What causes a person to be horny
Causes of Seemingly Constant Arousal
The smell of your partner’s cologne; the touch of their hair against your skin. A partner who cooks a meal; a partner who takes the lead in a chaotic situation.
Sexual interests and turn-ons vary from person to person. What gets you going may be nothing like your best friend, or sometimes even your partner. Everyone has sexual urges — some more than others.
Because libido and sexual arousal are subjective, it’s hard to know what’s considered “a lot” or “constant.”
But if you believe you’re having sexual urges more than you’re comfortable with or staying in a state of stimulation, there might be a few things to explain that. Keep reading to find out more.
Some causes for constant arousal are shared in both people with a penis and people with a vagina. A combination of factors could lead to frequent arousal.
Hormones
Hormones play a significant role in libido. Spikes of testosterone may boost arousal. Likewise, people who engage in sexual behavior have higher testosterone. That creates a cyclical situation, which could cause a boosted sex drive over time.
Aphrodisiac foods
Certain foods can increase arousal and make you crave a little time between the sheets. If you’re filling your plate with these foods (purposefully or not), you may be giving a bit more fuel to your engine.
Alcohol and drugs
Does a glass of red wine make you tingle below the belt? You’re not alone. Though alcohol and other substances can interfere with sexual function, they may actually make you more aroused to begin with. That’s because they loosen up your inhibitions and leave you feeling a bit more frisky than you would be if you were sober.
Hypersexuality
Hypersexuality is a hotly debated topic among healthcare providers. Everyone’s sex drive is unique.
But if you’re feeling uncomfortable with your sexual urges and find they’re interfering with your daily life, like the ability to be productive or form relationships, then it’s worth exploring it.
Cisgender women and people assigned female at birth (AFAB) may feel more aroused for these reasons:
Menstrual cycle
The days in a menstrual cycle are filled with changing hormones as well as events that are designed to activate your sex drive.
For example, some people report feeling more easily turned on during the middle of their cycle, or about 14 days before their period starts.
That’s about the time of ovulation. In terms of evolution, that makes sense. Ovulation is when you’d be most fertile and most likely to conceive. Your body turns up your sex drive to boost chances of procreation.
Others report feeling more turned on just before their period. When you have your period, your pelvis is more congested with fluid, which could trigger sexual arousal.
Likewise, some people like to be sexual on their period. The blood provides a natural lubricant. The risk for getting pregnant is also lower, though not zero.
Full bladder
The clitoris, vagina, and urethra are tightly packed in your pelvis.
When the bladder is full, it may put pressure on those sensitive areas, which could be arousing.
Pregnancy
Pregnancy can do funny things to your sex drive. In the first days and weeks, changes to hormones may have you seeing red — for your partner, that is.
If cisgender men and people assigned male at birth (AMAB) find themselves constantly aroused, these causes might be part of the reason:
Constant contact
With genitalia on the outside of the body, frequent rubbing, tugging, and touching may be a subtle reminder about sexual activities. That can lead to constant arousal.
Frequent masturbation
It’s commonly believed men think about being sexual much more than women. Indeed, research says men do think about it a bit more, but only barely.
However, there’s another thing they do more that may have an impact on arousal: Men masturbate more frequently, according to one study. This could lead to more frequent arousal.
It’s not necessarily a bad thing to be horny frequently.
Sexual drive is a healthy thing, as is sexual activity.
But if you think your constant arousal is getting in the way of other aspects of your life, you may want to consider talking with a doctor or sex therapist. They can help you explore the function of your sexual behavior.
If arousal and the need to engage in sexual behavior feels mandatory, or you have a compulsive urge to act on them, you may need to talk about these underlying urges. This could be signs of a hypersexual disorder.
Of course, one person’s “constantly” turned on may be very different from another’s. It helps to talk with a medical professional about these thoughts and desires. That way, you can get a handle on whether they’re typical, or if you need to seek treatment.
If you want to dampen your sex drive, a few treatment options may help. Ultimately, you may need to talk with a doctor so you can get a better understanding of possible underlying issues that are playing into your constant arousal.
Have regular sex
Sex can be healthy for more than your relationship. It can help relieve stress and regulate your hormones, too. If you regularly have sex, you might feel fulfilled and not have an unquenchable craving.
Work out
It’s a different kind of physical engagement, but it’s certainly one that could help you alleviate some of that sexual tension. Exercise releases some of the same chemicals and hormones as sexual activity. It can help divert your energy into healthy, productive ends.
Masturbate
As long as masturbation isn’t getting in the way of your work, personal relationships, or other commitments, it’s a fun way to get to know your body, your likes, and your cravings.
Find creative outlets
If you want to use that energy for something not related to sex, consider finding hobbies or volunteer opportunities that can help you apply that passion somewhere else.
Your libido can change from day to day. It certainly changes throughout your life.
If you feel as if you’re constantly aroused, that may not be a bad thing. A healthy sex drive can be a positive quality.
But if you think your desire for sexual engagement is interfering with your day-to-day responsibilities and plans, consider seeing a doctor or sex therapist.
They can help you look for possible underlying health issues that could be contributing to your notched up desire. They might also help you find ways to harness it.
Why Am I So Horny? 9 Causes Of High Libido & What To Do
Factors that can affect libido, aka how horny you are:
1.
Hormones
When thinking about hormones and sex drive, testosterone often comes to mind. Indeed, testosterone is linked to sexual functioning and desire across genders, and when your testosterone is high, your libido may be higher too.
Lots of lifestyle factors and bodily processes are associated with increases in testosterone, such as regular exercise1, ovulation, or hitting puberty2, among many others.
While testosterone is linked to libido, naturopathic doctor and sexologist Jordin Wiggins, N.D., says it's more nuanced than that. Both estrogen and progesterone also affect libido. "Estrogen is more clearly linked with physiological arousal (blood flow to the genitals, vaginal lubrication)," certified relationship and sex therapist Indigo Stray Conger, LMFT, CST, tells mbg.
Beyond that, Wiggins says it's also important to look at the hormones that contribute to pleasure, connection, and arousal, like dopamine and oxytocin.
These hormones tend to be flaring when we're at the height of romance3, which is why libido can sometimes seem higher at the start of a new relationship.
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2.
Diet
Certain foods, sometimes labeled aphrodisiacs, are believed to increase libido in some people. According to osteopathic OB/GYN Anna Cabeca, D.O., both chocolate and cheese contain a substance called phenylethylamine4 (PEA).
The substance is a "natural amphetamine manufactured by the brain in response to the feeling of love," she says. "And PEA is believed to be responsible for that hormonal rush during sex."
Research is still inconclusive as to how effective aphrodisiacs really are for increasing libido, but some common aphrodisiacs like oysters, avocados, and omega-3 fats do contain vitamins and minerals that support overall health, including hormone health and therefore sexual health.
3.
Alcohol
In general, many people find that alcohol can make them feel more horny. That said, the relationship between alcohol and sex drive is complicated. A 1995 review5 published in the journal Recent Developments in Alcoholism says, "Alcohol consumption increases subjective sexual desire, arousal, and pleasure for many women, although it lowers physiological arousal."
This may be because alcohol increases testosterone in people with vaginas but then decreases genital responsiveness6, making it more difficult to orgasm.
The physiological effects aside, the lowered inhibitions sometimes produced by alcohol can also simply make people more open to sex than they ordinarily would be when sober.
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4.
Frequent masturbation
Masturbating frequently can both directly and indirectly increase libido. "When we ignore our body's drive and arousal cues for too long through distraction, stress, or lack of a partner, those cues begin to go dormant," Stray Conger explains.
So, the more someone engages in sexual activity of any kind, including masturbation, the easier it is to become physiologically aroused.
More directly, Wiggins says, "It can also increase the release of hormones, like dopamine and testosterone." And while masturbating is often a solo sport, it can also help to increase pleasure with a partner.
"Individuals who masturbate often know what they like and how to communicate it to their partner so, therefore, report greater satisfaction in relationships and better intimacy and sexual communication," Wiggins says.
5.
Menstrual cycle
If you've ever felt horny before or during your period, you're not alone. The hormonal fluctuations that occur throughout the menstrual cycle can both increase and decrease libido.
Reproductive endocrinologist Sheeva Talebian, M.D., explains that both testosterone and estrogen peak during ovulation (about 14 days before the period), and the influx of both hormones tends to heighten sex drive.
During the period, OB/GYN and integrative women's health expert Suzanne Gilberg-Lenz, M.D., says there is an increase in blood flow to the pelvic and genital regions.
Similar to an increased blood flow to the penis during an erection, blood flow to the vagina may increase desire. (And yes, it is generally safe to have sex during your period.)
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6.
Pregnancy
There are a couple of factors that could increase sexual arousal during pregnancy.
"All that estrogen in women's bodies can improve their sex drive," functional medicine doctor and OB/GYN Wendie Trubow, M.D., says. "Additionally, there's a lot more blood flow going to the genital areas, which increases and improves sensation." According to her, all of these feelings are "totally normal and good!"
Unless a doctor or OB/GYN advises against sex and orgasms while pregnant, it's perfectly safe to engage. If sex becomes uncomfortable further into your pregnancy, you may need to try a different position.
For heterosexual couples, Trubow recommends having the woman lie on her side with the male partner behind her. For two female partners, the pregnant person will probably still be more comfortable on her side, Trubow says, but her partner doesn't have to be behind.
7.
Your bladder
For people with vaginas, a full bladder could potentially make you feel horny.
Because the clitoris, vagina, and urethra are all so close to one another, a full bladder can put pressure on the genitals and stimulate arousal.
The placement of these body parts, unfortunately, also increases the risk of developing UTIs from sex.
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8.
Seasons
Some studies have pointed toward a drop in male testosterone (and therefore libido) in the summer7 and a subsequent peak in the fall8, drawing a connection between sex drive and seasonal changes.
Changes in mood triggered by seasonal changes can also affect sex drive. "If you are someone who has seasonal depression, you may also notice a drop in libido during these times," Wiggins says. "Women with low sexual desire are far more likely to experience symptoms of depression9 than women who do not have low sexual desire, highlighting how closely linked mental health and libido really are," she says.
While most people associate seasonal affective disorder with winter, the symptoms can also occur in the summertime. According to psychiatrist Roxanna Namavar, D.
O., seasonal affective disorder is a response to the drastic change in weather and sunlight—which occurs both at the end of fall and the end of spring.
9.
Situational factors
There are plenty of situational factors that can cause someone to feel horny. "What's really important to understand about female desire in most cases is that it isn't usually spontaneous," certified sex coach Gigi Engle tells mbg. "Sexual desire is a bio-psychosocial event. Meaning, for desire to occur, we need the right number of factors to be in play."
A few common factors that can turn someone on in the moment are new relationships, erotically charged situations, or people you find attractive:
- New relationships: The "honeymoon phase" often describes the beginning of a relationship when two partners can't keep their hands off each other. During this part of the relationship, Engle says couples' brains tend to be awash in feel-good hormones like oxytocin and dopamine.
"That's why we feel so sexually aroused and horny all the time in new relationships," she explains. "We don't need many of the other situational factors because we're so high on 'new relationship energy."' - Erotically charged situations: According to Engle, any type of sexually charged situation, like sexting, dirty talk, or watching erotic materials, can trigger desire and arousal in the brain. "This factors in the psycho-social aspects of desire," she says.
- Being around people you find attractive: Naturally, when you're around someone you find attractive, it can make you feel horny. Especially if the two of you are flirty or touchy with one another. "Being around people you think are hot is creating your own micro-erotic climate," Engle says. "You'll wind up hornier because those people are acting as activating events for your desire."
Is there such a thing as being too horny?
There's nothing wrong with frequently feeling horny.
In fact, a healthy sex drive and sex life are important for overall health and quality of life10. "Sexuality is normal and healthy, and having sex in any amount is a positive contributor to both mental and physical health," Stray Conger says.
Some people will naturally have a higher sex drive than others, which is only a problem if it's distracting or disruptive for the particular individual experiencing it.
"Being too horny is a thing when it becomes a problem for you and causes difficulties in your life," clinical sexologist and sex therapist Cyndi Darnell tells mbg.
If that's the case, some of the methods for releasing sexual energy below can help, as can speaking with a reputable sexuality professional.
What about hypersexuality?
Hypersexuality11 has been defined in research as the "inability to regulate one's sexual behavior that is a source of significant personal distress," though the concept is hotly debated among experts.
Not all experts agree that it's a real condition, and it is not recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Likewise, the American Association of Sexuality Educators, Counselors, and Therapists states that there's not enough empirical evidence to support the existence of "sex addiction."
All that said, if your experiences around sexuality and desire feel distressing or out of control, it's worth reaching out to a sex therapist or other sexuality professional for support.
"It is understood that out-of-control sexual behavior12, as referred to by skilled professionals, is a thing, but it's not a disease as such," Darnell says. "It's about a balanced relationship with sexuality, pleasure, values, and emotions."
How to deal with horny feelings:
Have sex regularly.
If you're feeling horny and have a consenting partner, have sex. Not only does frequent intimacy increase overall satisfaction in a relationship13, but sex also boasts health benefits, like lowering stress and increasing cognitive functioning, according to sex therapist Sara Sloan, Ph.
D., LMFT-A. In fact, she recommends having sex every 48 hours.
Masturbate.
One of the easiest ways to get your sexual energy out is through masturbation. "Somatic techniques and mindful masturbation are a great way to energize the body and release stored erotic energy," Darnell says. "Tantric practices can also be helpful, moving sexual energy around the body to use in other ways."
There are many other health benefits of masturbation, too.
Find other sexual outlets.
Virtual sex and phone sex are creative ways to get your sexual energy out without actually engaging in any physical acts if you don't want to. Watching porn, either with a partner or on your own, can also help scratch the itch. (Here: our guide to finding ethical porn.)
Exercise.
While it's definitely a different type of physical activity, exercising can also help lower stress and release feel-good hormones. In that sense, engaging in exercise may release some built-up sexual tension in the body.
Practice mindfulness.
Mindfulness meditations are meant to help people connect with their breath and focus on the present moment. This technique has often been used to help treat addiction and in that same sense may help with compulsive sexual behaviors 14if they begin to interfere with your daily life.
Some people use meditation as a way of getting the effects of masturbation without doing it.
When to get help.
If feeling horny begins interfering with work, relationships, or other areas of life, or if it feels significantly distressing to you, reach out to a reputable sexuality professional such as a sex therapist.
It may also be important to get help if you're engaging in risky sexual behaviors that could have a potentially damaging impact on your health, Stray Conger adds.
One of the biggest hang-ups for people who feel horny often is shame. According to Megwyn White, certified clinical sexologist and director of education at Satisfyer, this shame is often due to a stigma around the topic of sexuality and masturbation.
A sexuality professional can also support you in working through these negative feelings so you can feel more at peace with yourself.
The bottom line.
There are plenty of everyday factors that can make you feel hornier than normal. Some of them can be controlled, like what we eat and how often we masturbate. Others, like our hormonal fluctuations or the change in seasons, are inevitable.
"It's important to recognize that it's totally normal when you feel horny," White says, noting that feeling horny is just your body sending you a message about what it wants and what feels good. Unless your high libido is interfering with your daily life, there's nothing wrong with those sexual urges.
What controls erection?
No wonder they say that the largest sexual organ is in our head. It is the brain that "manages" all manifestations of the human sexual sphere: it creates an emotional mood, the need for sexual intercourse, attraction to the opposite sex and provides reactions that realize this attraction.
In the language of science, attraction to the opposite sex is called "libido". Against the background of libido, erotic pictures, combined with irritation of the corresponding zones, cause excitation of the sexual center in the brain. As a result, nerve impulses rush from this center to various organs and make the heart “flutter” and breathing quicken.
Blood pressure rises. Under the "guidance" of the centers of the spinal cord, the penis fills with blood, increases many times (4-10 times) and tightens. This is how an erection occurs. Emotional arousal and activation of the glans penis lead to the contraction of the seminal vesicles and the release of sperm - ejaculation and orgasm. Violation of the coordinated work of any of these links can cause sexual disorders, primarily the loss of the ability to have an erection.
Since ancient times there has been a search for funds that could help a man. I drank a love drink, and even better, swallowed an inconspicuous pill - and please, appeared before the woman in full strength and readiness.
Such remedies were called "aphrodisiacum" after Aphrodite, the Greek goddess of sensual love. Despite centuries of searching, the vast majority of these remedies were either tonic, like ginseng and vitamins, or exciting, like coffee and chocolate, or simply talismans, acting purely psychologically. The only effective remedy was the bark of the African yohimbe tree. Why is it so difficult to influence the behavior of the penis? After all, a person usually controls his body well: even with his eyes closed and in weightlessness, his arms and legs are completely subject to the will. But the whole point is that we can only command those muscles that are attached to the bones.
But there are other muscles that are beyond our control. They are located in the walls of internal organs and blood vessels. The penis is under the control of such muscles, and therefore almost does not depend on the will of the owner. Nevertheless, his behavior is determined by nerve impulses. The nervous regulation system resembles a telegraph connection.
In the command post, an "order" appears in the form of electrical signals that run along wires - nerves. At the end of the wire sits a "telegraph operator", translating current impulses into orders that are transmitted to the organs. These orders are those substances that cause the muscles to either contract or relax. Inside the penis are two so-called cavernous bodies. Muscles pass along the walls of the "caves", thanks to which they can change their volume. In the usual, "flaccid" state, the muscles of the cavernous bodies and the muscles of the small arteries of the penis are in a state of weak contraction - tone. A small amount of blood constantly circulates in them, but this is not enough to give the penis elasticity.
The situation changes completely with sexual arousal. Powerful impulses come to the genitals, which cause relaxation of the muscle fibers in the walls of the arteries and the cavernous bodies of the penis. As a result, the penis and cavernous bodies are filled with arterial blood, increasing in size - an erection occurs.
When sexual arousal falls, the muscles in the cavernous bodies contract and squeeze blood out of them, like water from a sponge - the erection ends. The substance that tells the muscles to relax is called acetylcholine. It is quickly destroyed by a special enzyme. When rats were injected with substances that inhibited the action of this enzyme, they copulated for hours. However, these substances act indiscriminately.
American scientists have proposed another solution to this problem. In 1998, he was awarded the Nobel Prize in Medicine for the discovery of a special chemical link between acetylcholine and muscles. This is nitric oxide, which provides the formation of substances that lead to relaxation of the muscles of the cavernous bodies and to an erection. Now pharmacologists have the opportunity to manage this process. At what age does an erection appear and when does it normally disappear? The first physiological erections occur in boys as early as 5-6 years old and are not associated with erotic experiences.
Then erections become more frequent, and during puberty they already appear as a manifestation of attraction to the opposite sex.
The maximum ability to have an erection in a man is about 20 years old, then it gradually decreases, but completely disappears for everyone in due time - for someone it remains up to 90 years, for someone it is lost even after 40 years.
What diseases lead to the loss of the ability to erect?
First of all, alcoholism, since in large doses alcohol has a detrimental effect on the ability to have an erection. The same is true for drugs, especially cocaine, ecstasy, phenamine: they increase potency for a short time, but literally “turn it off” after a few doses. Reduces potency and prostatitis, and diabetes, and some hormonal diseases, as well as vascular sclerosis, especially the vessels of the lower extremities. The same thing happens if, without the advice of a doctor, they begin to take male sex hormones - their excess acts in the exact opposite way.
Depression, anxiety, and the expectation of some kind of trouble also have a bad effect. When does an erection fail? In young people, an erection during the first sexual intercourse often fails due to excessive arousal. The more a young man desires intimacy, the harder it is to get an erection. And here the tactful behavior of a woman is very important - after all, sometimes the reason is in herself, in the fact that she said or did something wrong. If something does not work out with repeated contacts, a pathology can be suspected. In general, a particular woman does not mean so much to a man at 20, but the older he gets, the more important her individuality becomes for him. How does the intensity of sexual activity affect erection? Any deviation from the norm is bad - both excess and deficiency. It is known that long breaks - several months - reduce erections. There is even such a thing as "impotence of sailors." On the other hand, 7-8 intercourse per week can also reduce potency. What can be considered the norm of sexual life? Everyone has their own, of course.
But on average, for a family man, this is 2-3 sexual intercourse per week. The minimum normal frequency is once every two weeks.
Is fertility related to erection?
Not directly. In a man, the peak production of sex hormones is reached by the age of 30, and potency at this time is already decreasing, although very smoothly. The ability to conceive remains much longer. Although, if infertility is associated with a lack of sex hormones, erection may also decrease. How does physical activity affect? Moderate exercise (see also exercises for prostatitis) increases potency, excessive - reduces. And it's not just fatigue. Building powerful muscles "takes away" a lot of sex hormones, as a result, potency decreases. This should be remembered by those who are fond of bodybuilding. Does the ability to have an erection depend on nationality? It is known that southerners are more easily and quickly excited, but are not able to maintain an erection for a long time. Northerners are the opposite.
Erectile dysfunction in men | Symptoms, complications, diagnosis and treatment
Approximately one in two men over the age of 50 has some form of erectile dysfunction (ED) symptoms. However, age is far from the only cause of erectile dysfunction.
Stress and nervous tension were previously thought to be the main causes of ED. But medical studies have shown that often the appearance of ED is associated with chronic sluggish and oligosymptomatic diseases, and the deterioration of erection can be an early sign of a more serious illness.
Timely diagnosis and treatment of chronic diseases will allow you to enjoy good physical health and sexual activity in your mature years.
What is erectile dysfunction?
ED is defined as a condition in which it is difficult to achieve or maintain an erection sufficient for sexual intercourse.
ED may occur:
• In violation of the blood flow and innervation of the penis.
• For prolonged nervous tension.
• As the first symptom of cardiovascular disease (atherosclerosis, heart failure, hypertension) and diabetes.
How does an erection occur?
During sexual arousal, the brain signals to the nerves, which results in the release of specific chemicals that increase blood flow to the penis. There is a rapid blood supply to the two cavernous bodies (corpus cavernosum Fig. 1). The spongy tissue inside the cavernous bodies relaxes and fills with blood. The blood pressure in the penis rises and causes an erection.
When a man reaches orgasm, a second impulse of nerve signals reaches the penis and causes the spongy tissue to contract. The blood leaves the cavernous bodies and the erection disappears.
Men know that the size of the penis can change depending on the ambient temperature or stress. This is normal and reflects the volume of circulating blood entering and exiting the penis.
Although ED becomes more common with age, aging does not always cause erectile dysfunction.
Some men are sexually active in their 80s.
Risk factors for ED
• Injuries of the pelvis.
• Surgery for cancer of the prostate, colon, rectum, or bladder.
• Cardiovascular diseases
• Peripheral arterial disease (narrowing of the arteries with reduced blood flow).
• Hypertension.
• Diabetes mellitus.
• Drinking alcohol.
• Drug use.
• Smoking (including vaping).
• Certain medicines
• Emotional stress due to depression, or relationship problems with a partner.
Physiological factors
• During an erection, the outflow of blood from the cavernous bodies is not blocked. If blood does not accumulate in the penis, a man cannot achieve an erection. This problem can occur at any age.
• Nerve signals from the brain or spinal cord do not reach the penis.
• Injuries to the spine or pelvic surgery can damage the nerves in the penis.
• Pelvic cancer treatment affects erectile function.
• Surgery and/or radiation therapy for prostate cancer, colorectal cancer, bladder cancer - may cause ED. Approximately 6-12 months after treatment, a urologist should be contacted for sexual health issues.
• Medicines used to treat other conditions.
Some drugs adversely affect erection. Patients should discuss the side effects of medications with their doctors.
Emotional causes of ED
Sex requires mind and body to work together. Emotional or relationship problems can trigger or exacerbate ED.
Some emotional problems that can lead to ED:
• Depression.
• Conflicts with a sexual partner.
• Stress at home or at work.
• Stress due to social, cultural or religious conflicts.
• Anxiety about sexual activity.
Diagnosis
Diagnosis of ED begins with a conversation with a urologist.
Sign up for a consultation using this link. Your doctor will ask you questions about your general health and erection problems. He will also advise you to do the necessary tests and studies. It is important to find the cause of your ED so that treatment can be as effective as possible.
Be prepared to answer a series of questions. Some of these questions will be very personal and may seem uncomfortable. Honest and detailed answers will help you find the cause of dysfunction and choose the right treatment for you.
First, your doctor will want to know about your general health and lifestyle details. It is very important to tell your doctor about any medications you are taking, whether prescription or over-the-counter. If you smoke, tell me how much. If you drink alcohol, please indicate how often. Your doctor will also ask about recent stresses in your life.
When discussing the specifics of your ED, your doctor is likely to ask the following types of questions:
• How long have you had these symptoms? How long ago and in what order did they appear?
• Do you have spontaneous erections at night or in the morning?
• If you have an erection, how stable and how long is it? Are there any problems with penetration into the partner?
• Do you have problems with sexual desire or arousal?
• Do your erections change at different times, such as when you enter the vagina, during stimulation, or when you masturbate?
• Do you have erection pain?
Questions about your emotional health might include:
• How often do you experience severe stress?
• Causes of anxiety or depression? Do you have mental health problems?
• Do you take any medication to improve your emotional state?
• How satisfied are you with your sex life? Have there been any recent changes?
• How is your relationship with your partner? Have there been any recent changes to them?
Medical examination
Medical examination is a way to check your general health.
When dealing with ED, it often starts with an examination of your genitals (penis and testicles). Depending on your age and risk factors, the examination may expand to include a cardiovascular examination. Depending on your age and family history, your doctor may do a digital rectal examination to check the condition of your prostate. These tests are usually safe and painless. Make an appointment with a urologist VTSERM them. A.M. Nikiforov EMERCOM of Russia for advice and appointment of the necessary diagnostics.
Lab Tests
Your healthcare provider may order additional blood and urine tests to look for other health problems not found during the physical examination.
Other tests
Questionnaires are often used by experts to assess the severity of ED. The specialist may ask about the features of the onset and maintenance of an erection, your assessment of sexual satisfaction.
Additional diagnostic tests.
• Blood test for testosterone and other male sex hormones.
• Blood test to measure the level of glucose (sugar) in the blood.
• Ultrasound (dopplerography of the penis) to check the quality of blood flow.
• Injection into the corpus cavernosa of a blood flow-stimulating drug to induce an erection
• Pelvic x-ray, arteriography, MRI, or CT (rarely needed, only if trauma or cancer has occurred).
Treatment for ED
If ED is affecting your quality of life or your relationship with a loved one, it must be treated. Treatment is aimed at correcting or improving erectile function and maintaining overall health. Find out more about surgeries performed in the Department of Urology.
Lifestyle changes
Treatment for ED begins with taking care of your heart and blood vessels. Your doctor may point to "risk factors" that can be eliminated or minimized. You may be recommended:
• Change your food basket and diet (eg, eat more plant-based foods and limit fatty or fried foods).
• Maintain a healthy weight.
• Stop SMOKING!
• Increase physical activity.
• Limit your use of drugs and alcohol.
• Get more sleep (ideally 7-8 hours per night).
Your doctor may advise you to change your previous medications. Please do not stop or change prescription drugs without first talking to your doctor.
Emotional health care
Your doctor may also offer psychological counseling to resolve relationship conflicts, domestic stress, and depression.
Drug treatment
ATTENTION!!! DO NOT SELF-MEDATE - CONTACTING A SPECIALIST WILL HELP YOU TO DEFINE AN EFFECTIVE TREATMENT WITH A GUARANTEED RESULT!
Treatment always starts with non-invasive (non-traumatic) methods.
Tablet preparations.
Drugs known as type 5 PDE inhibitors increase blood flow in the penis. These are drugs that are taken orally in the form of tablets.
For best results, men with ED should take these tablets about an hour or two before sex. PDE-5 inhibitors improve blood flow to create stronger erections. Approximately 7 out of 10 men get a good result from the treatment, while the effectiveness is lower in people with diabetes or cancer.
If you have a heart condition and are taking nitrates, you SHOULD NOT take PDE-5 inhibitors. Always check with your doctor before using PDE5 inhibitors.
Most often, the side effects of PDE-5 inhibitors are mild and short-lived. Most common:
• Feeling of heat, redness of the face.
• Headache.
• Indigestion.
• Muscle pain.
• Nasal congestion.
Talk to your urologist about possible problems.
Vacuum therapy
Vacuum Erectors is a plastic cylinder that fits over the penis tightly against the skin at the base of the penis. A special pump at the end of the device pumps out air and forms a low pressure area around the penis.
This leads to blood filling of the cavernous bodies. Then an elastic ring is put on the base of the penis to block the outflow of blood. The vacuum erector provides an erection lasting up to 30 minutes. With proper preparation, 75 out of 100 men can get a sufficient erection with this device.
Food additives
Biologically active (food) additives (BAA): quite popular, but may be unsafe. Check with your healthcare professional before taking any supplements and treating ED on your own. Supplements may include PDE-5 inhibitors, sometimes at excessively high doses. They may also contain unknown ingredients.
Testosterone therapy
In rare cases where there is low sex drive (libido) and low blood testosterone levels, testosterone replacement therapy may help improve libido. Also, testosterone can be combined with PDE-5 inhibitors.
Intracavernous injection (ICI) and intraurethral (IU) therapy
With low efficiency of tablet preparations, you can use the drug - Alprostadil.
This drug is given as an injection into the penis (Caverject) or into the urethra using a special applicator (MUSE).
Intracavernous injection
Alprostadil must be injected into the lateral surface of the penis inside the corpus cavernosum. The effectiveness of treatment reaches 85%. Many men who do not respond to PDE-5 inhibitors develop firm erections that last up to 20-30 minutes.
Your doctor will teach you how to administer, how much to administer, and how to safely increase your dosage at home. It is very important to perform the first injection in the urologist's office before doing it yourself.
The most common side effect of ICI and IU therapy is prolonged erection, called priapism. Priapism is an abnormal erection that lasts more than four hours. This condition is accompanied by pain and harms the cavernous tissue. In the event of priapism, the patient should go to the emergency room. With late presentation and recurrence of priapism, even surgery may be required.
Treatment of priapism requires the removal of stagnant blood from the penis, as well as the introduction of special drugs. Men should be careful because priapism can lead to varying degrees of damage to the tissues of the penis, up to irreversible (cavernous fibrosis). Fibrosis significantly worsens ED or causes complete lack of erection.
Men who have an erection lasting longer than two to four hours after a CCI should immediately seek help from the emergency department.
Intraurethral (IU) therapy
In IU therapy, a tiny capsule of the drug Alprostadil is injected into the urethra to a depth of 3 cm, after which the drug dissolves and is absorbed inside the canal. The use of IU therapy makes it possible to refuse an injection and its unpleasant consequences, but, unfortunately, it has a lower efficiency than ICI. Intraurethral therapy should also be started in the doctor's office.
The most common side effect of IU therapy is a burning sensation in the penis, rarely priapism may occur.
Surgical treatment
The main type of surgical treatment for ED is penile prosthesis implantation . For men who have failed drug treatment or have severe drug side effects, or if ED occurs after cancer surgery (radical prostatectomy), a penile prosthesis may be the only effective treatment.
Penile prostheses
Penile prostheses fit completely inside your body. They provide good rigidity to the penis for a long time, and this allows you to have a full sex life. Although the operation to implant a penile prosthesis (however, like any operation) is associated with a risk of complications, nevertheless this operation has a high level of satisfaction among patients with ED. Today it is the best choice for many men.
There are two types of penile prostheses.
Semi-rigid (semi-rigid, bendable)
This is the simplest type of implant and consists of two rods made of silicone and metal.
These rods give the male penis the axial rigidity needed for sexual penetration. The prosthesis can be bent for convenience after sexual intercourse, when urinating.
Inflatable prosthesis
In an inflatable prosthesis, two fluid-filled cylinders are placed inside the cavernous bodies. Special thin tubes connect the cylinders to a pump implanted under the skin of the scrotum and to a reservoir located in the bladder area. When a man pumps, fluid is pumped from the reservoir into the cylinders and causes the penis to tighten. Inflatable prostheses provide a normal erection and create a natural sensation for your partner. With an inflatable prosthesis, men can control the rigidity of the penis. Inflatable prostheses allow couples to maintain a stable erection throughout the entire time of sexual contact.
Penile prostheses restore erection, but they cannot correct orgasmic or ejaculatory disorders caused by previous cancer surgery.
How is the operation going?
Penile prosthesis surgery is always performed under anesthesia.
Usually one small skin incision is made under the penis at the junction with the scrotum. Blood loss is usually minor. The patient spends no more than 1-2 days in the hospital.
Penile Implant Recovery:
• Most men experience moderate pain in the early postoperative period, requiring analgesics. Skin sutures are removed after 5-7 days.
• Discomfort, bruising and swelling may occur for up to 2-3 weeks after surgery.
• For the first month, men should limit physical activity. The surgeon will explain which exercises are useful during the wound healing period.
• Most men can start having sex with a prosthetic penis by the eighth week after surgery. If swelling or pain remains, the use of the implant may be delayed. Before use, the surgeon will show you how to safely inflate and empty the implants.
The most unpleasant postoperative complications are hematoma and infection. Over time, the use of the prosthesis increases the risk of breakage of the device.
In this case, surgery may be required to replace it. When in doubt about the need for a prosthesis, it is helpful to talk to someone who has had the same surgery before.
If an infection occurs after the operation, the prosthesis will be removed. For the most part, modern dentures are reliable. But if a mechanical failure occurs, then the prosthesis or its component will need to be replaced surgically.
Most men with penile implants and their partners say they are happy with the results.
State of the art treatments in clinical trials
• Extracorporeal shock wave therapy (ESWT) is a low-intensity shock wave treatment of the cavernous tissue that is designed to help restore a natural erection.
• Intracavernous injection of stem cells - contributes to the restoration of cavernous tissue.
• Intracavernous administration of autologous (own) platelet-rich plasma (APRP) - to restore cavernous tissue.
Currently these techniques are not included in the standard treatment for ED, but may be offered as part of clinical trials.
