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Intimacy With Impotence: The Couple's Guide To Better Sex After Prostate Disease - Paperback | Diverse Reads

Intimacy With Impotence: The Couple's Guide To Better Sex After Prostate Disease

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Erectile dysfunction is a frequent consequence of prostate cancer and other prostate disease treatments. Though unwelcome and embarrassing, it doesn't have to end a couple's sex life. Both informative and practical, Intimacy with Impotence gives couples cause for hope. It discusses impotence in lay terms, provides information on the commercial therapies and medications both available and being researched now, and gives practical advice about lovemaking-from getting in the mood to commonsense suggestions to erection-less satisfaction. Written with complete honesty and compassion by a prostate cancer survivor and his wife, this is the essential resource for couples trying to reestablish intimacy and sex in the face of impotence.

ISBN-13: 9780738207896

Media Type: Paperback

Publisher: Hachette Books

Publication Date: 05-28-2004

Pages: 240

Product Dimensions: 6.00(w) x 9.00(h) x (d)

The founding vice-chair and former Director of the National Prostate Cancer Coalition, Ralph Alterowitz is currently the President of the Education Center for Prostate Cancer Patients. He lives in Potomac, Maryland. Barbara Alterowitz is a marketing executive with an international technology firm. She lives in Potomac, Maryland.

Table of Contents

Foreword ix
Preface xi
Acknowledgments xiii
List of Contributors xv
Introduction xvii
1 Impotence: An Opportunity to Revive Intimacy 1
Key Points 1
Reality Hits 2
From Relationship RUT to CREST 5
Breaking the Erectile Dysfunction Mindset 6
Back to the Subject of Sex: Happiness Is an Erection--or Is It? 7
Mindset 10
2 Facts about Impotence 11
Key Points 11
Causes of Erectile Dysfunction 12
Sexuality, Impotence, and Age 13
What Is a "Normal" Sex Life? 13
It's Over--or Is It? 14
Trollope Works for Me 15
The Effects of Prostate Cancer Treatment: What's the Truth? 17
Am I the only one with a problem? 17
Is nerve sparing or nerve grafting surgery a miracle treatment? 18
Is potency known immediately after surgery? 19
Will my penis be shorter after radical prostatectomy surgery? If it is, can I still have intercourse? 19
Do I need testosterone injections to increase my desire or treat my erection problems? 20
Does hormone treatment destroy desire and potency? 20
Can sex stimulate cancer? Can I transmit cancer to my partner through sex? 20
Will my partner have any effects from my radiation treatment for prostate cancer during intercourse? 21
What are the effects of treatment for benign prostatic hyperplasia (BPH)? 21
General Questions and Answers about Impotence 21
Do I need an erection to have an orgasm? 21
Can my partner have an orgasm if I don't have an erection? 22
Does satisfaction require having an orgasm? 22
If one medication, such as Viagra, does not work for me, will another one work? 22
3 Talking with Your Partner 23
Key Points 23
Elephants Bite 25
Planning for Talking 29
Improving the Quality of the Relationship 29
Step 1 Are you in a RUT? 30
Step 2 What would you like? 30
Step 3 Make arrangements 30
Step 4 Have a heart-to-heart talk 31
Step 5 Do it! 32
Step 6 Review 33
Two Effective Approaches to Handling Differences 34
Sex and the Single Man 35
4 Reviving Loving 37
Key Points 37
Relearning Loving 39
Creating a Loving Environment 41
Increasing Desire 43
Pleasing a Woman 45
Loving Is a Partnering Activity, Not a Solo Sport 46
Learning about Your Own--and Your Partner's--Anatomy 47
Be Creative in Your Love Life 48
Making Things Romantic 50
Early Bird Special Sex 51
The Partner's Role 52
Take Time 54
Just Do It: Make Love 54
5 Sensual Sex 57
Key Points 57
A Sensual Encounter 58
What Sensual Sex Is All About 61
Getting in the Mood 61
Getting Prepared 63
Sensual Arousal 65
Kissing 65
Touching 66
Touchpoints 67
Giving and Receiving 71
Penile Massage 71
Oral Sex 71
Massage 72
Visualization and Sexual Fantasy 73
Special Techniques to Assist in Sex with Impotence 75
Using gravity 75
Massaging the penis 75
Partial penetration 76
Female orgasms with a limp penis 76
The Self-Renewing Relationship 77
6 Getting into Shape for Sex 79
Key Points 79
Eating Right 81
Exercising 82
Physical activity and routines 84
Pelvic floor exercises 86
7 Talking with Your Doctor 89
Key Points 89
Understanding the Doctor's Situation 90
Preparing for a Visit to Discuss Sexual Dysfunction Issues 91
Writing down your questions 91
Making the appointment 93
Getting the Most from the Meeting 94
How to Be Sure the Doctor or Other Professional Is Truly Listening 96
8 Commercial Therapies and Medications 97
Key Points 97
Is There a One-Size-Fits-All Treatment? 98
Treatments: What Works for You? 99
Understand the psychological side effects of treatment 100
Understand what anxiety can do 101
The importance of a conservative approach 102
Why so much information? 103
Pill Splitting 106
Interpreting Clinical Trial Results 106
The List of Treatments 108
Penile rehabilitation 109
Oral medications 113
Topical medications: penile creams and gels 127
Intraurethral medication 131
Penile injection (intracavernosal injection) 135
New medications in development 144
Devices 147
Penile splints and supports 147
Vacuum therapy systems 147
Penile implants 158
Surgery 162
Neural therapies 162
Nerve sparing surgery 162
Nerve grafting surgery 165
Neural regeneration 167
Penile vascular surgery 167
New target areas for erectile dysfunction research 169
9 Nonapproved and Off Label Treatments 173
Key Points 173
Combination Therapies 175
Combination therapies using sildenafil (Viagra) 175
Sildenafil (Viagra) and doxazosin (Cardura) 175
Sildenafil (Viagra) and apomorphine (Ixense and Uprima, in Europe, Latin America, and Asia only) 175
Sildenafil (Viagra) and a tension ring 176
Sildenafil (Viagra) and a vacuum erection device 176
Sildenafil (Viagra) and intraurethral prostaglandin E-1 (MUSE) 176
Sildenafil (Viagra) and intracavernosal injection (Caverject) 176
Combination therapies using yohimbine hydrochloride 177
Yohimbine and L-arginine glutamate 177
Yohimbine and Naltrexone 177
Off Label Drug Usage 178
Dopamine receptor agonists 178
Herbal Products and Dietary Supplements 178
Ginkgo 180
L-arginine 181
Kava 181
Korean Red Ginseng 182
10 Putting It All Together 183
Romeo and Juliet 183
Napoleon and Josephine 184
Bill and Jill 186
Appendix A Treatments for Erectile Dysfunction 189
Table A-1. Medications 190
Table A-2. Devices 191
Table A-3. Combination Therapies 192
Table A-4. Non-FDA-Approved Therapies 193
Table A-5. New Medications in Development 194
Appendix B Manufacturers of Erectile Dysfunction Products 195
Appendix C Resources 201
Appendix D References and Further Reading 205
Books 205
Scientific and technical papers 208
Index 213