How men can improve their sexual performance

Many men have sexual problems. Doctors call it sexual dysfunction. Health issues, anxiety, fear of relationships, and other problems can cause this problem.

About 31% of men and 43% of women have some kind of sexual problem. However, many types of sexual dysfunction can be treated or resolved in other ways. Ongoing research has prompted physicians to pay more attention to this issue than ever before.

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Common Sexual Problems

You can have problems at different points during sex. Men may experience:

• Lack of sexual desire
• Inability to get or keep an erection
• Orgasms that happen too slowly or too quickly
• Inability to have orgasms
• Other possible issues are:

Deformities of your penis. One type is Peyronie’s disease, in which a buildup of collagen or scar tissue causes the penis to bend.
Retrograde ejaculation is when semen is forced back into your bladder instead of out of your penis. This may happen in men with nerve damage from diabetes, or after bladder or prostate surgery.

Sex and Aging

Some changes in sex drive and sexual performance are normal as you age. You may need more foreplay before sex, or more stimulation to get and maintain an erection. After reaching arousal, an erection can take a long time.

But drastic changes could be a sign of a bigger problem. Contact your doctor if this happens.

Health Problems

Your overall health and any medical conditions you have also affected your sex life. Conditions that can affect your sexual ability or desire for sex include:

• Heart and vascular (blood vessel) disease
• Diabetes
• Hormone imbalances
• Nervous system disorders like multiple sclerosis and Parkinson’s disease
• Obesity
• High Blood Pressure
• High cholesterol

A sudden change in your sexual desire or ability to have sex may be a sign of a medical condition. If you notice them, tell your doctor.

Medications for depression and blood pressure can also affect sex. If you’re having problems after starting a new medicine, ask your doctor how to manage side effects or if they can change your prescription.

Smoking, heavy drinking, and other unhealthy habits can affect sexual function. On the other hand, regular exercise, weight loss, and stress management can improve your sex life.

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Mental and Emotional Issues

Stress, anxiety, depression, and other mental and emotional problems can significantly affect your sex life. Worrying about your performance during sex can get in the way of enjoying sex. Thus, guilt can be caused by sex, fear of pregnancy, or the memory of a traumatic sexual experience.

Sexual problems can also arise because of insecurity in your relationship. Anger at your partner, a sour relationship, and other ongoing issues can affect your sex life.

Getting Help

You may feel scared or embarrassed to talk to your doctor about your sexual problems. But talking about your concerns is the first step towards getting help.

Your doctor will ask questions about what is happening. They may perform a physical and order other tests (such as blood tests) to determine whether an underlying health problem is causing it.

Treatment Options

If a medical condition like heart disease, diabetes, obesity, or depression is affecting your sex life, your doctor may want to treat it first.

Your doctor may encourage you to stop unhealthy habits, such as smoking or excessive drinking, and to exercise. These will improve your overall health as well as your sex life.

Other treatment options include:

• Counseling to help you manage stress, anxiety, fear, or guilt, or to address depression or other mental health concerns
• Medications for erection problems that you take as a pill, such as Cialis, Levitra, Stendra, or Viagra
• Medicines for erection problems that you get as a shot, like alprostadil
• Testosterone replacement therapy and other hormone treatments for imbalances
• Medical devices, such as vacuum erection devices, help you get an erection
• Penis implant surgery
• Surgery to correct penis deformities
• Penile traction therapy, in which you wear a device on your penis to correct deformities

Is Testosterone Replacement Therapy Right for You?

Many men with low Testosterone experience improvements in energy levels, libido, and mood after testosterone treatment. If Your Testosterone Is Low, Why Not Change It?

Not very fast. Low testosterone does not require self-medication. Testosterone Replacement therapy can have side effects, and the long-term risks and benefits are not known. Only men with symptoms and low blood levels of testosterone should undergo testosterone replacement. Talking with your doctor is the best way to find out if testosterone therapy is right for you.

Subtle Symptoms of Low Testosterone

The symptoms of low testosterone are sometimes obvious, but they can also be subtle. Testosterone levels naturally decline in men as they age for decades. But some conditions can lead to abnormally low levels.

• Low sex drive (libido)
• Erectile dysfunction
• Fatigue and poor energy level
• Decreased muscle mass
• Body and facial hair loss
• Difficulty concentrating
• Depression
• Irritability
• Low sense of well-being

If a man has symptoms of low testosterone and tests show abnormally low testosterone levels, a doctor may recommend treatment. However, millions of men with low testosterone have no symptoms and are currently offered no treatment. Furthermore, men of low status are not allowed to practice medicine because of their old age.

Forms of Testosterone Supplements

Testosterone replacement therapy is available in several forms. All can improve testosterone levels:

• Skin patch (transdermal): Androderm is a skin patch worn on the arm or upper body. It’s applied once a day.
• Gels: AndroGel and Testim come in packets of clear testosterone gel. Testosterone is absorbed directly through the skin when you apply the gel once a day. AndroGel, Axiron, and Fortesta also come in a pump that delivers the amount of testosterone prescribed by your doctor. Natesto is a gel applied inside the nose.
• Mouth patch: Striant is a tablet that sticks to the upper gums above the incisor, the tooth just to the right or left of the two front teeth. Applied twice a day, it continuously releases testosterone into the blood through the oral tissues.

Why not a simple testosterone pill? Oral testosterone is available. However, some experts believe oral testosterone can have negative effects on the liver. Using other methods, such as skin patches, gels, orally disintegrating tablets, or injections, bypasses the liver and gets testosterone into the blood directly.

Benefits of Testosterone Therapy

What Can You Expect From Testosterone? Preaching isn’t difficult because everyone is different. Many men report improvements in energy levels, libido, and erection quality. Testosterone can increase bone density, muscle mass, and insulin sensitivity in some men.

Men have also seen improvements in mood due to changes in testosterone levels. These problems are rare, or they are too wide, or too isolated. Learn about the best testosterone boosters for 2021 and beyond.

Karen Herbst, MD, Ph.D., an endocrinologist at the University of California, San Diego, specializes in testosterone deficiency. He says one in 10 men is “happy” with testosterone, although most “don’t think much about it.” Most people have a generally positive but variable response to testosterone replacement.

Risks of Testosterone Therapy

Side effects of testosterone replacement therapy include redness, itching, or pain at the injection site.

However, there is also evidence that using testosterone may increase your risk of heart attack or stroke. Experts note that the benefits and harms of long-term testosterone treatment are not known, as large clinical trials have not yet been conducted.

Prostate cancer: Testosterone can stimulate prostate cancer to grow. Most experts recommend screening for prostate cancer before starting testosterone replacement. Men with prostate cancer or elevated prostate-specific antigen (PSA) should probably avoid testosterone treatment.

Sleep apnea: This condition can be worsened by testosterone replacement. It may be difficult for men to detect this themselves, but their sleeping partner can often tell. A sleep study (polysomnography) may be needed to make the diagnosis.

Blood clots: The FDA requires that testosterone replacement products carry a warning about the risk of blood clots in veins. This could increase the risk of deep vein thrombosis and pulmonary embolism, a potentially life-threatening clot that occurs in the lungs. Products already carried a warning about the risk of blood clots due to polycythemia, an abnormal rise in the number of red blood cells that sometimes occurs with testosterone treatment. Now the warning is more general to include men who don’t have polycythemia.

Congestive heart failure: Men with severe congestive heart failure should usually not take testosterone replacement, as it can worsen the condition.

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