Men's Sexual Health

Men: What Your Sex Life Says About Your Health
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Sex is great until, well, it's not so great. When something goes awry, it's easy to blame being in a bad patch or a bad relationship. Or . . . could your body be trying to tell you something?

"There's an increasing awareness that sex isn't just about quality of life -- sex can be a harbinger of underlying medical conditions," says urologist John Mulhall, director of the Sexual Medicine Program and the Sexual Medicine Research Laboratory at Weill Medical College of Cornell University in New York City.

The following ten sex scenes are no fun, but they're worth mentioning to your favorite primary doctor or urologist (the specialist who handles many men's plumbing issues).

Sex scene #1: You're just not interested any more.

It might be: Low testosterone

Lots of things can cause your sex drive to shift into neutral: work stress, falling out of love, lack of sleep. (See also: Sexless After 40? Don't Be!) But what if those things don't apply and you'd still rather count sheep than make love? Or if the sights and touches that once turned you on leave you literally unmoved? You might have a hormone out of whack.

"Testosterone is the most important metabolic hormone for men," Mulhall says. "If it's low, you're at increased risk for osteoporosis, type 2 diabetes, coronary artery disease, metabolic syndrome, and premature death -- and your only symptom may be low libido."

What to do: Get your testosterone level checked with a simple blood test. Make the appointment for before 10 a.m., Mulhall says, when levels are highest. If yours is low, you'll be referred to a urologist or endocrinologist who can help you evaluate treatment options, which include testosterone supplements.

Sex scene #2: You're just not interested -- and you're feeling down, too.

It might be: Depression -- or depression meds

Loss of interest in sex is a classic sign of clinical depression. Yet the treatment for depression can have the same side effect. Talk about a catch-22. Drugs in the SSRI family of antidepressants (including Prozac, Paxil, and Zoloft) have been found in many studies to zap desire in both men and women. (They can also cause anorgasmia -- the inability to climax.)

What to do: If you haven't been diagnosed with depression and you're feeling low (along with experiencing low libido and other common symptoms of depression, mention all this to a doctor. Clinical depression is highly treatable with talk therapy and medication. If you're currently being treated with an antidepressant, ask your prescribing doctor about switching to a class of drugs less associated with sexual side effects, such as bupropion (Wellbutrin). Ask, too, about taking a "drug holiday" from an SSRI if you're on one; some doctors endorse quitting these meds for a day or two at a time in order to allow libido to bloom.

Men: What Your Sex Life Says About Your Health

Sex scene #3: More and more often, you can't hold an erection.

It might be: A heart problem (the cardiovascular kind, not the romantic kind)

Say you're a relatively healthy midlife guy, a little overweight, and you start having erectile trouble. Count yourself lucky. It might be your tip-off that you're three to five years away from coronary artery disease, says Mulhall. "Two-thirds of men who have had heart attacks had erectile dysfunction (ED) that predated angina by at least three years," he says. "Men are increasingly being diagnosed with ED due to low blood flow, which increases their chance of heart disease."

What to do: Get your cholesterol checked. It's abnormal in 75 percent of men with ED, Mulhall says. "ED isn't just about having bad sex; it's a window to your vascular health," he says. And before things worsen, start exercising and lose weight.

Sex scene #4: You suddenly can't get it up -- but you were fine last month.

It might be: A blocked artery, especially if your leg mysteriously hurts too

The occasional limp penis is a casualty of naturally decreasing hormone levels as men age and experience changes in relationships, says Adam Tierney, a urologist with Dean Health Systems in Madison, Wisconsin. But what happens when ED comes on suddenly? An unusual but worrisome cause is aortoiliac occlusive disease, or Leriche's syndrome, a narrowing of a heart artery due to blockage.

Hallmarks of Leriche's syndrome: erectile problems that come on suddenly (one week you're fine, and the next you have persistent issues) and are accompanied by pain in the leg (especially the calf) or the buttock, especially when you walk or exercise. People with problems of the nervous system (Parkinson's disease, multiple sclerosis, diabetes) are at higher risk, as are smokers and those with high blood pressure.

What to do: Report this unusual combination of symptoms to your doctor. "It's another kind of blood flow issue," Tierney says.

Men: What Your Sex Life Says About Your Health

Sex scene #5: Your penis aches while you're having intercourse.

It might be: Peyronie's disease

Peyronie's disease, an uncommon condition that can develop at any age, is the formation of abnormal scar tissue under the penile skin, which can cause a hardened spot in the middle or make the penis bend slightly when erect. It's often simply noticed as a constant discomfort during intercourse. "Some guys come in and say, 'My penis just aches when I have sex,'" Mulhall says.

What to do: Always take pain as a sign something's amiss -- and tell your doctor. Peyronie's cause is unknown, but it's not an STD or a cancer. (It sometimes runs in families.) There's no surefire treatment, although surgery is often successful.

Sex scene #6: Your partner, touching you, asks, "Hey, what's that?"

It might be: Testicular cancer

Testicular cancer is asymptomatic -- it doesn't hurt. But it often presents as a painless bump or swelling on the testicle, which can be detected through self-exam (a good monthly habit) or by a partner's roaming hands during sex.

What to do: Testicular cancer has a near-100-percent cure rate in early stages, so don't ignore a lump; get yourself to a doctor. The best time for self-exams: standing up in a hot shower, when your muscles are relaxed.

Sex scene #7: You ejaculate way too quickly.

It might be: Hyperthyroidism

Premature ejaculation (PE) -- climaxing either before intercourse or very soon after it begins -- is the bane of younger men but can strike at any age. How soon is too soon is a relative issue, but a general rule of thumb is that PE is a problem when it routinely strikes without any control within a couple of minutes of insertion and sooner than either partner would like. As many as one in three men experience it at some point in their lives. Psychological issues (too excited, too immature, guilt) were once blamed for all cases, but doctors now know there can be physical causes, especially a malfunctioning thyroid (the gland responsible for making and storing key regulatory hormones).

"For some men, the only symptom of hyperthyroidism is premature ejaculation," Mulhall says. One 2005 study found that fully half of men with a malfunctioning (hyper) thyroid complained of PE.

What to do: Though premature ejaculation is hard for many men to talk about, it's highly treatable. If blood tests and an exam point to hyperthyroidism, medication can return your sex life to normal. And if your thyroid checks out OK? Therapies that thwart PE include breathing exercises, distraction, using a condom to diminish sensation, and behavioral therapies. SSRI-class antidepressants are also prescribed because, Tierney says, in healthy people without PE, they cause delayed orgasm.

Men: What Your Sex Life Says About Your Health

Sex scene #8: When you ejaculate, it hurts.

It might be: A muscle spasm disorder, or prostatitis

In women, there's a condition known as vulvodynia, mysteriously chronic pain of the vulva (around the vaginal opening). Penile pain at orgasm is thought to be the male counterpart, Mulhall says. The latest thinking on both conditions is that they're some kind of nerve disorder, although it's not clear whether this is in response to an infection or some kind of trauma, or what. It's more often seen in young men in high-stress phases of life.

Another possible cause for painful ejaculation is prostatitis, an inflammation of the prostate, which is a gland located up under the rectum. "It's a benign condition but an annoying one," Tierney says. And the cause is a mystery in this case, too.

What to do: Dysorgasmia (orgasmic pain) is tough to treat. Some men choose to endure discomfort, while others work with a qualified doctor (usually a urologist) to try various treatments.

Sex scene #9: When you ejaculate, nothing comes out!

It might be: Your prostate meds

Retrograde ejaculation is a condition where you experience orgasm -- but little to no semen comes out. (It exits through the bladder.) Alpha-blockers such as tamsulosin (Flomax), used to improve urination in men with enlarged prostate, are a common culprit. Sometimes diabetics also experience this due to nerve damage.

What to do: Nothing, unless it bothers you. "Most men don't care, but some do," Tierney says. A couple struggling with infertility would want to explore drug treatments or assistive reproduction techniques to remedy the condition.

Sex scene #10: It takes forever to ejaculate -- if it happens at all.

It might be: Diabetes, or prediabetes in the form of a weight problem

In 9 out of 10 men with anorgasmia -- the inability to reach orgasm -- the root cause is psychological (anything from performance anxiety to work stress to a history of childhood sexual abuse). But in the remaining 10 percent of cases, there's a penile sensory problem, most often caused by nerve damage due to diabetes, Tierney says.

Diabetics typically have other clues to the disease, including numbness in the feet, thirst, itchy skin, excessive urination, and fatigue -- but they don't always link the condition to sexual performance problems, which can include the inability to climax.

Overweight but not diabetic? "There's increasing evidence that obesity itself is a medical cause of erectile dysfunctions and loss of libido," Tierney says. "And obviously it can be a psychological barrier in the form of self-esteem issues."

What to do: Ask your doctor about medications to treat ED, such as Viagra or Cialis, but be aware that because diabetics often have heart problems, these drugs aren't always recommended. Instead: Don't discount the healing power of lifestyle changes.

"People want to take a pill to make sexual problems better, but a pill won't fix problems that are further back," Tierney says. "Sometimes the best fix is to do the hard work of taking better care of yourself: stress management, losing weight, working on the underlying medical conditions."

Paula Spencer Scott

Paula Spencer Scott is the author of Surviving Alzheimer's: Practical Tips and Soul-Saving Wisdom for Caregivers and much of the Alzheimer's and caregiving content on Caring. See full bio

over 4 years, said...

I am diabetic and lost interst in sex.I consulted my family doctor who prescribed Cialis for me. Moved to another town and have a question which I supposed to have asked my doctor: Can one use Cialis , for examples, for as long as he live or after sometime change to another medication that could give the same results. I am asking this question as I am still taking Cialis but do not get erection.

almost 5 years, said...

It is too much help full information for health care.

almost 5 years, said...

This is very interesting and educational. I will see my doctor and do Blood test . Thank You.

about 5 years, said...

Oh, for Pete's sake, I am so TIRED of this emphasis on sexual activity among the old! This sex-obsessed culture keeps dinning it into us that if you're not sexually engaged, you barely qualify as alive. Many so-called "primitive" cultures freely acknowledge that a man (like a woman) has a certain number of active sexual years before he "withers", and Socrates is recorded as exclaiming how relieved he was to have lost the drive and the ability which used to put him at the mercy of "this little tail of flesh". My husband and I have to sleep in separate beds now, since I *must* get enough sleep to be alert enough to take care of him -- he has Alzheimer's. I miss the huggy closeness of (actually) sleeping together, but I don't miss sex with someone who has forgotten what a gentle sexual touch is, and himself takes forever to climax. His meds reduce his libido, thank god, so we can concentrate on the mutual affection and regard that are appropriate to our real current situation, not some cultural ideal of eternal rumpy-pumpy that may suit some, but does not suit everyone. ONE SIZE DOES NOT FIT ALL in sexual matters any more than other things, and I wish all these "advisors" could keep that in mind when they pontificate about elderly sex.

over 5 years, said...

What in gods name is a women writing this article for? Don't they have MEN reporters??!!!!

about 6 years, said...

what happen to a man having low quality(watery) sperm and low sperm conditions?

about 6 years, said...

keep me updated

about 6 years, said...

Very good experience in live to know about

about 6 years, said...


about 6 years, said...

Would like to forward the article to my brother and friends but can't find the link !

about 6 years, said...

Looking back it appears to me that you need a partner for sex. I've started looking for a partner, but no luck so far. Another person made the comment that women are looking for $$$'s now. Well that is exactly what I have found in the last couple of months of looking. I'm coming to the conclusion that the woment in the US are dreaming of a fantasy that only exhists at Barnes and Noble or When the time comes for me i'm going overseas.

about 6 years, said...

What sex life?

about 6 years, said...

I haven't had an orgazm in such a long time...I think I have erectus interruptus! Is there a pill I can take to get a orgazm? I take vigara just to read Playboy Ragazine!

about 6 years, said...

All topics covered were very helpful

about 6 years, said...

Give more natural lifestyle changes suggestions.

over 6 years, said...

Very interesting infofmation!

over 6 years, said...

Overall, this artticle is very good. However, another good point, that i strongly feel should addresed is a few psychological factors of us Males. Many males, such as I, must admit overall they are very, very visual. Please do not take me wrong here, an say... "Oh you males, "all you think about is the visual aspects of Sex, and she must be gorgeous" No, no, no, please, that is a big help, if your partner is very attractive to You, but that is not my overall point here. I am only saying, that Chemistry is a huge factor, along with true desire to have sexual relations with another, all these things become a huge factor. Yes, medical problems can, and do cause serious problems, with sexual relations among Men/Women however, finding someone that you really care about,along with Chemistry, the "Zing Factor", i like to call it , between two people that cannot be forced, and must come naturally between you and your partner, is the best meds one could ask for. Along with Love, Zing, and mutual true passion, there is nothing that can stop two people from sharing God's gift of pleasure. Ciao

over 6 years, said...

Peyronie's disease? I figured out why my penis bent to almost 90º. Several times while my wife was on top and inserting my penis she jabbed me with her finger nails. After about 15 to 20 years of that no wonder it caused a scar and now bends. There was a period leading up to the final end where there was redness and a rash like flaking in the area and it started to hurt even more and more until it stopped working.

almost 7 years, said...

good information ------------

almost 7 years, said...

Good advice for guys.

almost 7 years, said...

Look into Tantric Sex and learn what the ancient learned and explored years ago. Our western medicine has ignored sexuality or put it as a "dirty thing" but in the east they have celebrated sexuality and have learned many strategies for improving one's sex life without drugs. Things that this article said indicate that there is still a lot of ignorance re: sex in the west. Because you ejaculate after a few minutes of insertion you have premature ejaculation? Then a lot of american men have this. The average time from start to finish for american men is about 10 -12 minutes including foreplay, the actually time from insertion to ejaculation is often just a couple of minutes. If your ejaculating before you even insert or during the foreplay then perhaps then you have premature ejaculation so try "solo cultivation" to improve this. If you don't ejaculate then you have problem? In Tantric sex the goal is not to ejaculate with every orgasm so you can have multiple orgasms. Nowere in the west do they tell us how to have multiple orgasms (women do it why can't men?) or give us any train or instructions in sex. Look into Tantric sex and become a sexual kung fu master. It's a lot of fun and both you and your partner will be pleased.

almost 7 years, said...

iam very impressed with all you are doing.thanks a million.

almost 7 years, said...

Hello anonymous and Joel A Samue­l, Thank you both for your comments. If you would like, you can post your questions in our Ask & Answer section, here: ( ). I hope that helps. Take care -- Emily | Community Manager

almost 7 years, said...

The article is good but you have not said anything on how to deal with Ed resulted from heart problem. is it reversible,?

almost 7 years, said...

I understand that there are a number of ways to treat ED. If any of the methods work is the person still considered a heart disease patient and if so then what? I also thought high levels of testosterone can be harmful.

about 7 years, said...

Hello obodoo, Thank you for posting your question. Unfortunately, we are unable to diagnose medical problems for our site members, or provide medical guidance online. While members of our community may respond to your question, we recommend that you contact a doctor offline regarding this medical issue. Take care -- Emily | Community Manager

about 7 years, said...

mine is a question - anytime i take any sexual enhancement drug, i experience lower back pain after sex the following day. why is that?

about 7 years, said...

I often wondered about some of these problems which affect me. Now I will discuss these matters with my Dr. at the next visit. Thanks for the article.

about 7 years, said...

I am so glad you posted this again. I can't tell you the number of men who experience these symptoms. As a single woman, it is very uncomfortable having sex with a man the first couple of times and have him ejaculate within a minute after penetration or not be fully erect. I have often wanted to tell them they might have a medical issue. But, it is too uncomfortable when you are just getting to know someone. I would like to see the subject of a women might best suggest men seek medical help. The men I have been with act like its normal. If I were a man, I would be embarrassed.

about 7 years, said...

yes it was i have had trouble ejaculating for about 5 months now. I know now what to ask my doctor

over 7 years, said...

I have no sex life, it's ok. Women don't put out anyways, unless they see $$$, then that's what seems to affect the womans libido the most. How has my health been?, pretty bad, and going downhill fast, that's ok I have medical insurance, sick days, etc. Costs to much - women that is. It's just to much of a drag dealing with American girls, if I marry, it will be a foreign girl.