Archive for the ‘Health’ Category

How To Become a Better Patient-You Need to Ask the Vital Questions

May 10, 2010

It is not easy being a patient.  Most patients are nervous and anxious when visiting a doctor and often forget to ask vital questions that will impact their health.  Here are six questions that you should ask your physician when he\she prescribes a new medication:

1.  What does this medication do?  What is the purpose of the medication?

2. How will I know if the medication is working?  Can you tell me about how long I will have to wait before the medication begins to work?

3. What are the side effects of this medication?  What should I do if I experience these side effects?  How common are these side effects?

4. Why is this medication good or effective for my condition?

5. Are there any other non-medication alternatives that I could try that may do the same as the medication?

6. What are the consequences of not taking this medication?

7. Is this a new drug?  Would a less expensive generic drug work just as well?

By asking these questions, you will demonstrate to your doctor that you are actively involved in your medical care.  You now become a part of the “team” and there is no one who should be more interested in your care than you.

Water, Wet and Wonderful

May 3, 2010

Water is one of life’s best elixirs; there are few things as available, inexpensive and health-giving —so drink up.

Even though it is readily available, tasteless and free, most Americans do not drink enough water. And water remains one of nature’s most perfect medications. In fact, water is the most essential component of your diet.

While you can live for several weeks without food, you can live only a few days without water. Water loss of three percent of the body weight or approximately two quarts without replacement can result in weakness and lethargy. A 15-20 percent water loss can be fatal.

Nearly half the total body weight consists of water. To ensure good health, the average person requires two to three quarts of water per day because this is the volume that is lost in perspiration, urine, feces and breath. Nearly half of the food we eat consists of water.

Water is necessary for nearly all bodily functions such as digestion, circulation, excretion, nutrient transmission and temperature regulation.

More specifically, there are thirteen ways that water works in the human body:

  1. Water quenches thirst. There is no better liquid to quench your thirst than water. Many people are incorrectly informed that you only need to drink water in hot weather. The truth is large volumes of water are lost through your breath in cold, dry weather. Although you can substitute other beverages such as colas, coffee and electrolyte drinks, there is no other drink that contains fewer calories and more nutrients than water. In fact, affricated beverages can act as diuretics and cause the body to excrete water and important chemicals like potassium.
  2. Water aids digestion. Water dilutes the acidity in the stomach and causes the release of enzymes necessary for digestion. Water is also a natural laxative and relieves constipation.
  3. Water cools the body during exercise. As the body heats up during exercise, the internal thermostat promotes perspiration. Internal body temperature can be decreased with the consumption of cold water. Cold water is best because it is absorbed into the circulation more quickly than warm water.
  4. Water promotes waste excretion. The kidneys are the paired organs used to remove metabolic bodily water material. Water is essential for these incredible filters to do their work and flush out the body’s waste products.
  5. Water carries nutrients to the cells. All of the body’s cells are bathed in a saltwater solution.  Blood moves nutrients to the cells and removes the waste products to the kidneys and liver. Water is necessary to maintain the blood volume to carry out these vital functions
  6. Water reduces kidney stones. If too much calcium, oxalate or uric acid is excreted in the urine, crystals will form and start the growth of kidney stones. The best treatment to reduce kidney stones is to drink enough water to keep the particles from hitting one another and starting the crystallization process
  7. Water lubricates the joints. The bones glide against one another with minimal friction because of a lubricant called synovial fluid. Drinking plenty of water increases the synovial fluid and reduces the wear and tear on the joints
  8. Water promotes good skin tone. Skin elasticity is maintained when the body is well hydrated.  Chronic fluid loss leads to dry, wrinkled skin.
  9. Water dilutes alcohol and relieves headaches. There is no better remedy for a hangover than several glasses of water. Water dilutes the alcohol content in the blood stream and decreases its effect on the brain and central nervous system alleviating headache and hangover associated with excessive alcohol consumption.
  10. Water decreases pre-menstrual fluid retention. Some women experience salt retention during their menstrual periods. This leads to excess water retention as well. Diuretics or water pills only offer a temporary solution. Paradoxically, you can promote salt excretion by drinking more water. As the water is passed through the kidneys, it excretes the excess salt as well as the excess water.
  11. Water is a diet aid. Drinking a glass of water before each meal leads to a sensation of fullness before you sit down to the table, thus acting as a natural appetite suppressant. Water helps the body metabolize stored fat. If there is not adequate water to rid the body of waste through the kidneys, then the liver must be called in to do the kidney’s work. If the liver is doing the kidney’s work, it cannot metabolize body fat and weight loss is slowed or stopped.
  12. Water is a natural relaxer. Water is an excellent way to wash away tension. Swimming induces a feeling of calmness and exhilarates the body, similar to a jogger’s high.
  13. Water aids pregnant women. A pregnant woman should be especially conscious of getting eight to ten glasses of water a day. Water will clear her system of added metabolic body waste contributed by the fetus. It will also help prevent dehydration that may result from morning sickness.

How much water is enough? The time-honored advice of drinking eight to ten glasses of water a day still holds true. However, the more you exercise, the more you need to drink. A good rule of thumb is to drink approximately one quart of water for each hour of exercise.

Drinking too much water is rarely a problem. Too much water, more than six quarts a day, can dilute body minerals and electrolytes producing lethargy, confusion and if not corrected, convulsions and coma. The treatment is simple: Decrease the water intake and allow the kidneys to flush out the excess.

Bottom Line: Water is truly the elixir of life.  So enjoy one of life’s greatest medicines and it’s free.  Drink up!

Testosterone Replacement Therapy-A little Dab Will Do Ya

April 25, 2010

A man’s sex drive or libido is thought to be connected to the level of testosterone, the hormone produced in the testicles which circulates in his bloodstream. Low testosterone, also known as hypogonadism, affects approximately four to five million American men. The condition is also linked with diminished interest in sex, impotence, reduced muscle mass, decreased bone density and lowered mood and energy levels.

Who needs testosterone?

Though the body’s own production of this hormone trails off gradually in men after the age of 30 or so, not many men seek testosterone-replacement therapy or even get their testosterone levels tested.   If a man is experiencing a decrease in his libido or sex drive, complains of lethargy or tiredness, he should see his doctor and obtain a simple blood test to determine if he is deficient in this important hormone.

In the past the only treatment to replace the testosterone was injections of the hormone every two weeks or applying testosterone patches to the scrotum or other areas of the body.  The injections were occasionally painful and the patches often caused skin irritation.

Now testosterone is available as a gel or paste (AndroGel, Teststim) applied to the skin of the shoulders, upper arms or abdomen once a day.  The gel is clear, colorless topical gel that men apply once daily to the shoulders, upper arms and/or abdomen. The gel dries within a few minutes, during which time the skin absorbs the testosterone. The skin serves as a reservoir for the hormone, which slowly enters the bloodstream. Normal testosterone levels are restored soon after application.  The testosterone gel will be available with a prescription in pharmacies throughout the United States by the end of the summer.

In studies conducted on hundreds of men who are testosterone deficient, the gel quickly raised circulating testosterone to desirable levels, and maintained it within normal range. The gel also increased sex drive, bone mineral density, and lean body mass and improved mood and energy levels.

At the present time the gel is not indicated for use in women and has not been evaluated in women. Pregnant women should avoid skin contact with the area on men where the gel has been applied as the testosterone in a pregnant woman can cause harm to the fetus.  The testosterone gel is not recommended in young men to improve athletic performance.   Testosterone is contraindicated for men who have prostate cancer that is spread beyond the prostate gland.  For some men with localized prostate cancer who have symptoms of low testosterone, a low serum testosterone level, and a PSA that is at very low levels, they may receive testosterone if they are monitored closely with PSA testing.  (See my blog “Testosterone Treatment in Men With Prostate Cancer-The Controversy”)

The next step.  If you are experiencing a decrease in your sex drive, feel lethargic, or have less energy, you may have a decrease in your testosterone level.  Contact your physician and request a testosterone blood level.  If it is decreased, the solution is just a dab of gel away.

Testosterone Treatment in Men With Prostate Cancer-The Controversy

April 25, 2010

I have been a proponent of testosterone replacement therapy in men

with documented low levels of testosterone.  Men with low testosterone

present with lethargy, malaise, decrease in libido, erectile

dysfunction, falling asleep after meals and loss of muscle mass.  The

diagnosis is easily made with a blood test, the serum testosterone

level, and is easily treated with injections of testosterone or the

application of testosterone gels to the skin.  The medical textbooks in the 1990’s state that the treatment is

contraindicated in men with difficulty with urination, untreated

obstructive sleep apnea, high blood counts, and in men with prostate

cancer.

But now there are a few doctors who question the advice of avoiding

testosterone in men who have been successfully treated for prostate

cancer.  For decades the prevailing treatment for men with prostate

cancer that spread beyond the prostate gland was to decrease the

testosterone produced by the testicles.  This was accomplished by

removing the testicles or orchiectomy, or medically castrating the men

with drugs that produced castrate levels of testosterone in the blood.

Dr. Abraham Morgentaller, a urologist a Beth Israel Deaconess

Hospital in Boston, began treating men with prostate cancer, who had

symptoms of low testosterone and confirmed by the blood testosterone

test, with supplemental testosterone.  This was certainly against the

previous advice of other urologists.

What is the evidence to support this new approach to testosterone

deficiency in men with prostate cancer?  Dr. Morgantaler published a

report that men who developed prostate cancer had a statistically

lower testosterone level than men who were free of prostate cancer.

He also started treatment of a select group of men with prostate

cancer with testosterone and followed them closely with PSA tests and

found that there was no increase in the PSA test but marked

improvement in the men’s libido, energy level, and over all quality of

life.

So what is a man to do?  Talk to your doctor.  If your doctor agrees

that there may be a roll for testosterone in men with prostate cancer,

you can receive therapy with testosterone replacement.  In my practice

I select men who have zero, or near zero, PSA tests for at least one

year after treatment for prostate cancer.  They receive testosterone

replacement under close scrutiny and must agree to getting a PSA test

every month.  If the PSA rises, then they must agree to discontinue

the testosterone replacement therapy.  For more information go to my

website, www.neilbaum.com

Treatment of the Enlarged Prostate Gland With Laser Therapy

April 25, 2010

The prostate gland is a walnut sized organ below the bladder, which surrounds the urethra.  For reasons not completely understood, the prostate gland begins to grow around age 50 and causes symptoms affecting urination.  The enlarged prostate gland is a non-cancerous condition that affects nearly 14 million men over age 50.

The symptoms of the enlarged prostate include frequency of urination, getting up at night to urinate, urgency to urinate, decrease in the force and caliber of the urine stream and feeling that the bladder is not emptying.

The treatment for enlarged prostate includes medication to shrink the prostate gland or to relax the muscles in the prostate to relieve the obstruction.  Surgical therapy includes transurethral resection of the prostate (TURP) or open surgery for very large prostate glands. Recently laser therapy has become available for treating the enlarged prostate gland and is considered minimally invasive therapy.

Laser therapy is a procedure performed with a small fiber that is inserted into the urethra, the tube in the penis that allows urine to go from the bladder to the outside of the body.  The fiber delivers high-powered laser energy, which quickly heats the prostate tissue, which causes the tissue to dissolve or vaporize.  This process is continued until all of the enlarged prostate tissue has been removed. The end result is a wide-open channel for urine to pass through the urethra.

Laser therapy can be performed in a hospital outpatient center or an ambulatory treatment center.  Usually no overnight stay is required.  However, in some cases when a patient comes from a great distance, has associated medical problems such as heart disease, diabetes, or severe hypertension, or is in frail condition, an overnight stay may be recommended.

After the procedure

Most men will go home within a few hours after treatment. If a tube or catheter was inserted after the procedure, it will usually be removed the next day after the procedure.

Most patients experience marked improvement in their urinary symptoms immediately after the procedure.  This improvement typically occurs within the first 24 hours after the procedure.  However, the past medical history, health condition and other factors can influence treatment recovery.

Some men may experience mild discomfort such as slight burring during urination and small amounts of blood in the urine for a week or two.  Also, depending upon the condition of a man’s bladder, he may experience greater frequency and urge to urinate.  This will resolve over time as the bladder adjusts now that the obstruction has been removed.

There is no change in a man’s sexual function after the procedure.  His ability to engage in sexual intimacy after the procedure is unchanged.  Most men can begin sexual activity two weeks after the procedure.  Approximately 25% of men will have a decreased or absence of ejaculation at the time of orgasm.  The fluid is still there but goes backwards into the bladder and passes in the urine the next time the man urinates.

What are the risks of the laser procedure?

Every medical treatment may have side effects.  The same is true for the laser treatment.  The most common side effects include:  blood in the urine, bladder spasms, and urgency of urination.  These symptoms are usually temporary and will subside in a few days or weeks.

Bottom Line: Enlarged prostate gland is a common condition that affects most men after age 50.  Treatment options include medications, surgery and minimally invasive treatment using lasers.  The laser treatment produces a rapid improvement in urine flow, a quick return to normal activities, short or no hospitalization.

Tips and Tricks for Smoking Cessation

April 23, 2010

I have never met anyone who has smoked for several years who declares that they enjoy smoking or that they could quit anytime they wanted. Nothing could be farther from the truth. Studies have shown that nicotine addiction is as hard to break as heroin or cocaine addiction. This article will focus on tips and techniques to help smokers kick the habit. After reading this article and if you are a smoker, you will have suggestions to help get the nicotine monkey off your back.

There are two phases to successful smoking cessation:

  • Phase one is getting help and assistance.
  • Phase two is staying smoke-free and not relapsing as so many quitters have done in the past.

Phase One-Getting Help

The most successful quitters are those who get help and plenty of it. Sadly, eighty percent of smokers who quit do so without being in any program. Many studies have shown that 95% of these self-reliant quitters fail, and go right back to smoking a short time later.

That’s the bad news. The good news is that most smokers can successfully kick the habit if they recognize that they can’t do it alone. Your past failures are not a lesson that you are unable to quit. Instead, they are part of the normal journey toward becoming a nonsmoker.

Successful quitters buy a “How to Quit Smoking Book”, or a motivational cassette tape program in a bookstore, and listen to the tapes in your car. Next, there are help groups in most communities including New Orleans. The American Cancer Society, or the American Lung or Heart Associations have inexpensive and effective, smoking cessation programs. The National Cancer Institute’s Smoking Quitline, 1-877-44U-Quit, offers counseling by trained personnel.

Other top of the line, physician-endorsed methods include nicotine replacement and Zyban. The nicotine patch or gum are now available at any pharmacy without a doctor’s prescription. The anti-depressant Zyban and nicotine inhaler do require a doctor’s prescription.

Recently the FDA approved a new medication, Chantix, which was designed to inhibit a part of the brain that is responsible for the addiction to nicotine. As a result the medication reduces a smoker’s nicotine addiction, as well as decreasing the craving for cigarettes and diminishes the withdrawal symptoms for those who decide to go cold turkey.

Chantix is given twice a day for 12 weeks and then an additional course of 12 weeks of medication is recommended to increase the likelihood of long-term abstinence and to reduce the urge to smoke.

Phase two-staying smoke free and not relapsing

Those who have successfully kicked the habit will report that overwhelming surprise attacks of a desire for cigarettes are sure to come a few weeks or months into your new smoke free life. You can anticipate irresistible urges that may take you by surprise and try to encourage you to have “just one”. Even months after you have been smoke-free, the experts say that you can count on these cravings occurring.

When these nearly out-of-control urges come, one of the best ways to make them pass is to take a few deep breaths. Perhaps the single most powerful and important techniques is taking a few deep breaths when that uncontrollable urge arrives. Every time you want a cigarette, do the following:

Inhale the deepest lung-full of air you can, and then, very slowly, exhale. Purse your lips so that the air must come out gradually.

As you exhale, close your eyes, and let your chin gradually sink over onto your chest. Visualize all the tension leaving your body, slowly draining out of your fingers and toes, just flowing on out.

This is a variation of an ancient yoga technique from India, and is very centering and relaxing. If you practice this, you’ll be able to use it for any stressful situation you find yourself in. And it will be your greatest weapon during the strong cravings sure to assault you over the first few days when you stop smoking.

Another important technique you can use to avoid relapsing is self-talk. Several times a day, quietly repeat to yourself the affirmation, “I am a nonsmoker.” Many quitters see themselves as smokers who are just not smoking for the moment. They have a self-image as smokers who still want a cigarette. Silently repeating the affirmation “I am a nonsmoker” will help you change your view of yourself, and, even if it may seem silly to you, this is actually useful and very effective.

Self-talk is a reminder to yourself that if you can hold out for just five minutes the overpowering urge to smoke will completely pass.

Bottom Line: No one needs to be told that smoking is unhealthy. Nearly everyone who smokes would like to quit. However, the addiction to nicotine is often more than most of us can handle without assistance. If you use the two- phase technique I have recommended, you can plan to become and remain smoke-free. Remember, when treating tobacco dependency, every step towards quitting is one step closer to success.

10 Steps to Prevent Impotence

April 22, 2010

Cystitis-How To Leave Home Without It

April 13, 2010

What does sex, bubble bath and thongs have in common?  Answer: They may all be causes of cystitis.  If you are a woman who has ever suffered from cystitis then you will know just how debilitating and miserable it can be, you you can perhaps take comfort from the fact that you are far from alone.  It seems that at last 20% of women have had an attack at some point in their lives, and 20% of those will get more than one episode a year.

There is certainly no mistaking the feeling it brings, which usually starts with a strong sensation of needing to urinate.  When you try to go, it either burns horribly, or nothing seems to come out.  You may have a full, uncomfortable sensation in the bladder, plus an aching back and stomach and a general feeling of being unwell.  The most common cause is an infection caused by bacteria.  It isn’t only a female problem but far more common in women than men.  The reason is that the internal plumbing of women is much shorter than in a man and the relationship of the rectum which is usually the source of the bacteria is closer to the urinary tract in women than in men.

A bacteria, called E. Coli, is usually the culprit.  Since E. Coli coming from the rectum can reside in the vagina and then can have easy access to the urethra or the tube that transmits urine from the bladder to the outside of the body.  This is why it is beneficial for women to wipe from front to back when they use the restroom.  If you swipe the wrong way, you can move the bugs from the rectum into the vagina and then into the urethra.  Another recommendation is to switch from nylon or synthetic underwear to the cooler cotton briefs which discourage the growth of bacteria.  Also, thongs and G strings may be very sexy but they are bad news for cystitis sufferers as the string is an effective way for bacteria to hitch a ride from your bottom to your bladder.

Another suggestion is to change the bacterial flora of the gastrointestinal tract.  This can be accomplished by regularly eating yoghurt which contains the good bacteria lactobacillus or acidophilus.

It is also crucial to drink large quantities of water to flush away any bacteria.  Also, it is recommended that sufferers of frequent cystitis go the toilet when you first feel the urge.  The longer you hold in urine, the fuller your bladder is, with more potential for bacteria to grow and proliferate.  Using bubble baths or irritating soaps around the vagina should also be avoided as these agents can upset the delicate balance of acidity and alkalinity in your skin so that bacteria can flourish.

It also appears that sexual intercourse, promotes moving bacteria from the vagina into the urethra.  This then starts the process of bacterial multiplication in the bladder and creates the symptoms of cystitis.  Therefore, it is important for women who get cystitis after intercourse to urinate frequently after sexual intimacy to wash the bacteria out of the urethra so they don’t become permanent residents and create an infection.

For years doctors have recommended cranberries of a method to reduce the attacks of recurrent cystitis.  Initially, it was thought that the cranberries were a source of acid and this prevented cystitis.  Now research has shown that the cranberries contain chemicals that help stop the bacteria from sticking onto the bladder wall.  Because cranberry juice can be quite high in sugar, you might prefer to take one of the cranberry supplements that are available.

Beating back an attack

The first practical step is to consume 2 glasses of water every 20 minutes for the first three hours.  This will help you ladder to flush itself out, and sometimes is enough on it s own to prevent further problems.  If not, gulp down a few glasses of cranberry juice.  Sipping a glass of water with a teaspoon of bicarbonate of soda stirred into it may help the burning sensation when you urinate.

If these simple measures don’t relieve your symptoms in a day or two, you may need to see your doctor and take a short course of antibiotics.  Failure to treat the infection can result in a much more serious kidney infection.  Also, if you have more than 3-4 infections in a 12 month period you will want to see your doctor to be sure there isn’t something else more ominous causing these infections.

When Your Urine Turns Red

April 13, 2010

Most men have an ejaculate (the fluid that contains the sperm) that is white and slightly cloudy.  When it turns red, it is a frightening occurrence.  Hematospermia, or blood in the ejaculate, is a symptom that provokes great anxiety in patients due to fears of malignancy or sexually transmitted diseases. For most men, hematospermia is not a serious, life-threatening condition.

One could think of blood in the semen in almost the same way one would think of blood in nasal mucus when one has a bad cold or sinus infection. It certainly is a sign of problems, but it’s nothing to panic about. Seeking a medical opinion is highly recommended in any instance.

Most men with hematospermia usually report brownish to red discoloration of the ejaculate. More than 90% of patients have no prior genitourinary symptoms or significant factors in their history. The ages range from 14 to 75, with an average age in the late 30’s. It is not uncommon, however, for it to affect men between the ages of 30 and 40. About 90% of men who have had hematospermia will have repeated episodes.

The cause is not specifically known and is poorly understood. Most commonly, it results from nonspecific inflammation of the urethra, prostate and/or seminal vesicles.

In about 50% of patients the cause of hematospermia is not clearly understood or known. Semen originates from multiple organs, including the testicles, epididymis, vas deferens, seminal vesicles, and prostate. Most of the semen comes from the seminal vesicles and prostate and it is probably from these two organs that most hematospermia cases originate.

Infections or inflammation of the organs listed above account for most of the other causes. Cancers are rarely causative and account for a very small percentage of hemospermic diagnoses.

With the introduction of ultrasound-guided prostate biopsies, we are seeing a large number of patients — about a third of the patients who received the test — with hematospermia after the biopsy.

Patients with hematospermia are usually categorized into one of two groups. The primary hematospermia group is where the patient’s only symptom is blood in the ejaculate. This means that there is no blood in the urine (neither visually nor under a microscope). Also, the patient has no symptoms of urinary irritation or infection and the physical exam is completely unremarkable. Patients who have this type of hematospermia with no other findings are essentially found to have no other problem. The condition is “self-limited”, which means it will go away in time without treatment. About 17% of patients will have one episode and no recurrence.

Secondary hematospermia is when the cause of bleeding is known or suspected, such as immediately after a prostate biopsy, in the presence of a urinary or prostate infection, or cancer. Unusual causes include tuberculosis, parasitic infections and any diseases that affect blood clotting such as hemophilia and chronic liver disease. Patients who have hematospermia associated with symptoms of urinary infection or visual and/or microscopic blood in the urine require a complete urologic evaluation.

Most men with hematospermia are in their 30’s and the problem almost always subsides spontaneously, usually within several weeks. Hematospermia may be associated with infection, but is rarely secondary to malignancy. Patients that have persistent hematospermia for longer than three weeks should undergo further urologic evaluation to identify the specific cause.

The physical exam should include a genital and rectal exam, as well as a blood pressure test. Hypertension can be associated with hematospermia. Some urologists recommend transrectal ultrasounds to look for stones and cysts in the prostate, seminal vesicles and ejaculatory ducts. This may also help rule out prostate cancer.

Other urologists recommend cystoscopy because hematospermia can be secondary to urethral and prostatic pathology. Overall, hematospermia almost always resolves spontaneously and rarely is associated with significant urinary pathology. In a Japanese study, less than 1% of patients had prostate cancer associated with hematospermia.

Hematospermia can be a very frightening occurrence to any male, but in the end, most of these patients are found to have no abnormalities and require no therapy. Hematospermia is prone to continue on and off, but it is usually self-limited and carries no increased risk of any other disease, nor is the patient felt to be putting his sexual partner at risk. To reiterate; malignant cancers of the testicles and prostate are very rarely associated with hematospermia.

Bottom line-hematospermia is a frightening condition that suggests a mild inflammation of either the prostate gland or seminal vesicles.  No treatment or use of medication will result in return of the semen to its normal color.  If you have this condition, check with your doctor or your urologist.

EjD, Ejaculatory Dysfunction-The New Sexual Dysfunction

April 11, 2010

Millions of men suffer from EjD or ejaculatory dysfunction.  The most common variety is premature ejaculation followed by retarded ejaculation or not being able to achieve an orgasm.  Another less common EjD is retrograde ejaculation or seminal fluid going back into the bladder instead of exiting the penis at the time of orgasm.  This article will discuss the three common EjD conditions and what can be done to resolve them.

It is estimated that one-third of American men suffer from premature ejaculation or ejaculation within seconds of vaginal penetration.  This is of great concern and embarrassment to those who experience this malady.

One folk remedy that is available to all men is self-stimulation or masturbation. Having repeated orgasms will bring on delayed ejaculation in nearly every man. The best premature ejaculation tip is to double the number of orgasms a man has per week. And if that doesn’t work, double it again.  Now isn’t that a great assignment?

Another method that requires cooperation with the partner or significant other is the “pull out technique.” This consists of having sex for a few minutes then pulling out and stopping for a few minutes to postpone orgasm.

Another method is to decrease the stimulation of the penis using desensitizing cream such as topical xylocaine.  Also, using one or more condoms can decrease the sensation and can prolong ejaculation.

When these non-pharmacologic techniques are ineffective there are medications that can help prolong the time from penetration to ejaculation. Selective serotonin reuptake inhibitors, or SSRIs — are known to cause delayed ejaculation.  Using an SSRI four to six hours before intercourse, men prone to premature ejaculation can last longer.

Delayed ejaculation (or retarded ejaculation) affects a much smaller number of men.  With this problem, men cannot reach orgasm at all, at least not with a partner.  It is most common associated with aging where more stimulatin is required for a man to reach an orgasm with advancing years because the nerve endings in the penis become less sensitive.  Delayed ejaculation may be caused by medicines – like antidepressants– are common culprits.

Retrograde ejaculation is the least common of the ejaculation problems. Retrograde ejaculation can be caused by diabetes, nerve damage, and various medications such as alpha-blockers like Flomax, which are used to treat enlargement of the prostate gland. Retrograde ejaculation is harmless and won’t interfere with the feeling of orgasm. (It can also make for an easy post-sex clean-up.) But since it does affect fertility, some men may need treatment if their partners are trying to get pregnant.

Bottom Line

EjD is a common medical condition that can be overcome.  Be open and communicate with doctor and share your concern with your partner.  Don’t suffer in silence and let the tension mount up and compounding the problem.  Most men with some advice and perhaps some medication from their doctor can overcome this problem.  This translates to less worry and more sex.  Who could ask for anything more?