Difficulty Reaching Climax
Question
DR.,
I am a 50 year old male in very good physical condition. Last year I experienced a sudden decrease in my normally high sex drive. My Dr. prescribed a testosterone gel as my testosterone levels were a little low.
This treatment has helped my sexual drive but now I’m having difficulty in reaching climax and my seminal volume seems low. Additionally, my testicles are typically more drawn up than in the past and seem smaller as though they have less fluid in them.
Any suggestions or ideas? The difficulty reaching climax is the biggest issue for me.
Thanks,
Dave
Answer
Last Updated: December 13, 2014
Dave,
Libido or sex-drive in men is fairly dependent on their level of testosterone or male hormone, but not entirely. So checking the hormone level and using replacement therapy if is found to be low will help libido, increase energy, increase muscle mass, and help prevent osteoporosis (thinning of the bones does occur in men too). That being said one must be careful not to overlook an adjuvant cause of poor libido which is the waning interest of one’s spouse for various reasons (illness, stress, etc). In fact I would wager that a great number of cases of poor libido are not necessarily testosterone-related but examples of deteriorating communication between the spouses. This is not related to the longevity of the marriage since even couples who have had quality conversation on a daily basis for years must occasionally step back and “regroup” by carefully reexamining where they have been in their lives and where they wish to go in the future. And this will reflect itself in the quality of their marital intercourse.
Males having difficulty ejaculating (“reaching climax”) are almost always “holding back” subconsciously because something in their relationship is just not right. This can also be manifested as a “partial” ejaculation where the volume is reduced (there are other causes in older gentlemen I won’t go into here). This isn’t something we treat with a pill—this difficulty requires the couple to sit down and honestly discuss what is going on in their lives that is creating some stress/anxiety/concern on the husband’s part. A neutral third party facilitator is always a good idea (church counselor, clinical psychologist or marriage & family counselor, etc) since they can help prevent “finger-pointing” or blaming and help the couple to quickly hone in on the real problem(s) and work toward a solution.
Normal testicles do not change their size unless inflammation has occurred which deposits fluid around them and increases their size. They can get smaller with age very slowly. Interestingly high doses of testosterone therapy will also cause them to shrink. They are quite mobile because a special muscle (cremasteric muscle) moves them up and down to keep their temperature about 1½ degrees cooler than the rest of the body for proper sperm production.
Greg Polito, MD
Libido or sex-drive in men is fairly dependent on their level of testosterone or male hormone, but not entirely. So checking the hormone level and using replacement therapy if is found to be low will help libido, increase energy, increase muscle mass, and help prevent osteoporosis (thinning of the bones does occur in men too). That being said one must be careful not to overlook an adjuvant cause of poor libido which is the waning interest of one’s spouse for various reasons (illness, stress, etc). In fact I would wager that a great number of cases of poor libido are not necessarily testosterone-related but examples of deteriorating communication between the spouses. This is not related to the longevity of the marriage since even couples who have had quality conversation on a daily basis for years must occasionally step back and “regroup” by carefully reexamining where they have been in their lives and where they wish to go in the future. And this will reflect itself in the quality of their marital intercourse.
Males having difficulty ejaculating (“reaching climax”) are almost always “holding back” subconsciously because something in their relationship is just not right. This can also be manifested as a “partial” ejaculation where the volume is reduced (there are other causes in older gentlemen I won’t go into here). This isn’t something we treat with a pill—this difficulty requires the couple to sit down and honestly discuss what is going on in their lives that is creating some stress/anxiety/concern on the husband’s part. A neutral third party facilitator is always a good idea (church counselor, clinical psychologist or marriage & family counselor, etc) since they can help prevent “finger-pointing” or blaming and help the couple to quickly hone in on the real problem(s) and work toward a solution.
Normal testicles do not change their size unless inflammation has occurred which deposits fluid around them and increases their size. They can get smaller with age very slowly. Interestingly high doses of testosterone therapy will also cause them to shrink. They are quite mobile because a special muscle (cremasteric muscle) moves them up and down to keep their temperature about 1½ degrees cooler than the rest of the body for proper sperm production.
Greg Polito, MD
Answered By:
Gregory Polito, MD
Gregory Polito,MD, KM, Past President of CANFP, retired from a urologic practice, with a sub-specialty in vasectomy reversal
