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John, a handsome, muscular fellow of 28 was sitting across from me pouring his heart out.  His story was so familiar, because I have been helping men like him (and women) for the past 25 years in my medical practice focusing on sexual problems.

He has been having difficulty getting and keeping erections for the past year or two, with the problem getting gradually worse. He and his girlfriend of 3 years called it quits recently.  He felt sad, angry, and hurt especially when she said in frustration, "you can't even get it up."

His past history was also not unusual.  Around 18, shortly after starting intercourse, he noticed a creeping 'fear of performing.'  A need to prove himself as a capable, skillful lover pushed into his awareness more strongly with each new relationship.  Especially, if the girl was attractive.

He has been to doctors.  Some told him "it's just anxiety, you'll get over it."  One prescribed Yohimbine (he was 19), and it helped a bit, but only for a short time.

A highly advertised 'sex clinic' taught him how to inject his penis, and then switched him to Viagra.  These gave him erections, along with headaches and altered vision, plus cost a bundle.  (I jokingly call it, 'sex tax').

He keenly wanted to be free of medication, but had difficulty recalling when he last had intercourse without medication.

Significantly, he awoke with firm erections often, and had no difficulty masturbating to ejaculation.

He liked sex, and women, and exercised 3 to 4 times a week.  He also did weights.  He had a secure job, which he liked.  He hoped someday to marry and have a family.

Well, several weeks into our treatment program, using no medication, John is well on his way to being a changed man.  Some of my patients say a miracle has happened.  I don't argue with them, but only wish more people would realize that help for sexual problems exists, without the need for drugs.  But you have to take the initiative to find a reputable specialist who knows what they are doing.

I hope to offer some help (or at least motivation) to readers like John within the limits a column like this offers.  But, I recognize many single men (and women, and couples) have all kinds of issues they are dealing with which don't require a therapist.  How to please a woman, how to communicate effectively, how to get a couple's desire in sync are just a few of the many issues we can explore.
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Everyone has to get to know some basic facts about sexuality.  Education is a major key to a happy sex life.  Most people don't realize that our basic sexual attitudes are formed at a very early age.  If we are lucky, we have parents who feel comfortable with their own sexuality and teach children from the ground up, in age appropriate ways not only accurate information, but also attitudes.  For example, being comfortable about nudity within the family will help children feel a sense of comfort about their own changing bodies, as they grow.

Raising children with "penis pride" and "clitoral consciousness", as my eminent colleague Dr. Yates puts it in her classic book 'Sex Without Shame', would help to nurture a sexually healthy society, I believe.

If Mary and Steve, an attractive couple in their early thirties, had come from this kind of positive background, their five year marriage would not have been close to ending when they came to see me. Mary was turned off sex, and Steve was climbing the walls.  Along with her sex negative upbringing ("be careful with boys, they're only after one thing" her mother used to say), Mary dreamed that "saving" herself for marriage will fulfill all her sexual longings.  Unfortunately, Steve's sex education came mostly from watching porn videos, and he was puzzled at Mary's turn off at his "expert" technique.

My treatment of this couple went back to fundamentals and after about ten sessions both felt re-born, re-committed, and in love.  I treasure the picture of their baby they sent about a year later.

Certainly, over 25 years of practice, I have seen how relieved people can be when they realize their problem is not unique, and are happy to find there usually is a solution.  I feel gratified to be working in a field where I can offer help to people in such a sensitive area as their sexuality and love life.