Health and medical information

“I’m an optimistic person. At first it was new. You think oh my God.’ Now I don’t even think about it. It just takes a little practice, like with everything new,” says Janice, a real estate agent whose high energy is reflected in her vibrant voice. “It took at least a couple of months to adjust to it. After a while it was the same as natural,” she explains. Janice and her husband, Bill, have been married more than 30 years.

Jane, a 48-year-old self-described “retired Mom” who’s been married 20 years, is also satisfied with the results of her husband’s surgery. “I’m definitely pleased. It’s 90 percent as good as when he was in his 20′s, and that’s terrific. And no more premature ejaculations! Even if he does ejaculate, he can go longer. You do have to change positions. The woman-on-top works better because of the bend of the prosthesis.” The only change Jane noticed is a slight reduction in the circumference of the erect penis. “Thaf s where he loses about 10 percent,” she says.

For Jane, a clear-headed look at the potency problem and the solution was helpful. “We’ve adjusted. Ifs like false teeth, or a false arm. I look at it like this: You lose something, you replace it.”

Studies have found that, generally, women are satisfied with the results of the implant. Not surprisingly, there is a correlation between the partners’ satisfaction: Usually, when one is happy, so is the other. And the more involved the partner is from the beginning, the more likely she is to be pleased with the results.

Getting Used to the New You

Ifs normal to have some adjustment problems after implant surgery. Most couples solve these without much difficulty. Just knowing what to expect can make it easier.

Each couple is different but ifs not uncommon to:

• Have some anxiety about being able to have intercourse.

• Notice that the penis looks somewhat different.

• Take some time to adjust to the fact that erection is no longer physical evidence of arousal—that desire can be shown in other ways.

• Need to try out different positions.

• Need to spend time getting comfortable to the point where the implant is no longer an issue.

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Because of the considerable expense and inconvenience of sleep lab tests, cheaper at-home versions of the NPT test have been developed. These take-home varieties can actually measure how many erections you have during the night, and how long each one lasts. Usually, you just carry home a little suitcase containing equipment similar to that used in the sleep lab. The device is safe and quite accurate when used properly. Be sure you get an in-office demonstration so you understand just how to use the device before you take it home.

Some of the take-home tests have a beeper that goes off when an erection registers, so the man or his partner can check the firmness. One home NPT test monitors the rigidity itself. But many of these tests do not test firmness, which is certainly an important factor.

Other at-home tests, while useful, can only measure one erection per night. There are essentially two types: the Snap-Gauge and the stamp test. The Snap-Gauge is a piece of Velcro which is placed around the penis. As the penis expands and becomes rigid, little plastic bands on the gauge will break, indicating that a firm erection has taken place. However, it can’t measure how long the erection lasts. Like all other types of NPT tests, this one doesn’t hurt. And it is easy to use.

Another alternative is the use of commercially available stamps, called PotenTest, made specifically to test erection capability. Like the other methods, you place the stamps around your penis and go to sleep. The stamps break along the perforation when you have an erection.

Both the Snap-Gauge and the stamps have drawbacks. They don’t measure the length or the frequency of erections. Most men normally would have several erections during the course of a single night, and this information is not collected by these methods. Furthermore, if you roll over or are a very active sleeper, both the stamps and the gauge may falsely indicate an erection.

There’s one method that requires no equipment at all—you just need a willing partner who will observe you while you sleep to see if you have any erections. If you do, she can feel the penis to determine rigidity. For this test to be accurate, your partner has to stay awake all night. You have to lie on your back or side—this won’t work for stomach sleepers! Trying this once should be enough. If it doesn’t work, you can use another technique to get the same information. Not all partners want or are able to stay up all night, but finding out that you have just one normal erection is an important piece of information to share with your doctor.

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Harold, at fifty-five, had a dangerously high cholesterol count of 300 milliliters, coupled with a very low HDL of 25 milligrams. (It’s important to note that both high cholesterol and low HDL are markers of ED.) I began him on a course of Mevacor, a cholesterol-lowering agent, and his reading soon dropped to 220. Unfortunately, he also developed ED. Understandably upset, Harold wanted to try other medications.

At his next visit I recommended that he switch to prescription niacin (which is not found in health food stores). While this proved to be an effective treatment for both his cholesterol and erection problems, there were other unpleasant side effects to confront: abnormal liver function and facial flushing. Fortunately, there was another alternative. Harold began to take Cholestid, a bile-acid resin, and in a couple of months his cholesterol stabilized at 210, and his HDL levels rose to a much-improved 41. His liver function was normalized, and the new cholesterol-lowering drug did not produce any erection problems.

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Adrenal or thyroid glands go into overdrive, or shut down almost completely, can sabotage erections quite effectively – by reducing sexual desire and by marking the man feel terrible. In many cases, such disorders are fairly easy to spot because the symptoms are oblivious to a trained medical eye – sometimes the’re so dramatic that anyone would realize something was wrong. A man with an overactive thyroid, for example, may have affine tremor in his hands, bulging eyes, thinning of his skin and a very fast heart rate, as well as a decreased desire for sex and poor erections. In fact, in most cases, patients with such problems do get treated, because the unpleasant and uncomfortable symptoms send them to their doctor. There are some cases on record, however, in witch the only symptoms were erection problems. Blood tests can identify these less obvious cases.

The two adrenal glands, which are located just above the kidneys, can also wreck potency if they produce too much or too little of cortisone-like substances. Once this condition is corrected by surgery or medication, adrenal patients will find their potency restored. No permanent damage to potency take a place.

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