OK, we know the fact that sometimes, having your man last longer in the bedroom is not the world’s biggest turn-on when you’re overworked and overtired. But sometimes there can be a real problem, which begs the question – when do men really need help, and what help should they be seeking?

There may be one (or more) of three separate issues:

• Loss of desire, or libido
• Impotence
• Premature ejaculation

Losing the loving feeling

Women are largely conditioned to think of men’s libidos like boy scouts – ready, willing and able to perform 24 hours a day. But the reality is that men can experience a loss in libido (desire) as they age, and their libido can be adversely affected by physical and psychological causes including:

• Alcoholism
• Drug abuse
• Obesity
• Some prescription drugs
• Major diseases such as diabetes and cardiovascular disease
• Depression
• Stress and overwork
• Relationship problems
• Interestingly, studies have also shown that men’s testosterone can drop by a third after becoming a dad. This is thought of as a biological response to make them more caring and less aggressive.

Erectile dysfunction

Impotence, or erectile dysfunction (ED) is quite different to loss of libido – in most cases, impotent men are highly desirous of their partner but their equipment just won’t come to the party. Impotence describes the inability to get an erection or keep an erection until ejaculation. It can make men feel frustrated, inadequate and anxious.

Impotence is often an early sign of an underlying medical condition. In fact, almost 60% of all adult-onset diabetes is detected as a result of the onset of impotence. Other causes include:

• Heart disease
• Hypertension (high blood pressure)
• High cholesterol
• Surgery to prostate, lower back or lower spine
• Hormone and thyroid conditions
• Kidney or liver disease

There can be psychological reasons for impotence as well, including:

• Depressions and anxiety
• Post-traumatic stress disorder
• Extreme fatigue
• Relationship problems
• Sexual identity problems
• Sometimes a new supplement could be having an adverse affect

Premature ejaculation

While we tend to think of premature ejaculation as a problem mainly occurring in young inexperienced men (well, that’s what happens in the movies!), premature ejaculation is a condition that is described as one “in which a man ejaculates earlier than he or his partner would like him to”. So basically, this is a subjective condition. You like a quickie? He likes a quickie? Premature ejaculation is not going to be a problem for you – but if you want to engage in hours of tantalising tantric lovemaking, you are going to run into trouble.

Medical reasons for premature ejaculation

Over time, just about everything imaginable has been linked to premature ejaculation but in fact, there are very few medical causes. Some research has shown a link between hyperactive pelvic muscles and premature ejaculation – and some experts recommend that sufferers practice pelvic floor exercises to gain better control.

Lasting longer in the bedroom

The whiz-bang drug therapies that are endlessly advertised with the purpose of “helping your man last longer in the bedroom” will only improve erectile dysfunction and premature ejaculation problems. Loss of libido requires different strategies.

Viagra

Viagra is the brand name for a synthetic chemical called sildenafil citrate. Originally developed as a blood pressure medication (which didn’t work), early trials showed that the drug has a benefit for men with erectile dysfunction. Viagra works by blocking an enzyme in the body and allowing more blood to flow to the penis.

Does it work? Overwhelmingly, Viagra works for most men by improving their erection (or allowing them to have an erection at all). But it isn’t for everyone – there are wide-ranging possible side effects that can preclude some men from taking it.

Nasal delivery technology and lozenges

The active ingredient in nasal delivery technology and lozenges is usually clomipramine, an anti-dpressant that is prescribed primarily to treat OCD. One of the side-effects of clomipramine is that it desensitises the penile muscles which allows ejaculation time to be prolonged – perfect for those experiencing premature ejaculation.

The two different delivery methods – lozenge and nasal spray – are popular because both deliver the medication directly into the blood stream so that the effects are felt almost immediately (ideal when you’re getting in the mood)

Does it work? This type of drug therapy does work but does require daily doses aside from an additional dose prior to sex.

This article was written by Ella Walsh for Kidspot, New Zealand’s best family health resource.