A Man's Guide to Sexual Health

A Man's Guide to Sexual Health

www.trebest.webs.com

Contents An owner’s manual for men

2

Everyone is different

4

There are no secrets about size

7

How an erection happens

8

And the result is...

11

Problem...what problem?

14

If you are having a problem

23

What should I say to my doctor?

25

Facts and fiction

27

Guarantee

31

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An owner's manual for men Think about all the tools, equipment and appliances you’ve bought in your life. Almost all of these came complete with an owner’s manual containing instructions

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troubleshoot or fix things if they stopped working correctly.

So why is it that you don’t get an owner’s manual for your body — especially your sex organs? Surveys show that in most healthy relationships, the penis is something that is used a lot. Unfortunately, it’s not always user friendly. You assume your penis will always work perfectly and mostly it does. But sometimes it fails and that’s scary. The situation can be bewildering, frustrating and at times terrifying for both you and your partner. 2 www.trebest.webs.com

A N OW N E R ' S M A N UA L F O R M E N

It seems there is a real need for an owner’s manual for the penis — to help you when something goes wrong and tell you how to fix it. That is the purpose of this manual — to tell you, in plain language, some of the things you need to know. To answer some of your questions and lessen some of your fears, and mostly to let you know that you’re not alone: every man with a penis is in much the same boat. This owner’s manual includes information on: ● how your sex organs work ● reasons why you might suddenly find it difficult to have sex ● what your doctor can do to help when there’s a problem ● how to help your partner understand the problem and share in solving it ● ways to get back to a good sex life. Although this manual may answer some questions about problems with sex, if you think you have a problem, you should always talk with your doctor for personal advice.

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Everyone is different Much as your nose or ears are unique, so is your penis. No two penises are exactly alike, each has its own personality, some are lean and sensitive, some are thick and bulky. The head of one may resemble a fireman’s helmet, another may be round, blunt or cone shaped. Your penis is actually quite hollow — it is made of three tubes which run from the base to the tip.

Structure of the penis Tubes of erectile tissue — these fill with blood during an erection

Blood vessel

Cross-section of the penis

Urethra (tube allowing urine to pass from the bladder)

Blood vessel Tube connecting to the bladder — allowing urine to be passed Direction of cross-section

Spongy tissue (most of the penis is made of this tissue)

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Testis

EV E RYO N E I S D I F F E R E N T

● One tube connects to your bladder and allows you to pass urine. ● The other two tubes are used to make your penis hard enough to have sex (an erection). They are filled with a special sponge-like tissue that swells and becomes firm when blood flows into it. This happens when you become aroused or feel like having sex. ● There is about seven to eight times more blood in your penis when it is hard than when it is soft. In a hard penis, the blood normally can’t flow back out. This is because the pressure of the blood in the tissues closes the blood vessels that would carry it out to the rest of the body. All this is controlled by the brain. Once sex is over, the muscle tissue contracts and allows the blood to flow away, back into the rest of the body. You can see that your penis has to be able to change function as needed. When at rest it is used to empty the bladder of urine, when aroused and erect (hard) it provides the way to have sex and is a channel for semen. ● Between half and one teaspoonful of semen comes out of your penis each time you ejaculate (discharge semen). ● The semen contains millions of sperm — yet only one is needed to make a baby.

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EV E RYO N E I S D I F F E R E N T

● A smaller amount of semen will be released if you have a few ejaculations during one sex session. If you have many hours or days between the times you have sex, then the amount of semen should be about the same each time. ● Regular sexual activity can keep the body’s sexual systems in good shape. Lack of use can create its own problems with sex after a time. ● As you may have noticed, it is difficult to urinate when the penis is erect. It is also difficult to ejaculate semen when the penis is limp. All men are born with uncircumcised penises. If your penis remains unchanged, it takes a little more time to keep the nooks and crannies clean. ● Draw the foreskin (hood) back fully. ● If it gets stuck on the rim of the penis, or if it is painful and seems to stick in places a small repair job may be necessary. This simple procedure loosens the foreskin and doesn’t require circumcision. ● Remember to replace the hood in a comfortable position.

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There are no secrets about size Nearly every man is concerned about the size of his penis. In many cultures, potency, maleness and general strength are thought to be set by the size of the penis. This is a fantasy because the penis will constantly change its size depending on the outside temperature, your inside feelings and the circumstances of the moment. Your penis shrinks with fear and cold and appears larger in a warm, comfortable atmosphere. Yet, it is frequently when at rest that men try to compare themselves. There may be no worse place to try to compare yourself with others than in a urinal line or a group shower room. It is almost impossible to judge what the erect size of your penis is when it is at rest and limp. In spite of the fact that all penises are physically different, their size when erect and hard is more or less the same. ● When erect, the average length of the penis is twelve centimeters (about five inches). ● A penis that seems small can swell a great deal to become erect. A seemingly large penis may swell less. Both types end up more or less the same size when fully erect. ● Size can be an illusion in men of differing build. A small, slightly built man may have what appears to be a large penis. A large, heavily built man’s penis may look smaller. 7 www.trebest.webs.com

How an erection happens An erection — a hard penis — is simply a sign of comfort and arousal (sexual excitement). It doesn’t take a lot of arousal to cause an erection, especially for younger men. Usually, men do have erections while they sleep. They accompany dreams which happen three or four times each night — whether you remember them or not. This happens to women too. When a woman dreams, her sexual organ (the clitoris) swells, similar to what happens to the penis during an erection. ● If your dreams are in any way anxiety provoking or scary, there will be no erection. ● When you wake up with an erection, you are still in part of the dream cycle. Your erection has nothing to do with having a full bladder. It is also not always a sign of arousal. Young men can get an erection very quickly — through erotic stories, pictures or fantasy — or just thinking about sex. As you get much older, it takes longer for your penis to harden. More time, stimulation or manual help may be needed.

How it works There are both physical and mental ingredients involved in having an erection. These are parts of your relationship that can also affect your sexual health.

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H OW A N E R E C T I O N H A P PE N S

What a man needs for an erection

Good nerve supply to the penis from the main nerves of the hip and backbone areas

Healthy blood vessels to carry special body chemicals and to control the blood flow for an erection to be possible

This is what a man needs to have an erection: ● Healthy blood vessels throughout his body, so the blood flows in the right ways. ● No nerve damage in the area of the hips, stomach or the actual sex organs. ● The right amount of special body chemicals (the ones that travel in the blood and affect the sex organs. For example, those that help the blood stay in the penis during intercourse). ● A relaxed and happy outlook, without too much stress. www.trebest.webs.com

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H OW A N E R E C T I O N H A P PE N S

Being sexually aroused is the most important trigger to an erection. It is a step-by-step process that is set in motion by substances that are always present in the body, just waiting to be called into action. The process is like this:

You have a sexual or erotic feeling

A special body chemical is released causing the muscles in the walls of your penis to relax

Blood flows into the spongy tissue of your penis causing it to harden and become erect. As the inside of your penis fills with blood, the spongy tissue squeezes against veins in the walls of your penis stopping the blood from flowing back out. All this blood held in your penis keeps it hard.

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And the result is... ...the ejaculation. This is a sudden spurt of semen lasting a few seconds. It can feel differently depending on how intense the arousal was. ● If you have frequent sex ending each time with an ejaculation, the strength of your feelings and the amount of semen may lessen for a while. Once your body has had a rest for a few hours or days, the amount of semen should return to normal. Usually a certain amount of semen is produced by the body each day. The making of sperm inside the body continues at the same rate as long as a man is in good health. The number of times a man has sex over his lifetime does not affect the amount of semen the body produces. Sometimes the intensity of the sexual feeling may be so great that the muscle twitch may spread to the back passage (anus) causing a short, sharp pain there — this is normal. Some men have difficulty with ejaculation. The semen may be passing into the bladder and not out of the tip of the penis. If this happens, it may need a visit to a doctor for repairs. Many men ejaculate too quickly. They finish before their partners can enter the general flow and rhythm of the sexual experience to enable them to also achieve an orgasm. Lasting longer is a learned experience and can contribute to a mutually satisfying relationship with the partner. 11 www.trebest.webs.com

A N D T H E R E S U LT I S . . .

‘Wet dreams’, or ejaculating during an erotic dream while you are asleep, is normal for all men. There is a normal build up of the semen that the body releases on its own while you sleep.

After an ejaculation the system goes into reverse

A different special body chemical is released

This causes the muscles of your penis to contract or pull inwards. Blood now flows back out of your penis and into the rest of your body

Your penis returns to its limp state

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A N D T H E R E S U LT I S . . .

All erections are angled sharply upwards. As you grow older your penis gradually sags to become more at right angles with your body. Your erection will last as long as the sexual stimulation lasts. A sudden distraction may cause you to lose your erection. If the stimulation is still there your penis might become hard again. Fear or worry may cause an erection to fail. In younger men, both getting and losing an erection can happen quickly. In older men this is more gradual. As you age, it may become more difficult to reach an erection — and you may lose it before you are ready to. But this doesn’t always happen. There are many senior citizens who function very well sexually. Paying attention to your general health, taking care of your penis, having a good relationship with your partner and a healthy attitude towards sex will all help you as you age.

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Problem...what problem? Did you know that more than half of all men over 40 have had a problem with getting and keeping an erection? In America alone, it is thought that over 30 million men may suffer from this problem.

Only 2 million have ever had treatment (that’s only one man in every 15).

Over 100 million men (1 in every 10) in the world worry about not being able to have an erection at some point in their lives.

It is a very common experience and is now understood to be a real medical condition that can be treated. There are many problems — both physical and emotional 14

— that can affect the smooth functioning of your penis. www.trebest.webs.com

P RO B L E M . . . W H AT P RO B L E M ?

Physical problems Among the physical problems that may cause you to have trouble with an erection are: ● Aging ● Illness ● Accidents ● Smoking ● Operations ● Alcohol, and ● Drugs (both prescriptions from the doctor and illegal drugs)

Aging Sometimes, the aging process causes a change in the sexual habits and abilities of men. This doesn’t happen to everyone, but changes can occur in the time it takes to get and keep an erection and in the hardness of your penis. It’s all perfectly natural, and the solution may be an easy one. If an older man finds it difficult to have sex, extra foreplay and attention may solve the problem. This could be enough to help get your sex life back to normal. 15 www.trebest.webs.com

P RO B L E M . . . W H AT P RO B L E M ?

The chart below shows some of the differences among men as they age.

to en e T

40

Younger men can usually have an erection at almost any time, just by thinking about sex. They also usually have a higher sex drive than older men and may recover after ejaculation and be ready to have sex again in just a few minutes.

– 40

70

A man's response to sexual thoughts becomes slower, and more foreplay tends to be needed. Manual help might be needed to make the penis firm enough to be able to have sex.

0 er 7 v O An older man's erections may be less firm, and he might find it difficult to have sex again for quite a few hours after a first ejaculation. For men in their 70s, this can be as long as 12 to 24 hours.

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P RO B L E M . . . W H AT P RO B L E M ?

Illness As men age, there are lots of common diseases that can all cause problems in getting and keeping your penis hard enough to have sex. Illnesses such as hardening of the arteries, high blood pressure, stroke, heart

disease,

heart

attacks,

diabetes (where the body is unable to control the blood sugar level) and injury to your sex organs can all cause problems. If a man has cancer and is treated with chemotherapy, radiotherapy or surgery, this can also cause problems with sex. Other illnesses such as kidney and liver diseases can affect your sex life, particularly if those special organs begin to fail. Often, when many illnesses start, a man can find it difficult to have or keep an erection because the body makes changes to try to get well again. This can mean taking energy away from sex to help make a man well again. For long-term illness, this can be a slow process and the loss of ability in having an erection might not even be noticed for quite a while. A man can also have problems with the balance of the special body chemicals that help sex happen or control how a man feels in general. For example, there is a 17 www.trebest.webs.com

P RO B L E M . . . W H AT P RO B L E M ?

thyroid gland in the body that can be overactive or underactive, and this can make a man feel restless or very tired all the time. A thyroid gland problem can cause a man to lose interest in sex because he is not relaxed enough or doesn’t have the energy. There can be problems with the levels of body chemicals that can control how a man feels about sex. The body chemical that controls sex in men is called testosterone and this is also what makes a man grow more hair than a woman, have a deeper voice and develop male sex organs (the penis and testicles). As a man ages, the amount of testosterone in the body nearly always begins to drop quite naturally. This is one reason why sex drive and ability can decline with age.

Accidents and operations Some men have problems with sex after they have had an accident or operation. This is usually because there has been some damage to nerves or blood vessels. Anything that causes the blood flow into your penis to be reduced can stop your penis becoming hard enough for sex. 18 www.trebest.webs.com

P RO B L E M . . . W H AT P RO B L E M ?

Accidents or operations affecting your lower body might cause nerve damage that could affect your penis and whether you can have an erection. Breaking bones, such as your hips or lower back (the pelvic area), or accidents to the spine can also affect the nerves or blood flow and cause erection problems. Operations on organs in the lower body, such as the prostate, the bladder or large bowel, can also have an effect on your sexual function.

Drugs Over 200 drugs used for other illnesses can affect your sex life. They include drugs to help depression, worry or high blood pressure. This kind of side effect may be only short term, or sometimes other drugs can be found that won’t cause this kind of problem. In either case, it’s important that the prescribed drugs are taken, because the illnesses they treat can be very serious.

Also,

the

illnesses themselves can cause sexual problems. 19 www.trebest.webs.com

P RO B L E M . . . W H AT P RO B L E M ?

Smoking and alcohol

Drinking too much alcohol or smoking a lot of cigarettes can damage the blood vessels and nerves that affect your ability to have an erection. Giving up any of these can have a positive effect on your sex life — if the habit is stopped in time. It may take a while for your body to recover from the use of alcohol, drugs or cigarettes. Your doctor can give you good advice about what you might expect.

Emotional problems Emotional problems can play a major role in being able to get and keep an erection, and they are often poorly understood. 20 www.trebest.webs.com

P RO B L E M . . . W H AT P RO B L E M ?

One of the reasons most often mentioned as causing sexual problems is stress. Few people today are totally free of stress or worry. The stresses in our world, both at home and at work, have become part of our lifestyle. Because stress lowers the levels of important male body chemicals, a man might not want to have sex as often, and there might be a drop in the ability to perform when he does try. Some of the other emotional issues that may cause sexual problems are: ● thinking too much about other issues and forgetting about your sex life ● shyness ● concern about performance or about the size of your penis ● being in a new relationship ● worry about a long-term relationship. 21 www.trebest.webs.com

P RO B L E M . . . W H AT P RO B L E M ?

Another big issue is fear of failure – it’s hard to believe that fear of failure causes failure, especially when you are so determined to succeed. Other emotions such as depression, worry or anger can also affect your sex life. Sometimes these feelings are so deep that you are not even aware of them and the effect they are having. This is when a doctor might suggest going to a counselor (a person who works with emotional problems). These experts can give advice on why you have a problem and then help to solve it.

Remember! At all ages, your desire to have sex and your ability to get and keep an erection is affected by: ● your overall health ● what happens in your social life ● how happy or positive you are about life in general ● what sort of attitude you have to problems not related to sex ● your lifestyle — how busy you are, what else is on your mind at the time. Also, remember that for most men who cannot get or keep an erection the problems can be treated. A visit to the doctor can usually sort out a treatment that works. 22 www.trebest.webs.com

If you are having a problem Having a problem getting or keeping an erection is a big deal for a man. You might still feel like you want to have sex but you can’t because your erection is not hard enough, or it goes away too quickly or might not last long enough to satisfy your sexual partner. Men don’t often know why their sex lives have started to be a problem and they can feel sad, frustrated or maybe even angry. In a relationship, sexual problems like this can lead to problems like arguments, blame, loneliness or sadness. Some men hide their difficulties from their partners. Unfortunately, this doesn’t solve the problem or make it go away. Sometimes it creates more problems. Your partner may feel unloved or unwanted — or might think you are having an affair or want to end the relationship. Not being able to have sex can greatly affect both your life and your partner’s. If you are experiencing a problem having sex — getting an erection or keeping one — there is help available and there are medical treatments. The first step is to see your doctor.

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I F YO U A R E H AV I N G A P RO B L E M

Here’s what some men with sexual problems have said to their doctors:

“I kept my thoughts to myself and became “I'm afraid very bitter” of losing my partner...” “It can't be good for my partner...”

“I feel less of a man”

“I'm afraid to get married...”

“A huge sense of loss and an increasing feeling of uselessness” 24 www.trebest.webs.com

“I began to feel like it was all my fault and that there was no solution...”

What should I say to my doctor ? Among the many things that have

kept

men

from

What is normal for my age ?

talking about their sexual problems is the fear that

“the problem is in the mind”. Hopefully, you now understand that if you are having a problem getting or keep-

Why is my erection not like it used to be ?

ing an erection, it may be because of a physical reason be

Why do I have an erection in the morning but not at other times ?

that

can

treated.

Talk to your partner.

And

talk to your doctor.

Are there any side effects ?

Why am I having difficulty getting an erection ? These are some

examples of the questions doctors get asked most often on this page. You might like to use them, so you can find out all you need to know about your problem

How much do treatments cost ?

and about treatment. 25 www.trebest.webs.com

W H AT S H O U L D I S AY TO M Y D O C TO R ?

Why am I not feeling as interested in sex as usual ?

If you go to your

doctor, it might be a good idea to take a pen along, so you can make notes of what your doctor says. You may also want to write down some

Do treatments really work ?

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questions of your own before you go.

Facts and fiction There are lots of myths about sex and sexual ability. These are a few of the ones heard most often — and the real answers to the statements... “Too much sex when you’re young will mean you can’t do it as much when you are older” WRONG Your sex life can carry on well into old age. Younger men may be more healthy and energetic so they feel like having sex much more often — but this has no effect on what they will be able to do when they are much older. Many older men (in their 70s, 80s and more) have become fathers. “An erect penis must be absolutely straight” “Urinating after sex will WRONG wash out the possibility Some of an infection” penises WRONG have a slight curve. This is Germs can completely enter the body normal. through the skin of penis and this can happen in a few seconds. Trying to wash out any germs after sex can be too late. Wearing a condom is the best way to reduce risk to you or your partner.

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FAC TS A N D F I C T I O N

“Men who can have more than one erection during sex are more masculine than men who can only have one erection” WRONG All men need a rest after ejaculation while the body replaces semen. The time for resting usually gets longer with age as your body’s overall function slows down. Also, some men might have only one erection during sex and then they continue the intimacy of sex in other ways. Sex is based on shared experience, not a “Men with single performance. circumcised penises last longer during sexual intercourse, because the head of the penis is less sensitive” “It’s all in the mind, WRONG there is no real problem”

WRONG An erection problem has a physical cause. Usually it can be a sign of another illness or can occur because some medicines have side effects that cause this type of problem.

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Lasting longer is an internal sense, an awareness and a feeling of control and it can be learnt.

FAC TS A N D F I C T I O N

“If a man can’t keep an erection it means that he doesn’t love his partner any more” WRONG You may be so involved with your partner that you try too hard to have an erection. Because emotions can be so intense, you can feel under stress and the stress itself can stop an erection. These feelings can become a downward spiral of failing to have an erection and then feeling inadequate. No matter how hard you may try to relax or whatever other approach is used, the spiral of trying and failing may continue. This is when outside help should be looked for and a visit to the doctor could really help. “Once you have a problem with erection you just have to learn to live with it” “Only old men are affected by this condition” WRONG Men of all ages are affected. By the age of 50 almost all men will have experienced some problems in having and keeping an erection.

WRONG It can almost always be treated. Millions of men are enjoying sex again after treatment.

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FAC TS A N D F I C T I O N

“Not being able to have an erection is a sign of a loss of manhood or lack of sex drive” WRONG Erection problems usually involve other health problems which can include: ● problems with blood flow in the body (such as high blood pressure)

diabetes (changes in blood sugar levels) or its treatment

●

shock or wounds from accidents or operations.

●

“Only a few men suffer from problems like this” WRONG Over 100 million men (1 in every 10) in the world are not able to have an erection at some time in their lives — it is a very common condition.

“Women prefer men with large penises so that they will have an orgasm” WRONG The nerves that trigger a woman’s orgasm are near the entrance to the vagina so penis size does not really matter. Often it is really other factors in the relationship that encourage sexual response.

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