Sex Life In the Tank? Suggestions For Getting Back on Track

Sex Life In the Tank? Six Suggestions For Getting Back on Track

The movie, Hope Springs, with Meryl Streep and Tommy Lee Jones, which describes a couple that, have fallen out of love and had their sex life in the tank. With the help of a therapist, staring Steve Carrell, they were able to rekindle the sexual fire that they once had. What can you do if the same thing is happening to you?

Try Something New-It Is The Spice of Line
There’s biological evidence that novel experiences, both sexual and non-sexual, cause the release of dopamine in the brain. Dopamine is a chemical messenger that’s connected to the pleasure center in your brain. Remember how exciting your romance was when you first met and first had sexual intimacy? That’s because the romance was novel and everything is novel and your brain responds accordingly.

Be creative. Try a different place, a different time, a different position, a new sex toy. Sex every Saturday night in bed with papa on top for 4 minutes is not going to cut it. Try having a morning quickie. Attempt sex in the shower, or on the kitchen island. Do it on the floor or in the changing room at Victoria’s Secret. It isn’t a secret that you won’t be the first couple that tried that venue! Try it at 25,000 feet on your next flight.

Got a headache or are too tired? Take a Romantic Break
All couples are tired at the end of a long day with many demands. By the time you get everyone to bed and deal with unavoidable chores, you just don’t have the energy for a romantic evening.
Instead of waiting until just before you put out the lights, take a break from the computer the newspaper or a TV show (unless it is Modern Family) for a romantic encounter before going night-night.

Take Your Sex Life Off of the Back Burner
Make a date with your partner. Set aside one day a week to have time together. Hire a baby sitter and leave the home for something special. I don’t suggest that you go for the humdrum such as dinner and a movie thing, which seems like it’s supposed to be a lead-in to sex. Instead tray a shared experience such as biking, bowling, or something silly. Return from your night out with new sexual vigor and you can be sure you will be singing, “Come on baby light my fire!” Now don’t make date-night a once upon a time event. Make it a priority and stick to it like you stick to the other obligations on your schedule. Let it become a habit, and you’ll feel reconnected, and the desire will just grow from there.

If It Hurts, Get Help-NOW
Sometimes it’s not that you’re not feeling in the mood, it’s that your body isn’t cooperating because sex is actually painful. This can be a big issue for women approaching menopause, and you might be too embarrassed to tell your partner. It is entirely normal for women to have vaginal dryness after menopause. When the vaginal lining becomes thin and dry this can result in painful intercourse. This pain is due to an estrogen deficiency and can be corrected with oral or topical estrogen creams or vaginal tablets.

For women who have had breast cancer and should not use any estrogen supplements, there are lubricating jellies like K-Y jelly Vaseline, or Replens that do not contain any estrogens but do decrease the friction and pain associated with sexual intimacy.
Some men have a condition called Peyroine’s disease, which results in a significant bend of the penis resulting in pain for both the man and the women. There are treatments for this condition and men should see their urologist. (For more information on Peyroine’s disease see my YouTube video at http://www.youtube.com/watch?v=qkZZPBdWztY)

Your Libido or Sex Drive Has Mysteriously Disappeared
A dwindling libido may not just be a sign of aging. It may be the sign of another health problem or behavioral issue. For example: Depression, anxiety, and hormonal imbalances can all contribute to sexual dysfunction. In men, the inability to get an erection can be an early warning sign of diabetes or heart disease, or testosterone deficiency. Some medications, including antidepressants and blood pressure drugs, can lower your sex drive. Smoking and excessive alcohol consumption can put a damper on sexual response. Even too much time on the bike can lead to problems in bed. Both men and women who are always on their spin bike or the small seat on a road bike can have problems with orgasm and arousal, because of the pressure put on the nerves and blood vessels that supply the penis or the vagina. Sleep apnea can also be a culprit and can lead to lack of oxygenation of the genital tissues. See blog (https://neilbaum.wordpress.com/2012/08/17/not-enough-sleep-can-lead-to-not-enough-sex/) for more information on sleep apnea and its treatment.

Bottom Line: Sex at age 20 is easy and fun and occurs without any effort. Sex in mid life can take some work, effort, and time. Invest in your relationship; you will be happier, healthier, and will have more love and affection from your partner. If that isn’t reason enough to get your sex life back on track, tell your partner that Dr. Baum prescribed it!

If you have any ideas for putting the fire and passion back into your relationships, let me hear from you. I’m always looking for new ideas. Don’t hold back. No idea is too wild or far out.

This blog was modified from a recent post on WebMD by Gina Shaw (https://mail.google.com/mail/u/0/?hl=en&shva=1#inbox/13939af485fb6048)

Want To Have a Longer Penis? Lose A Few Inches Around Your Waist

It seems every man is interested in the length of his penis.  Let the truth be told; it isn’t the length of the “member” that cuts the mustard, but how you use it that counts.  That being said, how can a man increase the length of his penis?  As men age, there is often an increase in girth of the abdomen which creates the illusion that the penis is smaller.  In actuality the penis size doesn’t change, but the perspective of man looking down over his protuberance makes the penis appear shorter.  (The same man may find that his shoes also appear shorter!)

Rule of thumb: If you lose 35 pounds, which means a decrease in abdominal fat, you gain over an inch in length in penis size….and you can see your shoes again!

Bottom Line: If you are looking for reasons to practice a healthy life style such as diet and exercise, then one of the benefits will be a perceived increase in length of your penis.

 

The Penis Has a Mind of Its Own-What Can You Expect From Your Best Friend Who Resides Between Your Legs as You Enter Middle Age

Let’s face it guys, as we get older our sexual prowess and our ability to engage in sexual intimacy decreases.  As we age our testosterone level falls and many men enter into a male menopause, often called andropause.  As a result it takes more stimulation to create an erection and it may take more time to achieve an orgasm and the time between an ejaculation\orgasm and the next erection increases.  If this isn’t enough, there is a decrease in semen volume and the power of the ejaculation also diminishes as we enter middle age and beyond.

Coupled with a decrease in sex drive and a decrease in the rigidity of the erections with age, there is a decrease in the length of the penis.  For some men the decrease in the length is more apparent than real.  That is, with increasing age there is a concommitent accumulation of fat in the lower abdomen which makes the penis appear shorter to the man when he looks down at Willy when he and Willy are in the shower!  So if you are looking for some motivation to lose weight and, as a result, increase the size of your penis by an inch or two, this just might be the stimulus you have been waiting for!

For some men the loss of length is more than just a figment of the imagination. As men age the natural depositon of cholesterol placques inside the blood vessels will restrict the blood supply to the penis and thus impair the deliver of oxygen and nutrients from the blood stream which are so necessary for maintaining the function and the length of the penis.  By the way, this same process of cholesterol deposits in the blood vessels to the penis are also occurring in the blood vessels of the heart and can contribute to heart disease and even a heart attack.

Another natural and normal consequence of aging is that the penis becomes less sensitive.  Thus the need for more genital stimulation in order to achieve and maintain an erection.  When a man is in his sexual prime, age 20-30, the mere touch of a feather can illicit an erection.  For a man in his 50s, it may take several minutes of genital stimulation in order to achieve an erection.

But there is some good news.  Although we have fewer erections, and need to work harder to achieve an erection, the sexual gratification remains intact.  Older men enjoy sexual intimacy just as much as their younger counterparts.

Bottom Line:  Don’t say good by to sex or put Willy to sleep just because you have reached middle age.  Sex is still good whatever your age.  It just takes a little more time, a positive attitude, and, oh yes, a partner!

Want To Lose Weight? Check Your Testosterone Level!

This blog was excerpted from an article by Dr. Julius Goepp in Life Extension, October 2010.

Low testosterone promotes abdominal obesity in aging men. As men age, many men become trapped in a vicious cycle that leads to life-threatening abdominal obesity. No matter how much men exercise or how little they eat, these men are unable to shed this excess weight that accumulates in their belly. It has been demonstrated that low testosterone and obesity reinforced each other, trapping men in a spiral of weight gain and hormonal imbalance. In spite of this widespread threat to men’s health, most physicians do not test for testosterone levels in their obese male patients. If they did, millions of men could be protective against the scourge of metabolic syndrome, type 2 diabetes, high blood pressure, atherosclerosis, erectile dysfunction and cancer. If you haven’t to be one of these plagued  men, please have your testosterone blood levels measure and share the results with your doctor. Experts now recommend testosterone testing for most men of middle-aged men and beyond.   There is compelling evidence for the role of testosterone therapy as a means of promoting weight loss.

A Lark in the Park May Put a Correction in Your Erection

I recently attended the American Urologic Society meeting in San Francisco, May 31-June 3, and I attended a program about male sexual dysfunction.  I was pleasantly surprised to hear of a study that reported that men who exercised on a regular basis were better performers in the bedroom.  Those men who exercised regularly had better erections and had sexual intimacy more frequently those men who led sedentary life styles.  Even men who had  moderate exercise, like take a brisk walk for 30 minutes four times a week were much less likely to have sexual dysfunction than those who were walkers.  It was noteworthy that even moderate exercise such as yoga and walking were just as beneficial as strenuous exercise such as jogging and swimming.

The researches from Duke University suggested that exercise may increase blood flow through the penis, making it easier to get an erection.  Also, working out may make men feel better about themselves and that in turn may improve sexual prowess.

Bottom Line: Men, you may just be able to keep that Viagra, Levitra, or Cialis tablet in the medicine cabinet if you started a regular exercise program.  The best would be to take that walk with your partner as your relationship will also improve if you take time to be with each other on a regular basis.

SOURCES: 105th annual meeting of the American Urological Association, San Francisco, May 29-June 3, 2010. 

Erin R. McNamara, MD, Duke University Medical Center and June 4, 2010 issue of WebMD article by Charlene Laino

Preventing Erectile Dysfunction

What can you do to keep erection problems at bay?

Give yourself time. “As a man gets older, it may take a longer period of genital stimulation to get an erection,” says Dr. Baum. “For men aged 18 to 20, an erection may take a few seconds. In your thirties and forties, maybe a minute or two. But if a 60-year-old doesn’t get an erection after a minute or two, that doesn’t mean he’s impotent. It just takes longer.”

The time period between ejaculation and your next erection also tends to increase with age. In some men aged 60 to 70, it may take a whole day or longer to regain an erection. “It’s a normal consequence of aging,” says Dr. Baum.

Consider your medication. Drugs your doctor has prescribed might be at the root of the problem. Or it might be those over-the-counter antihistamines, diuretics, or sedatives you’re using. Realize, of course, that what affects your neighbor may have no effect on you.  More than 200 drugs have been identified as problematic. Drug-induced impotence is most common in men over 50, says Dr. Baum. In fact, in an American Medical Journal study of 188 men, drugs were the problem 25 percent of the time.

If you suspect your medication, consult your doctor or pharmacist. He may be able to change the dosage or switch you to a different drug. Do not, however, attempt to do this on your own.

Beware of recreational drugs. Examples include cocaine, marijuana, opiates, heroin, morphine, amphetamines, and barbiturates.

Go easy on the alcohol. Shakespeare hit it on the head when he said in MacBeth that alcohol provokes desire but it takes away the performance. That happens because alcohol is a nervous-system depressant. It inhibits your reflexes, creating a state that’s the opposite of arousal. Even two drinks during cocktail hour can be a cause for concern.

Know that what’s good for the arteries is good for the penis. The penis is a vascular organ.  The very things that clog your arteries-dietary cholesterol and saturated fat-also affect blood flow to the penis. In fact, all men over age 38 have some narrowing ofthe arteries to the penis.

So watch what you eat. High cholesterol is probably one of the leading causes of impotence in this country.

Don’t smoke. Studies show that nicotine can be a blood vessel constrictor. A study of healthy adult mongrel dogs at the University of California at San Francisco showed that the inhalation of smoke from just two cigarettes was enough to prevent five dogs from getting a full erection and a sixth dog from maintaining one. The researchers believe that inhalation of cigarette smoke blocks erection by inhibiting the smooth muscle relaxation of the erectile tissue.

Relax. Being in a relaxed frame of mind is crucial. Here’s why. Your nervous system operates in two modes. When the sympathetic nerve network is dominant, your body is literally “on alert.” Adrenal hormones prepare you to fight or take flight. Nerves shuttle your blood away from your digestive system and penis and into your muscles.

Plan ahead. It is a good idea to decide in advance what you’ll do if you don’t get an erection.   If it happens repeatedly, call your doctor.

PANEL OF ADVISERS

NEIL BAUM, M.D., is director of the New Orleans Male Infertility Clinic, a clinical assistant professor of urology at Tulane University School of Medicine, and a staff urologist with Touro Infirmary in New Orleans, Louisiana.

RICHARD E. BERGER, M.D., is a urologist with Harborview Medical Center in Seattle, Washington.

He is the author of Biopotency: A Guide to Sexual Success.

JAMES GOLDBERG, PH.D., is research director of the Crenshaw Clinic at San Diego, California, and a clinical research pharmacologist.

IRWIN GOLDSTEIN, M.D., is co-director of the New England Male Reproductive Center at the Boston University Medical Center in Massachusetts and is an assistant professor of urology at Boston University School of Medicine.

Pellets for Improving Your Libido or Sex Drive

Nearly 30 million men suffer from erectile dysfunction (ED) or impotence and nearly half that number have a decrease in their sex drive or libido.  However, many men believe that erectile dysfunction and diminished libido are the same thing.  It is important that men understand the difference between ED and libido.  ED is the inability to achieve and maintain an erection adequate for sexual intimacy with a partner.  Loss of libido is a decrease in the interest for sexual intimacy.  ED and loss of libido can be separate issues or can occur together as it is common for a man who suffers from ED for a prolonged period of time will also experience a decrease in libido.

What are the symptoms of decrease in libido and what are the causes of this condition?   A decrease in libido is usually a result of a decrease in the level of testosterone which is a hormone produced in a man’s testicles.  A decrease in libido is the most common symptom of testosterone deficiency.  Men with a decrease in testosterone also experience a lack of energy and often complain of lethargy.  Men with decrease in testosterone also experience a decrease in strength or endurance, lose height, fall asleep after dinner, and may even experience depression or a decreased enjoyment in life.

Now there are treatment options for low testosterone which include the insertion of testosterone pellets, Testopel, underneath the skin.  The pellets will boost the testosterone level for 4-6 months.

How is Testopel administered?

Other than the initial stick of a needle used to numb the insertion area, Testopel insertion is pain-free.

The insertion area is 3-4 inches below your beltline–approximately at the top of your rear hip pocket.

• Each Testopel pellet is very small – about the size of a grain of rice
• Testopel is placed just below the skin into your fat layer. Once implanted, most men have no awareness that the pellets are there.
• The right number of pellets is based on the serum testosterone level
• After Testopel is inserted, your doctor will close the implant site using Steri­Strips. Stitches are not needed. The area will then be bandaged and a cold compress applied.
• Patients can return to work the same day that the pellets are inserted

The Testopel results in improvement in:

• Improved mood

• Increased sexual interest

• Restoration of erectile function

• Increased muscle mass

• Increased strength of bones

Bottom Line:  Testosterone deficiency is a very common disorder.  The diagnosis is made by a blood test that detects a low level of testosterone.  Treatment with Testopel is a very effective treatment option.

Testosterone Treatment in Men With Prostate Cancer-The Controversy

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

Sexual Problems in Men-Is it low libido or impotence

Nearly 30 million men suffer from erectile dysfunction (ED) or impotence and nearly half that number have a decrease in their sex drive or libido.  However, many men believe that erectile dysfunction and diminished libido are the same thing.  It is important that men understand the difference between ED and libido.  ED is the inability to achieve and maintain an erection adequate for sexual intimacy with a partner.  Loss of libido is a decrease in the interest for sexual intimacy.  ED and loss of libido can be separate issues or can occur together as it is common for a man who suffers from ED for a prolonged period of time will also experience a decrease in libido.

What are the symptoms of decrease in libido and what are the causes of this condition?   A decrease in libido is usually a result of a decrease in the level of testosterone which is a hormone produced in a man’s testicles.  A decrease in libido is the most common symptom of testosterone deficiency.  Men with a decrease in testosterone also experience a lack of energy and often complain of lethargy.  Men with decrease in testosterone also experience a decrease in strength or endurance, lose height, fall asleep after dinner, and may even experience depression or a decreased enjoyment in life.

Some causes of testosterone deficiency include:

Testes – medical problems that begin in the testes can prevent sufficient testosterone production. Some of these conditions are present from birth; for example Klinefelter’s syndrome, a genetic disorder that affects the sex chromosomes. Other conditions may occur at various stages of a boy or a man’s life; for example, undescended testicles, loss of testes due to trauma or ‘twisting off’ of the blood supply (torsion), complications following mumps, and the side effects of chemotherapy or radiotherapy.

Pituitary gland – the most common condition that affects the pituitary and leads to low testosterone levels is the presence of a benign tumour. The tumour may interfere with the function of the gland, or it may produce a hormone that stops the production of the gonadotrophins and stops the pituitary gland from signalling the testicles to produce testosterone.

Hypothalamus – particular conditions, such as tumours or congenital abnormalities, can prevent the hypothalamus from prompting the pituitary gland to release hormones. This will inhibit testosterone production by the testicles. This is a rare cause of androgen deficiency.

Drugs can also decrease libido. Many prescription antidepressants can diminish sex drive. Other medications with this side effect include tranquilizers and blood pressure medications. Illicit substances, such as heroin, cocaine, and marijuana, when used heavily and chronically, may lower libido and sexual performance.

Testosterone levels gradually decline after the age of 40. Some estimates suggest that up to one in five men over 70 years have low testosterone levels. A number of factors may contribute to the fall in testosterone, in addition to the ageing process itself. For example, any cause of poor general health, including obesity, will lower testosterone.

The diagnosis of low testosterone is made by a careful history and physical examination followed by a blood test that measures the testosterone level in the blood.

Treatment for proven androgen deficiency is based on hormone (testosterone) replacementtherapy. Testosterone can be administered by tablet, skin patch or gel, injection (short or long acting) or implant.  There is a long acting implant that consists of a pellet that is placed underneath the skin using a local anesthetic in the doctor’s office.  The pellet usually lasts for approximately 6 months and can be easily replaced using the same technique. Men who receive testosterone replacement therapy will require regular visits with their doctor. Prostate examinations are performed according to a man’s age and other risk factors for prostate cancer.

The benefits of testosterone replacement therapy include Increased sexual interest, restoration of erectile function, increased muscle mass, increased strength of bones, and improved mood and sense of well being.

Most sufferers of Low testosterone believe their symptoms are simply a function of growing older. As a consequence, they never seek the medical attention needed. Today, low testosterone treatment options exist that can relieve the symptoms of decreased testosterone and can help men reclaim their lives.

Bottom Line: Testosterone deficiency and the accompanying symptoms of decreased libido, lack of energy, and loss of muscle mass is a common condition that affects millions of American men.  The diagnosis can be easily confirmed with a blood test and the treatment using testosterone replacement therapy can be achieved with several treatment options.