other complications. It’s important to go over all the risks and benefits of this treatment approach with your doctor. Together you can decide whether your overall health makes you a good candidate for the procedure.

It’s also important to note that an implant is permanent. It would only be removed under certain circumstances, such as infection or malfunction.

Once you have a penile implant, it permanently alters the penile anatomy. This means other treatments can’t be used after it’s placed.

Lifestyle changes

While not a specific treatment, making some changes in your day to day can make a noticeable difference in erectile function. Some helpful strategies include:

  • quitting smoking
  • limiting or avoiding alcohol or substance use
  • maintaining a moderate weight
  • exercising more often than not
  • following a healthy diet that supports cardiovascular health, such as the Mediterranean diet

Why these treatments?

PDE5 inhibitors are widely used among older adults because they’re generally safe, effective, and convenient.
Because ED medications are taken on an “as needed” basis, there isn’t the same concern about missing a dose that there may be with potentially lifesaving drugs, such as high blood pressure medications or blood thinners.

Older adults who find the side effects of PDE5 inhibitors too uncomfortable may prefer injections. Those who are used to self-administering medications, such as people who give themselves insulin shots to treat diabetes, may be more comfortable with penile injections.

Penile implants avoid the concerns about side effects altogether. And since the body’s response to medications can change over time, an implanted prosthesis also means not having to worry about changing medications or dosages.

How effective is it?

ED treatments vary in how long each one is effective, as well as side effects. Regardless of which kind of treatment you choose, there are some important facts to keep in mind:

  • ED medications typically take 30 to 60 minutes to become effective. Medications such as sildenafil usually wear off in about 4 hours or so, while tadalafil’s effects can linger for nearly 36 hours. Your general health and other factors will affect these time estimates.
  • If you don’t get the results you want from one PDE5 inhibitor, a different one may be a better match.
  • ED medications don’t cause erections. Sexual stimulation is still required to become aroused.
  • As you get older, you may require more stimulation to become aroused than you did when you were younger.
  • An erection triggered by a penile injection may occur within 15 minutes, though sexual stimulation may still be required for the medication to work.
  • Recovery from inflatable penile prosthesis surgery can take 4 to 6 weeks. This means no sexual activity or great physical exertion should take place during that time. Once you’re free to engage in intercourse, the prosthesis takes only minutes to be inflated.
  • Lifestyle changes, such as strategies that boost cardiovascular health and weight management, have also been proven to be effectiveTrusted Source.

Is it safe?

ED medications can be taken safely with most other medications, though they shouldn’t be used if you take nitrates or alpha-blockers.

The combination of PDE5 inhibitors and these medications could causeTrusted Source a dangerous drop in blood pressure.

People with heart disease or kidney disease should discuss the use of PDE5 inhibitors with their doctor. They may prescribe a lower dose, which may or may not help you achieve the results you want.

Injections pose different risks than oral medications as it may be possible to hit a blood vessel or nerve with the syringe. Also, scarring is possible. It’s best to make the injections in different places each time to reduce scarring.

Implant surgery is generally safe, and the technology is constantly improving. It’s important to find a surgeon who has ample experience with this procedure.

When to see a doctor

You can often chalk up occasional episodes of ED to stress, fatigue, relationship conflicts, or other temporary conditions. They don’t necessarily indicate a problem that needs medical attention.

But frequent problems with ED can point to the need for medical attention, especially if the ED is affecting relationships, self-esteem, and quality of life. Talk with your doctor or a urologist if this is the case for you.

Having that conversation is also important because ED can sometimes be an early symptom of diabetes or cardiovascular disease. Your doctor may want to order blood tests and other screenings to check for these underlying conditions.

The bottom line

ED at any age can be a troubling condition. Among older adults, it may be more expected, but it’s nevertheless still a concern.

ED medications and other treatments have a track record of effectively and safely treating ED symptoms in older adults.

Proper treatment starts with a frank conversation with your doctor. Don’t be embarrassed to have this conversation. Rest assured your doctor has the same talk with many other people, year in and year out.

It’s also important to talk openly and honestly with your partner. ED is simply a health condition. It should be approached thoughtfully in a straightforward manner, in the same way you would address any other condition, like arthritis or high blood pressure.

Counseling may also be helpful for both you and your partner while you seek the right medical care for this common concern.

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I watched the first episode of reality series ‘Good Sex,’ and seeing men ask for sex help was really hot

On the television series “Good Sex,” couples agree to put cameras in their bedrooms during sex and talk about the footage with a coach after.

By Julia Naftulin

  • The new discovery+ series “Good Sex” has couples put cameras in their bedrooms. A sex coach uses the footage to help improve their intimacy.
  • In the first episode, men reveal their sexual issues, like erectile dysfunction and overall inexperience.
  • The show is a reminder that sex should be a safe space to explore desire and pleasure.

On the new television series “Good Sex,” couples willingly plant video cameras in their bedrooms while they have sex, then fork the tapes over to a sex coach for help.

Caitlin V. Neal, the show’s resident sex coach, has spent more than 10 years helping men with erectile dysfunction, premature ejaculation, and pleasuring women.

Minutes into the first episode, a 48-year-old man named Ben admits he has trouble getting out of his head during sex with his partner Annie, which has led to erectile dysfunction. When Neal later examines video footage of their lovemaking, she finds out Annie’s dog is in the room while they’re getting it on, which interferes with Ben’s ability to focus. In the same episode, a man in his 20s reveals he’s never had sex, and wants to learn how to please a woman before he does, so Neal walks him through different pleasure points by caressing an anatomical model of female genitals.

As Insider’s sex and relationships reporter and advice columnist, I constantly read questions from women who want to save their sex and love lives. So it was refreshing to watch men get candid about their sexual concerns, like when Ben said a disconnect between his brain and body was likely the reason for his “limp dick.”

To me, “Good Sex” is a reminder that sex can be awkward and fulfilling all at once. Like the willingness to ask for help, good sex requires self-awareness, self-love, and feeling safe enough to show you’re still figuring it out.

“Good Sex” takes a raw approach by showing couples in the midst of their sexual mistakes, not just how they resolve them.

A 48-year-old named Ben opened up about difficulty achieving orgasm during sex

Ben said he’s only been with three women in his life, including his current partner of two years, Annie. They said they were both previously married to their college sweethearts.

“As great as our sex is, I’m not able stay hard, or even get hard, sometimes,” Ben told the camera during the first episode. He said current erectile dysfunction issues have made sex feel disheartening and distressing, especially coming from a previous marriage where he wasn’t having a lot of sex.

During their first session with Neal, Ben said erectile dysfunction medication hasn’t helped, and he wants to orgasm during sex with Annie.

According to Neal, the pursuit of good sex challenges people, especially men, to be more emotionally open.

“Sex is an inherently vulnerable act. And so if you’re looking to improve your sex life and you’re serious in your commitment to improving your intimacy, vulnerability is a requirement to getting the results that they want,” Neal said.

According to Neal, the showrunners’ idea to use cameras along with sex coaching made for “exponentially faster transformations, growth, and impact” because she could see what was actually happening, not just hear it from the couple’s blurry recollections.

“Imagine trying to explain, step by step, what happened the last time you had sex with your partner. Especially if you don’t have something to compare it to, it’s really difficult for someone to articulate what actually happened,” Neal, who also has a YouTube channel dedicated to sex advice, told Insider.

Healthy sex and relationships require work

The show offers snippets of each couples’ sex-coaching sessions and the bedroom homework Neal assigns them, but there’s a lot more work going on between scenes, she told Insider.

Each coaching session is between 90 minutes and two hours. It also takes time for a couple to unlearn the sex routines they’ve grown accustomed to over the past five to 30 years, Neal said.

When viewers watch “Good Sex,” Neal hopes they walk away with the realization that a fulfilling sex life requires commitment and help.

“We have no problem hiring career coaches, mechanics, people to install things in our homes. But for some reason, we have the story that sex is something we have to deal with privately, without any help. By putting cameras inside of those closed bedroom doors, we’re able to see this isn’t something you have to deal with in isolation. It’s not something that should be a source of shame,” Neal said.

A dedication to honesty and emotional openness in the name of self-improvement? Now that’s hot.

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A Guide to Sexual Dysfunction

Sexual dysfunction is when you have difficulty at any stage of sexual activity that prevents you, your partner, or both of you from enjoying or performing the act.

This article will define sexual dysfunction. It will also discuss the different types of sexual dysfunction, the causes, and treatments.

By Mandy Baker

What is sexual dysfunction?

Sexual dysfunction is when you have difficulty having or enjoying sexual activity, and it concerns you. It is the result of an issue within your response cycle. The sexual response cycle has various stages:

  • excitement, which includes arousal and desire
  • plateau
  • orgasm
  • resolution

Sexual dysfunction affects people of both sexes assigned at birth. It is also fairly common, affecting over 40% of females and 30% of males. While it can occur at any age, sexual dysfunction is more common among those ages 40–65 years.

Many people avoid talking with their doctor about sexual dysfunction out of embarrassment and discomfort. However, treatments are available to help the issue. If you are experiencing sexual dysfunction, contact your doctor and be open with them so they can suggest the most effective treatment for you.

What are the types of sexual dysfunction?

There are four main categories of sexual dysfunction. These categories include:

  • Desire disorders: These involve your desire and interest in sex. They are also known as low libido or libido disorders.
  • Arousal disorders: This type of disorder means it is difficult or impossible for you to become sexually aroused.
  • Orgasm disorders: These disorders involve delayed or absent orgasms.
  • Pain disorders: These disorders involve pain during intercourse.

There are various types of sexual dysfunction disorders within each category. Some are more common than others.

Hypoactive sexual desire disorder

Hypoactive sexual desire disorder (HSDD) is one of the most common sexual dysfunction disorders. HSDD is sometimes a lifelong condition. It can affect anyone.

If you are experiencing HSDD, it means you have little to no sex drive and do not have much interest in sex in general. Someone with HSDD typically shows the following signs:

  • having little to no thoughts or sexual fantasies
  • having no response to sexual suggestions or signals
  • experiencing a loss of desire for sex in the middle of it
  • avoiding sex completely

Erectile dysfunction

Erectile dysfunction (ED) is when you have difficulty getting or maintaining an erection. It is the most common sexual dysfunction males visit their doctor for, affecting more than 30 million people.

It is not uncommon for most males to experience ED from time to time, especially after age 40. However, it becomes an issue when it is progressive or begins to happen more routinely.

ED can be a warning sign of cardiovascular disease. It can also cause:

  • low self-esteem
  • depression
  • distress within the individual and their partner

ED is treatable. Contact your doctor if you are experiencing ED and it is affecting your life or relationships.

Orgasm disorder

It is not uncommon for people, especially females, to have difficulty orgasming from time to time. However, it is more of an issue when:

  • you do not have orgasms
  • it takes a long time for you to orgasm
  • you do not orgasm as often as you would like
  • your orgasms are not as strong as you would like or expect
  • you feel sad, anxious, or concerned

Genital arousal disorder

Genital arousal disorder is when you have difficulty becoming or staying aroused. In females, this often means that the desire to become aroused may be there. However, your body, mind, or both do not react as expected.

These issues with arousal may come from emotional issues, behavioral issues, or an underlying medical condition. Speak with your doctor to help discover the underlying issues and get treatment.

Vulvodynia

Vulvodynia is persistent pain in the vulva that is not due to an infection or other medical condition. The pain typically lasts for at least 3 months. However, it can become a long-term issue as well.

Pain in the vulva area is the main symptom of vulvodynia. This pain may be:

  • burning, stinging, or throbbing
  • sore
  • triggered by touch
  • worse when sitting
  • constantly present in the background
  • widespread

If you are experiencing unexplained pain, contact your doctor.

Premature ejaculation

Premature ejaculation is when you ejaculate sooner than you would like or expect during sexual activity. In the United States, 1 in 3 males between the ages 18–59 experience premature ejaculation.

Premature ejaculation is not always a cause for worry. However, if it is happening routinely, is causing issues in your relationship, or concerns you, contact your doctor.

What are the symptoms of sexual dysfunction?

The symptoms of sexual dysfunction vary depending on the person and the cause of the dysfunction. Some common symptoms do occur, however.

Signs in both males and females

Both males and females may experience:

  • difficulty becoming aroused
  • a lack of sexual desire
  • pain during intercourse

Signs in males

Males with sexual dysfunction may experience:

  • inability to achieve or maintain an erection
  • delayed or absent ejaculation
  • premature ejaculation

Signs in females

Females may experience:

  • vaginal dryness
  • inability to achieve orgasm
  • pain that may be due to vaginal spasm or inflammation of the vulva

  • What causes sexual dysfunction?

    Many possible issues can contribute to the development of sexual dysfunction. These include:

    How do you treat sexual dysfunction?

    Treatment for sexual dysfunction mostly depends on its type and cause. Speak with your doctor to diagnose the underlying cause and find the most effective treatment for you.

    Treatments for sexual dysfunction include:

    • Medication: Medications to treat underlying medical conditions can help sexual dysfunction as well. Certain medications, such as viagra or hormone replacements, may also help. The effectiveness of certain medications depends on the cause.
    • Mechanical aids: Vacuum devices, penis pumps, and penile implants are all possible options if you have trouble achieving or maintaining an erection. For females who experience muscle tightening or spasms, special dilators may help.
    • Therapy: Both psychotherapy and sex therapy can help treat the psychological causes of sexual dysfunction.

    Self-help tips for sexual dysfunction

    Ways you can help yourself with sexual dysfunction include:

    • being open with your partner
    • masturbating
    • limiting your use of alcohol or drugs
    • stopping smoking
    • using lubricants
    • exploring using sex toys
    • limiting your stress
    • exercising regularly
    • practicing kegel exercises

    Summary

    Sexual dysfunction is not uncommon. Both males and females experience it. Many find it embarrassing and uncomfortable to talk about.

    However, many issues that cause sexual dysfunction are treatable. Therefore, speaking with your doctor can help. Being open with your partner about the issues can help your sexual dysfunction and your relationship.

    Sexual dysfunction may be a sign of an underlying medical condition. Contact your doctor if you are experiencing signs of sexual dysfunction and it is causing you concern or affecting your relationships.

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10 Top Sex Ed Tips for Those 50 and Older

Making love is about more than intimacy. It’s good for your health, too

By Robin Westen

How sexy are your 50s?

If you think sex is the province of the young, you’re wrong. People in their 20s are having less sex now than ever before, studies show, so it’s possible that you’re as active, or more so, as the average millennial. About a third of us are getting busy several times a week, one survey found.

And most of us are still in the game: 91 percent of men and 86 percent of women in their 50s report being sexually active, although activity levels vary widely. So, there’s no “normal” amount of sex for people our age. What matters more is that you and your partner are happy with your sex life. Men and women age differently, and some studies indicate that sexual interest wanes differently as well. Combine that with emotional and physical issues, and it’s possible that you and your partner aren’t on the same wavelength when it comes to making waves.

The upsides, however, go way beyond our cravings for intimacy, pleasure and connection. Sex boosts our immune systems, improves self-esteem, decreases depression and anxiety, relieves pain, encourages sleep, reduces stress and increases heart health. (In one study, men who had sex at least twice a week were 50 percent less likely to die of heart disease than their less active peers were.) Another bonus: You burn more calories making love than by watching The Great British Baking Show.

Not only is there a lot of science around the subject of later-life lovemaking; there’s also a range of products and medicines that can help. Take these steps to revitalize your sex life.

1. Connect emotionally

Women are twice as likely as men to lose their enthusiasm for sex in long-term relationships, research shows. The problem isn’t always reduced estrogen; it could be an absence of emotional closeness. In these cases, try listening more, praising more and showing more kindness. Individual, couples and/or sex therapy can help as well. Look for a sex therapist certified by the American Association of Sexuality Educators, Counselors and Therapists.

2. Address vaginal dryness

It’s one of the top impediments to sex among older women: 34 percent of women ages 57 to 59 experience dryness and discomfort during intercourse, one study found. For help, try over-the-counter remedies before and during sex, such as water-based lubricants (K-Y Jelly and Astroglide), oil-based lubes (olive, coconut and baby oils) and OTC moisturizers (Replens and Revaree). Use these a few times a week, even if you’re not having sex.

3. Emphasize foreplay

“Regardless of the level of dryness, every woman needs to be primed with foreplay before intercourse,” says Elizabeth Kavaler, M.D., a urologist-urogynecologist at Total Urology Care of New York. Another tip: Encourage a woman to orgasm first, which provides more moisture for intercourse and other penetration.

4. Don’t let ED keep you down

Half of men who are in their 50s experience erectile dysfunction (ED), and the gold standard for treatment is prescription meds. Safe, effective options include Viagra (which lasts for four to six hours), Levitra (four hours), Cialis (up to 18 hours) and Stendra (up to six hours).

For the minority of men who can’t rely on a pill, other choices include alprostadil (a drug that’s self-injected into the penis) and Muse (a suppository that slides into the penis). Vacuum pumps use suction to coax erections, and new treatments include platelet-rich plasma (PRP) therapy, which may regenerate nerves and improve blood circulation.

5. Don’t ignore other conditions

Any problem that affects overall health can interfere with sexual pleasure. “Cardiovascular issues such as high blood pressure, as well as diabetes, can negatively impact blood flow,” which isn’t good for sexual arousal, notes New York ob-gyn Alyssa Dweck, M.D., coauthor of The Complete A to Z for Your V. “And depression or anxiety can reduce the desire or ability to have sex.” The problem? Medicines that treat these conditions may also affect sexual desire and response. Speak with your health care provider about side effects and possibly switching meds or adjusting the dosage or timing.

6. Consider estrogen

Women, if over-the-counter lubricants aren’t doing the trick, consider estrogen replacement therapy (ERT), which treats hot flashes and vaginal dryness. The most common delivery methods are creams and pills (you can self-apply Estrace and Premarin with an applicator or take these in pill form), insertable tablets (with Vagifem, you use an applicator to slide a tiny tablet into the vagina) and a ring (Estring, which your doctor inserts, or you can do this yourself; it needs to be replaced every three months). ERT is not recommended for anyone who has or had breast cancer, or for those who have recurrent or active endometrial cancer, abnormal vaginal bleeding, recurrent or active blood clots, or a history of stroke.

7. Think about lasers

A treatment called fractional laser therapy can help reduce vaginal dryness without estrogen. It works like this: A laser creates tiny superficial burns in the vaginal canal. As the area heals, this leads to fresher collagen development and increased blood supply, which makes the area more elastic and responsive, Kavaler explains. (She cautions against vaginal rejuvenation surgery, which is a cosmetic procedure: “It can reduce sensitivity in the area and can make orgasms even more difficult to achieve or, in some cases, sexual intercourse permanently painful.”)

8. Confront incontinence issues

In a national poll of more than 1,000 women, nearly half of those over age 50 reported bladder leakage during sex. The primary reason: Sexual stimulation puts pressure on the bladder and urethra. If you’re hoping to get lucky in the hours ahead, avoid consuming beverages or foods with caffeine, such as coffee and chocolate; caffeine stimulates the bladder and acts as a diuretic (citrus fruits and juices are diuretics, too). Men whose prostates have been removed can also experience incontinence during sex. This condition, known as climacturia, can be treated in a number of surgical and nonsurgical ways. Plus, medications such as Ditropan and Vesicare can decrease urination frequency.

9. Turn down testosterone

In late 2020, the American College of Physicians stated that testosterone replacement should no longer be administered to treat a lagging libido (testosterone can have serious side effects, including an increased risk of prostate abnormalities). Denver urologist David Sobel, M.D., offers three easy alternatives: “sleep, reducing stress, and — the big one — exercise.” Even better: Work out with your lover. Seventy-one percent of runners say that running as a couple plays a healthy role in their sex life, according to a 2021 survey according to a 2021 survey.

10. Overcome arthritis aches

About 58 million Americans have arthritis, and over half are younger than 65, reports the Centers for Disease Control and Prevention. Arthritis can limit your ability to engage in sex. In addition, an empathetic partner may resist sex to avoid creating discomfort. An option: Ask your partner to experiment with more comfortable positions. Also, time sex for when you feel best (rheumatoid arthritis pain is usually more acute in the morning), the Arthritis Foundation advises. Taking a warm bath, alone or together, can help relax joints before making love. If the pain is severe, try an OTC medicine such as ibuprofen before having sex, or speak with your doctor about prescription medications.

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Can Xanax Cause Erectile Dysfunction?

By Laura Dorwart

Xanax (alprazolam) can cause sexual side effects, including low libido (sex drive) and erectile dysfunction (ED).1 Xanax is a prescription medication used to treat anxiety disorders, such as generalized anxiety disorder (GAD) and panic disorder. It is also sometimes used to treat insomnia, muscle spasms, and seizures.2

Xanax belongs to the benzodiazepine drug class, which works by slowing down central nervous system (CNS) activity. Some of the most common side effects of Xanax include drowsiness, dry mouth, irritability, dizziness, headache, and difficulty concentrating.2

This article will discuss why Xanax causes sexual dysfunction for some people, how to manage Xanax and ED, and more.

Does Xanax Cause ED?

Many prescription medications used to treat mental health conditions have sexual side effects. Recent research shows that Xanax (alprazolam) has been linked to erectile dysfunction (ED). ED can involve difficulty getting or sustaining an erection, abnormal ejaculation, and delayed or diminished orgasms.3

In clinical trials, people who were taking Xanax for symptoms of panic disorder experienced sexual dysfunction. Of the people who took Xanax, 7.4% reported having sexual side effects compared to 3.7% of people who were given a placebo (an inactive pill).4

In another study, people with panic disorder symptoms experienced a reduced sex drive, orgasm dysfunction, and ED when taking Xanax.5 Results from a Boston Area Community Health Survey in 2013 also associated long-term benzodiazepine use with increased ED symptoms among people aged 30 to 79.1

Xanax Sexual Side Effects

Xanax has been linked to a number of possible sexual side effects, including:

The risk of sexual side effects from Xanax may increase for people who take it more often, for a longer period of time, and/or at a higher dose. A 2018 case study revealed that higher doses of alprazolam could raise the risk for anorgasmia among male patients.6

Causes of Erectile Dysfunction

It’s not entirely clear why Xanax sometimes causes ED. However, researchers believe that the answer could be related to how the drug affects the central nervous system (CNS). 

Benzodiazepines like Xanax work by slowing down CNS activity and increasing the levels in the brain of certain neurotransmitters (chemicals that carry signals between nerve cells), specifically dopamine and gamma amino-butryric acid (GABA)—a neurotransmitter that acts as a sort of sedative.7

While this mechanism effectively reduces stress, it may have the same inhibitory effect on libido and sex drive. Low libido can lead to ED and other kinds of sexual dysfunction.

Even if your ED symptoms started around the time you began taking Xanax, it’s possible that your symptoms are due to another physical or mental health condition. Other common causes for ED may include:3

Most people take Xanax to treat symptoms of anxiety and other mental health conditions. Because anxiety and depression have both been linked to (and can exacerbate) ED, it’s important to address your underlying conditions as well as any sexual side effects you might experience from Xanax.8

Managing Erectile Dysfunction on Xanax

There are several possible ways to manage Xanax-related sexual dysfunction, including:

  • Lowering your dose: Under the supervision of your healthcare provider, you might be able to take a lower dose of Xanax to decrease the severity of sexual side effects.6
  • Taking Xanax less frequently: Chronic and frequent use of benzodiazepines is linked to higher rates of ED.1 Taking Xanax less often may improve your sexual functioning. Discuss your dosing schedule with your healthcare provider.
  • Switching to another medication: Your healthcare provider might be able to prescribe another antianxiety medication with a lower risk of ED.
  • Taking medications for ED: Taking prescription medications to treat ED may counteract the sexual side effects of Xanax.
  • Treating underlying conditions: Treating the symptoms of underlying conditions, such as anxiety and depression, can improve your overall sexual health.

Talk to Your Healthcare Provider

If you experience ED or other sexual side effects while taking Xanax, talk to your healthcare provider. They may be able to prescribe another medication, lower your dose, or refer you to another specialist who can help.

Summary

Xanax (alprazolam) is a common prescription medication that belongs to the class of drugs known as benzodiazepines. Usually, Xanax is prescribed to treat anxiety disorders and panic disorder. It may also be prescribed to treat seizures, insomnia, and muscle spasms.

Some people who use Xanax report experiencing sexual side effects. In addition to erectile dysfunction (ED), some people with Xanax experience reduced sex drive, anorgasmia, problems with ejaculation, and orgasm dysfunction. These sexual side effects may be due to the drug’s effects on the central nervous system.

People who experience ED while taking Xanax should talk to their healthcare provider about how their treatment could be modified to reduce this side effect.

A Word From Verywell

If you are experiencing sexual side effects while taking Xanax, don’t be afraid to reach out to your healthcare provider. They can offer alternatives and other solutions to help you treat your condition while improving your sexual functioning.

Frequently Asked Questions

  • How does antidepressant medication cause erectile dysfunction?
    Antidepressant medications and other psychotropic drugs can cause erectile dysfunction (ED) by affecting the activity of hormones and neurotransmitters. For example, selective serotonin reuptake inhibitors (SSRIs) may cause sexual side effects due to the drug’s impact on serotonin, dopamine, and testosterone levels.9

    Xanax (alprazolam), which is usually prescribed to treat anxiety, may cause ED and reduce sexual drive by slowing down central nervous system activity.7

  • What are the other side effects of Xanax?
    In addition to sexual side effects such as erectile dysfunction and low libido, Xanax can cause side effects like headache, drowsiness, irritability, difficulty concentrating, difficulty urinating, dizziness, nausea, constipation, and changes in appetite.

    More severe side effects may include difficulty breathing, skin rashes, problems with speech or coordination, seizures, and disorientation.2 If you have any of these side effects, seek medical attention immediately.

  • Does Xanax lower testosterone?
    It’s unclear exactly how Xanax (alprazolam) affects testosterone levels, as research is limited. The only study found was an older one on rats that showed Xanax did not affect testosterone levels.10

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    How to Prevent Erectile Dysfunction

    By Shamard Charles, MD, MPH

    Erectile dysfunction (ED) is the inability to develop and maintain a penile erection for satisfactory sexual intercourse or activity. It is the most commonly reported sex problem in people with a penis, affecting at least 18 million people in the United States.1 It is also called erectile disorder.

    The symptoms of ED may be exacerbated by age due to natural declines in testosterone.1 Testosterone is a hormone that influences the sex drive, among other functions. Testosterone replacement does not improve ED but can help with libido and arousal, making it easier to get an erection.

    The ability to develop and maintain an erection is largely governed by sexual arousal, a complex process that involves the brain, hormones, emotions, nerves, muscles, and blood vessels.

    Although older age is the variable most strongly associated with ED, physical or psychological factors can impact sexual function, desire, or arousal, all of which can cause ED.2

    This article will discuss ways to prevent ED, including diet, exercise, losing excess weight, managing high blood pressure and cholesterol, smoking cessation, alcohol moderation, stress reduction, and more.

    Eat a Healthy Diet

    Eating a diet rich in natural foods like fruits, vegetables, whole grains, and fish—with lesser amounts of red and processed meats and refined grains—has been shown to decrease the likelihood of ED.

    A study of over 21,000 found that men with the greatest adherence to a Mediterranean diet or Alternative Healthy Eating Index 2010 (AHEI-2010) diet were least likely to develop erectile dysfunction.1

    These diets emphasize the consumption of vegetables, fruits, nuts, legumes, and fish or other sources of long-chain fatty acids (types of omega-3 fatty acids), and avoidance of red and processed meats.

    Men under 60 who most closely adhered to the Mediterranean diet were 40% more likely to regain normal sexual function.1 Of note, eating a heart-healthy diet also lowers your cardiovascular risk factors, such as blood pressure, blood sugar, and cholesterol levels. These factors greatly contribute to the development of ED.

    Exercise

    Keeping up with a regular exercise routine is especially helpful for those whose ED is caused by inactivity, poor circulation, obesity, low testosterone, or cardiovascular disease.

    Exercise lowers blood pressure and blood sugar, increases blood circulation throughout the body, and improves heart health. It is also a natural way to raise testosterone levels.3 Burning fat also decreases the risk of vascular (blood vessel) disease and diabetes—two major causes of ED.

    Curing your ED doesn’t necessarily mean that you have to make drastic changes. Even small increases in activity can make a difference.

    One study found that patients recovering from a heart attack who were put on a progressive walking program starting at just six minutes a day reported 71% fewer incidences of ED over 30 days than those who didn’t walk.4

    Other research has suggested that moderate exercise can help restore sexual performance in obese middle-aged people with ED.5

    People with ED found at an early age (before age 50) may have undiagnosed cardiac problems. A person in this age group may be sent for a heart evaluation before treatment is started for the erection problems. Early-onset ED could be a warning sign for deeper issues in the heart.

    Lose Weight If Needed

    Losing weight is a health goal for many reasons. Can one of those reasons be to help cure erectile dysfunction? The short answer is yes.

    Weight loss has a twofold advantage of directly alleviating ED and improving your physical health. Dropping a few pounds lowers blood pressure and prevents further narrowing and blockages in your arteries, allowing blood to travel more efficiently.

    Studies have shown that excess belly fat can cause an inability to get or maintain an erection.6 The endothelium, a small sheath of tissue that forms the interior lining of all our blood vessels, can become damaged by excess belly fat.

    As a result, your body may not release enough nitric oxide—a molecule that signals the surrounding muscles to relax in order for the blood vessels to dilate and create an erection.7 Even more, carrying excess weight can lower testosterone levels, which further compounds the problem.

    Having excess weight can also lead to a visible loss in penile length. Losing weight may lead to a visibly larger length to the penis, with the extra fat and tissue no longer covering up the base of the penis. The extra visible length is an added bonus to better erection quality with weight loss.

    Fortunately, reducing your beltline can reverse your ED. In one major study, over 30% of men minimized, if not completely cured, erectile dysfunction via weight loss by eating 300 fewer calories per day and exercising more over several weeks.8

    Weight loss typically comes from both reducing your calorie intake and increasing physical activity. Increasing physical activity seems especially helpful in lowering rates of ED.5

    Losing weight, particularly belly fat, is integral to alleviating ED. Here are some ways you can reduce your waist size:

    • Eat regular nutritious meals. Avoid skipping meals. Substitute cooked meals for processed foods and takeout. Eat a balanced diet of fruits and vegetables.
    • Emphasize portion control. Keeping portion sizes in check using the MyPlate method (in which you eat the different food groups in appropriate amounts) is a great way to curtail overeating and ensure that you eat a balanced meal.
    • Replace sugary beverages like soda, energy drinks, and fruit juices with water, black coffee, or unsweetened tea.
    • Limit alcohol. Alcohol use is often associated with poor eating habits. Also, the liver burns alcohol instead of fat, which results in bigger waistlines.
    • Incorporate more fiber into your diet. Fiber makes you feel fuller for longer, which curtails mindless eating.
    • Exercise daily. The United States Preventive Services Task Force (USPSTF) recommends 30 minutes of sweat-breaking exercise for a minimum of five days a week.9

    Manage Blood Pressure

    High blood pressure damages blood vessels, reducing blood flow throughout the body, including the penis. Hardened and narrow blood vessels make it difficult for blood to flow into the penis before intercourse.10

    Erectile dysfunction may be an early warning sign of damaged blood vessels. When your blood flows naturally, you can have healthy erections. Natural arousal leads to increased blood flow to your penis, causing an erection.

    This process becomes more difficult with high blood pressure. Slowing of blood flow in the pelvic region can make getting or maintaining an erection a challenge. This change in sexual function is sometimes a warning sign of a larger problem, prompting people to seek help.

    People who have isolated high blood pressure but otherwise a clean bill of health are usually safe taking ED drugs. But if you have health complications like severe cardiovascular disease or urinary tract issues, ED drugs are generally not recommended.11

    It is also important to avoid high blood pressure, as medical treatments for blood pressure have the potential side effect of ED.

    Avoid High Cholesterol

    High cholesterol is a risk factor for many conditions that can lead to ED, such as heart disease.12 High cholesterol levels lead to atherosclerosis, a condition that hardens and narrows blood vessel walls.

    Atherosclerosis reduces blood flow throughout the body, including the penis. Hardened and narrow blood vessels make it difficult for blood to flow into the penis before intercourse.

    One of the earliest signs of heart disease is the inability of blood vessels in the penis to enlarge, allowing enough blood flow to get and maintain an erection. One study found that men over the age of 69 with ED had more than twice the number of heart attacks, cardiac arrests, and strokes than similarly aged men without ED.13

    Eating a heart-healthy diet, doing routine exercise, and taking a statin, or another prescribed cholesterol-lowering drug, can bring your cholesterol to healthy levels, decreasing your cardiovascular risk and potentially alleviating your ED symptoms along the way.

    Don’t Smoke

    Smoking is an independent risk factor for ED. It causes vascular changes to the endothelium of blood vessels, which interferes with nitric oxide production and signaling.14

    Smoking also causes vascular changes that increase your risk of heart disease, hypertension (high blood pressure), and diabetes, which are also associated with the development of erectile dysfunction.

    Many people smoke to reduce their sexual performance anxiety (fear or worry related to having sex), unaware that they are exacerbating the problem.

    Quitting smoking has immense health benefits. So even though it may not completely reverse ED, it may contribute significantly to improving penile function and your overall health.14

    Experts believe that vaping is no better than cigarettes when it comes to the risk of erectile dysfunction.15 Try to avoid smoking altogether, whether cigarettes, cigars, or vaping.

    Drink Alcohol in Moderation

    Drinking large amounts of alcohol can make it difficult to get or keep an erection because alcohol interferes with the chemical messengers that tell the penis to fill with blood.

    One study looking at nearly 50,000 men found that over half of those who reported that they were alcohol dependent had some type of sexual dysfunction, with one quarter citing ED as their main problem.16

    Chronic alcohol use also interferes with the production of testosterone, the hormone that governs male sexual functioning. Lower testosterone levels affect sperm production and sexual desire. Alcohol can also increase your total calorie intake; that can cause increased weight gain, which can also exacerbate ED.

    Heavy alcohol use has also been associated with:17

    • Low sexual drive (libido)
    • Reduction in size of sex organs (binge drinking over a long time can cause the testes and penis to shrink)
    • Lower fertility
    • Higher rate of sexually transmitted infections (chronic alcohol users are more likely to engage in sexual practices that carry a higher risk)

    If alcohol use is the sole culprit of ED, the condition will usually resolve once alcohol use is stopped.

    Check Testosterone

    Testosterone levels drop with aging, so as you get older you may want to check your levels if you’re experiencing symptoms of ED. 

    Testosterone is central in the male sexual response, including the desire for sex and the mechanics of triggering an erection.12 Lower levels could mean problems getting and maintaining an erection, although people with perfectly normal amounts of testosterone can have erectile dysfunction.

    Boosting testosterone alone doesn’t always improve erections, but it can in a subset of people, so it should be considered for those with low testosterone.12 Taking low doses of testosterone may also give you the added benefit of increased libido.

    Still, improved testosterone levels don’t always mean levels that are high enough to make a difference in sexual performance. It is not unusual for a healthcare professional to add Viagra (sildenafil) or a similar medication if a person is still not satisfied with the quality of their erection when given testosterone therapy alone.2

    Avoid Anabolic Steroids

    Every year, 1 million to 3 million people in the United States use anabolic steroids (AAS).18 These drugs have been used off-label (for other than indications approved by the Food and Drug Administration, or FDA) for decades. Various reasons include enhanced aesthetics, improved athletic performance, increased muscle mass, or other symptomatic benefits.18

    Anabolic steroids interfere with the body’s capacity to produce testosterone, which may lead to erectile dysfunction.

    Taking steroids, whether androgens taken as part of testosterone therapy for a medical condition or recreational anabolic steroid use in bodybuilding, can affect the hypothalamic-pituitary-adrenal (HPA) axis. This means that it upsets your balance and regulation of hormones and impacts pituitary gland function.

    Fortunately, ED issues such as testicle shrinkage and low libido may begin to disappear once you stop steroid use.

    Check Medication Side Effects

    It’s been estimated that 25% of all ED is caused by side effects from medication.19 Certain drugs taken for high blood pressure—notably thiazide diuretics (water pills) and beta blockers—have been linked with deterioration in sexual function.

    Therefore, be on the lookout for medications in these drug classes, and never start a blood pressure medication without medical supervision.19

    Avoid Stress

    Like alcohol, stress interferes with signals between the brain and body that get and maintain erections. The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement.

    A number of stressors can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:

    • Depression, anxiety, or other mental health conditions
    • Job loss, job promotion, or work stress
    • Financial burdens
    • Death in the family 
    • Changes in health
    • Relationship problems due to stress, poor communication, or other concerns
    • Anxiety about sexual performance

    Increased stress can also increase your risk of other conditions that may cause ED, such as heart disease, high blood pressure, high cholesterol levels, obesity, and excessive alcohol consumption. These all contribute to ED independently, so addressing the root cause of your stress is paramount in alleviating ED in many people.

    Talk therapy is a useful tool to unpack your thoughts and feelings, and sometimes it’s all that you need to jumpstart your sex life. It’s also important to note that stress can be both a cause and a symptom of ED.

    In other words, stress can affect your sexual arousal and therefore cause ED. But not being able to perform in bed may also make you anxious and nervous or lead to sexual avoidance, which can further exacerbate your ED.20

    Talking to your partner about ED can be understandably difficult, but communication is a part of any healthy relationship and sex life. Talking about your difficulties takes the pressure off you and informs your partner of what’s going on.

    It can also serve as an opportunity to engage in more pro-healthy behaviors like quitting smoking, exercising more, and eating a heart-healthy diet.

    Joining a support group and reimagining your sex life are also worthwhile coping mechanisms. Talking to strangers can be a stress reliever.

    Hearing the thoughts and feelings of others can serve as a reminder that intimacy is not dependent on penile penetration. Naughty talk, foreplay, and intimate touching are also important components of a healthy sex life.

    Summary

    You can help prevent many of the causes of erectile dysfunction. Following a healthy eating plan, quitting smoking, never doing drugs, limiting alcohol, maintaining a healthy body weight, monitoring blood pressure and blood sugar, and aiming for at least 30 minutes of activity most days are tried-and-true methods that not only stave off ED, but keep your heart healthy and strong.

    A Word From Verywell

    If you are having trouble maintaining a healthy lifestyle or natural methods have not prevented ED, talk to a healthcare professional who has expert knowledge in the management of ED. Together, you may uncover other tactics to use. In addition, there are prescription medications and even surgical treatments that may help.

    Frequently Asked Questions

  • Who is most at risk of erectile dysfunction?
    People over the age of 60 are at the highest risk of ED because of natural drops in testosterone levels. Approximately 40% of people with a penis have some experience of ED by age 40. By age 70, nearly 70% are impacted to some degree.21
  • What is the main cause of erectile dysfunction?It’s difficult to think of ED as a condition with one cause and one effect. A multitude of risk factors for ED should be considered.

    The ability to develop and maintain an erection is largely governed by sexual arousal, a complex process that involves the brain, hormones, emotions, nerves, muscles, and blood vessels. Physical or psychological factors can impact sexual function, desire, or arousal, all of which can cause ED.

    ED is commonly caused by decreases in testosterone with age, as well as impaired blood flow to the penis due to a multitude of conditions ranging from diabetes and high blood pressure to heart disease and side effects of medication.

    The impact of mental illness, such as depression and anxiety, as well as psychological factors like stress, are also major contributors to ED at any age.

  • Which drugs cause erectile dysfunction?Using recreational drugs like cocaine, opiates, amphetamines, and possibly marijuana can prevent you from getting or maintaining an erection.22

    While some substances may disrupt the physiological processes that lead to erections, others may hinder your ability to become aroused or mask psychological, emotional, or physical factors that may be causing your ED.

    A wide variety of prescription drugs also can influence erections.

    • Complete Article ↪HERE↩!

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    Foods to Cure Erectile Dysfunction

    By Molly Burford

    Erectile dysfunction (ED) is a condition in which the penis cannot obtain, or sustain, an erection firm enough for sex. ED is more common in older populations, affecting 44% of people with a penis ages 60 to 69, compared to 5% of those under age 40. However, cases of ED in younger age groups are becoming more prevalent.1

    While occasional occurrences of ED are common, it becomes a cause of concern if it happens more than 50% of the time. This means there may be an underlying psychological or physical issue that needs to be addressed.2 There are a number of potential causes of ED, and more than one factor may be to blame.

    One of the biggest causes of ED is a lack of blood flow to the penis, which can happen due to high blood pressure (hypertension) or hardened arteries (atherosclerosis). As it turns out, diet can help both of these conditions, which in turn can help improve ED symptoms.

    Read on below to learn more about how your diet may play a role in ED and what foods can help improve the condition.

    Foods That Help Erectile Dysfunction

    Spinach

    Spinach is a low-calorie, leafy green vegetable with a high density of various vitamins and minerals, including potassium, magnesium, vitamin A, vitamin K, vitamin B2, vitamin C, calcium, and more.

    Spinach also contains a substantial amount of folate, which is also known as vitamin B9. A 1-cup serving of raw spinach contains 58 micrograms (mcg) of folate. Folate deficiencies have been linked to ED.3
    <h3″>Avocado

    Avocado is a high-calorie, nutrient-dense fruit. It is an excellent source of magnesium, potassium, vitamin C, and vitamin K.

    When it comes to ED, avocados also contain a rich amount of vitamin E. A 100 gram (g) serving of avocado contains 2.7 milligrams (mg) of vitamin E.4 A 2021 study found vitamin E and ginseng improved symptoms of ED after six weeks.5 The researchers hypothesized vitamin E and ginseng would be beneficial in cases of ED due to their antioxidant properties.

    Watermelon

    Watermelon is a water-dense, low-calorie fruit that’s composed of 92% water. It contains citrulline, a compound known to help relax blood vessels and improve blood flow.

    A 2018 study found that study participants that supplemented their ED medication (like Viagra) with L-citrulline-resveratrol saw improvements.6

    Dark Chocolate

    Dark chocolate isn’t just delicious. It is also packed with flavonoids, an antioxidant, which may reduce the risk of someone developing ED

    In 2018, a study showed that participants who ate 50 milligrams (mg) or more of flavonoids daily were 32% less likely to report symptoms of ED.7A Word From Verywell

    ED can, understandably, be a frustrating and concerning experience. However, there are steps individuals can take to enhance their reproductive health. One area often forgotten is diet.

    Research shows that eating a balanced diet is vital for overall health, and sexual health is no exception. Incorporating more nutritious foods such as spinach, watermelon, olive oil, salmon, and others may help improve symptoms of ED.

    Talk to your doctor about your concerns. Again, while bouts of ED are common, repeated instances may signify an underlying physical or psychological issue that needs to be taken care of.

    1. Rastrelli G, Maggi M. Erectile dysfunction in fit and healthy young men: psychological or pathological? Transl Androl Urol. 2017;6(1):79-90. doi:10.21037/tau.2016.09.06
    2. Cleveland Clinic. Erectile dysfunction. Updated October 14, 2019.
    3. Karabakan M, Erkmen AE, Guzel O, Aktas BK, Bozkurt A, Akdemir S. Association between serum folic acid level and erectile dysfunction. Andrologia. 2016;48(5):532-535. doi:10.1111/andr.12672
    4. U.S. Department of Agriculture. Avocados, raw, all commercial varieties. Updated April 2019.
    5. Vitamin E and ginseng combined supplement for treatment of male erectile dysfunction: A double-blind, placebo-controlled, randomized, clinical trial. Advances in Integrative Medicine. 2021;8(1):44-49. doi:10.1016/j.aimed.2019.12.001
    6. Shirai M, Hiramatsu I, Aoki Y, et al. Oral l-citrulline and transresveratrol supplementation improves erectile function in men with phosphodiesterase 5 inhibitors: a randomized, double-blind, placebo-controlled crossover pilot study. Sex Med. 2018;6(4):291-296. doi:10.1016/j.esxm.2018.07.001
    7. Mykoniatis I, Grammatikopoulou MG, Bouras E, et al. Sexual dysfunction among young men: overview of dietary components associated with erectile dysfunction. J Sex Med. 2018;15(2):176-182. doi:10.1016/j.jsxm.2017.12.008

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    Can Sleep Apnea Cause Erectile Dysfunction (ED)?

    by Annamarya Scaccia

    Obstructive sleep apnea (OSA) is the most common type of sleep apnea. It’s a potentially serious disorder. People with OSA stop breathing repeatedly during sleep. They often snore and have difficulty sleeping.

    Sleep disorders can impact your testosterone and oxygen levels. That can lead to many different issues, including erectile dysfunction (ED). Research has found a high prevalence of ED in men with obstructive sleep apnea, but doctors are not exactly sure why that’s the case.

    Researchers have found evidence that men who have obstructive sleep apnea are more likely to have ED, and vice versa. A 2009 Trusted SourceJournal of Sexual MedicineTrusted Source studyTrusted Source found that 69 percent of male participants diagnosed with OSA also had ED. A 2016 studyTrusted Source found erectile dysfunction in about 63 percent of study participants with sleep apnea. By contrast, only 47 percent of men in the study without OSA had ED.

    Furthermore, in a 2016 surveyTrusted Source of over 120 men with ED, 55 percent reported symptoms related to sleep apnea. The findings also suggested that men with ED are at a higher risk of having other undiagnosed sleep disorders.

    Scientists still don’t know why, exactly, men with obstructive sleep apnea have higher rates of ED. Sleep deprivation caused by sleep apnea may cause a man’s testosterone levels to dip. It may also restrict oxygen. Testosterone and oxygen are both important for healthy erections. Researchers have also suggested that stress and fatigue related to lack of sleep may make sexual problems worse.

    Research has shown a link between dysfunction with the endocrine system and sleep disorders. Hormone overactivity between the brain and the adrenal gland may affect sleep function and cause wakefulness. A 2014 studyTrusted Source also found that low testosterone levels can lead to poor sleep. However, there’s no evidence that obstructive sleep apnea impacts testosterone production.

    There are several types of sleep apnea, although the main three are:

    • obstructive sleep apnea
    • central sleep apnea
    • complex sleep apnea syndrome

    All three versions of the sleep disorder have similar symptoms, which sometimes makes it harder to receive a proper diagnosis. Common sleep apnea symptoms include:

    • loud snoring, which is more common in obstructive sleep apnea
    • periods where you stop breathing during your sleep, as witnessed by another person
    • waking up abruptly with a shortness of breath, which is more common in central sleep apnea
    • waking up with a sore throat or dry mouth
    • headaches in the morning
    • difficulty getting to and staying asleep
    • excessive daytime sleepiness, also known as hypersomnia
    • problems concentrating or paying attention
    • feeling irritable

    Although more research is needed, scientists have found that treating obstructive sleep apnea may also help ease symptoms of ED. According to the International Society for Sexual Medicine, many men with OSA who use continuous positive airway pressure (CPAP) for treatment experience improved erections. CPAP is a treatment for OSA where a mask is placed over your nose to deliver air pressure. It’s thought that CPAP improves erections in men with OSA because better sleep can raise testosterone and oxygen levels.

    A 2013 pilot study found that men with sleep apnea who underwent tissue removal surgery, known as uvulopalatopharyngoplasty (UPPP), also saw a decrease in ED symptoms.

    In addition to CPAP and tissue removal surgery, other treatments for obstructive sleep apnea include:

    • using a device to increase air pressure in order to keep your upper airway passages open
    • placing devices over each nostril to increase air pressure, known as expiratory positive airway pressure (EPAP)
    • wearing an oral device to keep your throat open
    • using additional oxygen
    • taking care of underlying medical issues that may cause sleep apnea

    Your doctor may also recommend other surgeries, such as:

    • making a new air passageway
    • restructuring your jaw
    • implanting plastic rods in the soft palate
    • removing enlarged tonsils or adenoids
    • removing polyps in your nasal cavity
    • fixing a deviated nasal septum

    In milder cases, lifestyle changes such as quitting smoking and losing weight may help. If your symptoms are caused or worsened by allergies, medications to help control allergies may improve your symptoms.

    Research has found a clear correlation between obstructive sleep apnea and ED. Scientists still don’t understand why the connection exists, but there’s enough evidence to show a causal link. Studies have shown that treating obstructive sleep apnea may have a positive impact on ED symptoms. This is due to improvements in testosterone and oxygen levels.

    Talk to your doctor as soon as possible if you’re experiencing sleep apnea and ED symptoms. Treating OSA may not only help you get and keep an erection more often, but it may also prevent other health conditions such as heart problems.

    Complete Article ↪HERE↩!

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    COVID-19 could cause male infertility and sexual dysfunction

    – but vaccines do not

    By

    Contrary to myths circulating on social media, COVID-19 vaccines do not cause erectile dysfunction and male infertility.

    What is true: SARS-CoV-2, the virus that causes COVID-19, poses a risk for both disorders.

    Until now, little research has been done on how the virus or the vaccines affect the male reproductive system. But recent investigations by physicians and researchers here at the University of Miami have shed new light on these questions.

    The team, which includes me, has discovered potentially far-reaching implications for men of all ages – including younger and middle-aged men who want to have children.

    An illustration of human sperm cells.
    Some men who had the COVID-19 virus might experience diminished sperm production and fertility.

    What the team found

    I am the director of the Reproductive Urology Program at the University of Miami’s Miller School of Medicine. My colleagues and I analyzed the autopsy tissues of the testicles of six men who died of COVID-19 infection.

    The result: COVID-19 virus appeared in the tissues of one of the men; decreased numbers of sperm appeared in three.

    Another patient – this one survived COVID-19 – had a testis biopsy about three months after his initial COVID-19 infection cleared up. The biopsy showed the coronavirus was still in his testicles.

    Our team also discovered that COVID-19 affects the penis. An analysis of penile tissue from two men receiving penile implants showed the virus was present seven to nine months after their COVID-19 diagnosis. Both men had developed severe erectile dysfunction, probably because the infection caused reduced blood supply to the penis.

    Notably, one of the men had only mild COVID-19 symptoms. The other had been hospitalized. This suggests that even those with a relatively light case of the virus can experience severe erectile dysfunction after recovery.

    These findings are not entirely surprising. After all, scientists know other viruses invade the testicles and affect sperm production and fertility.

    One example: Investigators studying testes tissues from six patients who died from the 2006 SARS-CoV virus found all of them had widespread cell destruction, with few to no sperm.

    It is also known that mumps and Zika viruses can enter the testicles and cause inflammation. Up to 20% of men infected with these viruses will have impaired sperm production.

    Male patient getting vaccinated.
    Early findings suggest neither the Pfizer or Moderna mRNA vaccine affects male fertility.

    A new study on vaccine safety

    Additional research by my team brought welcome news. A study of 45 men showed the Pfizer and Moderna mRNA vaccines appear safe for the male reproductive system.

    This, then, is another reason to get the vaccinations – to preserve male fertility and sexual function.

    Granted, the research is only a first step on how COVID-19 might affect male sexual health; the samples were small. Studies should continue.

    Still, for men who have had COVID-19 and then experienced testicular pain, it is reasonable to consider that the virus has invaded testes tissue. Erectile dysfunction can be the result. Those men should see a urologist.

    I also believe the research presents an urgent public health message to the U.S. regarding the COVID-19 vaccines.

    For the millions of American men who remain unvaccinated, you may want to again consider the consequences if and when this highly aggressive virus finds you.

    One reason for vaccine hesitancy is the perception among many that COVID-19 shots might affect male fertility. Our research shows the opposite. There is no evidence the vaccine harms a man’s reproductive system. But ignoring the vaccine and contracting COVID-19 very well could.

    Complete Article ↪HERE↩!

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    How Much Blood Does It Take to Get Hard?

    by James Roland

    An erection is the result of increased blood flow to the penis. But you may be wondering exactly how that works, and whether there’s a specific amount of blood that your penis needs to achieve an erection.

    In some cases, reduced blood flow to the penis can cause noticeable changes in the penis. But many other parts of your body, like your nervous system and hormones, also impact how and when your penis gets hard.

    Read on to learn more about what blood has to do with erections. We’ll also cover what you can do if you feel unsatisfied by your erection when you masturbate or have sex.

    The actual amount of blood needed to get hard varies among people. On average, it’s thought to be about 130 milliliters (mL), or 4.4 ounces. It’s a small fraction of the 1.2 to 1.5 gallons (4,500 to 5,600 mL) of blood circulating throughout the adult human body at any given time.

    Because an erection needs a relatively small amount of blood, there’s no increase in blood production in the body. But blood is redirected to supply tissue in the penis, which means that a little less blood can be directed elsewhere in the body.

    Here’s exactly what happens to the penis physiologically during an erection and how blood is involved in this process:

    Inside the shaft of the penis are two columns of spongy tissue called corpora cavernosa. This tissue contains blood vessels. When your penis is flaccid, arteries are constricted, supplying just enough blood flow to keep the tissue in the corpora cavernosa healthy.

    When you become aroused, the smooth muscles of the arteries in the penis relax, allowing the blood vessels to expand and fill with more blood. This expands corpora cavernosa tissue too, making your penis larger and firmer.

    To make an erection happen, the brain, nervous system, blood vessels and certain hormones are recruited. Here’s how this part works:

    • Nerve signals from the brain based on arousing stimuli, like visual imagery or erotic thoughts, can cause the muscles in the corpora cavernosa to relax.
    • Sensory stimulation of the penis or surrounding area can trigger a similar response, with nerve impulses signaling to the tissue in the corpora cavernosa to prepare for sexual intercourse.
    • During sexual stimulation, the body releases a chemical called nitric oxide (NO). This helps dilate the blood vessels and activate an enzyme called guanylate cyclase to trigger the release of cyclic guanosine monophosphate (cGMP). This chemical relaxes the spongy tissue and allows it to become engorged as arteries expand with greater blood flow.
    • After an orgasm, the additional blood that engorges the corpora cavernosa will start to flow out through veins in the penis. The same amount that entered at the start of the process will also exit.

    What if blood doesn’t flow back out?

    Blood that doesn’t properly flow back out of the penis can result in a condition called priapism. Blood pooling in the penis this way can damage tissue in the corpora cavernosa.

    Priapism is more common in people with blood disorders, like sickle cell anemia, but can also be brought on by medications or other factors, like the use of cocaine or conditions like leukemia.

    In addition to blood, the hormones testosterone and oxytocin may both play a role in getting and maintaining an erection.

    A 2016 review in the The Journal of Sexual MedicineTrusted Source notes that testosterone may play a role in the timing of an erection by helping to relax the penile arteries so they can fill with blood.

    Some individuals with ED and low levels of testosterone may benefitTrusted Source from testosterone therapy, but levels below the normal range are still enough to achieve a healthy erection. Testosterone also drives sexual desire, and low levels may cause a drop in libido.

    Oxytocin has also been identified as an important component in arousal. But researchers in the 2016 review noted that the use of oxytocin to create sexual arousal needs to be studied more.

    Several factors can affect blood flow to the penis or the ability of the penis to become erect, like:

    • Circulation problems. Cardiovascular disease, high blood pressure, diabetes, and high cholesterol can reduce blood flow to the penis and other parts of the body.
    • Nervous system dysfunction. Neurological disorders like multiple sclerosis, Alzheimer’s disease, and Parkinson’s disease can interfere with proper signaling from the brain to initiate the sexual arousal process.
    • Tissue damage. Radiation treatment to the bladder or prostate can sometimes harm the nerves and blood vessels that bring nerve and chemical signals to the area for arousal and blood vessel dilation. This can make it difficult or impossible for the penis to engorge itself with blood.

    A lifestyle that focuses on good physical, mental, and emotional health promotes good circulation. This is one way to help increase the likelihood of erectile function.

    Try these tips to support healthy erections and overall well-being:

    • Consider quitting or cutting back on smoking. The chemicals in cigarette smoke can injure your blood vessels.
    • Get regular aerobic exercise. Exercising throughout the week helps improve circulation, energy, and overall fitness and self-confidence.
    • Eat a balanced diet. Focus on vegetables, fruits, whole grains, and lean protein sources.
    • Address mental health issues like depression and anxiety. These can affect not just your sexual health, but your overall health.

    A 2018 studyTrusted Source found that following a Mediterranean diet was associated with a reduction in ED symptoms, compared with a typical Western diet high in fat and processed sugars.

    Another 2018 studyTrusted Source also found that an exercise regimen of 40 minutes done four times a week decreased ED within 6 months, especially for individuals experiencing ED caused by cardiovascular disease, obesity, or a sedentary lifestyle.

    An occasional episode of ED or erectile dissatisfaction, an erection that isn’t firm enough for satisfactory intercourse, is normal. This can occur when you are:

    • tired
    • distracted
    • stressed
    • under the influence of alcohol

    If you notice frequent ED or dissatisfaction even with lifestyle changes, especially if there’s no obvious trigger, talk with a primary care professional or a urologist.

    Other signs that you should see a doctor include:

    • Noticeable changes in your sex drive. These could be triggered by hormonal changes or factors like stress, depression, poor sleep, or relationship troubles.
    • Premature ejaculation. This is especially the case if you’re ejaculating much earlier than you typically expect.
    • Painful erections. These can result from tissue damage or infection.
    • Pain when urinating. This might be a sign of an infection or other conditions that can affect your urinary tract.

    The most common ED treatments are medications like PDE5 inhibitors. These include tadalafil (Cialis) and sildenafil (Viagra). These drugs work by protecting cGMP, which encourages blood flow to the penis and greater blood retention in the corpora cavernosa during sexual activity.

    Another possible treatment is a vacuum erection device (or penis pump), a tube that you place over your penis.

    A handheld pump pulls air out of the tube, creating a vacuum that triggers blood flow to the penis. A ring is then slipped around the end of your penis when you remove the pump to help maintain the erection during sex.

    Penile injections or penile implant surgery can also help treat severe cases of ED or those that are caused by another condition like diabetes (known as refractory cases).

    Healthy blood flow to the tissue within the penis helps produce an erection, and it only takes about 130 mL to get you hard.

    But creating the right environment for proper blood flow involves the brain and nervous system, plus certain hormones and chemicals. Many factors go into healthy sexual function, and many issues can interfere with it, too.

    If you notice changes in your erectile function, see a doctor. It’s a common concern and often one with a variety of effective treatments.

    Complete Article ↪HERE↩!