Thu | May 23, 2019

Dear Doc | I can't stand up for her

Published:Sunday | May 20, 2018 | 12:00 AM

Q I am a man in my early 50s. I was married once and back then, sex was good. But since my ex-wife and I parted some years ago, I found out that whenever I'm to have sex, I can't have any erections, but when am alone, I have an everlasting erection. It is now becoming a problem for me and my fiancee, and we're to get married soon. Is there anything that can be done to fix this problem? Someone was saying that enough blood is not reaching my penis.

A Thank you for this question. There is a very simple explanation to what is happening to you, but before I jump into the answer, let me first speak generally on sexual dysfunction for the benefit of those readers who may not be as brave as you to admit they may have a problem.

Erectile disorder, previously called impotence, refers to the inability to achieve or sustain an erection adequate for sexual activity. It is the most common form of sexual dysfunction in older men.

Normal sexual function has five stages: desire, arousal or excitement, plateau, orgasm, and resolution.

Each of these stages is either physiologic or psychologic in origin, and for normal male sexual function to exist, it requires the interaction between the physiological (vascular, neurologic, hormonal), and psychological systems.

The initial obligatory event required for male sexual activity is to achieve and maintain an erection. This is primarily a vascular phenomenon, (relating to blood vessels) triggered by brain signals and facilitated only in the presence of an appropriate psychological mindset.

Now, the fact that you can achieve and maintain an erection when you are alone proves that there is nothing wrong with you physiologically (enough blood is reaching your penis), and that your inability to achieve an erection with your sexual partners after your divorce is psychological in origin.

Psychological issues are one of the main causes for erectile dysfunction. Anxiety, fear, depression, worry and pressure can all cause performance problems for men. Such an example can include a man being worried about his sexual performance in an encounter with a new partner; but even more particular to you is something called 'Widower's Syndrome'.

I know you are not a widower, but it still applies to you.

Widower's syndrome occurs to men who have been in a committed and loyal relationship for a long time. Once the relationship goes sour, these men start experiencing an inability to have sexual relationship with a new woman, and find it hard to get or maintain an erection with their new partner after their wife or long-time girlfriend.

Men who are in their 40s or older are the ones mostly affected.

Now, the thought behind the cause of widower's syndrome is the inability to deal with a new partner because of a sense of loyalty to the old one. So even though affected men are with new people, they tend to avoid physical intimacy as they do not get 'turned on'. As they then attempt to force themselves into getting intimate, they face serious issues in 'getting their penis up'. It can be a cause of distress, and may harm the future of the man being able to find a companion, or maintain a relationship.

If any of the above seems to apply to you, there is hope! It can be fixed!

Eighty per cent of these cases are treated when the man is able to let go of the guilt of getting intimate with a new partner. Treatment for this cause of erectile dysfunction therefore requires counselling more than medications; and mainly involves getting to the root of the issue.

Q I am 26 years old, and for quite some time now, I have these tiny white bumps around the rim of my penis. Is there any treatment that can be done to them?

A Seeing small bumps on your penis will undoubtedly cause worry; especially if you are sexually active, you may be afraid that it is a sexually transmitted infection (STI).

However, those bumps might not necessarily mean that you have an infection; you may instead have a condition known as pearly penile papules.

So, what are pearly penile papules?

They are very tiny (1 to 2mm) round bumps that are attached to the rim of the head of the penis. These bumps commonly appear in one or several rows, going all the way around the rim of the head of the penis. The bumps can sometimes be the same colour of the skin, or translucent, white, yellow or pink in colour.

These bumps are completely normal in some men, and are not a sign of infection or uncleanliness. They are also not cancerous. It is unclear as to how many men have them, but they can occur in up to 48 per cent of men. They do, however, occur more commonly in uncircumcised men than in circumcised men.

Because these bumps on the penis are not caused by an infection, are not painful or uncomfortable and, in essence, normal, they do not need to be treated or removed. They also become less noticeable as men get older.

Some men, however, are embarrassed by the bumps because they are afraid someone will think they are an STI, and want to have them removed. Carbon dioxide laser removal is the best and most effective treatment for their removal, but it can result in scarring or infection.

A sexually transmitted infection that can resemble pearly penile papules, is genital warts.

Genital warts are caused by the human papilloma virus, the most common sexually transmitted infection.

Genital warts may appear as a single wart or a collection of warts around the penis. They may be smooth or have a cauliflower-like appearance. Treatment of genital warts varies based on the number of warts present and their location.

Only someone who has actually seen the lesions can accurately differentiate and diagnose what they are, so it is best to visit your doctor and let them take a look.


Q There is this young lady in my community. I really like her, but every time I try to talk to her when I see her, she never replies; she just walks right pass me. I remember an instance when I saw her and asked her if I could get to know her. She said, 'Why you want to know me for?' She is playing hard to get. I want to give up, but every time I see her, sometimes I try to talk to her, sometimes I don't. What should I do, Doc?

A Thank you for this question. I do understand that such a scenario can be frustrating. However, it is best to respect her wishes. She actually may not be playing hard to get, but may have numerous reasons for her response to you. She may already have a boyfriend, or be preoccupied with other things in her life, such as work, school or family issues, and might genuinely not be interested in a relationship, or be in an emotional place to entertain any new friendships at the moment. To persist or force a response that you would prefer, can be seen as harassment, and result in an even worse response or outcome than what is present now. With time, she may become more receptive to you, so for now, just be polite and cordial and find something to distract you from your feelings for her; a new sport or hobby maybe.