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Dr. J’s Top 10 for Men: Erection Concerns—Up, Down and Every Which Way

Posted Jul 17 2009 12:00am
“I wouldn’t recommend sex, drugs, or insanity for everyone, but they’ve always worked for me.”
Hunter S. Thompson

We’ve just had another big influx of readers. So in addition to welcoming all you newbies, here’s a note about how to get the most out of this blog. As regular readers can attest, you might find it a bit different from other blogs you’ve read because my intention is to be both entertaining and educational. Each new post adds to the information presented in the previous one; so to get the maximum benefit, I recommend you begin with the introductory post from way back in August 2006 and read forward from there. Or skip around to whatever topics interest you. Wherever you land, I think you’ll agree our special items are chock full of info you won’t find on most regular menus.

Now where were we? Ah yes. Recently we’ve been having some fun with a list of questions I like to call the Top 10 Men’s Concerns, representing the most common sexual concerns expressed by men. So far, we’ve discussed penis size and shape issues, we spent some time on self-pleasuring (such fun!), and now for the next few weeks, we’ll be looking at an assortment of concerns drawn from real questions I’ve received from readers just like you. I’m doing this because you’ve been such very good readers and hardly ever misbehaved (well, except for that one time, at band camp); so after each and every question, you’ll find my answer. Oh—and really astute readers (that’s right, I mean you) will doubtless remember that at the end of this last year, we surveyed the top 10 women’s concerns. Guys, it’s your turn to stand up and be counted, so read on.

Our first guest has signed in and asks a question dealing with types of physiological conditions that can affect erections.

***


“Dear Dr. J: I have ED but cannot take Viagra, Cialis, Levetra because of a heart condition. Any suggestions as to the treatment of the ED? Are pharmaceutical researchers close to coming up with a drug that can be taken safely by folks like me?”

Dr. J’s Response:

First, you’ll need to be more specific about what you consider to be “ED.” This is a term that means many different things to different people. People use it to refer to anything from "I had six beers and a fight with my wife and couldn't get it up" to someone who has a physiological condition that prevents blood flow to the penis and requires medical intervention. Are you referring to erections? If so, do you have what we professional sex researchers commonly refer to as “morning wood”? Do you experience erections upon awakening? I’m being serious, because it’s important to know if you’re experiencing erections at times other than when you’re with a partner (e.g., morning erections). If you ARE, this would indicate that there aren’t any physical causes and that there’s something emotional/psychological contributing to your concern (performance anxiety, etc.). If you AREN’T having any erections at all, then your heart condition is most likely obstructing the blood flowing to your penis, and you should consult a urologist to discuss what your options are.

Recent references to male sexuality seem to be limited to Viagra, penis mechanics, and such. If you listen to the radio or read the newspaper, you’re bombarded by ads from the pharmaceutical/medical industry asking whether you’re performing “up to par” (the inference being that if you’re not having “porn star sex,” you must be below par) and whether you want “better performance,” stronger erections (what IS a “weak” erection anyway?), to last longer, etc. The implicit message, of course, is that you’re supposed to perform like some machine, never, ever complain or question, and just be satisfied that you’re “getting some.” Pleasure? What’s that? Not only does this do a huge disservice to men, but it also leaves you vulnerable to exploitation by reinforcing the idea that what they’re selling is not only what you should want—it’s what you should NEED! And if you don’t, what’s wrong with you? Am I the only one who sees how self serving and manipulative this is? Do we really want to allow Madison Avenue to define our sexuality and turn it into yet one more consumer product?

Performance is the enemy of both pleasure and fun. The #1 cause of male sexual concerns is quite simply that many men focus on their performance rather than on their pleasure.

Picture this: You’re an actor, shooting a scene in which you’re eating a succulent gourmet dinner. You’re focused on your lines and technique, but not on the food. How much do you think you’d enjoy the actual meal? Well, sex is the same: if you focus on performance, you’re just working; and with an attitude like that, you’ll miss out on all of the fun.

Oh, sure, sometimes performing can be enjoyable; but eventually it’s just work. Have you bought into this model? If so, you might have discovered that sex is beginning to feel like a chore instead of fun. The first step in letting go of this attitude is educating yourself. Read The New Male Sexuality by Bernie Zilbergeld, a classic and still the best book on the subject. My male students swear by it. It will also help you to open up and share your concerns with a partner. I’ll let you in on a secret: some men assume their partners want them to perform, but that usually isn’t the case. You might find there’s more room for flexibility than you ever thought possible.

Let’s discuss developing erection reliability: Do you feel you always have to be in charge and it’s up to you to initiate sex? How does this make you feel? Are you comfortable telling your partner what you need? Try exploring any conflicts you may have about being sexual, including any past negative messages that have bothered you regarding any aspect of sex, especially issues that come up when you think about what being “manly” means to you. I’m sure it won’t surprise you to learn that many men sometimes just want to be held, kissed and stroked. You should also ask yourself whether you’re angry at a partner or feeling resentful.

It might help you to know that erections can change over the course of a lifetime, and while they may be different, this does not mean you can’t still have a great sex life.

When you're younger and just beginning to be sexual with others, erections pop up everywhere--including when you don't want them! Post-pubescent men are highly excitable. As you age, you’ll find that you need more direct touch and stimulation, especially if you use condoms, which can limit sensation somewhat. This is just part of life and doesn’t indicate any underlying condition to worry about.

Also as part of the aging process, you'll find that erections sometimes take longer, and even come and go. Again, this is not an indication if ill health, but just part of life. Have you ever looked up something on the internet and then got so distracted by something that popped up that you forgot what you were originally looking for? Well, like many other things, sexual interest ebbs and flows, depending on other circumstances in your life. Your medical condition can also affect blood flow to your penis, resulting in less firm or less frequent erections. Be aware that the more stress you’re under, the less energy your body has to respond sexually. In other words, stop worrying!

Worrying about erections is a dead-end street. All it will do is make you anxious, which will make your penis even more uncooperative. Don’t forget that you don't need an erection to be sexual, have fun, experience pleasure, etc. Relax, enjoy your own unique sexuality and stop judging yourself. And find partners who aren’t hung up on outdated macho ideas of what constitutes “good” sex. Most of us are more interested in a caring, sensitive partner than one with a “porn star” penis.

And one more thing: “ED” is short for “erectile dysfunction.” If you look up the word “dysfunction” in the dictionary, you’ll find that it means “broken.” So, my friends, this is a very misleading term because it asserts that any man’s penis that didn’t work EVEN ONCE the way the pill commercials insist it should, is broken. Huh? It’s time for men to fight back against this disempowering, inaccurate and traumatizing term. That’s why here at Dr. J’s House of Fun, we use the much more accurate and user-friendly term “erection concerns.”

Tune in next week for the second part of this discussion when we’ll ask the musical question: “why won’t my penis go up at will, whenever I want it to?”

With Pleasure,

Dr. J
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