Sexual Health for Men (cont.)

BURROWS:
Your husband may benefit from an underlying evaluation of his general health. The doctor would examine him, question him and draw hormone levels. Most likely these will return normal and the two of you would benefit from couples counseling. Possibly, however, seeing a physician rather than counselor would be a good step to initiate this process.

MEMBER QUESTION:
Hi Dr. Burrows, thanks for answering our questions. I have read so much research on saw palmetto saying it's a weak inhibitor, and it does not reduce the prostate by much compared to Proscar. I'm 24 years old; will it do any harm to me? Is it also good for hair loss? My doctors say it will not do any harm but it won't do any good, considering my age. Is that true?

BURROWS:
Saw palmetto was initially thought to act similarly to medications such as Proscar. However, after extensive testing it does not appear to inhibit the same enzyme that Proscar works on. Saw palmetto does seem to have a beneficial effect for men with DPH symptoms, and also may be beneficial in preventing prostate cancer. As for hair loss, there have been no studies or even anecdotal reports showing saw palmetto having any influence.

MEMBER QUESTION:
I recently heard of an experimental drug developed as a tanning agent that also caused erections and weight loss. Do you have any information? (And, can we all buy stock in the company?)

BURROWS:
I think you're referring to a melanocyte-stimulating hormone (MSH) product that is in development by a company called Palotin. Preliminary data appears that it will increase the libido of both men and women. I am uncertain of its effect on diet and weight loss. This medication looks promising and is in phase two of trials, possibly one to two years away from being released.

"The most important change a man can do to improve loss of sexual function is to quit smoking and to increase exercise."

MEMBER QUESTION:
I play college hockey and I was wondering if taking shots to the groin frequently will affect me later on in life. I am 21 right now.

BURROWS:
If you have ever noticed significant bruising or swelling after one of these injuries, then a scrotal ultrasound should be done to see if there has been a rupture to a testicle. Injuries which cause testicular rupture can result in scarring which will decrease both sperm production and testosterone production.

MEMBER QUESTION:
My husband's testicles have grown very large. He refuses to go to the doctor. What should I do?

BURROWS:
Send him to the doctor emergently for an ultrasound. He likely, however, has a hydroseal, which is water around the testicle, but he should be evaluated for testicular cancer.

MEMBER QUESTION:
Why does cranberry juice help urination so much? What's special about it?

BURROWS:
Cranberry juice does not appear to have any beneficial effect on urinary tract infections or prostatitis. It is a good way to increase your fluid intake, but also has a lot of sugar, so be careful of calories.

MEMBER QUESTION:
I'm thinking about taking an antidepressant for premature ejaculation. I'm looking into the PC exercises, but I need something right now for my relationship. I'm 24 years old.

BURROWS:
Currently many physicians are using off label SSRI family of antidepressants treated in conjunction with Viagra, Levitra or Cialis, to be taken two to four hours prior to sexual activity. Common SSRIs include Zoloft. Lexapro, Paxil. They are not taken daily, such as for depression, but as a low dose along with the potency medication.

MEMBER QUESTION:
I have been having problems when I get aroused with maintaining an erection. I have also noticed a lot of semen leakage when I have this problem. If there is no leakage, then I can have an erection without any problems. What might be going on?

BURROWS:
This sounds like premature ejaculation and loss of erection with a climax, hence the semen leakage. You should discuss this with your physician to determine if you are a good candidate for medical therapies.

"Many men have a difficult time reaching sexual climax with vaginal intercourse when they are accustomed to masturbation or manual stimulation."