Intimacy with Impotence: The Couple's Guide to Better Sex after Prostate Disease
Author: Ralph Alterowitz
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.
Oncology Nursing Forum</I>
"Excellent...an easy-to-read, candid book that could offer a great deal of understanding and help to couples experiencing erectile dysfunction."
Library Journal
Cancer survivor Alterowitz and his wife, Barbara, have revamped their The Lovin' Ain't Over: The Couple's Guide to Better Sex After Prostate Disease. As in the original edition, the authors rely on a team of researchers and medical/psychological consultants. Suitable for older and/or conservative couples, their well-organized text has no slang or graphics and cautious discussion of noncoital activities. The message: impotence offers an opportunity to revive intimacy through more sensual, romantic sex. The text focuses on FAQs regarding prostate surgery and impotence; learning to have satisfying, sensual sex; and devices, pharmaceuticals, and other products to enhance erections (e.g., combination and off-label drug therapies, herbal products, and dietary supplements). "Key Points" sections help orient readers, and the appendixes of treatments, manufacturers, resources, and reading matter are very good. But more about sex toys and outercourse techniques (e.g., sharing masturbation) could have been included. For public libraries, to be complemented by Virginia and Keith Laken's Making Love Again, which emphasizes psychological issues.-Martha Cornog, Philadelphia Copyright 2004 Reed Business Information.
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 |
Look this: The Commanding Heights or Confessions of an Economic Hit Man
Hungry: Lessons Learned on the Journey From Fat to Thin
Author: Allen Zadoff
Weight loss advice, laughter, and inspiration from the delicious, caloric, yet uncomfortably large life experiences of a formerly fat man.
Allen Zadoff spent years reasoning that a big, healthy man should have a big, healthy appetite and that his rapidly increasing girth was no more than a regular guy thing.
At 350 pounds, however, it became clear that what had started as a little weight problem was destroying his life. Desperate to find a new way of living that would carry him into thin and beyond, Zadoff began to focus less on what he ate, and more on the physical and emotional underpinnings of what he came to understand as a disease. The pounds melted away, and so began the adventure of a lifetime.
Following Zadoff's incredible journey both up and down the scale, Hungry blends his personal story with surprising strategies for weight loss success; it is as laugh-out-loud funny as it is inspirational.
Los Angeles Times
There's no shortage of books on how to lose weight. Hungry is not that sort of book. It's about the importance of understanding the emotional sources of hunger, about how much more effective that understanding is than any diet could ever be, about the myths we create about our bodies that must be debunked. Its gentle, non-preachy, funny and forgiving tone is uncommonly appealing.
People keep talking about all these male enhancements and impotency cures but have you read anything on the products? Have you even read an Ixense review?
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