SEX & LIBIDO

9 Do I have to put up with impotence due to my age?

A Man’s ability to achieve an erection does decline with age, says suks minhas, a consultant andrologist at Imperial College Healthcare NHS Trust. At age 40, around 40 per cent of men are affected by erectile dysfunction; by 70, it’s 70 per cent, according to a major U.s. study.

‘But this doesn’t mean you should just put up with it,’ says mr minhas.

‘Erectile dysfunction later in life can be due to a number of factors, including high cholesterol, high blood pressure, diabetes and low testosterone — that’s why it’s a good barometer of general health and can be the first sign of an underlying condition, such as heart disease.’

This is because tiny blood vessels in the penis can become clogged up first.

‘Losing weight is the first step. This can help get high cholesterol and blood pressure under control and help with testosterone levels, all of which should improve erectile function.’

The first-line treatment is taking drugs called PDE5 inhibitors, including Viagra, Cialis and Levitra. ‘They all work in the same way, by dilating blood vessels to the penis.’

Viagra and Levitra are short-acting and can work within one hour, wearing off after four to six hours, while Cialis takes two hours to work, but can be effective for 24 hours.

From spring, men will be able to buy Viagra over the counter from a pharmacy, providing they meet certain criteria (it won’t be sold to men with severe heart disease or those who are taking medications it could interfere with). sideeffects include facial flushing, headache and a runny nose (as a result of relaxed blood vessels).

If tablets don’t work, other options include injections into the penis of the drug alprostadil, which relaxes the penile muscles and blood vessels while helping to keep blood in this area. They can be prescribed by a GP and the patient injects himself. If this doesn’t work, there’s another type of injection — usually prescribed by a urologist, rather than a GP — called Invicorp, which can be less painful. Vacuum pumps and penile implants are the next and final option for severe cases.

10 What can I try to make it last longer?

PREMATURE ejaculation usually happens within about one minute of beginning to make love — or before it’s even started, explains Lorraine Grover, a psychosexual nurse specialist in London and trustee of the sexual Advice Association. ‘In fact, it’s thought to be more common than erectile dysfunction.

‘In younger men, it tends to be anxiety related; in older men it can also be linked to medical conditions, such as changes in the prostate gland, nerve complications from diabetes and heart disease. Having an unsympathetic partner definitely won’t help, either.’

There is one drug licensed for premature ejaculation, Priligy (dapoxetine) available on prescription. A type of antidepressant, it can be taken ‘on demand’ around one to three hours before needed: it’s claimed the drug can help intercourse last three times as long. The most common side- effects are nausea, dizziness, headache and diarrhoea.

so- called ‘delay sprays’ that contain local anaesthetics ( usually lidocaine) work by reducing the sensitivity of the tip of the penis. They can be prescribed by your GP.

‘One non-drug treatment that can be effective — with practice — is the “pinch and squeeze” technique,’ adds Lorraine Grover. ‘men with premature ejaculation struggle to control their levels of arousal. This technique can help control the sensation’. see sexualadviceassociation.co.uk for more information.

11 Can I get Viagra for my husband?

NO: THE prescription will be written for him and cannot be obtained on his behalf.

12 I’ve lost interest in making love — what can I do?

THERE are many factors that can influence a woman’s libido, explains Dr Catherine Hood, an NHS associate specialist in psychosexual medicine in London.

‘First, what’s happening in your relationship? There are times when our libido wanes — often due to stress at work or tiredness with a young family. Illness, the menopause or even taking the Pill can affect women’s libido, as it affects the amount of available testosterone.’ reduced libido in women over 50 is very often due to vaginal dryness, adds gynaecologist Dr Heather Currie.

And rather than reduced libido, it could be your relationship is changing, suggests Dr Hood. ‘In long-term relationships it’s quite natural for sex to alter. At the start, it’s all lust and desire — for those who are lucky, that can be for as long as two years; for those who are unlucky, two months. After that, the pace slows down.

‘There is also very often a difference in libido between a man and woman,’ she adds. ‘Generally speaking — although I must stress not always — one person, usually a woman, loses what’s known as spontaneous desire. They don’t think about sex that much, they don’t initiate it and don’t really feel like having it.

‘But when they do have sex, they often quite enjoy it — they have what’s known as a reactive sex drive.’

The key, she says, is to increase intimacy so you feel more like making love. ‘Also, the person with the reactive sex drive needs to be open to the idea of having sex — not just short-circuit the whole idea: you do have to make the effort.

‘Very often, the more you have sex, the more you want it.

‘But you need to make time for intimacy. Foreplay can be an issue. some women complain their husband’s idea of foreplay is to grab their breasts. If a woman’s spontaneous desire has evaporated, that is not going to get her in the mood! Ask how your partner’s day was, make them a cup of tea, etc. Otherwise it can become just another demand in their day.’