Is a prostate problem the cause of my sexual problems after I started dating online at age 76 after a divorce? Ask Doctor ELLIE CANNON
Q: I am a healthy 76 year old and just started online dating after my divorce. However, during sex I have difficulty maintaining an erection. Even when I have a climax, I experience a pleasurable feeling, but I produce nothing. Should I be concerned about my prostate?
Dr. Ellie answers: Men often experience sexual problems later in life due to an enlarged prostate or its treatment. The prostate is a small gland at the base of the bladder surrounding the tube that drains urine. It is often described as the size of a walnut, but as men age it can become much larger.
Regular exercise, quitting smoking and reducing alcohol consumption have been shown to help combat erectile dysfunction
Of course, men can also get prostate cancer. An enlarged prostate will make it more difficult to urinate, due to the proximity of the prostate to the bladder, and cause sexual problems.
These problems are usually erectile dysfunction and problems ejaculating. There are treatments that can combat an enlarged prostate, but it is important to know that these can also lead to sexual problems.
A commonly used medication for prostate problems is finasteride, a daily tablet that can make urination easier.
However, more than one in 100 men who take it will experience problems getting an erection and/or problems ejaculating.
Men who do not respond to medications are often offered a transurethral resection of the prostate – also called TURP – in which parts of the prostate are cut away.
It is thought that as many as three-quarters of men who receive a TURP will have difficulty ejaculating due to damage to the nerves and muscles in the prostate area.
Similarly, surgery to remove the prostate often leads to dry orgasms – from which nothing comes out – because the gland is involved in the production of sperm.
There are things you can do yourself to reduce the severity of your complaints.
Regular exercise, quitting smoking and reducing alcohol consumption have been shown to help combat erectile dysfunction.
If the problem persists – or worsens – you should talk to your doctor about treatment.
Question: I am a woman in my late seventies. In 2018 I was prescribed alendronic acid after I fell and broke my wrist. I’ve heard that you should stop taking this medication after five years, but my doctor says I should keep taking it. I also asked for another bone density scan, but she said I didn’t need one. Is this correct?
Dr. Ellie answers: Alendronic acid is the drug we most commonly use for the bone-thinning condition osteoporosis, and it is usually safe to use it long-term.
Taken as a weekly tablet or drink, it reduces the risk of further breaks. Our bones are constantly being broken down and rebuilt by specially adapted cells within them. Osteoporosis occurs when too much bone breakdown occurs, causing them to weaken. Alendronic acid slows down this process. Normally after five years of treatment you will have a review of your medication to decide whether you still need it. This often involves a bone density scan, also called a Dexa scan. A patient can continue taking the medication for another five years or take a “treatment vacation” and stop taking it for a few years.
Alendronic acid has some common side effects, including constipation, dizziness, and headache
Alendronic acid has some common side effects, including constipation, dizziness, and headache.
If treatment causes too many problems or does not control osteoporosis, patients may be offered a new medication. However, it is difficult to make this decision without further Dexa scan.
The Royal Osteoporosis Society provides excellent support. You can speak to one of their specialist nurses on 0808 800 0035. Afterwards it may be worth requesting a consultation with your GP to determine why your medication is being continued.
Q: My doctor recommended that I take statins, but ten days after I started taking the pills I started experiencing severe tingling in my feet and hands. I immediately stopped taking the drug, but two months later the pins and needles have turned into a painful stabbing sensation all over my body. My feet feel like they are burning.
Despite this, my GP refuses to see me for an appointment, saying this is a matter for the pharmacist. What should I do?
Dr. Ellie answers: This is not the standard of care someone should receive from an NHS GP. Anyone with new symptoms or possible side effects from medications should be offered an appointment.
It may be worth registering with a new practice to make it easier for you to access a doctor. Pins and needles are a rare side effect of statins. The fact that the feeling continues after you stop taking the pills may indicate that there is no connection. A feeling of electric shock or burning, especially in the feet, may be a condition called peripheral neuropathy, in which the nerves do not work properly. Peripheral neuropathy is often caused by a vitamin B12 deficiency and can be reversed. Therefore, it is crucial that you visit a doctor.
If it’s the statins, a doctor may recommend other ways to treat cholesterol, such as diet and lifestyle changes, or other medications.
People with back pain are fobbed off
The latest figures show that as many as 2.8 million Britons are ‘economically inactive’ due to poor health.
That’s double what it was a decade ago – and includes an increase of almost three-quarters of a million since the pandemic. This is probably because it is now so difficult to get treatment for even serious problems.
Mental and respiratory conditions top the list of reasons for becoming ill for a long period of time. The other most common are ‘musculoskeletal problems’, often back problems. But back problems can be quickly resolved with advice, exercise and a physiotherapy examination.
It frustrates me that even when I refer my patients for the latter, it is simply not available; they are fobbed off with telephone appointments and brochures. Have you had trouble getting help for your back pain? Write and let me know.
Do you have a question for Dr. Ellie Cannon? Email DrEllie@mailonsunday.co.uk
Dr. Cannon cannot enter into personal correspondence and her responses must be placed in a general context.