Although ED is considered to be a benign disorder it can have a dramatic effect on the QoL of many men, as well as their partners. Questionnaire instruments are now available to measure the impact on an individual’s QpL. HoAvever, of equal interest to the physician as the number of patients suffering, is the number presenting and, increasingly, what can be done to identify those non presenters with ED who have other significant undiagnosed health problems that would benefit from therapy. Increasingly, epidemiologists are trying to assess the magnitude, at least numerically, of the problem and the impact of potential risk factors. Armed with questionnaires such as the Brief Sexual Function Inventory, and the International Index of Erectile Function (IIEF) and its derivatives, we have begun to quantify ED prevalence.
A major problem with the assessment of the prevalence is whether the patient in the surgery or conmiunity will truthfully disclose the extent of his ED or even want to discuss it at all. In today’s post’sildenafil era, many couples will still accept impaired sexual function as being an inevitable consequence of the aging process. In general, recent surveys have only served to confirm the data of the Massachusetts Male Aging Study (MMAS), 1987-1989. This community-based survey undertook a random sampling of health status in men between the ages of 40 and 70 years. Although the sampling was confined to the Boston area, more recent surveys have shown that it is probably representative of America’s diverse populations, and East and Western Europe. There is no evidence to suggest that the epidemiology of ED is radically different in Latin America, the Pacific Rim, or Japan. The MMAS shows that over 50% of men in that age range will experience some degree of ED. Read the rest of this entry »

Improving ‘Men’s Health’ should be a major concern for all physicians. On average, a man’s life expectancy is 7 years less than that of a woman. They will often prematurely die, or become disabled by preventable diseases. This difference has traditionally been attributed to some unchangeable genetic susceptibility. However, the gap is slowly narrowing and the validity of this assumption is now highly questionable. In the developed world, women have frequent contact with healthcare services throughout their lives, from the cradle to the grave. ‘Women’s Health’ is perceived as a priority and access to it is considered an inviolable right for all women. After completing childhood health surveillance procedures, they will see a family physician regularly to obtain contraception, for ante” , peri’ and post-natal care, for cervical cytology screening, for advice about the menopause and hormone replacement therapy, and for mammographic screening. They will also bring along their children and grandchildren for advice, providing further opportunities for health screening and advice.
Some men will not see a doctor from the time of their last childhood health surveillance consultation until they have their first heart attack, or worse. They often consider themselves ‘immortal’ and unable to spare the time for health maintenance. Any opportunity to encourage men to participate in health screening and maintenance activities should be enthusiastically developed by primary care teams. Read the rest of this entry »

“You never know a man until you know how he loves.”
Sigmund Freud
Stimulated by the hormone testosterone, men have been driven to populate the earth, planting their seed wherever they could at every opportunity. No small part of this drive is the intense sensation of pleasure derived from the simple act of ejaculating. Reaching a peak of sexual excitement, spewing ejaculate from the tip of their wand of light, and collapsing in a swoon of energy and tension release commonly takes only a matter of minutes for most men. As the simple diagram illustrates, this experience is a little bit like stepping off a precipice and flying into an abyss. The urge to do this repeatedly seems to be almost irresistible and becomes an obsession with many men. A typical male between the ages of fifteen and thirty can scarcely think of anything else day and night. Read the rest of this entry »

“The degree and kind of a man’s sexuality reach up into the ultimate pinnacle of his spirit.”
Friedrich Nietzsche – Beyond Good and Evil
Is this an all too familiar scenario? Hot and heavy loving with hungry kisses and tender caresses that promise orgasmic bliss for both you and your eager partner when all of a sudden you’re one thrust past the edge, the dam bursts and it’s over. You’re finished, “spent” and ready for sleep. She’s still waiting for more, perhaps wistfully contemplating a purchase of that acrylic-vibrating dildo her friend has been raving about.
Most ordinary men believe that ejaculation is the best part of sex. But there is something better—orgasms without any ejaculation at all. It is possible to have many orgasms in a single session of lovemaking, none of which includes an ejaculation. Furthermore, if you end lovemaking while you still have desire, in other words without ejaculating, you will super-boost your immune system and increase your physical energy, mental creativity, emotional resilience and spiritual quickening. Read the rest of this entry »