Australia

About Last Night: I’m 57 and have been impotent for some time

Q: I’m 57 and have been impotent for some time. My doctor advised me that my angina meds make it unsafe for me to take tablets such as Viagra. A friend has been encouraging me to try penile injections, which he said were amazing, but I’m squeamish about needles. Recently, however, he’s developed a sharp bend in his penis and has been told it’s been caused by misuse of the injections, and that it might not be treatable. I can’t find info about this online. Have you heard of this?

A: Male erectile dysfunction is a sensitive and emotionally charged issue, with most men still equating putting a hard penis into a vagina with ‘having sex’, and being a potent male. Many find the inability to get an erection devastating, and withdraw from all forms of physical affection because they do not want to initiate something that they believe they cannot follow through on. This withdrawal can have a more damaging effect on their relationship than the erection problem itself.

Maureen Matthews.

Maureen Matthews.Credit:Simon Schluter

As with male pattern baldness, men’s vulnerability and desperation can be exploited for commercial ends. A range of treatments and solutions are advertised, with the suggestion that you will soon be hanging a towel on your erection, or using it to play the piano. They are seeking to maximize their profits, and their advice is not always reliable. Your doctor is the best person to advise you about erectile function treatments.

Accurate and up-to-date information and advice about some of these issues can also be found at A Touchy Subject.

The condition your friend describes is called Peyronie's disease. A build up of plaque, or scar tissue, on the shaft of the penis can cause it to bend. This can be painful, and can make penetrative sex difficult.

Approximately 10 per cent of men will develop Peyronie's for no obvious reason, and others will get it as a result of an injury, or as a side effect of radical prostate surgery. If it occurs, it needs to be treated quickly to stop it getting worse.

Of course, prevention is better than cure. Generally, penile injections are considered quite safe, and the risk of Peyronie's is rarely mentioned in the literature. All medical treatments can have negative side effects, however, and you must take this seriously. If you are using penile injections, it is important to follow a strict set of procedures and protocols.

Melissa Hadley Barrett is a West Australian-based sexologist and nurse practitioner. She specialises in this area, and regularly administers penile injections. She offers a free handout with instructions on how to use the needle correctly, and her website includes an instructional video.

You should only use this injection twice a week, with a two-day gap between injections. If you are inebriated, or in a sexually-charged situation you might be tempted to exceed this, but that will increase any risks.

Never inject in the same place every time. You need to use both sides of the penis, and up and down the shaft. You also need to inject to the correct depth. An auto-inject device will help with this.

Penile injections can also be safer, and more effective, when used in conjunction with a low dose of a medication such as Cialis. Your doctor will tell you whether or not this therapy is suitable for you.

Finally, remember that all therapies are optional. Many people do not realise that a man can have an orgasm, and many can ejaculate, without having an erection. Also, up to 80 per cent of women cannot climax with penetrative sex. If you are willing to be creative – and to try new things – you can still give your partner sexual pleasure, with your hands, your tongue, and pleasure-enhancing toys.

If you are struggling with this, it would be a good idea to seek professional help.

A sex therapist can help you to create your own style of sex life. They can also assist you in dealing with any psychological pain caused by your condition.

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