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Health of Sexual

It's All About Men's Sexual Health

The facts on male libido, infertility, 'enhancement' and more.
By Rich Maloof for MSN Health & Fitness

It's not an enormous stretch to say that men are somewhat clueless about women's sexual health. We've been trying to understand you ever since middle-school health class and, as you know, our success has been marginal.

Still, the male body holds a few mysteries of its own. To help explain them, we contacted Harry Fisch, M.D., professor of clinical urology at Columbia University in New York. Fisch is the author of Size Matters: The Hard Facts About Male Sexuality that Every Woman Should Know (with Kara Baskin; Three Rivers Press, 2008). It's quite possible he has never blushed in his entire professional life. Which is more than we may be able to say for you, readers of the gentler gender, after considering what follows.

It's natural for his drive to drop

Levels of testosterone, the hormone that fuels the male libido, drop 1 percent to 2 percent every year once a male hits the age of 30. Taking the long view, that decrease can halve a man's libido by the time he reaches retirement. How does male drive play into expected sexual frequency? According to the American Sexual Behavior Study of 2006, the frequency of intercourse for married couples between the ages of 18 and 29 is 109 times per year (about twice a week). For couples in their 30s, the mean drops to 87; and for couples in their 40s, to 70 times per year. Couples over the age of 70 have sex at an average of 17 times per year. (Apologies if we've just made you picture your mom and dad.)

Healthy men have healthy libidos

Age, as well as physical health, plays a role in testosterone levels and, by extension, sexual drive. Testosterone is broken down in fat—especially fat found around the waist, which absorbs the hormone with disturbing efficiency. If a man has a disproportionately large belly for his frame, chances are his sexual drive is lower than it could or should be.

Also, the presence of varicoceles can cause low testosterone. Varicoceles are distended veins in the scrotum, and the heat emitted by their heavier blood flow disrupts the production of testosterone and sperm. "When a man's testicles are hanging low," explains Dr. Fisch, "it's because they have varicoceles. The testicles drop because they're trying to get farther from the body to cool down."

As an interesting side note, testicles will rise back toward the body after varicoceles are surgically corrected. Says the unflappable Dr. Fisch, "I mean, you don't see anyone advertising 'Correct your scrotal sac!'But the skin can come back to normal if the heat is removed. For men with low-hanging testicles, it's not that the skin has lost elasticity; it's the heat inside."

No, he's not always in the mood

Even when the testosterone tank is full, his motor may not rev. Contrary to the notion that guys can never have enough sex, not every time is the right time.

Mood disorders or intermittent mood disturbances like a bout of anxiety will dampen desire. Physical pain, likewise, usually sends a signal to the body that it's time to be insular and protective. And, while a little bit of alcohol can help shed inhibitions, too much booze is completely inhibiting. "One of the biggest things that [can cause] a decrease in sex drive is drinking too much," says Dr. Fisch. "Alcohol is a depressant and will ultimately diminish drive. If a man is repeatedly having trouble in bed, the first thing he should do is cut out the alcohol."

Nearly half the time, he is the infertile one

Fertility issues can be tough on couples, and the heavy emotional toll is compounded by a significant financial burden for those who pursue in vitro fertilization. Before exploring expensive routes to impregnation, consider that for 40 percent of couples having trouble conceiving, it's the male, rather than the female, who's infertile or subfertile. (In 40 percent of cases, infertility is due to a problem with the male, the same percentage represented by females. In the remaining 20 percent, both partners contribute, or the cause of infertility is unknown.)

Sperm count, shape (morphology), and motion (motility) are the major factors in male infertility. Two of the most common culprits in dropping the quantity or quality of sperm are varicoceles and infections of the prostate. According to Fisch, one of every three men who enter a doctor's office for prostate screening has prostatitis and doesn't even know it.

The good news is that varicoceles can usually be corrected with surgery, and prostatitis with antibiotics. "More often than not, male infertility is correctable," says Fisch. "You can frequently correct the underlying problem and achieve a pregnancy naturally."

He may not be aware he has an STD

By age 25, half of all sexually active people in the U.S. have contracted an STD, and the most prevalent diseases can be completely asymptomatic. It's not a matter of trust—even the most sensitive, honest guy can simply not know he's carrying a sexually transmittable disease. That goes for HPV, the most common STD, and other widespread conditions including trichomoniasis, chlamydia, and even HIV. According to the Centers for Disease Control and Prevention (CDC), 90 percent of all people with genital herpes don't know they have it.

Being free of symptoms is no excuse for not getting tested. Unfortunately, it's when people make assumptions about a partner's sexual health— assumptions based on emotion rather than clinical fact—that they wind up needing treatment for an infection they never thought they'd acquire. Only 8 percent of the nation's sexually active young women believe they're at risk, though about 50 percent will contract an STD. So, as good a guy he is, you have to ask yourself: Isn't there a significant chance you could find yourself in that 42 percent margin?

He knows a condom may be necessary, but it's a drag

It's not just a matter of romance but physical sensation when your man says he doesn't want anything to come between the two of you. But unless other means of protecting your health and/or preventing unwanted pregnancy are in place, he needs to know there's simply not a choice.

Though guys may complain about the barrier to direct contact, some couples reap an unforeseen benefit to condom use. Says Dr. Fisch, "As far as I know, no condom is going to make a healthy guy lose his erection. They can actually be helpful for men with premature ejaculation because they reduce sensation. It feels a little like being slightly numb, which can be a good thing."

The equipment can break

Despite the implication of that particular slang terminology, there's no bone in the penis. Instead, its shaft is composed of sponge-like tissue (that stiffens with the pressure of blood flow), attached to a suspensory ligament. However, errant sexual activity can result in enough pressure to cause a fracture of the ligament. This rare event is evidenced by two disconcerting sounds: an audible pop, followed by a howl of pain.

Says Fisch, "It usually happens when a woman is on top and the penis comes out during sex. If she sits down on it and the penis hits her pubic bone, the pressure of her weight is too much." Fractured penile ligaments represent a medical emergency, and surgery is required to correct the tear.

He may be hurt if you suggest "penile enhancement"

Think twice before delivering your loved one a bottle of ExtenZe as an early birthday present. Your message may not be so subtle nor so welcome. Besides, the late-night TV ads that promise to increase membership are for the most part bogus.

You'll both be well-served to know that average size is a little more than five inches, seen in all its glory.

"There's no way of making the penis longer than it is," says Fisch, "but what can make it appear or feel larger is increased blood flow. Viagra and other pharmaceuticals have proven helpful for this, and can increase girth, but there are natural means to achieving the same end. Antioxidants, including those found in berries and the bioflavonoids found in teas, can increase blood flow. As I always say, what's good for the heart is good for the penis."

You can preserve your guy's self-respect by quietly sharing your blueberries and pouring him a daily cup of green tea. Meantime, when estimating your partner's size in a discussion with friends, he'll thank you for rounding up.

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Sun Smarts for Healthy Skin

Before you bare your skin to sunny Memorial Day skies, beware: The risk of skin cancer may be higher than you think.

Skin cancer is the most common type of cancer, and it's estimated that 50% of all people who live to age 65 will have at least one bout with skin cancer. This summer, be sure to watch your skin and protect it with sunscreen—and be aware of the following:

• Who is most at risk? People who tend to sunburn or freckle easily, have red or blonde hair, fair skin, blue or light-colored eyes or who spend a great deal of time in the sun.
  
• Why is skin self-examination important? Recognition of changes in skin growths or new growths is the best way to detect skin cancer in its earliest stages. If brought to a doctor's attention early enough, skin cancer cure rates could be almost 100%.
  
• When should it be done? Skin exams should be performed monthly, preferably after a bath or shower.
  
• Warning signs: Any skin abnormality, including a change in size, shape or color of a birthmark, mole or blemish; a new or unusual growth; or a sore that won't heal. Warning signs do not necessarily indicate cancer. However, if you experience any of these signs, contact your physician.

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Anti-stress Eating

When you’re under a deadline, or domestic pressures mount, you may pass up low-fat granola bars and orange juice for chocolate and coffee. But during times of tension, healthy eating is more critical than ever. Stress can cause the body’s stores of several key nutrients to drop by as much as one-third. This means your immune system can suffer, making you more vulnerable to illnesses like the common cold and flu. Here’s a guide to three key anti-stress nutrients.

• Vitamin E, found in foods such as wheat germ and spinach, can boost resistance. The recommended daily allowance (RDA) is 8 to 10 milligrams, but this may not be enough to have an antistress impact.

Talk to your physician about the benefits of vitamin E supplements.

• Vitamin C, found in foods like citrus fruit, broccoli and red peppers, is key to stress control. Stress triggers the release of hormones from glands that are also storage sites for vitamin C in the body. When these glands increase hormone production, they begin to lose their vitamin C stockpiles. Since immune cells and tissues rely on vitamin C for repair and function, this vitamin C loss lowers your resistance to infection.

The RDA for vitamin C is 60 milligrams, but talk to your physician about the benefits of an increased dose.

• Magnesium, found in foods like bananas, kidney beans and lentils, is another important antistress nutrient. The theory is: magnesium contributes to the production of calming brain chemicals, and stress hormones seem to increase the excretion of magnesium. The current RDA for magnesium is 280 to 350 milligrams, but supplements during times of stress may help.

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