Part One
At Utah Men’s Health we hope that there are no questions you are too embarrassed to ask us; but, for some people going to the doctor can feel a little overwhelming, especially when it concerns a private area! The providers at Utah Men’s Health have compiled a list of men’s sexual health questions that they find their patients are most hesitant to ask:
- Do different sexual positions increase or decrease chances of pregnancy?
No. Penetrative vaginal intercourse can result in pregnancy no matter what sexual position is used. If you stop intercourse due to pain of a position, this can decrease your chance of pregnancy if intercourse is interrupted around the time of ejaculation.
- Can I drink alcohol with Viagra and Cialis?
Yes. There will not be a negative interaction between the two; but, keep in mind that with alcohol consumption your erection may be not as firm and the medication may not work as well.
- Is there a surgery that can be performed to increase the size of my penis?
Even an implanted penile prosthetic will not increase the size of your penis. If you are overweight, getting to your ideal body weight will help restore some of the length you have lost since gaining weight. Many men will ask about injections to add girth and if there is a procedure to increase length. The AUA (American Urological Association) considers fat injections to increase penile girth and suspensory ligament division surgery to increase length, to be unsafe and ineffective.
- Is my penis average in size compared to other men?
This is a question that is hard to answer, though one that is a concern to a lot of men. There is a great variability in measurement techniques, including the amount of force the clinician uses to stretch the penis. Also, some men will note a significant change in penile length once it is erect, while others will notice that their penis only becomes more rigid. There is not a “number” that men should set as their benchmark. The biggest take-home for patients regarding this is to keep a healthy weight and seek care if you feel like your erections are not rigid enough, or if you have other penile concerns. Some medical conditions and surgical procedures can reduce penile length. That length lost cannot always be restored, although the ability to achieve full erections can assist in sexual function satisfaction no matter the situation.
- How long should my erection last for sex?
The answer to this question varies per patient. There is not a standard time that all men should be able to maintain an erection. For most men, the goal is to get an erection that is rigid enough for penetrative intercourse and that lasts until both partners are satisfied. Patients are counseled that if an erection has lasted over 3 hours, they are to seek care with the nearest emergency room for management of priaprism.
- What is considered premature ejaculation?
There is not a universally accepted amount of time that a male should have an erection prior to ejaculation. The key point for this diagnosis is from the AUA guideline definition. It defines premature ejaculation as “ejaculation that occurs sooner than desired, either before or shortly after penetration, causing distress to either one or both partners”. There is not a lab test that can determine this. This diagnosis is made based on patient report and physician assessment.
- What can cause me to not ejaculate after an orgasm?
Various surgical procedures and medications can cause a man to experience aspermia (no semen expelled from penis). Common causes of this can be a prostatectomy, taking Flomax (Tamsulosin), diabetes or nerve injuries.
- Is orgasm and ejaculation different?
Yes. Typically, an orgasm is the pleasure associated with ejaculating. Men can have an orgasm without ejaculation. On the flip side, men can ejaculate prior to orgasm. It is also possible to achieve orgasm and ejaculation without an erection that is adequate for intercourse. These conditions can have various causes, some that we can identify and treat, and some that we can’t.
- How much ejaculate should I have?
Ideally, men should have at least 1.5mL of ejaculate. This is equal to 0.304 US teaspoons, so it is not a large volume. It’s OK to have more, but if you are noticing less over time, especially during the time you are trying to conceive, we recommend seeking care with a urologist.
- Is penile curvature normal?
Some men have some slight penile curvature for as long as they can remember. If it is not painful or bothersome, that is OK. That is “your normal”. If it is painful or bothersome, then make an appointment for further evaluation and discussion of treatment options. If you notice new penile curvature that is bothersome, either with pain or cosmetic appearance, we encourage you to see us so that we can discuss next steps. This curvature can impact your erections, another element we can evaluate and treat.
We always encourage an open dialogue between patient and physician, and remember that there is probably nothing you can ask your urologist that we have not heard before! If you have more questions you would like answered, click here to request an appointment or call us at .
