Erection problems are more common than many people think. Most men have trouble getting an erection now and then, and it may happen more often as they age. But if you are frequently unable to get erections and this bothers you, talk to your doctor about it. This is especially true for men 50 or older. The mechanics of an erection are complex, and many things can interfere with it. The most common are physical problems, including diabetes; narrowed or blocked arteries; injury; drinking too much alcohol; and prescription drugs, including some used for high blood pressure and depression. Worry, guilt, or “performance anxiety,” can also cause difficulties. Although erection problems may be embarrassing and upsetting, they can usually be treated successfully. What You Can Do During lovemaking, relax and take your time. Talk to your partner about what arouses you sexually. If you are anxious about your ability to perform sexually, discuss the feelings with your partner (but not during lovemaking) When To Call Your Doctor If erection problems regularly interfere with your ability to have sexual intercourse or are causing difficulties in your relationship with your partner. If your taking drugs that might be causing the problem. If physical causes have been ruled out, ask for a referral to a qualified counselor or therapist to help you identify and address and psychological issues.

How To Prevent Sexual Inadequacy If you drink alcohol, have no more than 12-ounce cans of beer, two 5-ounce glasses of wine, or 1.5 ounce drink of hard liquor. If you smoke, quit. Exercise regularly and eat healthfully. Take steps to reduce your stress, try deep breathing, meditation, or yoga (see articles in HealthSaludUSA’s Body & Soul Channel). Ask your doctor about the Kegel pelvic muscles exercise; these may work well for men with narrowed arteries or other circulation problems.     Prostrate Problems - Signs And Symptoms GENERAL SYMPTOMS Frequent, sometime painful, or urgent need to urinate; urine might be bloody Consistently weak stream of urine, dribbling Incontinence (sometime)   ENLARGED PROSTATE Occasional feeling of incomplete bladder emptying PROSTRATE CANCER In early stages: Often no symptoms in early stages, occasionally followed by the symptoms described above. In later stages: Pain in the pelvis or lower back, or sometimes in other areas. PROSTATITIS • Pain in the are between the scrotum and anus • Painful ejaculation, blood in the semen or urine • Fever and chills (acute Prostatitis) • Pain in the lower back. WHAT IS A PROSTATE? The prostate is a walnut-size gland that sits at the base of the tube (the urethra) that runs between a man’s bladder and the end of his penis. (See color illustration D). It produces some of the fluid that carries sperm. ENLARGED PROSTATE: In most men, the prostrate gland grows larger with age; in fact, 75% of men over 50 have some enlargement. An enlarged prostate gland can squeeze the urethra and obstruct urine flow. This benign enlarged prostate isn’t cancer, nor does it need to be treated unless difficult or frequent urination becomes too bothersome. Surgery or medication can treat benign prostates. PROSTATE CANCER: The growth of malignant cells into tumors in the prostate is the most common cancer in American men. It can exist for many years without symptoms, until the tumor grow large enough to affect urination and produce symptoms. Prostate cancer progresses slowly and can usually be treated effectively when caught early enough. If untreated, it may spread to other organs or bone. Treatment can include surgery, radiation, or hormone therapy. PROSTATITIS: This condition is marked by an inflammation of the prostate. One form is caused by bacteria, which can move to the prostate from the urinary system. In acute cases, an abscess may form that has to be drained surgically. In chronic cases, the infection causes lasting discomfort but rarely a fever. Sometimes its only symptom is repeated bladder infections. The second, noninfectious form of Prostatitis has no known cause and does not respond to antibiotics. WHAT YOU CAN DO NOW If you are getting up frequently to urinate at night, avoid caffeine and alcohol, and reduce fluid intake before bed. Warm baths may help relieve pain and other symptoms. Take the prostrate quiz (see box below). Go over the results with your doctor. WHEN TO CALL THE DOCTOR If you develop the symptoms listed above. How To Prevent If ENLARGED PROSTATE There is no known way to prevent this condition. PROSTRATE CANCER Know your family. If your father or brother had prostrate cancer, your risk is much higher than if they didn’t. This makes following the next steps even more important. STEPS TO FOLLOW Cut down on animal fat in your diet, men who eat a lot of fat may increase their risk. Men over 50 should have an annual rectal exam to check for lumps on the gland. Some doctors also recommend a blood test (called a prostrate specific antigen, or PSA, test) that can detect prostate cancer. Hispanic-American men with a family history of prostrate cancer should begin their annual test at age 40. PROSTATITIS Treat any urinary tract infections before it can spread FOR MORE HELP Organizations: American Foundation for Urology Disease, 300 W. Pratt Street, Suite 401, Baltimore, MD 21201. 410-727-2908 Information specialists make referrals to prostate cancer support groups and send material on prostate problems. PENIS PROBLEMS Many problems can affect the penis. Fortunately, most of them are rare. An erection that won’t go away is commonly known as priapism. If untreated this can cause permanent damage. If an erection does not subside after four hours, call your doctor for emergency advice. If your doctor isn’t available, call 911 or go to an emergency facility. This rare and painful problem occurs when blood cannot drain from the penis. It may result from penile injections, including those intended to produce erections), diseases such as leukemia or sickle-cell anemia, side effects of some medications, or injury. It is not connected to sexual arousal. A small, pimple-like sore: usually on the head of the penis, a sore that lasts more than one week or two weeks can be a sign of penis cancer or of a sexually transmitted disease. In later stages, cancer symptoms may include bleeding or unusual discharge, pain with urination, and enlarged lymph nodes in the groin. Penis cancer is most common in uncircumcised men. Call your doctor for an immediate appointment if you detect any unusual sore or growth. Blisters: Either one or several, on or around the penis, can mean a herpes infection. An outbreak can be itchy, painful, or both, and needs a doctor’s care. A bend in the penis is commonly known as Peyronie’s disease: This condition occurs during an erection and can be painful. It may be caused by scar tissue in the penis - usually from an injury - which does not stretch or expand enough. The problem usually takes care of itself without treatment, but in rare cases, surgery may be necessary. Soreness and inflammation of the tip of the penis is called balanitis. This can be caused by infection or by irritation from clothing, condoms, or spermicides. It’s most common in men who are uncircumcised. Call your doctor for advice and an appointment. Tight foreskin is called phimosis. Sometimes the foreskin in uncircumcised boys or men is too tight to retract easily; this may make erections painful. Phimosis can also be caused by an infection under the foreskin. Uncircumcised men and diabetics have a higher chance of developing such infections. Call your doctor for advice and an appointment.   Knowledge is good medicine. Pass it on!TM

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