PRIAPISM: WHAT A MAN NEEDS TO KNOW

What is priapism?
Priapism is a persistent erection that is not caused by sexual desire or sexual stimulation. If your erection lasts for too long (more than 3 hours), you should see a doctor immediately to avoid permanent damage to the penis. It's believed that priapism is the result of problems with the nerves and blood vessels in the penis, which trap too much blood in the penis' erectile tissue, the corpora cavernosa.

Priapism can be serious, and can result in a loss of sexual functioning, unless treatment is sought very quickly.

What causes priapism?
Sometimes, the cause of priapism isn't certain, but in many cases, it can be seen as a possible side effect of prescription medications, or illicit drugs such as marijuana and cocaine.

Medications that can result in priapism include:

Physical causes of priapism include:

What treatments are available?
In general, the type of treatment or medication recommended for priapism depends on its cause. If a medication is the suspected cause of priapism, your doctor may suggest that you stop taking that medication and try an alternative. If you have a blood clot in the penis, you will need to have surgery to remove it so that blood can flow normally through the penis again.

For immediate relief, and to prevent permanent damage to the penis, a doctor may use a needle to drain the extra blood trapped in the penis and then flush out the vessels with fluid to restore normal blood flow.

What is retarded ejaculation?
It's normal for sexual response to change with age. The older a man gets, often, the more stimulation he needs to get an erection and ejaculate (‘come'), and the more time he needs between erections before he can have sex again.

As the name suggests, retarded ejaculation, also called delayed ejaculation, is a condition in which a man can get an erection, but he can't ejaculate easily, so it takes an abnormally long time for him to climax.

Retarded ejaculation is a rare condition, and shouldn't be confused with normal sexual response due to ageing. If you're concerned about your sexual response, ask your doctor for further advice.

What causes retarded ejaculation?
Retarded ejaculation can be triggered by anxiety about ‘coming' in your partner's presence, or fear of penetrating your partner, but sometimes there are physical causes.

For example, men with diabetes may find that they take longer to ejaculate than men without diabetes, and certain medications can delay ejaculation. These include some kinds of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), some types of blood pressure medications, and medications such as thioridazine, used to help treat schizophrenia.

What treatments are available?
If medication is the cause of retarded ejaculation, tell your doctor, who may be able to recommend a different treatment that avoids this unwanted side effect.

Often, the treatment for retarded ejaculation involves behavioural therapy, so your doctor may recommend treatment by a counsellor or psychotherapist.

The therapist may teach you techniques to help minimise anxiety about ejaculating and teach you some tips to help with timing, as well as offering advice to you and your partner to help improve your sex life.