Wet dream problems

Q: I read your articles with excitement today.

I am 53, currently having both ED and PE, I have a history of wet dream since I was a teenager until late thirties, once to two times per week.

During that time, I could easily gaining erection and the interval of intimacy was about a minute. Currently, I am having difficulty having erection and will try to penetrate with half erected organ and it will ejaculate a few seconds thereafter.

I have tried the blue pills a few times but with poor efficacy for hardness. I still experience premature ejaculation.

I am married happily for 25 yeas and blessed with 2 sons. My wife is very supportive all this while and our relationship are intimate except unable to have normal sexual intercourse.

Is there any remedy for my condition?

J

A: It gives me a sense of achievement to learn my articles give you excitement on a Sunday morning!! In fact, my editor informed me the column was most read in the Star-on-line last weekend. I could hardly contain my own excitement after hearing the news. Thanks, guys (of course, that includes my lady readers too).

I also read with further excitement, having learnt the fact you experienced wet dreams from teenage years till your thirties (up to twice a week, no less). This is somewhat unusual, as most men stop having wet dreams after the hormonal turmoil of their sexual peak. I not suggesting you are abnormal, I merely think you are a lucky man!

I guess you are lucky in one area, and not so lucky in others. You clearly described Primary premature ejaculation (PPE), which occurs from your first experience of intimacy. Our recent survey in Malaysia revealed PE can occurs in up to one in three men. PPE is a life-long condition, as oppose to acquired PE (APE), which occur in later in life. The emergence of ED in men with PE is also very common from the age of 50. I guess this is simply the fact of life.

I hope I haven’t dampened your excitement so far, because I am excited to offer you a solution. I understand you are disappointed having taking the blue pills with poor effect. I suggest you try other PDE5-I’s, as they all have different characteristics. The long acting PDE5-I and short acting SSRI may work best for you. The former pill can open up the vessels in your penis while the second medication would allow the neurotransmitters in your brain to prolong your ejaculation. See, the marvel of modern medicine!!

I hope you are further excited with my suggested remedy, I am wish you many more exciting years ahead in your marriage.



Q: I am 35 and I was married last October to my lovely 33-year-old-wife.

My wife just underwent a fibroid operation in January. Fortunately, she recovered well from the operation and the gynaecologist had encouraged us to go for a baby from July this year.

I am very excited with the prospect of being a father. I wonder if you can help me with some advice to improve my fertility?

Siva

A: Many congratulations on your recent marriage. I wish you many years of happy relationship.

All men are excited with the prospect of being a father. In fact, I read with interest a recent scientific article describing men with paternal nurturing instinct may have less testosterone, or even smaller testicles! What nonsense.

Sorry, I digress. Of course, you would like to start a family as soon as possible and hope all the vital organs are all functioning, and won’t let you down. Around ten percent of couples would face some difficulties of conceiving, despite trying for 12 months with unprotected intercourse.

In the recent past, we blamed the ladies for not making babies. It is increasingly apparent that 20-40% of the problems are actually male originated. Since your new bride has just undergone an operation with the good gynaecologist, and was given the green light, it is only sensible for you do your part.

First of all, produce a specimen. Your semen analysis will give you some indications of how many active normal forms of sperm you are harbouring. Next step, loosen the pants, the reduction in the scrotal temperature will ensure more spermatogenesis. Lastly, quit smoking, drink alcohol in moderation and exercise regularly. I assure you such a lifestyle will prepare you for a healthy fatherhood.

Q: My husband has been having dryness of the foreskin for some time. It comes and goes. Every time I ask him, he says its just dry skin.

It looks dry and cracked. But he says it does not hurt.

He applies cream and it helped to some degree. Sadly, the dryness recurs (according to him when he doesn't drink enough water)
Our sex life is not affected.

I just want to be sure its nothing, and I am keen for him to look into it before it gets worse.

Mrs. A

A: First of all, I just would like to find out that you are not seriously convinced by your husband’s reassurance, are you? Believe me, it hurts! It hurts especially having an erection. Bearing that in mind, I suspect sex isn’t painful, it is excruciating!

It is very typical for men to downplay any health issue, especially in the sensitive organ inside the trousers. This is cultural norm in most society. To many men, any sign of compromise in health is often perceived as a sign of weakness.

The intermittent dryness and cracked foreskin is highly likely to be caused by Balanitis Xerotica Obliteran (BXO). The origin of such condition is unknown, but has association with diabetes mellitus. The dryness is typically insidious and followed by breached of the skin integrity. The cracked skin usually gets worse after intercourse, and may even get infected. With such repeated cycle of inflammatory changes to the foreskin, it can only get tighter and cause phimosis.

Your husband may try to convince you such misfortunate is merely a consequence of dehydration. I hope to persuade you otherwise, as copious water is unable to reverse the disorder. Although steroid cream can have the potential of symptom relieve, rest assured such intervention is transient in efficacy at best.

Lets face it, the most likely reason your husband downplays his condition is the fear to part with his foreskin. Unfortunately, the odds of circumcision are almost imminent.

Please do him a favour, take him to see a doctor.

Q: What is your best advice for a Diabetes Type 2 patient?

Thanaraj

A: Thanks for the email. My advice is avoid it at all cost.

The views expressed are entirely the writer's own