Men's Sexual Health Archive

These conditions are associated with a higher risk.

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Most men are familiar with the common strategies to reduce their heart disease risk: keep cholesterol in check, manage high blood pressure, follow a heart-healthy diet, and perform regular exercise. But there may be other preventive steps you can take.

"Some age-related conditions can further increase your risk without you knowing it, which is why it's important to be mindful about all aspects of your health," says Dr. Michael Gavin, a cardiologist with Harvard-affiliated Beth Israel Deaconess Medical Center. "Fortunately, once they are recognized, these other risk factors can be addressed and managed."

Although many older men enjoy active sex lives, most don't share sex-related questions and concerns with their doctor.

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While you discuss many subjects with your doctor, like proper blood pressure and cholesterol levels, your sex life probably doesn't make the list — but it should.

"Even though you may have an aging body, you can still feel healthy, vigorous, and full of life, and your sex life should be part of that," says Dr. Sharon Bober, director of the Sexual Health Program at Harvard-affiliated Dana-Farber Cancer Institute.

On call

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Q. What causes urinary tract infections and are men at risk for getting them?

A. Although urinary tract infections (UTIs) are more common in women, men can get them, too. They occur when bacteria build up somewhere along your urinary tract. In men, UTIs can develop in the urethra (the tube that runs from the opening at the tip of the penis to the bladder), the bladder, the prostate, or the kidney.

Decades of research show that yoga can reduce the emotional and physical fatigue brought on by cancer treatment. In 2017, scientists reported for the first time that this is also true specifically for men undergoing treatment for prostate cancer. Men who took a yoga class twice a week during prostate cancer radiation treatment reported less fatigue, fewer sexual side effects, and better urinary functioning than men who did not.

The research team enrolled 50 men ages 53 to 85 who were diagnosed with early or advanced nonmetastatic prostate cancer. Of them, 22 were assigned to yoga classes and the rest did not participate in yoga. All the men received scheduled radiation treatments; 29 of them were also on hormonal therapy, and 19 had been treated previ-ously with surgery. The yoga and control groups were evenly balanced with respect to various cancer treatments as well as treatments for side effects.

In the journals

Men with intermediate-risk prostate cancer may benefit more from a shorter duration of hypofractionated radiation therapy (HRT) than from standard radiation therapy. With both types of radiation therapy, the total amount of radiation is given in multiple sessions over a set period. Compared with standard radiation therapy, HRT uses larger doses over a shorter period of time.

A study in the Nov. 4, 2017, European Urology Focus analyzed data of 3,553 men with prostate cancer, 65% of whom had intermediate-risk prostate cancer. The men were randomized to get either a one-month program of HRT or the standard radiation treatment regimen given over two months. After an average of five to six years, the intermediate-risk men who had HRT were less likely than men who got standard radiation therapy to have their prostate cancer return.

There's an upswing in cases of chlamydia, gonorrhea, and syphilis in the United States, and it includes older adults.

For as long as humans have engaged in sex, there have been sexually transmitted diseases (STDs). The term STD (which has replaced the older "venereal disease") generally refers to infections that can be transmitted by vaginal, anal, or oral sex. Among them are genital herpes, human papillomavirus, chlamydia, gonorrhea, syphilis, and human immunodeficiency virus (HIV). The CDC estimates there are about 20 million new STD cases every year, but only a fraction of them get reported.

STDs are on the rise in people of all ages. There were more than two million reported cases of chlamydia, gonorrhea, and syphilis in 2016. While the vast majority occurred in teenagers and young adults, there also were significant increases in cases among middle-aged and older adults (see "STDs reported among older adults").

On call

Q. I had a major heart attack earlier this year and received a drug-eluting stent. My doctor tells me that it's now safe to exercise and engage in sexual activity. But is it safe to use erectile dysfunction (ED) medications?

A. Most men who have recovered from a heart attack can resume their usual sex life. Once your doctor allows you to engage in moderate aerobic activity — sexual activity is often equated to the exercise level of brisk walking — you may safely use ED medications with certain precautions.

If lack of energy has drained your sex life, there are ways to reignite the passion.

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Your sexual drive can stay high late in life, but often your energy for sex can diminish. Low energy not only affects your sex life, but can carry over to other parts of your life, too. You can become apathetic, no longer find pleasure in favorite activities, and become more sedentary.

However, many of these issues related to lost sexual energy can be addressed. "Never think lack of energy means an end to your sex life, and there is nothing you can do about it," says Dr. Sharon Bober, director of the Harvard-affiliated Dana-Farber Sexual Health Program. "There are many strategies you can adopt to get back in the game."

In the journals

Observation only may be the best medicine for men with early-stage prostate cancer, suggests a 20-year study published online July 13, 2017, by The New England Journal of Medicine. Early-stage prostate cancer means the cancer is small, confined to the prostate gland, and can only be detected with a biopsy.

Researchers randomly assigned 731 men, average age 67, with localized prostate cancer to receive either surgery or observation only. At the 20-year follow-up, 62% of the men who had prostate cancer surgery had died of other causes, while only 7% died from prostate cancer. In comparison, 67% of the men assigned to observation died from other causes and 11% from prostate cancer. The absolute differences in mortality were not significant.

Women use kegels to strengthen their pelvic floor muscles, but men may also benefit from doing these exercises.

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Kegel exercises to strengthen pelvic floor muscles have long been seen as just for women, but they may be a way for men to address some common unpleasant issues as they age.

"Men also can have issues with these muscles, which can cause urinary leakage, bowel trouble, and even erection problems," says physical therapist Celia Brunette, with Harvard-affiliated Spaulding Rehabilitation Center.