6. I'm a virgin and can't maintain an erection
Q: I am 18 and have never had sex before. Last weekend I tried to have sex with my new girlfriend, but I went soft before I got in. She laughed at me and when I tried again the next night and again last night, I couldn’t even get hard.
What’s gone wrong? I am very worried that something serious had happened to me but when I tried masturbating, that was OK. What can I do?
A: You are not alone. This problem happens very, very frequently in young (and often in not-so-young) men and it is not only humiliating to a man but completely demoralising.
Fortunately, there is rarely anything physically wrong at your age. It usually occurs because of first night nerves. You get extremely anxious the second time round, watching yourself to see if you are going to be able to perform – and of course, you can’t.
It doesn’t help if your partner laughs at you (though this may just be because of her anxiety). The best and quickest way of getting help is to go to see your GP. Don’t be too embarrassed, as he or she will have heard the same problem many times before.
7. Is my penis smaller than average?
Q: I am 24 and I have a tiny penis when soft. My erection is 5.5 inches and when I look at porn, the men are very much bigger than me. Can you tell me how I can get a bigger erection? What exercises can I do and which treatment should I take? Is it possible to have an operation to make my erection bigger?
A: Many men worry a great deal about their size, and most think that they are under endowed, so the facts are important. A smaller soft penis enlarges by a greater percentage volume than a larger one.
The length of the flaccid penis varies between 5– 9.5cm (2–4 inches), and much depends on the temperature. The size of erections in men in the UK varies from 12–17.5cms or just under 5 inches to 7 inches, with an average of 16 cm or just over 5.5 inches.
Of course there will be a few either side of the normal range. The important thing is to remember that looking down on the penis gives a foreshortened view and therefore a false idea of its length.
Magazine photos are carefully angled to increase size, and models for porn films are chosen for their size of thier endowment.
Operations to lengthen the penis are not successful and cause a lot of expensive problems. Unfortunately none of the various bits of apparatus or drugs help other than very temporarily.
However, you are fine and normal, so there is no need to be ashamed of your endowment.
8. Have I masturbated too much?
Q: Often I cannot get a decent erection, although I can masturbate without difficulty. Why is this happening to me? Do you think it must be because I have masturbated too much when I was younger and have lost a lot of vital energy? What can I do?
A: This is not because you have masturbated too much. You cannot masturbate too much because the body gets tired after a number of ejaculations in a day and then you cannot get either an erection or an orgasm.
You won’t lose any more vital energy by masturbating than you would by having sex. If you are really so worried, I would suggest that you ask your GP for some Viagra, Cialis or Levitra.
9. My prostatectomy has left me unable to have sex
Q: I had a radical prostatectomy for cancer of the prostate last year. I now can’t get an erection. Sex is very important to us. What can I do?
A: I suggest you go to your GP and discuss the options, as there is almost certainly something you can use to get back to regular intercourse.
The first option would be tablets, with a choice of Levitra 20 mg, Cialis 20 mg or Viagra 100 mg, which are at their maximum dose.
If tablets are unsuccessful, a second option would be the injection into the penis, the thought of which makes tears come to the eyes of the strongest man, but which I assure you most men using it find quite painless! It’s an extremely successful method.
A further alternative is the vacuum pump. This can also be very successful, although it takes a while to get used to. If none of these options work, then there is the inflatable prosthesis, put in surgically along the shaft of the penis. This is rarely available on the NHS, but the other treatments are.
10. Can I take tablets if I'm on heart medication?
Q: After I had my heart attack three months ago, I was sent home with blood pressure tablets, a statin for my high cholesterol and either a spray or tablets to suck for chest pain, which I use occasionally. Now I find I cannot get an erection. A friend suggested Cialis (he takes it). Is it OK for me?
A: No, not if you have to use your spray (or put a tablet under your tongue) for the pain. Both contain nitrates, which clash with Cialis (as well as Levitra and Viagra) and make your blood pressure fall severely.
If you want to return to having sex, you should ask your doctor for a different treatment for your erection problems other than Cialis, Viagra or Levitra, or, alternatively, you can get tablets, which will control your chest pain and blood pressure without using nitrates, and then you can use Cialis.