What You Should Know about Men’s Sexual Health

2015-01-12

Written By: Christina Johnson

Anyone who watches professional sports on TV is bombarded with commercials dealing with erectile dysfunction (ED).

But despite what the ads may lead one to believe, men’s sexual health issues are more complicated than simply taking a pill and “letting the dance begin.” Men do have a biological clock. They do experience age-related hormonal changes, and there are good medical reasons not to ignore ED, even when it responds to medication.

Here are some facts about men’s sexual health that may surprise avid sports fans, Cosmoand GQ readers alike, all vetted by Mike Hsieh MD, program director of UC San Diego’sMale Fertility and Sexual Health Program, the region’s only medical center with a specific focus on male fertility issues.

ED is an early sign of cardiovascular disease

ED is an early marker for vascular problems. This is one reason why your primary care physician may – and should – ask you about your sex life. It’s a way to detect potential heart issues.

“Many men come to my office to talk about ED and they leave with a referral to one of our cardiologists,” Hsieh said.

Why is ED a risk factor for heart attack? Simple geometry: The penile artery is one-tenth the diameter of coronary arteries. The narrower tube is likely to clog before larger arteries in the heart.

Obesity, diabetes, sedentary lifestyle, smoking and hypertension put men at higher risk of ED and also heart disease. “They really are the same problem, just different parts of the body,” Hsieh said.

One study, published in the Journal of Urology, found that approximately 75 percent of men with chronic coronary artery disease had ED.

Men and women are equally likely to have fertility issues

Not too long ago, men were believed to be fertile forever (practically), but that’s not true.

“A 50-year-old man is not as fertile as a 30-year-old. That’s the take home message,” said Hsieh, who is also an assistant professor in the Department of Urology.

Advanced paternal age is associated with lower sperm counts and lower sperm quality, and increases a couple’s chances of having a child with genetic problems, he said.

Besides issues related to aging, men may have anatomical blockages, hormonal imbalances or genetic problems that can lower sperm counts, impair sperm motility or cause dysfunctional sperm shape.

Testosterone supplements are birth control for men

Locker room jokes about the anatomical disparities of body builders can have a real scientific basis.

“Testosterone therapy tells a man’s body it can shut down,” Hsieh said. “It gets lazy.”

The brain monitors testosterone levels and when it detects adequate amounts of the hormone, it directs the testicles to go on vacation. This halts sperm production.

“Giving a man testosterone is like giving him birth control,” Hsieh said. If a man is in his 50s or 60s, the fertility issues surrounding testosterone therapy are likely irrelevant, but for younger men who want a family, doctors should identify why there is a hormonal imbalance. Certain medications, including antibiotics and cancer drugs, can reduce testosterone production. In rare cases, low testosterone can also be the result of a brain tumor.

Food for thought: Male athletes who have taken performance enhancing drugs do not necessarily regain their full fertility after they stop taking the drugs. There can be permanent damage to a man’s sperm production.

Vasectomies are reversible

A vasectomy is surgical sterilization, but it is not permanent. A man still makes sperm after a vasectomy and if it has been less than ten years since the procedure there’s a 95 percent chance that the spaghetti-sized tubing (vas deferens) that was cut or clamped can be reconnected.

A vasectomy reversal is done under a microscope with sutures as fine as eye lashes. “It’s like sewing pasta together,” said Hsieh, who is an expert on the procedure.

“Manopause” is real

Men don’t get hot flashes, but they do experience age-related declines in sex hormones that mirror female menopause. Andropause usually begins as men approach middle age in the 40s and beyond.

“Every man goes through andropause,” Hsieh said. “But symptoms vary. Some men experience irritability, fatigue, weight gain, low sex drive and erectile dysfunction. Some don’t.”

Both male and female sex hormone levels diminish with age in men, and lowered estrogen levels can contribute to health problems, such as osteoporosis. The symptoms most men notice and complain about are usually associated with lower testosterone levels.

Testosterone therapy, however, poses its own set of health risks, including acne, balding, blood thickening and urinary dysfunction caused by an enlarged prostate. New studies show testosterone may also elevate a man’s risk of heart attack and stroke.

“We are starting to recognize the risks of hormone replacement in men,” said Hsieh.

Bottom line: Aging happens. Men who go on testosterone therapy should make sure they are closely monitored for potentially serious side effects.

Almost all forms of cancer treatment can have sexual side effects

Chemotherapy impairs sperm production because the treatment, by design, target cells with robust replication rates, such as hair follicles and sperm cells. Meanwhile, surgery or radiation, especially in the pelvic region, can damage nerves or alter blood supply to reproductive organs. The stress of cancer itself can also cause hormonal imbalances, which may hinder sexual function and fertility.

“We recommend fertility preservation for all men and women who have been diagnosed with cancer and want to have children,” Hsieh said. For men, fertility preservation involves freezing sperm or testicular tissue.

Don’t let Stress Kill your Sex Life

2015-01-09

Sex has many health benefits, but one that experts always mention is it is a great stress reliever. But stress can also obstruct a healthy sex life. A stressful day at the office can carry over into the bedroom, for instance. We get so caught up in what we are stressed about, that we can’t focus on the matter at hand, and an erection therefore will not come. This can distress your partner, who wants to know what’s wrong. But a failure to perform makes future sex less likely, as the memory of this failed performance can weigh on the mind, making an erection in the future even less likely. At this point, a vicious cycle can occur. This type of situation may lead to performance anxiety, which in turn can cause erectile dysfunction. Lots of men for this reason avoid sexual intimacy. Not only does that hurt your own psyche but that of your partner’s as well. They may think you no longer find them desirable which strains the relationship. Don’t let stress kill your sex life. Here are some ways to combat it.

Often just talking with your partner about the issue helps to relieve it. Though it may feel like admitting defeat, sharing your feelings and what’s going on is actually a form of strength. Your partner will understand and support you, helping you to solve the problem. But ignoring it will make things worse. Let your partner know how you feel and how that contributes to your issue. For many, just sharing how you feel is enough to undo the problem. When you are going to have sex, set the mood. Lighting, music, sensual talk, mutual massages, dirty movies and other accoutrements or acts can help. Take your time with foreplay. On another front, find ways to de-stress in a healthy way after work, before taking part in sexual activity. Exercise, meditation, listening to your favorite music or working on a relaxing hobby are some great options. Find ways to stop spectatoring. This is when you picture yourself failing at something. It becomes a self-fulfilling prophecy. Instead focus on what is happening before you, how good things look or feel. If you cannot stop spectatoring, seek out a licensed counselor or sex therapist. Regardless, see a doctor to make sure no physical issues are coming between you and a good sex life.

Are Semen Volume Enhancement Pills Effective?

There are lots of pills on the market today that say they can enhance the volume or amount of sperm in a man’s semen. The idea is that this increase will make him more fertile and increase a couple’s chances at conceiving. What’s more, they claim to increase his masculinity, bedroom prowess, even the strength of his orgasm. But are semen volume enhancing pills effective? First a little background. The range for normal semen volume is 2ml to 5ml per ejaculation. A man’s volume peaks between 30 and 35 years of age. His sperm volume is the lowest after age 55. Sperm count and volume has been decreasing in industrialized countries worldwide for over a decade now, what the media has called the “sperm crisis.” One recent study has linked this to the use of aluminum. This “sperm crisis” may mean it is more difficult for couples to conceive today. But it all depends on the couple. There are companies selling semen volume enhancement pills. But these are not effective. Overall, sperm volume changes little within the semen itself.

Men believe that increasing semen volume will increase their chances of conception. There are a lot of factors involved in conceiving a child. It is a complex issue. Certainly, this is to be brought up with a urologist or fertility specialist. Increasing the amount released during ejaculation doesn’t make one more masculine. Nor does it increase the pleasure of one’s partner. Some men believe that the more they ejaculate, the stronger their orgasm. This is also a fallacy. In fact, some of the strongest orgasms in tantric sex come from holding back one’s orgasm, not in the amount released. Sperm only makes up 1-10% of semen. An increase in semen volume is liable to take place from a period of abstinence from intercourse or masturbation, rather than a commercially sold supplement. Medical experts believe that it is not possible to increase semen volume at this time through any method known to medical science. Ignore ads on the internet that say you can do so merely by taking a pill. Instead, if you and your partner have been trying for one year and have not conceived, seek the help of a medical professional.

Study Discovers Roots of Sexual Anxiety

2015-01-07

We are all sexual beings. But how we regard, express and enjoy sex varies greatly. A new report is out containing 18 samples from the United States and Israel. It looks into how people regard sex. Researchers place this in the context of what they call the sexual behavioral system. This is a psychological system that helps one interpret sexual feelings, thoughts and experiences. Researchers discovered two entirely new variables to include into this system, which can illuminate us on how human sexual behavior operates, and in this way help address issues better. Most people believe sex to be a worthwhile and enjoyable experience. There is a minority however that harbor negative associations or experience anxiety when the topic comes up. These obstructive feelings can be rooted in societal pressure or one’s own adverse experiences. But they come to impede normal, healthy sexual encounters.The two newly discovered personality traits were hyper-activation of the sexual system, and deactivation.

Those who have a powerful appetite for sex are hyper-activators. But this is a front for fear of rejection and performance anxiety. They constantly worry about “not being good enough.” This type is more impulsive with their sexual behavior. They fantasize about sex more often, and these fantasies tend to be more detached, with elements of control or dominance. They give greater effort into attracting partners, are more likely to be coercive. These also have a higher interest in casual sex. The male version is more prone to premature ejaculation (PE), perhaps researchers assert due to over-stimulation. In a relationship this personality type is insecure, less trusting and more neurotic. Those with a deactivated sexual system are the mirror opposite. These tend to suppress their desires. They don’t think of themselves as a sexual person. This type does not go above and beyond to attract others. They were hurt or scarred in the past and now have a negative view about sex. This type is more likely to have orgasmic dysfunction—meaning difficulty reaching climax. In relationships these tend to be close minded, insecure and more neurotic. Interestingly, researchers found no significant gender differences. When tested, you can score high or low on one, the other or both. Scoring low on both is the best. These are the most well-adjusted when it comes to sex. See your doctor if you are experiencing sexual dysfunction, to find out whether the problem is psychological or physiological.

Diet, Substance Abuse and Male Fertility

2014-12-05

Recently, the American Society for Reproductive Medicine held their annual meeting in Honolulu, Hawaii. The topic of male fertility, in terms of diet and substance use, came up. Recent studies have found conflicts which leave specialists scratching their heads. But endocrinology and andrology experts say observational studies alone are not significant. Though in vitro fertilization (IVF) is better overall for those men who consume more fruits and vegetables, one study showed that eating produce with a high amount of insecticide residue affected sperm quality. But another study showed that vegetarians tended to have poorer sperm concentrations than omnivores. Another paper found that tobacco smokers have a higher risk of erectile dysfunction. But those who drank alcohol were less likely to experience it. Urologists often tell men to stay away from alcohol when trying to conceive. Yet, the final study showed that those men who had a high caffeine intake had more trouble conceiving, while male alcohol consumption seemed to increase chances.

The University of Illinois at Chicago’s Craig S. Niederberger, MD said, “While the results of some studies presented at the meeting seem to be contradictory, it is important to remember that observational studies often can’t tell the whole truth.” He went on, “A more rigorous scientific approach would include randomly assigning people to diets—what scientists call prospective randomization—and seeing what happens.” He added, “So we’re left with a basic rule of thumb: if it’s healthy for other parts of the body, it’s probably good for reproduction, too.” President of the American Society for Reproductive Medicine (ASRM) Rebecca Z. Sokol, MD, MPH said, “The human organism is complex and substances we inhale and imbibe have systemic effects beyond the stimulation the user is seeking.” She went on, “These studies provide new information that can help men make healthy choices for themselves, their partners, and their future children.”

Penile Bruising and the Issues it can Cause

Everyone bumps into something once in a while and gets a bruise. It’s inevitable. Lots of guys don’t even notice when it happens. But if your penis is seriously bruised, it could be a sign of deeper trouble. Most are nothing to worry about. But it is important to be aware of what might cause the issue, and when to go to a doctor or specialist to get checked out. Here are some issues to be aware of should you notice bruising in your nether regions. Each year emergency rooms all over the country deal with blunt force trauma to the groin. This could be a sports-related injury, work-related, a fight, motorcycle-related, or just some sort of accident. When capillaries under the skin are crushed or broken, the blood flows underneath, causing a bruise. However, if the injury is followed by severe pain from the penis or groin, see a doctor or go to the ER right away.  The penis itself has no bones. It gets hard when the spongy material within fills with blood. Still, the penis can be broken or torn. This is usually done when a man engages in risky or dangerous sexual maneuvers with his partner. Severe pain following a strange popping sound should alert a man to get to the hospital right away.

Another type has to do with lymph fluid. Lymph fluid is carried throughout the body by the lymphatic system. The penis contains these vessels. After a bout of rigorous sex, the vessels can become blocked. They may look like lumps on the surface of the penis, and can form patterns that appear bruise-like in color and manner. This is nothing to worry about and usually disappears by itself within a few days. For some, it can last as long as a few weeks. Without pain or any other symptoms, monitor it, but don’t worry too much. Bruising from a constant erection is another matter. If you have a painful erection that won’t go away for hours, this condition is what is called priapism. Priapism occurs when scarring within the penis traps blood inside. It can be very painful and demands immediate medical attention. This is an emergency. With priapism, bruising or a darkening of the skin may occur. Anything that seems serious should be checked out by a physician. For a small bump or light bruising, you can use warm or cool compresses if it bothers you, take over-the-counter medication such as aspirin or ibuprofen, and simply allow it time to heal.

Sexual function: relationships, well-being a significant influence in menopausal women

Past relationships and emotional health may have a much greater influence on menopausal women’s sexual function than hormones. This is according to a new study published in the Journal of Clinical Endocrinology & Metabolism.

Improper Masturbation Techniques can Cost you

2014-11-24

We’ve seen a big turnaround in the subject. Adults just a few short generations ago would tell young men that they’d go blind if they touched themselves. Now psychologists and medical professionals believe it is perfectly healthy and natural, and may even be a way to make sure sperm stays in tip-top condition. But when is masturbation too frequent? The simple answer is, when it interferes with your love life. If you cannot finish with your partner, or take so long that it becomes a burden, it is time to roll the frequency back, or even take a break altogether. Improper techniques can cost you as well. Unorthodox masturbatory practices were recently the topic of an article in the peer-reviewed Journal of Sexual Medicine. The most dangerous to a man’s sex life were those acts that do not mimic sexual relations with a partner, for example using a vacuum hose or a hot tub jet in order to reach orgasm. These men had less sensation within the penis, lower libidos, and less response when it came time to have sex with a partner.

Over masturbation due to easy access to internet pornography is another big problem for men today. Climaxing to these videos is fine. When it happens so often a man cannot reach orgasm with a partner, it becomes an issue. Also, some men get really specific about what kind of porn they like. These specifics may creep into the psyche. Now, he needs that particular kind of sex, position or scenario in order to reach orgasm, making bedroom activities much more narrow and confined. If this is the case, drop internet porn for a while, do not masturbate for two weeks, and spend ample time on foreplay with a partner after the two weeks are up, getting both of you highly aroused, before engaging in intercourse. Lastly, don’t engage in any masturbation that is too rigorous or can be dangerous. The more rigorously you handle the penis, the more desensitized it becomes, and the harder it is to reach orgasm. Just like with anything else, moderation is key.

How Sex is Good for You

2014-11-19

A recent study out of the University of Montreal claims that regular ejaculation lowers the risk of prostate cancer. But there are many other ways that sex is good for you, too. For instance, a 1999 study found that those who have sex twice per week helped protect their body against colds. Men who engaged in intercourse at this frequency had 20% more immunoglobulin in their bloodstream, which helps fight off sickness promoting bacteria and viruses. De-stress with sex, and if your partner doesn’t believe you, point them to a study in the journal Biological Psychology. Touching, kissing, holding one another, and other physical closeness lowers cortisol—the stress hormone. It also boosts oxytocin, a powerful, depression fighting hormone that helps us bond and feel connected. Want to look younger?  Getting some one-on-one time with your partner could mean preserving the impish rogue in the mirror, instead of seeing him turn into an old devil too soon. According to a study out of Royal Edinburgh University, those who had sex four times per week or more released higher levels of the hormones norepinephrine, dopamine, and adrenaline. This relaxes muscles and preserves skin cells, staving off wrinkles. Players beware. For this benefit “loving intercourse” was found more beneficial than simple promiscuity.

Want to protect your ticker? Spend more time between the sheets. Those men who had sex twice per week had a 45% less chance of having a serious heart attack, according to the New England Research Institute in Massachusetts. 1,000 men participated in the study. These results are now prompting doctors to ask patients about their sex lives. Looking to get a little more physical fitness in your life? Twenty four minutes in bed with a lover burns 104 calories, so say researchers at the University of Montreal. You should plan for a longer session to receive the full benefit. A quickie burns only 20 calories.  As we age, weakened bones become a serious concern for both sexes. Luckily, testosterone helps to strengthen them. Sex boosts testosterone which can in turn protect your bones. Trouble sleeping? A roll in the hay puts most guy’s right to sleep. French medical institute Inserm confirmed this. The release of the neurotransmitter serotonin makes you both happy and relaxed post-coitus. So the next time you are putting the moves on your partner, let them know your motives aren’t selfish, merely health-related.