Intimacy With Impotence: The Couple's Guide To Better Sex After Prostate Disease

by Ralph Alterowitz, Barbara Alterowitz

Overview

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.

Product Details

ISBN-13:	9780786730032
Publisher:	Hachette Books
Publication date:	04/27/2009
Sold by:	Hachette Digital, Inc.
Format:	eBook
Pages:	240
File size:	1 MB

About the Author

The founding vice-chair and former Director of the National Prostate Cancer Coalition, Ralph Alterowitz is currently the President of the Education Center for Prostate Cancer Patients. He lives in Potomac, Maryland.

Barbara Alterowitz is a marketing executive with an international technology firm. She lives in Potomac, Maryland.

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

Editorial Reviews

"Excellent...an easy-to-read, candid book that could offer a great deal of understanding and help to couples experiencing erectile dysfunction."

Oncology Nursing Forum

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.

Library Journal

"[This book is] outstanding, well-written, and should be read by all men and women."

From the Publisher