Q: I have problems with erection, sexual dysfunction. Is there any specialized doctor I can talk to about this?
A: First of all, you should consult your physician as far as your sexual health is concerned. If your personal doctor does not
know enough in this field, there are specialized physicians who treat either men or women only, or who treat both.
Q. How can I define whether the problem was caused by physical or psychological factor?
A. Nowadays, sexual dysfunction is usually caused by physical problems. And as far as psychological problems are concerned, they
are rather the consequences of sexual dysfunction, than the cause of it. It happens because often when you have sexual problems, you
cannot avoid some feelings of stress and other emotional reactions. And in their turn, these reactions may worsen already existing
problem. Contemporary medications are helpful for treating sexual dysfunction, regardless their cause. Besides taking some
medications, it is usually advisable to see both: an urologist and psychologist or sex therapist. All these doctors are
interdependent and if you consult one of them, they should refer you to each other to define the real cause of the problem and
prescribe the needed medication.
Q: I have had a problem of erectile dysfunction for many years. My wife is 40 and she is not interested in sex, as well as I.
Should I try to cure this disease then?
A: The problem of sexual dysfunction is rather common and is observed in about 31% of all men. Usually, it depends on age and may
cause many troubles, like loss of self-esteem, frustration, depression, humiliation and many others. But if you really do not care,
then it may cause none of the mentioned above. Thus, it should be treated only when there appear personal problems
Q: I have been experiencing erection problems. And I have troubles with my wife thus. She asks if I still find her attractive and
even suspects that I am seeing another woman. What can I do in this case?
A: Having sexual problems, many men feel humiliated in different ways and that is why they do not show the affection to their
partner in the same way it used to be. As they have often failured in sexual contacts, they do not want to experience this again and
thus they hesitate to initiate any sexual activities. That is why their partner usually feels unnecessary and undesirable. Women may
also think that their partners have some other woman. So, even if you have sexual problems, you should still be caring and loving
towards your partner. You should try to talk about your problems with your wife and prove that you still love her. You should
remember that not every sexual contact has to result in intercourse.
Q: I have been experiencing erectile problems. Actually, I am a healthy man and I have been exercising regularly. My doctor says
that since I am healthy, it must be a psychological factor causing impotence. But I do not feel any psychological problems. Can it
be a physical cause?
A: If a man is unable to achieve and/or keep an erection satisfactory enough for sexual intercourse for at least 3 months, it is
called then an erectile dysfunction. It can be of three types: mild, moderate and complete. It is true that healthy man may have
problems with erection due to some psychological factors. It may also be caused by: 1) due to neurological, psychological or
hormonal abnormalities; 2) one may failure in achieving erection secondary to artery blockage or 3) failure to store blood in
erection chambers due to scarring of the erection chambers. Thus, a man should go through he complete testing which will define the
initial cause of impotence and the medication needed.
Q: Recently, I started exercising and bought a bicycle following my doctor’s advice. But I was also told that riding a bicycle may
cause impotence. Is it true?
A: Riding a bicycle you are sitting on your ischial tuberosities or sit bones. This is a safe region to bear your body weight on
your sit bones. Fat and muscle lay over the sit bones and there are no associated nerves and arteries. In contrast, straddling a
bike saddle forces the rider to bear the body weight on the perineum (hidden part of the penis). Compression of the perineum may
lead to permanent nerve and artery damage, leading to numbness and sexual function, such as loss of erections. To avoid injury to
the perineum while riding, it is recommended to use a noseless two cheek split seat. If sexual dysfunction occurs following riding,
a full evaluation is indicated.
Q: During the erection my penis in bent to the left. I am embarrassed and am able to have intercourse only in one position. What is
more, my girlfriend says that sometimes it hurts her during the sex. What can I do in this case?
A: This kind of problem, curvature of the penis may be caused by two reasons: 1) you were born that way, and it is congenital, 2)
and it also may be acquired, usually due to Peryonie’s disease. during erection may be either congenital (you were born that way)
or acquired (usually due to Peryonie's disease). The latter condition is associated with scarring of the lining layer of the
erection chamber called the tunica albuguinea. The scarring is often the response to a previous injury of the erection during sexual
activity. But you should also see your doctor for full evaluation of the whole situation and to define the medication needed.