All your sex questions answered medically (Part II)

MIND YOUR BODY By Willie T. Ong, MD Updated March 03, 2009 12:00 AM

Sexually-transmitted diseases

Q. My lady friends say that you can tell if your husband is fooling around by the color of the semen. Is this true?

A. The normal semen is transparent or whitish in color. It is gel-like in consistency when released and it should liquefy in about 30 minutes, so it can swim up the vagina and into the fallopian tube for possible fertilization.

According to surgeon Dr. Anthony Ang, semen which is yellowish and foul-smelling indicates gonorrhea infection, a common sexually transmitted disease. Usual treatment is the superdrug Ceftriaxone given intramuscularly plus a few days of doxycycline tablets. See your doctor ASAP!

Q. I have smelly yellowish vaginal discharge. Is this bad?

A. The normal vaginal discharge is whitish and not foul- smelling. If it is yellowish and foul-smelling, it could be a yeast infection (not sexually transmitted). If you are sexually active and have multiple partners, it could be trichomonas, which is a sexually transmitted disease. It is best to see your gynecologist and have a checkup.

Q. What is HPV?

A. Human papillomavirus or HPV is a virus that causes genital warts. Some strains of the virus can increase your risk for cervical cancer, if your cervix becomes infected.

Unusual Sex Questions

Q. Is there a problem with anal sex or gay sex?

A. Yes, according to urologist Dr. Eduardo Gatchalian. Anal sex is not advisable because the anus, including the rectum inside, is a “dirty” organ meant for the body’s waste. It’s like putting feces on the male organ. Studies show that those who engage in anal sex are prone to serious infections like HIV-AIDS, genital warts, anal warts, and HPV virus. These diseases are very easily transmitted because of the breaks in the skin of the anus. The anus is tight and wasn’t meant for sex. However, if you can’t avoid anal sex, use a condom for protection.

Q. Is oral sex bad?

A. Oral sex is not bad as long as you and your regular partner are healthy. But don’t alternate oral sex and vaginal sex because this can transfer bacteria, especially sexually transmitted diseases, from the vagina to the mouth.

Q. Are there sexual positions that should be avoided?

A. Yes, contortionist and acrobatic positions are best left for real contortionists and acrobats. Normal people, like you and me, especially those with aching backs, should stick to the usual less strenuous positions. Go to a gym, work out, and perform better in bed.

Q. What is the G-spot?

A. The G-spot is the area where the back of the clitoris touches the top wall of the vagina. This area is very sensitive and crucial for a woman’s sexual arousal and orgasm. Sometimes, rubbing the G-spot can stimulate female ejaculation, which releases a clear fluid from the urethra. By the way, the G stands for Grafenberg, the last name of the German doctor who first described this area.

Sex, Pregnancy & Contraception

Q. When is it safe for women to have sex and not get pregnant?

A. Our good friend, OB-gynecologist Dr. Angela Du, says that women with regular menses are safe for seven days before menstruation and seven days after the first day of menstruation. So, for a lady with a 28-day cycle, this is from Day 1 to Day 7 (including the menstrual period) and Day 21 to 28.

The female egg cell can live for 24 hours only, while the sperm cell lives for 72 hours (3 days). The mathematical computation of safe days is based on the long life of the sperm. What about the other days? In those times, you would need artificial contraception (like a condom) or practice self control.

Q. Is it safe to have sex during menstruation?

A. Yes, our experts agree that it’s safe for both the guy and the girl, but it’s messy. Did you know that some men prefer to have sex during the menstrual period because they are confident their partner will not get pregnant?

Q. Is it safe to smoke when taking birth control pills?

A. Smoking (as you probably know) increases your risk for all kinds of illnesses, including heart attacks and strokes. Smoking as few as four cigarettes a day makes you seven times more likely to develop heart disease. Birth control pills that contain estrogen can also increase your risk for blood clots. Doctors usually advise smokers not to take these pills.

Talk to your obstetrician about taking birth control pills that contain only progestin (and not estrogen). Better yet, talk to your doctor about how you can quit smoking.

Female Sex Concerns

Q. I am 45 years old and have just undergone a hysterectomy (removal of the uterus) because of stage I uterus cancer. How can I increase my husband’s sexual pleasure?

A. According to Dr. Angela Du, there is a misconception that women who have undergone a hysterectomy cannot have pleasurable sex. This is simply not true. The woman’s vagina is still intact and the nerve endings are still connected in the vagina. You don’t need the uterus for sex.

The problem really is more psychological because the woman might feel less of a woman. After hysterectomy, there could be some dryness in the vagina, which can be treated by using lubricants like KY jelly.

Q. I am 31 years old. After my regular periods, I notice some white discharge. Should I take it seriously?

A. Normal vaginal discharge is clear or milky white with no unpleasant odor. Signs of possible infection include an increase in the amount of vaginal discharge, an abnormal odor or consistency of the fluid, the presence of pain, itching or burning sensation in the vagina.

Candidiasis or vaginal yeast infection causes a thick, white, cottage cheese-like, non-odorous discharge, and may also be associated with itching. Other causes of vaginal discharge, like sexually-transmitted diseases, should be ruled out. See your OB-gynecologist.

The Importance Of Circumcision

Q. Is it better to be circumcised or not? What are the medical benefits of circumcision?

A. There is some controversy on this topic. Dr. Rey Joson, a surgeon from the Philippine College of Surgeons, has long been an advocate of avoiding routine circumcision. Dr. Joson states that routine circumcision can cause undue pain and stress for the males.

However, Dr. Eduardo Gatchalian prefers that males undergo circumcision for reasons of cleanliness and reduction in cancer risk. Dr. Gatchalian cites that it has been proven scientifically that circumcised males have less risk for HIV-AIDS and other diseases.

Given a choice, I believe it is more advantageous to be circumcised. Aside from reducing cancer risk, circumcision avoids the problem of smegma production. Smegma is a foul-smelling discharge from the foreskin of the penis. Also, the foreskin of the penis has to be retracted during the sex act and is frequently injured during sex. But the choice is really up to you.

Q. When is the best time to get circumcised?

A. The best time for boys to get circumcised is around 10 to 11 years old, before the onset of puberty. The problem with circumcising infants with very small penises is that you may accidentally injure the head of the penis. And psychologically, boys are ready and willing to accept the pain.

Infertility Questions

Q. I have been married for five years already and yet we still have no children. My sperm count is low and my sperms are slow in moving. Are there vitamins for the sperm?

A. Actually, yes. Some doctors give testosterone injections to increase the sperm count. Vitamin E at 200 to 400 IU and zinc supplements are necessary for normal male sexual function. It’s not a guarantee, but it may help.

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For your sex concerns, see a urologist or gynecologist. E-mail comments to drwillieong@gmail.com.
View previous articles of this column.

Gastric bypass can reduce sexual dysfunction

Gastric bypass surgery leads to significant improvement in the sexual dysfunction experienced by many morbidity obese men, according to a recent study.

The effects of surgical weight loss on sexual function are not well studied, although dramatic improvements in diabetes, hypertension, and cardiovascular disease risk have been associated with gastric bypass surgery in previous studies.

The reason this is newsworthy is we have an increasing problem with obesity worldwide. One of the problems that arise[s] with morbid obesity is sexual dysfunction.

The decrease in sexual function can be considerable, “A male obese or morbidity obese — has the same amount of sexual dysfunction as a male 20 year older.”

Participants had substantially lower sexual function score before surgery than did normal-weight men. The researchers used sexual function score from a reference group of normal-weight men who participated in a previous study.

Only 20% of patients seeking [gastric bypass surgery] treatment are men. They think there are more social pressures for women. We believe sex life is important to men, so this will be an incentive for men to seek gastric bypass.

With lead author, a bariatric surgeon and their associates, assessed sexual function among 95 morbidly obese men before and after Roux-en-Y gastric bypass surgery. Their mean body mass index was 51k/m2 and the mean age was 48 years. No participant was taking a phosphodiesterase type 5 inhibitor.

Participants rated their preoperative and postoperative sexual function using the 11-question Brief Sexual Inventory. This instrument addresses multiple domains including sexual drive, erectile dysfunction, and overall sexual satisfaction.

Postoperative assessment was conducted at a mean of 19 months after surgery. Overall, in all sexual domain, all improved. This is what we expected to find, but “the degree to which they improve exceeded our expectations.”

Sexual drive scores, for example, improved from 3.9 to 5.4 (scale of 0-8) in a bivariate analysis. Erectile dysfunction scores improved from 6.3 to 8.9 (scale of 0.12), ejaculatory function improved from 4.9 to 6.3 (scale of 0-8), and sexual satisfaction improved from 1.6 to 2.2 (scale of 0-4). All of these changes were statistically significant.

The amount of weight loss predicted the enhancement in all sexual function domains in a multivariate analysis that controlled for age, presence of diabetes and hypertension, and cigarette smoking.

On average, participants had a 67% excess weight loss after one year. Their mean weight decreased from 155 kg (342 pounds) to 105kg (225 pounds). Because the researchers controlled for con-founders, “weight alone was responsible for sexual dysfunction [preoperatively], and weight loss alone was responsible for improvement in scores.

Sexual dysfunction should be considered one of the numerous reversible conditions in the morbidly obese, adding that this is the first study to look at sexual function in men after Roux-enY gastric bypass. Previous research assessed only nonsurgical weight loss options, with inconsistent results.

Another coauthor of the study said that we are fortunate to have one of the few academic bariatric surgery centers that keeps a large database and was willing to work with urologists. The findings will be easy to verify.

Not stratifying patients according to prior use of PDE5 inhibitors is a potential limitation of the study. They did not account for psychogenic impotence, which is supposed to be about 20% in all (impotent) men, but could be higher in obese men because body image plays a role.

The researchers plan to assess the impact of gastric bypass surgery on sexual dysfunction in females as well.

YOUR DOSE OF MEDICINE
By Charles C. Chante, MD

Updated February 15, 2009 12:00 AM
Link: http://www.philstar.com/Article.aspx?articleId=440510&publicationSubCategoryId=64

Love Potion #1

I held my nose. I closed my eyes. I took a drink!

I didn’t know if it was day or night.

I started kissing everything in sight, but when

I kissed the cop down at 34th and Vine,

He broke my little bottle of Love Potion #9 — Jerry Leiber and Mike Stoller

Aphrodite, the Greek goddess of love, had plenty of exotic elixirs to spark the sex drive, but, regretfully, she kept the recipes to herself. She did lend her name to the generic love potion — aphrodisiac — but these days the word conjures up disreputable images of “Spanish fly” (which, by the way, is made from dried beetles) and other powdery wastes of time. Still, people everywhere swear that certain foods give them a libidinal lift, from old standbys, such as oysters and chocolates, to the out-and-out bizarre (crushed rhinoceros horn, bear gallbladder, and dried bull scrotum). Many look for a magic pill that will fan their cooling (m)embers to flame again, and I wish it were as easy as telling them to pop a few candy-coated mollusks.

Oysters do contain zinc, necessary for the production of the male sex hormone testosterone, but you’d have to be very low in the zinc department and eat an awful lot of them to notice any difference in your desire or performance. According to Cynthia Watson, MD, author of Love Potions (Putnam), there’s a better chance of arousal from oysters by simply noticing their visual and tactile resemblance to the female vulva.

Chocolate is a more likely candidate, says Watson, because it contains phenylalanine, “an amino acid which increases the brain’s levels of the neuropeptide phenylethylamine, one of the body’s natural aphrodisiacs.” Again, it would take quite a bit of chocolate to induce overpowering lust, and the subsequent indigestion and weight gain (to say nothing of the Hershey wrappers scattered all over the bedroom) would probably undermine any sexual stimulation. The hard fact is that to maintain potency, you need to exercise and eat a balanced diet of unprocessed foods, with a slight emphasis on proteins. Research at the Massachusetts Institute of Technology indicates that protein-rich meals increase levels of norepinephrine and dopamine, two chemical neurotransmitters that stimulate the sex drive, while carbohydrates raise levels of serotonin, which may put your libido to sleep.

Unsaturated Sex

In study after study, a low-fat diet ends up being the key to better days and livelier nights. The poor dietary habits that cause atherosclerosis buildup endanger not just your heart, but your sex life as well. Just as unclogged arteries are critical for delivering blood to the heart muscles, the penis needs a free-flowing circulation to create and maintain a quality erection. Research at Boston University Medical School and the New England Research Institutes in Watertown, Mass. found that men with higher cholesterol levels were more likely to have problems with arousal, erection, and sexual performance.

The fat-laden diet is a double whammy. Not only does it promote clogged arteries, it also reduces testosterone. Within four hours of drinking a super fatty milkshake, study subjects at the University of Utah Health Sciences Center in Salt Lake City showed a reduction in testosterone levels by as much as 30 percent. Study participants given low-fat shakes showed no such effect. Researchers believe that excess fat interferes with the body’s ability to manufacture testosterone, impairing sex drive and performance. In her book, The Better Sex Diet: The 6-Week Low-Fat Prescription for Increased Sexual Vitality, Potency & Health (Living Planet Press), Lynn Fischer recommends maintaining a fat intake in the range of 10 to 20 percent to increase sexual energy. Fischer is speaking to both sexes: Studies show that women with circulatory challenges are more likely to complain of decreased desire and fewer orgasms, and that adopting a low-fat diet seems to improve their sexual response, especially as they get older.

Barking Up The Yohimbe Tree

There is little evidence of the sexual effects of specific nutrients, herbs, hormones, and synergistic formulas, but a few do seem to crank up the heat (if for no other reason than the people taking them believe that’s what they’ll do). Most promote adequate blood flow to the penis or help maintain testosterone levels. Of course, anyone considering using supplements for medical purposes should consult their physician. That said, here are a few of the more promising “aphrodisiacs” around.

To create an erection, pelvic nerves trigger the production of nitric oxide, which dilates the blood vessels; the smooth muscles in the penis swell, trapping blood in the organ. L-arginine is a key source of nitric oxide; it is present in chocolate, popcorn, gelatin, brown rice, oatmeal, and whole-wheat bread or, more powerfully, as a supplement; it works best combined with vitamin B-5 and choline. Niacin, also known as vitamin B-3, lowers cholesterol and increases blood flow by dilating blood vessels. It is found in figs, avocados, brewer’s yeast, wheat and rice bran, peanuts, and various whole grains and seeds. The warm “flush” feeling in the neck and joint excites many users who swear it enhances arousal. John Morgenthaler, co-author of Better Sex Through Chemistry (Smart Publications), says that niacin triggers a pivotal histamine necessary for quality orgasms. In Male Sexual Vitality (Prima), Michael T. Murray, ND recommends inositol hexaniacinate, which yields better results with fewer side effects than standard niacin.

Ginkgo biloba and panax ginseng also serve as vasodilators. Several studies, including one published in the Journal of Urology, found that the extract from the Japanese ginkgo tree may be useful in treating erectile problems resulting from poor blood flow. Ginseng has a long-standing reputation as an overall medicinal agent, though much of its folklore is viewed with skepticism by Western scientists. The word is Chinese for “essence of earth in the form of man;” the genus panax is from the Latin panacea or “cure all.” Natural Health Secrets From Around the World (Shot Tower) quotes the Atharva-Veda, an ancient medical text of India, as saying, “Ginseng causes an aroused man to exhale fire-like heat.” The herb is more readily accepted as a stress reducer (through its support of the adrenal gland) and an antioxidant that can lower cholesterol and triglycerides.

Yohimbe or yohimbine, originally derived from the bark of an African tree, is now synthesized as yohimbine hydrochloride and is the only legally prescribed aphrodisiac-like medication in the United States (though it has numerous side effects and should not be used by people with high blood pressure). The drug blocks certain nerve receptors, sustaining arousal by maintaining vasocongestion in the penis. According to Morgenthaler, about one-fourth of the men who take yohimbine for erectlie dysfunction are significantly helped (with up to 43 percent showing some response). However because it works better for psychogenic rather than organic impotence, this may be only a placebo effect.

Muira puama, a Brazilian folk remedy known as “potency wood,” has a reputation “as a sexual enhancer and as a treatment for impotence and frigidity,” says Watson in Love Potions. According to Murray, research from Paris has found muira puama to be partly effective for a majority of subjects with erectile problems, and that taking it with yohimbine appears to affect arousal. It is not known how muira puama works, but it is milder than yohimbe and has few side effects.

What’s left? Well, put down your Pepsi and pick up some sarsaparilla, an old-time soda flavoring (similar to root beer) that has turned out to be a sexual booster. The plant contains phytosterols, which form the raw material of testosterone. Sarsaparilla was the aphrodisiac of choice of some early native American tribes.

Finally, some good news for Starbucks: Of 2,000 people over age 60 polled at the University of Michigan at Ann Arbor, those who consumed at least one cup of coffee a day engaged in more sexual activity than those who abstained. Study leader, Ananias C. Diokno, MD (my classmate in that awesome UST Medicine Class of 1965), said it may have been the caffeine that stimulated the java imbiber, but that more research is needed before coffee is touted as an aphrodisiac, especially since too much caffeine can lead to sleeplessness and a decrease of testosterone.

The Most Potent Aphrodisiac Of All

Actually, the closest thing to a real love potion may not be the seeds and syrups and supplements, but the stuff we use to wash them down: plain ol’ H2O (Remember that erections are mostly blood and blood is mostly water!) A healthy diet, including plenty of water — combined with exercise and stress reduction — will help you feel better, look better, and function better.

Let’s face it: It’s the mind that orchestrates the moving parts, and the mind is the most potent aphrodisiac of all. If you are looking to jump-start your sex life, try taking time to smell, feel, touch, and savor your spouse. Enthusiastically embracing the beauty and wonder of the human body is Love Potion #1.

Happy Valentine’s Day!

AN APPLE A DAY By TYRONE M. REYES, M.D.
Updated February 10, 2009 12:00 AM

Addictive To Sex

“Sex is something I really don’t understand too hot… I keep making up these sex rules for myself, and then I break them right away.”
— J.D. Salinger (b.1919) U.S. novelist
The Catcher in the Rye (1951)

By DR. JOSE S. PUJALTE JR.

IN this supposedly macho culture, sex addiction is seen as some psychiatrist’s invention. Surely, there’s no such thing! An XXL libido maybe, but sex addiction? What’s that?

Definition. The experts’ definition is “any sexually related, compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones, and one’s work environment.” The key word there is “compulsive.” This means that the person is out of control – sexually. Now deviant sexual behavior might not be a problem if you were a Roman emperor but nowadays there will be a few snags here and there.

Take the sex addiction test. (If you get an erection reading this, no need to score).

1. Do you keep secrets about your sexual or romantic activities from those important to you? Do you lead a double life?

2. Have your needs driven you to have sex in places or situations or with people you would not normally choose?

3. Do you find yourself looking for sexually arousing articles or scenes in newspapers, magazines, or other media?

4. Do you find that romantic or sexual fantasies interfere with your relationships or are preventing you from facing problems?

5. Do you frequently want to get away from a sex partner after having sex? Do you frequently feel remorse, shame, or guilt after a sexual encounter?

6. Do you feel shame about your body or your sexuality, such that you avoid touching your body or engaging in sexual relationships? Do you fear that you have no sexual feelings, that you are asexual?

7. Does each new relationship continue to have the same destructive patterns which prompted you to leave the last relationship?

8. Is it taking more variety and frequency of sexual and romantic activities than previously to bring the same levels of excitement and relief?

9. Have you ever been arrested or are you in danger of being arrested because of your practices of voyeurism, exhibitionism, prostitution, sex with minors, indecent phone calls, etc.?

10. Does your pursuit of sex or romantic relationships interfere with your spiritual beliefs or development?

11. Do your sexual activities include the risk, threat, or reality of disease, pregnancy, coercion, or violence?

12. Has your sexual or romantic behavior ever left you feeling hopeless, alienated from others, or suicidal?”

If you answered yes to more than one of these questions, you may have a problem with sex addiction. This questionnaire was taken from Sex Addicts Anonymous and it is a guide if help is needed.

What now? If you are in school, you may want to meet with your guidance counselor (usually a psychologist). A psychiatrist is a medical doctor with professional training on handling deviant sexual behavior. Remember that the nature of sexual addiction is related to what experts call the 3Ps – pain (trauma or abuse early in life), panic (the result of unsuccessful attempts to rid oneself of emotional pain) and panacea, or a cure-all (using sex as a cure-all for everything that is wrong in one’s life). Since it’s an addiction, the “high” or euphoria from dysfunctional sex is not only short-lived but ultimately destructive.

Recovery. 2Ds are part of the journey to recovery: De-traumatizing and de-toxifying. At the bottom of sexual addiction is a failure of intimacy with one’s self and later on, with others. So in de-traumatizing, past events that caused depression and anxiety are identified not to exact more pain but to find closure so that one can move on. Moving on is about skills and the resolve to learn genuine intimacy. This is very different from the intimacy of rubbing skin. Detoxification for a sex addict is about getting away from toxic behavior. The person is re-introduced to the absence of a “high” – that is, living with the occasional boredom and blues, just like “normal” people.

There is nothing exciting and enviable about sexual addicts. They live in antithesis of love and pleasure. Like all addicts, they are unhappy, helpless and in pain.

The long road to recovery begins by accepting that sexual addiction exists and that victims are among us.

Billboard. Welcome home to our special Tito Ponching and Tita Lulay Sicat from Las Vegas, NV. They are retired doctors (orthopedic surgeon and radiologist, respectively) visiting Manila to catch some of the lingering cold weather but much of the warmth of family. Happy Birthday to high school buddy and the original “crush ng bayan” Ricardo “Ricky” Castañeda Ledesma. It’s great to be your friend all these years, Ricks.

Fact/Factoid. The educated and the enlightened in the 14th century knew that there were four cardinal virtues: Prudence, justice, temperance, and fortitude.

Dr. Pujalte is an orthopedic surgeon. e-mail jsp@pldtdsl.net Webpage: http://www.webspawner.com/users/jspujalte/index.html

Author: Dr. Jose S. Pujalte, Jr.
Source:http://www.mb.com.ph/archive_pages.php?url=http://www.mb.com.ph/issues/2009/02/08/OPED20090208147614.html

Your sex problems answered medically

Since I started writing my column, I have been getting a lot of sex-related questions. There’s no malice intended here, just straight medical facts about sex. You ask, I answer:

How much sex is normal for my age? I’m 24 years old.

The normal sex drive for men is related to the surge of testosterone, which starts during puberty, peaks during the early 20s, then slowly declines thereafter.

Dr. Eduardo Gatchalian, a urologist and past president of the Philippine College of Surgeons, candidly says, “At 20, you have sex three times a day. At 30, you have sex three times a night. At 40, you have sex three times a week. At 60, you have sex only thrice a month. At 70, he tries and tries. And at 80, he tries to remember.”

What is the normal erection time for the male organ?

There is no hard-and-fast rule, but the usual range for males is from 45 minutes to an hour. From a medical point of view, the male organ should remain erect as long as the sexual stimulus is present. And it should maintain its erection until it can perform its function, which is to ejaculate and release the sperm.

Why is it that foreigners are more sexually open unlike Filipinos who seem more timid?

We’re not sure which bunch of nice guys and gals you’re hanging out with, but there are a lot of expressive young people right now. Dr. Gatchalian surmises that this apparent shyness of Filipinos is due to our conservative cultural values. “Make no mistake, the sex drive is there, it is just repressed by the environment,” he says.

Impotence

What is the difference between impotence and infertility?

Impotence (also called erectile dysfunction) is the inability to maintain an erection, while infertility refers to the inability to fertilize and produce babies. A man can be sexually potent and yet be shooting blanks (infertile).

What causes impotence?

According to Dr. Rafael Castillo, past president of the Philippine Society of Hypertension, alcohol, cigarette smoking, and diabetes can lead to erectile problems — being not as strong as you once were. Believe it or not, smoking can affect the arteries of the penis and reduce the blood flow needed to maintain a hard erection. Alcohol may increase the sexual desire, but it leads to poor performance in bed. For diabetics, take note that five years of uncontrolled blood sugar can make the person impotent.

I take a long time in sex and have difficulty in ejaculating. What can I do to release faster?

What’s the most sexual organ in the body? Beep, wrong answer. Our most sexual organ is our brains. That is why you need full concentration and the stimulation of all the senses in order to ejaculate faster. A conducive environment means soft music, no mothers-in-law knocking, and no kids crying. Make use of all your senses (sight, smell, hearing, odor, and taste) and the mind, too. I leave this to your imagination.

What drugs can be used to treat impotence?

These prescription drugs are Sildenafil 50 mg. tablet, Tadalafil 20 mg. tablet, and Vardenafil 10 mg. tablet. All drugs are taken 30 minutes to one hour before the sexual act and can only be taken once a day under the supervision of your doctor.

Aside from drugs, what else can be used to treat impotence?

Apart from drugs, there are other medical techniques like 1) pellets inserted in the urethra, 2) penile injections, 3) vacuum therapy, and 4) penile implants.

With vacuum therapy, a cylinder is placed over the penis. Then by withdrawing air, a vacuum is created, mechanically enhancing the flow of blood into the penis. A last resort is the penile implant, which is composed of two inflatable balloons implanted inside the penis. This procedure costs around P150,000. Ask your urologist about these options.

Male Sex Concerns

What is the normal amount of semen released by the male?

According to Dr. Gatchalian, three ml. of seminal fluid or close to a teaspoon is the normal amount of semen. Anything less than 1.5 ml. is considered abnormal and may be a sign of infertility. Just for comparison (and to show the inadequacies of man), a boar can release up to 300 to 500 ml. of ejaculate!

I masturbate daily. Is this bad for my health?

In our interview with Dr. Gatchalian, he says that there is no physical harm in masturbation. There is also no medical risk involved, and it should not be considered a sexual perversion. However, we should be more concerned about the psychological problem that may result because the person may become too self-centered and concerned about his gratification only.

We advise those who are obsessed with masturbation to divert their attention to other things. Engage in sports, have a hobby, and enjoy your work. Try to avoid temptations like movies, magazines, and TV shows that stimulate your sex drive.

One time, I had bleeding of my penis after masturbation. What caused this? Please help!

Very vigorous masturbation can cause injury to the blood vessels of the seminal vesicles (located inside the testes). This is probably what happened to you. Don’t worry, it will heal by itself. Abstain from masturbation for a few days.

What is the normal length of the penis? My friends tease me for being “small.”

Guys, there is no correlation between the size of a relaxed penis and an erect penis. A relaxed penis can indeed look very small but that does not mean you’re inadequate. According to experts, the minimum size of an erect penis is at least three inches, so it can perform its function of copulation. However there are some people who had cancer of the penis and had part of their organ cut. Some proudly claim that even if their penis size is only 1.5 inches, they can still satisfy their partner. As my friend, Dr. Philip Cruz says, “It’s not the size of your pencil that matters. It’s how you write with it.”

How can I make my partner happy?

For women, having sex is not about sex alone. Sounds weird. right? Ladies love to be pampered with innovative gifts from the heart, like giving flowers, frequent “I love you’s,” and the rest of the package. You have to remember her birthday, the anniversary, or you’ll definitely hear about it in the morning. To avoid stress and headaches, buy her a gift. It’s cheaper.

What about guys? How do you make men happy? Simple. It’s just pleasurable sex. This is the fundamental difference between the male and female brain.

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Column: MIND YOUR BODY
Author: Willie T. Ong, MD

Updated February 03, 2009 12:00 AM
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