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NightWindWhisper -> RE: Can't stay hard (2/11/2007 8:46:15 AM)
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quote:
ORIGINAL: Koukei
The guy im having sex with can't stay hard. He swears it not me or the things I do and I believe him. He'll be hard one minute and the next it just fades away. It comes back shortly depending on what I do to him but we're both curious about why he can't stay hard. I can never seem to get him off, however he says he can do it by himself when he is alone. What could possibly be the problem?
Sticking to the question at hand and thinking that the statin issue really ought to be a new thread...
Koukei we are limited by the lack of information about him--to a point.
Erectile dysfunction (ED) is just as the name implies, dysfunction. (This does not include the rude penis that tries slip into the wrong orifice at the last moment.) Generally ED is the inability to attain an erection stiff enough and/or long enough to complete coitus. There is a second component here that you mention that could be very important, and that is anorgasmia. Anorgasmia is the inability to orgasm while having the ability to maintain the erection.
Anorgasmia is often linked to medications especially, but not limited to the anti-depressives and certain heart medications especially beta blockers.
Questions and thoughts to consider are:
>Is he on medications? Do those meds have either component as a common adverse effect at a rate of >2% of people using them?
>What is his age? Though not really accurate I look at the effect of age this way: Take the persons age, add 10%. For instance if a person is 50 his "group" has a 60% chance of ED. And yes, the 20 year old group has a 30% chance of ED. However this is ED "in some way," at some time, but not necessarily a continuing problem.
>ED is a common issue, but not always a problem. Here it is a problem because you say "problem." In many cases guys have periods of inability related to stress, or medication (the effect can be transient) and do not consider it a problem as some guys don't "need" to orgasm every time. Some couples feel that they have a good sexual relationship even when the male has no ability to attain an erection at all.
>As others have mentioned we have no idea as to his physical health. High blood pressure ( normal = or <119/69) is a huge issue. Even >140/85 will, over time damage the cardiovascular system. As pointed out smoking is a huge factor. So is extra weight and the presence or lack of adequate exercise.
>Ask him: "...do you get morning wood?" Every male gets a hard-on in the very early morning. The quality/duration of the erection seems to correlate closely with ED. This is important because if he says: "Yeah, I get rock hard and it can last for 20 minutes," then the diagnosis is that the issue is in the big head, not in the little helmet head (his penis). The fix = Route A below.
>If he says "I get hard, but it isn't very stiff, or no, or it does and gets a bit hard then the problem is usually related to blood pressure in his penis and the ability of certain valves and/or vein quality to maintain the level of pressure to give him a hard-on and to hold it. The fix= Route B
The suggested fix:
Route A: This is the most likely scenario for your case. Why? Because you told us so
>" When we first started having sex i could get him off all the time doing just about anything but not now."
>" I can never seem to get him off, however he says he can do it by himself when he is alone."
>" He has been under a lot of stress lately."
These statements show us that in the recent past he did fine. Also he does fine alone, and he is under a lot of stress. To cure this remove or help him to deal with the stress. I'd suggest trying to minimize the "need" for him to orgasm, let him realize that most men, at sometime in their life had this issue and it's ok. Performance anxiety can feed upon itself. The man feels anxious ("will I be able to...; Oh no, it's dying already...") The anxious thoughts interfere with the release necessary for orgasm and erection and whammo, the penis shrinks in shame.
If the "stress" is something of a long term significant issue that creates anxiety, and if he has medical insurance, a counselor might be useful to help him deal with the stress. Cialis might help--see below at "Meds"
Route: We are assuming that he has said that doesn't get decent morning wood. Therefore ED caused by physical problems are likely. See a doctor, any will do, though a urologist would be best. If his blood pressure is higher than 130/78 buy a blood pressure meter at Walmart and have him take a reading in the evening, relaxed, sitting down, >2 hours after eating. If it is higher than 120/70 an average over two weeks, fix it. The medical practitioner will suggest lifestyle changes and/or medication.
If his BMI (Body Mass Index) indicates overweight or obese (search keywords "BMI calculator") Drop the weight. Often ever 2-4lbs will drop systolic BP by one point. Do not go by perception, go by the BMI. Perception is often off by more than 30lbs. I frequently see people whose perception is that they are a few pound overweight when in fact they are obese. Being obese brings increased risk factors in many, many areas.
Cardiovascular exercise will help greatly if his BP is high. If he is over 40 and/or very out of shape, talk to the practitioner first. But cardiovascular exercise MUST be done properly. Many people say: "I walk..." or "I carry a lot of stuff around...." To increase cardiovascular health, reduce BP and pulse rate the exercise must be in the proper target heartbeat range and must be at least twenty minutes (continuous) at least three times a week. (Search "Target Heart Rate Calculator). Therefore he would need a seven minute warm-up, and a seven minute cool-down plus the 20 minutes in the proper range for him.
This is 34 minutes three times a week. I have seen many people go from a BP of "160/105" to <119/69 BP by doing just this, three times a week, over a year, while losing enough weight to be within the target BMI.
Most people when told they should do this whine "I don't have the time." My answer:
"I have talked to a large group of people who once said they too had no time for exercise, and now they say: 'I make the time." That group is composed of people who have had significant cardiovascular problems such as a heart attack."
I hope these suggestion help.
Meds: The common ED medications are Viagra, Levitra and Cialis. They each cost ~$10/tablet.
Viagra was first on the market and in my opinion has the worst adverse effects. I call Viagra the three step drug: First squirt some 12 hour nasal spray up you nose for the inevitable congestion. Then pop a couple of Ibuprofins for the soon to occur headache Finally take a stomach acid reducer because you will likely get wicked indigestion.
I suggest that a guy start at a low dosage and work up. Often times a practitioner will prescribe 10 milligram tablets. I suggest cutting that into quarters (with the doc's permission of course as not all meds can be cut into pieces!). If a quarter works, as it often does it only costs $2.50 a pop and the adverse effects are less. I do NOT recommend Viagra. Viagra works for 4-8 hours.
Levitra was the second med. However it too has the same (in my opinion-and not all people have significant adverse effects) adverse effects. I do not recommend Levitra.
Cialis was the third medication to hit the market. It has significantly less adverse effects and can last for 24-36 hours. I recommend that the patient ask for Cialis (and by the way--to say: "got any samples doc?" as they usually do.)
In the case mentioned above--will Cialis help? Maybe, maybe not. It might be worth trying.
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