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Men's Sexual Health Archive
Doctors often mum about sex after a heart attack
A week or so after having a heart attack, if you can take a brisk walk without any heart-related symptoms, it's fine to have sex. So say the guidelines from the American Heart Association. But most doctors don't share this advice with their patients, according to a study in the December 2014 Circulation.
The study included more than 2,300 women and 1,100 men between the ages of 18 and 55. Just 12% of women and 19% of the men reported receiving any counseling about sexual activity within a month of their heart attacks. Those who did get advice were often given restrictions (such as to limit sex or to take a more passive role) that are not supported by evidence or guidelines. Being female or older was linked to a lower likelihood of receiving counseling.
Ask the doctor: What works best for premature ejaculation?
Q. What are the most effective treatments for premature ejaculation? Do erectile dysfunction drugs like Viagra help with this problem?
A. Premature ejaculation, usually defined as ejaculation within one minute of starting intercourse, is initially treated with behavioral techniques to delay climax. This includes the squeeze technique, which involves applying pressure just behind the head of the penis when ejaculation approaches and maintaining pressure until the
sensation passes. However, in many men, this doesn't prevent ejaculation.
Ask the doctor: Is there such a thing as "male menopause"?
Q. Does a man's testosterone level always decrease with age? If my testosterone is low, do I need treatment for it?
A. Testosterone gradually declines over time in all men, but this does not necessarily lead to health problems. Some medications or illnesses can also suppress testosterone.
Ask the doctor: Weak ejaculation: Cause for worry?
Q. I've noticed that my ejaculations are weaker and lower-volume than in my youth. Is that normal? Could something be wrong with my prostate gland?
A. As men get older, they may notice some decline in the volume and strength of ejaculation. If the change is substantial, however, it warrants a visit with your doctor.
Pill-free ways to improve your sex life
Exercise, smoking cessation, and alcohol moderation can help bring sexual activity back into the bedroom.
Sex is important to health. It revs up metabolism and may boost the immune system. Frequent sexual intercourse is associated with reduced heart attack risk. And it's fun. So why aren't we having more of it? "There are many reasons why sexual activity can diminish in older age, but many sexual problems can be overcome with appropriate interventions, especially if the problems are relatively new," says Dr. Jan Shifren, co-author of the Harvard Special Health Report Sexuality in Midlife and Beyond.
Which drug for erectile dysfunction?
Erectile dysfunction pills have some differences, but price can limit your ED medicine choices
What are the differences between erectile dysfunction drugs? About half of men ages 40 to 70 have erectile dysfunction (ED) to some degree, although only one in 10 report a complete inability to have erections. Taking an ED drug produces an erection sufficient to start intercourse in about 70% of otherwise healthy men.
Does it make any difference which of the four drugs for erectile dysfunction you take? "Yes, there can be differences," says Dr. Louis Liou, chief of urology at Harvard-affiliated Cambridge Health Alliance in Boston. "For new patients, I have them try different ones to see what works best."
Matters of the heart: Sex and cardiovascular disease
Cardiovascular disease may change many aspects of your life, but sexual intimacy does not have to suffer as a result.
Thanks to early screening, lifesaving interventions, and sophisticated pharmacology, millions of people live full, active lives after a heart disease diagnosis. That can include sex. Although the physical and emotional strains of cardiovascular disease often take a toll on a couple's intimate activities, there is ample reason to persevere. "Sexual activity and sexual function are major quality-of-life issues for both men and women with cardiovascular disease," says Dr. Joanne Foody, director of cardiovascular wellness services at Harvard-affiliated Brigham and Women's Hospital.
Erectile dysfunction and the drugs to treat it
In many cases, medications are all a man needs to stay sexually active.
Erectile dysfunction (ED) affects almost 70% of men ages 70 and older. Fortunately, treatment is often just a matter of taking a pill. "We usually start with oral medications, and they're effective in about 50% of the cases," says Dr. Michael O'Leary, a urologist at Harvard-affiliated Brigham and Women's Hospital and editor of the Harvard Special Health Report What To Do About Erectile Dysfunction.
Research we're watching: Testosterone therapy linked to heart trouble
Over the past decade, ads touting testosterone therapy to treat low energy and a flagging libido in men have fueled a rapid rise in prescriptions for the hormone. Short-term studies suggest that testosterone therapy boosts bone mass, strength, and sexual function and improves some markers of heart disease risk. But concerns about the long-term safety of testosterone treatment (available as a gel, patch, or shot) linger, particularly after a 2010 study of testosterone in frail, older men was stopped early because of cardiovascular problems among the testosterone users.
Now, findings from a study of 8,700 male veterans with low testosterone add to the concern. Men who used testosterone therapy had a 30% higher risk of heart attack, stroke, or death over a three-year period than men who didn't use testosterone. The men, who were in their early 60s on average, had all undergone a heart imaging test, and most had risk factors for heart problems. Testosterone might boost heart risks by encouraging the formation of dangerous blood clots, say the authors, whose article appeared in The Journal of the American Medical Association.
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