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We are not stereotypes but have incredible diversity and ranges of thoughts, feelings, experiences, and sexual preferences. Some of us are saintly, some are villainous, while most of us are in the broad expanse in between. While we are diff erent from each other in many ways, we all seek sexual health. Here are principles and facts that are common to all of us when it comes to sexual health. Men’s sexual health is grounded on psychological and physical facts and truths. Fact #1: Healthy Men Are Proud of Their Sexuality Feeling good about your body and sexuality is essential to being sexually healthy. Th e truth about great sex is that every man deserves to feel proud and confi dent of his masculinity. Okay, there are jokes that sexual health for men is impossible or an oxymoron—that men are sexual idiots or “only think with their penis.” Th ese are simplistic stereotypes. Trash talk! Each man can feel proud of his masculinity. Sex is a good part of a man’s (and a woman’s) life, not something to feel ashamed or embarrassed about.

Feeling proud of your body, unashamed of your powerful sex drive and sexual desires, buoyed by your sexual function, and clear with yourself of the importance of feeling pleased and satisfi ed with sex are important principles of men’s sexual health. Th is confi dence is based in physical, psychological, and relationship principles that accept masculinity with pride and self-respect.

Myth 3: Sex requires an erection. Fact: Many men feel that the sexual encounter must end if he starts to lose an erection. The introduction of impotence drugs has further cultivated this belief. This can lead to further anxiety about erections and sexual situations. Pleasure for both partners comes in many forms and can be achieved in a variety of ways. Intimate or sexual contact is not limited to the erect penis only. The fact is that many men experience a lack of erection from time to time and this doesn’t need to suspend sexual activity. Your penis is only one sexual tool. With the sensory and tactile feel of hands, mouth, and imagination, there are many things you can do to satisfy a partner and experience sexual pleasure yourself. Don’t forget that your skin is your largest sex organ and your mind is the most powerful one. By the way, putting pressure on yourself to get an erection only makes it less likely that you’ll have one.

Myth 4: Sex is over when the man orgasms (comes,Viagra Myth). Fact: For most couples, this is typical, but it need not be the case. Alternatively, the couple may slow down, stop and start again during the process of having sex, taking breaks and communicating about their needs and wants. Gentle kissing, soft touching, and deep gazes can truly put the love into love making. If one partner is not yet satisfied, sexual activity can continue until both are ready to stop.

Myth 5: Every sexual encounter has to include an orgasm. Fact: While we may have heard of horror stories about “blue balls” and “lover’s nuts”, they are not harmful conditions. There may be some discomfort if a man doesn’t ejaculate, but it passes. He can still have a pleasurable sexual encounter without orgasm, especially once he gets past adolescence.

Myth 6: A man should always be able to ‘give’ his partner an orgasm

Any surgeries, prostate, kidney, bladder, pelvic, etc.. Any trauma to pelvic area, brain, or spine. Any treatment for cancer, chemotherapy or radiation. Your responses to the above questions will help determine whether or not you may have ED. If you have any doubt, you should consult a doctor as soon as possible. Seeking Medical Help It is important to recognize that some health professionals, including doctors and mental health professionals, may be more skilled than others at dealing with sexuality and erection problems, due to comfort level, experience, or both. It is suggested that you start with your personal physician, and seek a referral if appropriate. Typically, the most qualified and experienced medical professional to deal with physical causes of ED is a urologist. A urologist is a physician who has specialized knowledge and skill in the area of the male and female urinary tract and reproductive organs. Due to the variety of clinical problems encountered, knowledge of internal medicine, pediatrics, gynecology, and other specialties is required of the urologist. Urology is classified as a surgical subspecialty. A urologist with advanced qualifications in surgery may be a fellow of the American College of Surgeons (FACS). Your physician may refer you to a psychiatrist or psychologist, or possibly a sex therapist, sex counselor, or even a social worker, if it is believed that the nature of your ED is psychological. Psychological problems causing erectile dysfunction are varied but most can be helped. Therapy often leads to improved function in other areas of life as well as in sexual function. Psychotherapists often like to work with both partners. Therapy, like other treatments, can be uncomfortable but worthwhile. If you have concerns about your referral, discuss them with your primary physician.

Clinical Diagnosis

It is important that you prepare yourself to openly discuss your sexual problems with your physician. Your visit(s) are likely to include the following: Full interview – the doctor is likely to ask you questions similar to those mentioned in the Self-Diagnosis section in order to get a thorough understanding of your sexual, medical, and psychological history. Physical examination – your doctor is likely to pay particular attention to your genitals, as well as your nervous, vascular, and urinary systems. A blood pressure check is also routine, but especially significant in ED diagnosis. It can reveal unsuspected diseases, including diabetes, vascular disease, penile scarring or plaque (Peyronie’s), testicular problems, low male hormone production, injury or disease to the penile nerves, and various prostate disorders. Laboratory testing can be extensive, and may include the following: o Blood Tests and Urinalysis – Blood tests can indicate conditions that may interfere with normal erectile function. These tests measure hormone levels, cholesterol, blood sugar, liver and kidney function, and thyroid function. Excess prolactin (hyperprolactinemea) can lower testosterone levels, which can diminish libido. Both of these levels are measured, as well as levels of other sex hormones. If they are persistently low, an endocrinologist (hormone specialist) may be consulted. o CBC – Complete blood count (CBC) of red cells and white cells is used to evaluate the presence of anemia. A low level of red cells limits the body’s utilization of oxygen and can lead to fatigue and general malaise. The level of blood lipids (fats) such as cholesterol and triglycerides may indicate arteriosclerosis, which can reduce blood flow to the penis. o Liver and kidney function tests–Liver and kidney disease can create horomonal imbalances. Blood tests for liver function involve analysis of enzyme and serum creatinine levels, which are indicators of kidney efficiency. o Thyroid function tests–Thyroid hormones regulate metabolism and the production of sex hormones; a deficiency may contribute to impotence.

The Importance of Viagra: Concurrence vs. Dissension

In the age of medical progress, scientific knowledge and medical answers are generally unquestioned as the best, most efficient, most legitimate solutions. However, the history of science, medicine, and technology is also a history of attempting to solve social problems and control populations. -Meika Loe, author of The Rise of Viagra: How the Little Blue Pill Changed Sex in America In the late 1990s, Viagra emerged as a pop culture phenomenon due to the massive public response and plethora of international attention given to the drug by all modes of the media. It seemed that every publication, radio and television station opted to add the drug to its assembly of newsworthy items, albeit generally focusing on a specific aspect relating to its efficacy, development, safety, or social impact. Viewed optimistically, the barrage of media attention also served to legitimize sexual dysfunction, bringing the topic “out of the closet” as never before (Rosen, 1998). Hence, Viagra, considered such a popular ‘news-worthy’ event worldwide, as well as a completely new development in the field of erectile dysfunction treatments due to its reliability, discreet administration and minimal side effects (Goldstein et al., 1998), would undoubtedly capture the attention of even the most prestigious medical journals. However, the attention bestowed on the drug by these publications was lukewarm at best. I propose that a controversy arose in the international research community largely ‘under the radar’ at the time of Viagra’s launch, as well as in the coming years. Clinical medicine and nursing titles comprise the majority of a typical hospital library’s journal list and are of critical importance to large academic medical and research centers. Selected English language core clinical journals are found in the Abridged Index Medicus, which was published by the National Library of Medicine (NLM) from 1970 - 1997. Although the NLM no longer produces the Abridged Index Medicus as a print publication, the value of the titles as a core list of “selected titles of biomedical journal literature of immediate interest to the practicing physician” is still recognized (United States National Library of Medicine, 2005). These titles continue to be searchable on NLM’s Medline database as a search subset limit called ‘core clinical journals’. Two of the most prestigious core clinical journals are titled The Lancet (published in England), and the Journal of the American Medical Association (JAMA). If the complete archives of The Lancet are examined, a surprising find transpires. Of the 25 articles mentioning sildenafil in the title, abstract or keywords, only 7 are journal articles. The others are news events, commentaries, editorials and letters. Of these 7 journal articles, only 3 address sildenafil as a treatment for erectile dysfunction, including one focusing solely on its retinal side-effects. The remaining 4 journal articles report new, non-ED related, clinical uses for sildenafil. These include its use as a treatment for lung fibrosis and pulmonary hypertension as well as its effect on local inflammation reactions experienced by Crohn’s disease patients. From the examination of this journal, it becomes evident that sildenafil is seen as an interesting compound, but not necessarily as a compound of interest solely for the treatment of erectile dysfunction. An examination of the archives of JAMA nets similar findings. Of the 21 articles mentioning sildenafil in the title, abstract or keywords, only 7 are journal articles. All 7 of these journal articles, however, address sildenafil as a treatment for erectile dysfunction. If the term ‘Viagra’ is searched in these archives, although more items such as news reports and commentaries are found, none of the search results are journal articles. The fact that these core clinical journals did not publish many articles on sildenafil may suggest that the treatment of erectile dysfunction with Viagra was not, and is not seen as a very legitimate medical concern in the mainstream medical community. Debates in the letters, editorials, and commentaries about whether ED is a serious problem and one that the medical profession should be paying attention to, highlight this stance.

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