All About The Penis, Men & Male Sexuality
On this page, in this order:
An email: "I've been losing my libido for some time now. I find I want intercourse less, my desire for and interest in other women is much reduced, and I rarely initiate lovemaking anymore. My partner is very upset - she thinks she's not attractive to me any more. To be honest, she isn't, at least not sexually. And even if we do get down to it, my penis just doesn't respond."
Erectile dysfunction - impotence - loss of erection: whatever you call it, it's a blow to your sense of male pride, and it can shake your confidence to the roots the first time your penis stays soft when you might expect it to become erect.
Sometimes the cause is just circumstantial: you have a bad experience while making love and your penis goes soft; too many sexual demands are put on you by your partner and you can't meet them; you are tired, try to make love, fail and lose confidence; you're with a girl and it's your first time, but you don't really want to be having sex with her; you're putting on a condom and find it's such a turn-off that your penis goes limp. Whatever the original cause, what it comes down to is this: you lose your erection unexpectedly one day and then find the next time you try to have sex your penis remains resolutely soft. These are the circumstantial causes of erectile dysfunction, and they can be cured with a boost to your confidence, a bit of support from your partner, and maybe some Viagra to get over the shock.
But that's not what the guy who sent in the email at the top of this page meant. No, he meant that he'd lost the ability to get erect over a period of time, and now he was impotent.
The first question to ask anyone in this position is whether or not their relationship is going well, especially if it's long-term in nature. One sex therapist of my acquaintance says "the penis never lies" - by which she means that a soft penis can say more about a relationship than you'd ever guess on the surface. Anger, hostility, fear, boredom and many more emotions can all be brushed over in day-to-day communication, but a soft penis may tell the true story of what's going on between two people. Even when a man has a normal level of testosterone, depression can cause erection problems. And when a man has a low level of testosterone, he may be both depressed and impotent.
This is not to say that all erection problems are caused by low testosterone, but many are. Indeed, one clinic for men says that a combination of Viagra and testosterone replacement therapy can cure 95% of all cases of erectile dysfunction. (The moral of this fact is that the days of injecting chemicals into the penis to make it erect have long since gone, and the days of implanting prostheses into the penis - after first removing the erectile tissue - should never have been here in the first place.)
But how do you know if you have a normal level of testosterone? There are warning signs: you're approaching 40 or 50, you're losing your motivation, drive, energy, and enthusiasm for life, you find your libido is diminished, and perhaps you're experiencing a sense of futility, tiredness, exhaustion, and maybe even having hot flashes and night sweats. In addition, and worst of all, your penis may not only be refusing to get erect, but it may appear to be shrinking.
Naturally, as you may have guessed by now, I recommend testosterone replacement therapy to men in this position. And I recommend it because I have been on it for some time myself, and it has transformed my life.
Life is dismal as a man if you have no libido, aren't able to get an erection or have small, insignificant erections in place of large, powerful ones, aren't sexually interested in your partner, and feel depressed and tired all the time. But here's the thing - to deal with male mid-life hormonal issues, you need a good doctor: one who understands testosterone and how it works in the male body, one who can diagnose accurately your levels of free and total testosterone -- these terms are explained at www.the-penis.com/andropause -- one who can knowledgeably prescribe the best testosterone replacement regime for you.
A great place to start is by reading about male hormone replacement therapy on The-penis.com - that's the URL shown in the paragraph above. Finally, women have objected, it seems to me, to men appropriating the term "menopause", as in the male menopause. So let's call it the andropause. That sounds much more masculine. And there's more information here - www.midlifecrisismen.com and on the symptoms of the male menopause, whoops, sorry, andropause - www.midlifecrisissymptoms.org for all you men over 40 or 50....
Another good way to research this subject is to buy Dr Malcolm Carruthers' books, Androgen Deficiency In The Adult Male, which is a textbook, or Maximizing Manhood, which is more of a mass-market book.
My urine stream is weak
Assuming that this is not something you have had since birth (see this guy's query in the "medhelp" forums for an example of this) then it's most likely to be a product of ageing, as explained below. However, men with hypospadias can have abnormalities of development higher up their urethra which may cause narrowing of the tube they pee through (strictures), and it is therefore a good idea for them to see a doctor to ensure that any problem with peeing is not a congenital one.
But in general, this penile problem comes to men as they get older. There are various forms of it - difficulty in starting the urine stream, hesitancy as it flows, inability to empty the bladder, needing to pee frequently - and though there are several possible causes, the culprit is nearly always an enlarged prostate gland.
(By the way, difficulty in peeing when other people are around is not related to enlargement of the prostate. That's just a condition that's come to be known as "pee shyness" or parauresis - you can look it up on the internet.)
Although, as I hinted above, difficulty with peeing can be caused by things such as irritation due to cystitis or prostatitis, the usual cause of urinary difficulty in men is an enlarged prostate. Benign enlargement of the prostate is a very common condition in men over 40 - which is why a routine yearly prostate exam is recommended for them; although this involves a physical examination, it can help diagnose the problem early. In cases where the prostate has enlarged so that it is blocking the urethra, a simple surgical procedure known as transurethral resection can cure this; there are other treatments involving drugs, but you'd be well advised to do a lot of research in the consequences of different treatments to check which is right for you. Some can cause impotence.
Finally, if you do have prostate cancer - that's the non-benign form - don't be too quick to have a prostatectomy (removal of the prostate.) Old age kills a lot more men with prostate cancer than the cancer does, and surgery will leave you impotent and most likely with a non-existent sex-life.
Penis Problems: I couldn't get an erection when I wanted to have sex
Q: I am 16 years old. When I finally got down to it with a girl last week at a party, I had an erection while we kissed, then we went into the garden and lay down on the lawn, and my penis was still really erect until she put her hand on it. After that I couldn't get it up, even though she tried oral sex and I stimulated my penis by hand - we even tried to put my penis into her vagina when it was soft, because I thought that might make it hard again. I don't think she's told anyone but I can't face her - we're in the same class, and I'm scared to try again.
A: Sorry that your penis went soft when your girl started to touch you. It sounds like you're very embarrassed, and that's quite understandable. Many guys want to lose their virginity as soon as possible, and there can be great pressure on them to try having sex whenever the opportunity arises. With all the sexual images on the internet, in magazines, newspapers and especially on the TV, not to mention porn, it can be confusing for a young man these days to know deep down inside when he is actually ready to take his first step into the world of sex. But here's the thing - in days gone by, young men would boast about sex without ever having done it, and no-one would call them on it because almost everyone else was lying as well! These days, things seem to be a bit different - everyone seems to be in a race to lose their virginity (though a lot of them are still lying about it!). The problem is, a lot of teenagers try sex before they're ready - and often before they even want to.
There's an old saying, "The penis never lies" - meaning that when you have the chance to have sex but your penis remains soft, sex there and then may not be right for you. So I wonder if you really liked this girl, or knew her well enough to feel relaxed with her? Could you discuss contraception and what you wanted with her? Did you even know what you wanted? In short, deep down, did you feel that she was the right person for your first sexual experience? An experience of erectile dysfunction may be telling you something about your desire to have sex with the person with whom you are having those erectile problems.....!
If she was a lot more knowledgeable than you are, you might have been worried that you wouldn't be good enough, or scared that you wouldn't know what to do when it came down to sex........and if that's the case, and you couldn't discuss it with her, then it sounds as though it wasn't the right time for you - or she wasn't the right girl.
If you are having trouble getting an erection, to read more about erection problems and possible treatments this may be helpful - it's a fact that erection problems affect more than 10% of men at any time.
There's no need to feel pressured about losing your virginity: when the time is right it will happen. In the meantime, it may be better to focus on getting to know the right girl without any sexual pressure in the background. Once you've established a friendship with her, things will naturally move on until you both reach a point where you can start talking about if or when you want to have sex, and if you do, what form it will take: mutual masturbation, oral sex, or full intercourse.