Letters: Functioning with erectile dysfunction—beyond Viagra

Functioning with erectile dysfunction—beyond Viagra

“I am 60 years old and am beginning to have erectile problems. Viagra doesn’t work for me. Things start out fine but then, I ‘lose it.’ My wife is understanding but that doesn’t help because I know her very well and sex is important to her. It is humiliating and depressing. Do you have any suggestions?”
-J.E.B., Washington

This is the No. 1 complaint of men over 40. (Yes, it may start earlier, but most men don’t tell their buddies about it, and many don’t even tell their doctors.) For obvious reasons, erectile dysfunction has become a major industry in American medicine.

I reported on Viagra years ago. There has been a lot of experience with it over the ensuing years. It works for some but not others. Many other approaches are now available, from pills, to prostheses, to pumps, to injections in the penis prior to intercourse. (The Chinese like ground rhinoceros horn and ground tiger penis.)

If you don’t have the cahones to inject your organ, you don’t find surgery appealing, and the idea of a suction device with a strap tied around the base of the penis sounds preposterous, you might want to try yohimbine. Yohimbine is an herbal supplement that comes in pill form and can enhance sexual functioning. The reviews are mixed among the experts, but some men have been quite satisfied with it. Yohimbine supplements are available in most health food stores.

If your blood levels of testosterone are low, you may need supplemental testosterone injections. (The injection is in the muscle, not the penis.) This underrated hormone is essential for your general health, whether you are having sexual problems or not.

However, it is not a panacea for sexual problems. It will almost certainly increase your libido, but that doesn’t mean it will give you an improved erection. So testosterone alone may put you in the unhappy position of having an increased desire for sex but without having the starch to follow through.

If your experience is enough of a problem for you to write a letter, you are ready to see a specialist in this field. It will probably be a urologist but not necessarily. As most of my readers know, I have little respect for the “science” of psychology and even less for psychiatry. But there are few exceptions in both fields. One of my favorites is Bernie Zilbergeld, Ph.D. Dr. Zilbergeld wrote the best book I’ve seen on the racket of psychology, titled The Shrinking of America. His latest book is The New Male Sexuality, in which he discusses male impotence. I recommend it highly.

Action to take:

Read Dr. Zilbergeld’s book and then see a sex specialist, preferably an M.D. who specializes in this sexual function.