Penis problems & solutions
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We get a lot of emails asking for help. And with the assistance of our sexual therapist we do our best to answer them all. If you would like to send in your penis, sex or sexual health problem feel free to do so. You'll get a personal reply and the question and answer may also be posted here (anonymously, of course) to help anyone else in similar straits. Send your problem to: moreinfo "at" penis-website.
Penis problems page 1 - click on the problem below for our answer
1 The retractile penis, issues of size, width and length, too big and too small
Penis problems page 2 - click on the problem below for our answer
Penis problems page 3 - click below to see our answers
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I am now approaching 45 years of age and I find that sometimes I don't get erect in the way that I used to. Most of the time, my penis requires physical stimulation to become erect, the whole process takes longer, and I just don't feel as interested in sex as I would like to be.
I remember the exciting feeling from when I was younger of getting hard just by eyeing up a sexy woman whom I'd like to fuck, and I wonder if those days will ever return. But most of all, I just want to feel like a man again, and get a reliable erection when the opportunity for sex presents itself. What do you suggest?
First, see dysfunction Then keep in mind that the desire to have sex is one of the most powerful reminders that we are male! At least, that's how it must feel to some young guys, whose erections are unpredictable (and possibly unwanted), whose sex drive seems overpowering, and who have to masturbate regularly simply to keep their sexual urges under control.
And yet, no matter how problematical this may be when we are young, we seem to look back on the days of having a rampant penis with affection and longing when we are older.
It's a sad irony that as men's penises begin to calm down, women begin to find their sexual selves and the disparity of desire between the sexes switches in favor of women - at least for a fair number of people.
I'm not saying that this is a fate which befalls all men, but it is a fair statement that a lot of men in mid-life find themselves losing their sexual desire while their mates find a new interest and confidence in their sexual selves.
As men, our declining sex drive, and the associated arrival of ED is caused by a loss or decline of testosterone levels which becomes more acute as we pass 40 years of age.
In fact, the level of testosterone in our system begins to fall in our early 20's, usually gradually and slowly, but inexorably, so that when we are 50 we have, on average, only half as much testosterone as when we are 20. To make matters worse, our bodies become less sensitive to what testosterone there is in our bloodstream.
There's a comprehensive review of the whole phenomenon of what we can call the male menopause on The-penis.com [see The Andropause ], but what it amounts to is this: you have the choice of accepting it or doing something about it. In most cases, doing something about it means taking testosterone replacement therapy.
There's no right or wrong answer to this dilemma, but there are certainly some things which you can take into account when you consider your options. First of all, the fact that most men - including, probably, your doctor - know nothing about the possibility of testosterone replacement therapy does not mean that doing nothing is the right option.
It simply means that you need to educate yourself and find a better doctor. Low testosterone levels can affect mid-life men in many ways: tiredness, depression, muscular aches and pains, low energy, low libido, impotence, loss of drive and motivation, night sweats, irritability, and so on. In particular, if you're having erectile problems, if you can't use your penis in the way that gives you most pleasure - for sex - then you owe it to yourself to do something to put this right. Your penis may also appear to have shrunk - which, in fact, it may actually have done.
Second, many people will tell you that ageing is a natural process, and therefore you shouldn't (so the implication goes) be so presumptuous as to think of raising your testosterone levels.
Well, if you really want to suffer muscle loss, bone demineralization, loss of libido and depression, fair enough; if, however, you want to live a full and rewarding life - and that includes having regular penile erections - then get some testosterone therapy for you and your penis. You can read all about the symptoms of the male menopause or andropause here, and you can see how testosterone treatment may improve matters here as well.
Other useful references include Jed Diamond's book. This is a good starting point for learning about the subject of hormonal and sexual changes in male mid-life, and he is a fervent advocate of support for the natural psychological changes that go with the decline in testosterone.
Finally, you may hear some ill-informed people say that testosterone treatment can induce or stimulate prostate cancer. This is a misunderstanding of how the hormonal mechanism of men works. The authors of one article concluded: "There is no apparent association between testosterone replacement therapy and the development of prostate cancer." Here is another rebuttal..
Erectile dysfunction is sometimes associated with premature ejaculation. When erection problems and premature ejaculation occur together, the treatment methodology starts with the erection problems.
Q10: Please help me. My penis is so bent that it is difficult to have sex. Do I have Peyronie's disease? What can I do about this? I have enclosed a photograph.
Q: From the picture you can see that the head of my penis has gradually twisted around so that it no longer faces forwards. I think it has always been like this, but it has got much worse since I started having sex. What can I do, and will it get any worse as time goes by?
A: Most bends to the shaft of the penis are the result of Peyronie's disease, which usually starts with an injury to the penis. This can be relatively minor, perhaps a bang or twist to the penis which goes unnoticed during sex or masturbation. If the internal chambers of the organs are damaged, though, they may heal with the formation of some scar tissue. In some cases, and no-one really understand why - this spreads and forms a hard plaque which then stops that area of the erectile tissue expanding on erection. As a result, the shaft will bend because of the unequal forces inside it, producing the peculiar curve that is illustrated in the first photo. This can be corrected by an operation, though the straightened penis is usually shorter than it was before the operation.
Rotation of the penis head with respect to the shaft - shown in the second photograph - is called malapposition. It's a congenital anatomical variation which may accompany hypospadias (a condition in which the opening of the urethral meatus is displaced backwards down the shaft). It's not common, and the few men I've tracked down who have this problem say that yes, it does get worse over time, but only up to a point, after which it stabilizes. One man with a mild hypospadias told me that over the years the head of his penis had twisted more and more until it reached 90 degrees to the angle of the shaft when it was flaccid. He added that it looked more normal with an erection, when the head was only displaced by about twenty degrees. He confirmed this had got worse since he started having sex, so the strains of thrusting may contribute to the condition, which is presumably due to some underlying weakness in the structure of the organ. There is no remedy for this problem.
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