Fit for Sex!

Taking action to resolve impotence problems after prostate treatment



OK so you’ve just had a major surgical or medical intervention in your pelvic region and you now have an impotence problem that you need to deal with. And much of the following applies to men who are in peak physical condition and have an impotence problem.

It’s natural to assume that this is a simple physical problem.  But it’s much more complex than that. Having just had surgery or another prostate treatment or being in the middle of a major life crisis or generally feeling miserable and ‘turned off’ can result in impotence. And it isn’t going to be solved by popping a couple of tablets! The ability to have an erection is not only about getting the blood flowing to pump it up, but also about making sure that your whole system is working properly. And this is a very complex and delicately balanced system.

Nevertheless there are things that you can do physically to help and encourage things to work properly.  Here are some of my thoughts and experiences.


What the doctors tell you


Well the doctors do their job magnificently. They are there to be supportive and to give you as much positive encouragement as possible during the difficult post-operative phase.  So they keep telling you how fantastically you’re doing, how you’re going to have a ‘good outcome’ and that everything is going very well! But…………please note that they won’t commit themselves to particular timescales or make any predictions about success no matter how carefully you question them.

In respect of male impotence the encouragement is ‘if you don’t use it you lose it’.  So you really have to keep going ‘solo’ if necessary and to do it regularly. ‘Yes, it’s all going very well’ they say. But you know as only you can know in that post-operative phase that actually it isn’t going very well at all! You can try as much physical stimulation as you like but nothing – or virtually nothing – is happening!

And here’s another one of those contradictions that happens after surgery. In the Fit for Recovery section I describe a timetable of ups and downs over what can be a long period of time. The return to normal sexual function is much the same. While you’re feeling down and miserable it simply isn’t going to happen. When you’re feeling better and more upbeat you’ve got a better chance. But don’t be disappointed if it’s still not happening very much.

I got frustrated. I started to feel that things were going wrong. What I was experiencing wasn’t what the doctors were telling me I should expect to experience. In other words I certainly wasn’t ‘having a good outcome’! So after some research I found an academic article that stated quite clearly that nothing should be expected for the first three months. In my experience – and the experience of most other people I’ve spoken to –  this is more of a realistic expectation.

That doesn’t mean to say you shouldn’t keep up the stimulation. But you should keep your expectations low.  After three months or so you should start to feel better. The incontinence starts to be more manageable. Then the erectile problem starts to slowly resolve. The name of the game is to keep going and be positive. And at all costs avoid being disappointed because most of the time a feeble response is about the best most of us can expect during this recovery phase.

You’ll get some advice from your medical team on managing the problem. The advice obviously varies between medical teams, but here’s a general outline:


You may need to take tablets


There are a group of tablets known as phosphodiesterase type 5 (PDE 5) inhibitors that regulate blood flow in the penis. The best known of this group are Viagra (sildenafil) Cialis (tadalafil), and Levitra (vardenafil).  They all do very much the same thing because their molecular structure is very similar. The main difference is that Viagra only lasts for about four hours, Levitra lasts a little longer (but takes longer to start working) and Cialis lasts for about 48 hours. For many people Cialis is the drug of choice because it’s active for at least two days. So there’s no pressure on you to perform right now in case the power of the tablet runs out before it’s all over.

As these drugs open up blood vessels throughout the body they’re also very effective in lowering blood pressure. So if you have mild high blood pressure and take Cialis it gives you the best of both worlds on only three tablets a week. This is recognised as an effective strategy for managing mild high blood pressure. However because it lowers your blood pressure, overdosing (such as taking two tablets instead of one, or taking a second one too soon after the first) can lead to a sudden and potentially fatal drop in blood pressure.

This group of drugs is also associated with a number of other major side effects which have severe medical implications. You need to be aware of these and stop taking the tablets as soon as any of the side effects appear. You also need to be very careful if you’re taking any other medication. The combination could be very dangerous. So please check with your medical team before you start taking any of these drugs.

In my case I suffered from the most common and harmless symptoms which include headaches, indigestion, mild visual disturbances and periods of hot flushing. And the drugs had no effect whatsoever on the problem that they were supposed to be solving.  I very soon stopped taking them.


Other options


You can inject little pellets into your penis (Oooo…… no thanks!!) or use pellets that you introduce into your urethra. They’re supposed to cause an instant erection. I didn’t try them.

Vacuum pumps are also available and can be prescribed. The idea is that you place the applicator over your penis and the pump creates a vacuum. This encourages blood to be drawn into the penis causing an erection. I didn’t try these either.

Stents are often recommended when all else fails. They are elongated rings that you place over the penis to hold it up but they don’t actually cause any kind of erection, or help the dysfunction problem. There’s a video about one of these here on YouTube to give you an idea of what they do. Nor did I try these.


What the doctors don’t tell you


Male impotence is not a new phenomenon. It is and always has been a very common problem even without prostate surgery or any other medical conditions. There’s a vast industry devoted to helping resolve male impotence problems – problems that have existed since the beginning of time. The remedies vary from the ridiculous – such as consuming ground rhino horn because it shape and size simulates an erection (and apparently from which we get the term ‘getting a horn’) – to the perfectly reasonable – such as using herbal and other remedies which are reputed to have stimulating effects.

There’s a huge range of herbal and other remedies, as well as therapeutic massages, acupuncture, homoeopathy and many other therapies. The trouble with these ‘alternative’ therapies is that they are studiously ignored by the medical profession. Their derisory, dismissive attitude towards their potential effectiveness is because they’ve never been through a scientific trial to see whether they work or not. So, if you want to go down this route, it’s a matter of trying them out and what works for you may not work for others and vice versa. Because these are uncharted waters, it would be wonderful if you would join the forum on the site and share your experiences with others who are on the same or similar journeys.


So where do we start?


Well you can go to your local ‘hole in the wall’ sex shop and ask them to show you  their range of products and maybe make some suggestions. Their stocks are limited and their salesmanship is superb, but they’re not usually very knowledgeable. More upmarket sex shops sell a better range of products related to lovemaking and sexual function as well as porn and pills. Their salesmen are also often far superior. They sell all sorts of stuff including enhancement creams, vibrating rings and lots of other gadgets as well as pills of course.

An interesting alternative if you have a large Chinese community nearby, is that many Chinese medicine shops sell what they call “strongman formula” or “Chinese Viagra” which is made up of various herbal mixtures and supposed to be pretty effective.

Another possibility is of course the internet. There are literally hundreds of sites on the subject of male impotence. Many of them provide similar information but there isn’t much about what you can actually do. Online pharmacies sell a whole range of products including pills, creams and stick on patches. Sometimes the range of stuff available is overwhelming. What’s interesting is to look at the consumer reviews for each product. For just about every product there’s at least one comment saying something like ‘didn’t work for me!’. This is because, as I described previously, the ability to have an erection is a complex process and simply popping tablets or applying a patch simply will not make it happen in many cases.


And now, a little story


Early on in my recovery phase I was talking to one of my medical colleagues about how I couldn’t get an erection from medication, stimulation or anything else. He listened patiently and then asked “Do you dream?”. My immediate response was to think what a stupid and irrelevant thing this was to say. What has whether I dream or not got to do with me not getting an erection? I didn’t pursue the matter. But the question remained in my mind and finally it dawned on me. “Do you dream?”

So I put the question to you: Do you dream? What about? Or if you don’t dream what do you think about just before you go to sleep? Or what are the first things you think about when you wake up? If you’re dreaming or thinking about work targets, unpleasant things that have happened, annoying people or other irritations in your life, it’s unlikely that tablets or anything else for that matter will be helpful.

If on the other hand you’re dreaming or thinking about that lovely person who’s working on a project with you, or someone who gave you a warm smile when they served your lunch or someone you simply watched and had some unprintable thoughts about……….. well, I leave it to your imagination! I can only say that if you’re having those sorts of dreams and thoughts, the backdrop for action is good. If you’re not you need to work on this problem. And maybe get some professional help to try and re-awaken those thoughts and desires and the drive to do something about them.

So how do you increase your interest and attitude? How do you stimulate the kinds of thoughts that are going to lead to ‘success’? This is something that only you can do because only you know what’s going on in your mind – or not going on in your mind. And what it is in your mind that may be preventing you from relaxing and letting it happen. So at this point we go all the way back to the beginning to the section entitled The First Steps. A bit of thinking time and re-examination of your priorities and deciding which are the most important to you may be one of the best things you can do for yourself at this stage.

But sometimes we really do need a little bit of extra help to stimulate the right thoughts and hope to get the right reactions. Of course the obvious person to help with this is your partner if you have one. But this sort of help needs a very special relationship and very special skills. Plus a lot of patience because sometimes, for all sorts of reasons, it’s simply not possible to get going. So you might need to look for some physical stimulation elsewhere. But where?

A prostitute

Well the obvious source of physical stimulation is to seek the services of a prostitute. Yes it’s true that you’d probably get a lot of physical stimulation, but with a lot of unpleasant, nasty and potentially dangerous side effects as well. (Umm no thanks!!)

An affair

Well what about that lovely and attractive person in the office across the way who’s always so friendly when you meet. Hmmm…………….  starting an affair, or even thinking about starting an affair, can be very stimulating and start to repair the psychological and emotional numbness that’s causing your impotence.

But remember that dreams are often more exciting than reality. Affairs often don’t turn out to be relationships but more of a fantasy. But that can lead to ‘dreams’ and desires and urges and those may be sufficient for your needs/to get you moving. Or maybe not! While you’re recovering from surgery or some other crisis in your life, do you really want to start and build a whole new relationship with someone else?


Watching porn movies or leafing through porn magazines have many advantages. They are clean, they are available on demand and they certainly provide lots of stimulation without you needing to get entangled in another relationship. There are many, many erotic movies and photos online but beware that they often arrive with nasty viruses that can wreck your computer. Or you can buy them as DVDs online or through your local sex shop. So buying yourself a portable DVD player and finding some private time and space will often help you achieve the kind of stimulation you’re looking for.

But like everything else in life there are significant disadvantages to tackling the problem this way. Having brazen sexual gymnastics thrown in your face is very stimulating and can certainly create the physical reactions you’re looking for. But it bypasses the ‘dream’ part of your mind. Usually the fantasy is more exciting than the reality so although initially the pure physical stimulation of these movies may be helpful, sooner or later (preferably sooner) you need to consider weaning yourself off this stuff. You need to prioritise the ‘dream’ – reawakening your imagination and being able to enjoy your own personally created erotic fantasies – rather than simply having the whole panorama thrown in your face.

Novels and magazines

What’s important here is that you want mostly text with very few, if any, illustrations. Spicy novels or magazines full of debauchery and exciting, steamy episodes are excellent ways of awakening the backdrop of ‘dreams’ that you need to achieve to get the process going. Here you have words only so you have to dream up the pictures in your own mind and let your imagination express itself. Remember, developing your own fantasies, and ‘dreaming’ (even if this is only daydreaming) is creating the desire, raising your libido and sex drive, all of which are necessary before you can even think about getting an erection.

One last thought: It’s all very well you watching stimulating movies and then ‘going solo’. It’s all very well reading books and magazines and building up your own desires and dreams, but how about watching a movie, paging through a sexy magazine or reading a book together with your partner? Maybe reading sections aloud to each other and developing some shared fantasies? You may just be surprised at the results!

All of this assumes that you don’t have any long-standing emotional, psychological, relationship or other problems related to physical contact. If you do have these sorts of problems you may need to seek some professional help in resolving them before you try to get over the problem of male impotence.