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Sexual Myths

The success of sexual enhancement medications such as Viagra have sent more men to their doctors when they have a problem.

Nothing has done more harm to men and their understanding of sexual performance factors than the various sexual myths that are circulating around the watercooler and bathroom stall walls.

But there's not much focus on sexual health as part of overall wellness for men. Here are five sexual myths, and the real story:

Sexual health is a women's issue

This is one of the biggest myths. Compared with females, males begin having sex at an earlier age (16.9 vs. 17.4 years) and have more partners. But men have no medical equivalent to a gynecologist, whom women see regularly for wellness care. Males also have less access to information and counseling on sexual health issues such as sexually transmitted diseases and contraception, and are less likely to be covered by health insurance. Also, primary care physicians don't always ask about sexual health, even though sex problems can be a symptom of underlying conditions such as hypertension or diabetes.

Only older men get erectile dysfunction

"Everybody assumes it occurs at an older age, but it really occurs earlier, at a lesser degree," often to men in their 40s, says Gil Brito, a urologist in Scottsdale. "With a younger guy, it really has a negative impact, with sex performance," which worsens the problem, he says. The success of drugs such as Viagra, Cialis and Levitra have made men more likely to discuss erection problems with their doctors. That's good, because sexual dysfunction - the inability to achieve or maintain an erection - is often a symptom of an underlying physical problem, such as diabetes, hypertension or heart disease. With many younger men, early erectile dysfunction treatment can correct the problem so that the man doesn't need the pills anymore.

Lifestyle doesn't affect sexual health

Sex, drugs and rock and roll don't make a healthy mix. "Lifestyle is very important and can have a negative impact," Brito says. "Smoking is very bad for sex. An erection is basically increased blood flow. Smoking affects an erection through negative impact on the blood vessels." A little alcohol can improve the mood, but too much will hinder an erection. "Human instinct is for instant gratification." He will often prescribe medication such as Viagra in the interim. Sometimes, men will lose excess weight and tell him they don't need the pills any more. The pills work in about 65 to 75 percent of patients, Brito says. The rest need different treatments. "There are many options - injection therapy, pellets in the urethra, vacuum-erection devices. If all else fails, a penile prosthesis always works."

Low sex drive can't be helped

Just as with women, men's sex drive can wane as hormone levels decrease with age. "If a man has decreased libido, I'll check his testosterone levels," says Brito. Inadequate production of testosterone, called andropause, usually happens in a man's 60s, but can happen as early as his 30s. The treatment is testosterone therapy - after any chance of prostate cancer has been ruled out. Testosterone will accelerate the cancer cells' growth. Brito says men are more aware of andropause. "Savvy men will come in and say 'I'm not as sharp,' and ask about hormone levels. I'd never had patients ask that before."

Erectile dysfunction is the most common sexual problem

The most common sexual problem among men is premature ejaculation, or early ejaculation - when men feel they have no control over when they climax. Gene Gary Gruver, a clinical psychologist and licensed sex therapist in Tucson, says, "It almost always starts in the late teenage years, probably during the first coitus or the second," he says. "Then it builds in anxiety, and anxiety is what drives it," he says. At first, young men might assume that climax after a few seconds of intercourse is normal. "They quickly learn that it's not."

The quickest and easiest premature ejaculation cure and treatment is medication, usually an antidepressant such as Prozac. One of the side effects is delayed orgasm. Patients usually also meet with a sex therapist while they're taking the drug, and may eventually be able to stop taking the drug, he says. During sex, there is a "point of no return," when no matter what happens, the male will climax. "The secret is finding that point and slowing it or stopping it," Gruver says. But men believe if they stop and lose their erection, they won't get it back. That's not true. Left untreated, early ejaculation can lead to frustration for both partners, lack of interest in sex and affection, and even divorce. Treatment is about 95 percent effective, he says.

Jim Shaw

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