Herbal Health

There are different ways the surgeon can get access to the corpora cavernosa, where the implants are placed. The skin incision can be made around the head of the penis, at the base or along the length. (Uncircumcised men may need to have their foreskin removed during surgery.) The surgeon can also cut in or under the scrotum. Once the doctor is in the area, an additional cut into the corpora cavernosa is made so that the two parts of the implant can be positioned.

The implants come in several different lengths and widths, and the correct size will be determined when you’re opened up.

Once the implants are in place, they fit snugly inside the corpora cavernosa and don’t have to be sewn in place. The incisions are sewn shut, and the procedure is over. From start to finish, this type of operation routinely takes about an hour.

Recovery from this type of surgery is usually very uneventful. When you first check out the results, you’ll find yourself with a swollen penis. You may have a catheter in your bladder, and as anyone knows who’s had one, the sensation isn’t terribly pleasant. Once the catheter comes out (usually in about a day), you may feel a burning sensation when you urinate. The penis may temporarily turn purple from bruising about one day after the surgery.

Most men require some pain medication for several days, sometimes longer. You’ll want to take a week or more off from work, and in general, the whole genital area will be sore and tender. There’s a lot of variation in how much pain men feel during the recovery period; some men find themselves feeling pretty good in just a few days, others are in pain that requires medication for six weeks or so.

Often it will be difficult to bend the prosthesis in the first few weeks because of soreness and pain, even if it was designed to bend easily. (After surgery, it may take some types of implants

12 weeks or longer to bend easily and be easily concealed.) As time goes on, it becomes easier. Usually men are told to wait about 6 weeks before having intercourse. To be truthful, most men are not in the mood for love during the first few weeks of recovery, anyway.

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Soy reduces LDL cholesterol levels while at the same time raising HDL cholesterol readings. A 1995 analysis of thirty-eight human studies that appeared in the New England Journal of Medicine found that eating 1.6 ounces a day of soy lowered LDL cholesterol by 13 percent, with almost a 10 percent reduction in triglycerides. Simultaneously, HDL cholesterol rose 2 percent. Dr. James W. Anderson of the University of Kentucky, who authored the report, believes that soy can help cut heart disease risk in this country by 25 percent or more. And that, of course, means that the incidence of ED can be lowered as well.

Researchers have speculated that the high soy intake among the Chinese and Japanese is related to their corresponding low levels of heart disease. Other studies also suggest that soy removes LDL from the bloodstream, delivering it to the liver where it is broken down for excretion. The mechanism for this may be through the actions of substances known as phytoestrogens, a type of plant hormone akin to human estrogen. The result is artery protection from plaque build-up and protection from cancer.

A legume no bigger than a pea, soy is available in many varieties, including tofu (soy bean curd), and soy burgers, flour, milk, and tamari, a sauce. A high-protein, low-fat nutrient that can be substituted for meat, soy should be added to your diet. Just a few ounces a day can improve your health.

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When hypertension is present, blood pressure stays elevated all the time at 140 millimeters of mercury (mm Hg) over 90 mm Hg or higher, putting extra pressure on the heart and arteries. In turn, the pressure can damage the surface of blood vessels and may lead to cholesterol deposition, thereby further narrowing pathways and blocking blood flow to the spongy tissue of the penis. And if a man has a high cholesterol count, the risk of penile blockage is increased because plaque will form where an artery has been damaged by high blood pressure.

Almost every antihypertensive medication is linked to some form of sexual disorder, but some are more likely than others to cause specine problems. I often use diuretics, such as chlorthalidone and hydrochlorothiazide, as a first line of attack to lower blood pressure. In my practice, three quarters of the men taking these medications do not experience ED. However, for the quarter who do, I may prescribe an ACE (angiotensin-converting enzyme) inhibitor, such as Accupril or Vasotec, or possibly a calcium channel blocker, such as Norvasc or Procardia XL. I would tend to shy away from medications such as clonidine (Catapres), methyldopa (Aldomet), or reserpine (Hydropres). These drugs are known to have more significant ED effects.

Beta-blocker medications, which include atenolol (Tenormin), bi-soprolol (Ziac), metoprolol (Lopressor), nadolol (Corgard), propranolol (Inderal), and timolol (Blocadren) reduce the workload on the heart and, therefore, the arteries. I commonly prescribe these drugs for the treatment of a variety of cardiac problems, from coronary artery disease to hypertension. However, I’ve found that patients often complain of ED after using these drugs. If that’s the case, I’ll switch them to either a calcium channel blocker or an ACE inhibitor.

If a man has already developed ED due to an underlying medical condition, such as diabetes, or had instances of ED because of a diuretic medication he may have taken, then I will not recommend a beta-blocking drug as a first-line treatment or even as an alternative. Again, it’s the ACE medication or calcium channel blocker that I would prescribe. ACE inhibitors are one of the most commonly used classes of antihypertensives although, to date, no one is quite sure exactly how they work. It is suspected that they block an enzyme that is required for blood vessels to constrict. As a result, the vessels relax, which is favorable to erectile function. Of the heart medications, the ACE inhibitors—benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Zestril), quinapril (Accupril), and ramipril (Altace)—are least likely to create ED problems.

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Needless to say, married men, or those in committed relationships, aren’t the only ones affected by ED. Single men suffer, too, and their feelings delve into another emotional arena. In Jason’s case, being single complicated his ED immeasurably. A forty-three-year-old man who had never married, this landscape architect had put his dating life on hold ever since ED had become a problem. Before that, he had enjoyed the company of women. While he hadn’t been searching for a commitment, he nonetheless tried to make each relationship as fulfilling as possible, both sexually and, to the extent that he was able, emotionally

“I have to tell you,” he said, “the thought of beginning a new relationship is very scary to me. I could be wrong, but I strongly feel that a woman might think less of me if I just wanted sex all the time. I like sex as much as the next guy, but I want to be more than a walking erection.”

The pill worked beautifully for Jason—as soon as he found a woman he really liked and trusted.

The emotional issues in his case were:

• concern that his partner would want him just for sex

• a worry that he would, therefore, have to be in a constant state of arousal

Think about your own feelings concerning:

• erectile problems, and whether they were present at the beginning of a relationship

• the fear of losing control during sex

• whether the pill could bring you closer to your partner

• the potential sexual reaction of your partner

• the possibility that a restoration of sexual function could enhance—or threaten—your situation

• your concern about a partner’s response to your sexual overtures and techniques

• how sexually demanding your partner is

• sexual desire and what it means to you

• sensory pleasure, and your capacity for it

• the difference, if any, between your anticipated relationship and how it has turned out in reality

Seriously evaluate whether you and your partner are in agreement about using the oral medications. They can affect your life in many ways and you owe it to yourselves to address issues that concern you both.

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