Treatment for erectile dysfunction depends on the cause. Testosterone supplements may be used for cases due to hormonal deficiency. However, the cause is more usually lack of adequate penile blood supply as a result of damage to inner walls of blood vessels. This damage is more frequent in older men, and often associated with disease, in particular diabetes.

Most treatments work on a temporary basis: they enable an erection to be attained and maintained long enough for intercourse, but do not permanently improve the underlying condition. There are different treatments available:

Oral treatment
These work when there is sexual stimulation. Depending on the treatment, it will need to be taken 20 minutes to 1 hour before sex and the period of time over which it works can vary between 3 hours and up to 36 hours.

Alprostadil
This can be injected into the penis or inserted using a special applicator - usually just before sexual intercourse.

Vacuum pumps
These work by drawing blood into the penis and are also used just before sexual intercourse.

Hormone treatment
It is rare, but some men receive hormones for their erection problem. This does depend on the cause of the problem as well as other factors.

Surgery
Often, as a last resort if other treatments have failed, the most common procedure is prosthetic implants which involves the insertion of artificial rods into the penis.

Counselling
Counselling is often a consideration, both where a psychological cause is suspected or must be ruled out, or to assist in management of any distress.
ED can in many cases be treated by drugs taken orally, injected, or as penile suppositories. When pharmacological methods fail, a purpose-designed external vacuum pump can be used to attain erection, with a separate cock ring fitted to the penis to maintain it.

More drastically, inflatable or rigid penile implants may be fitted surgically. Implants are irreversible and costly.

All these mechanical methods are based on simple principles of hydraulics and mechanics and are quite reliable, but have their disadvantages.

In a few cases there is a vascular problem which can be treated surgically.

It’s just what you’ve always wanted: all those years of having cramps, weird food cravings, back pain, and crabbiness every single month are finally behind you. But you didn’t ask for the symptoms that come with the downside of menopause, which can often include a decrease in your sex drive. Take heart, though; no one’s telling you to say goodbye to great sex forever! Here’s the lowdown on what really happens during the Change – and why it might just be the best thing that’s ever happened to your love life.

Most American women experience menopause at around 51, and some experience symptoms of menopause well before their last period – even years beforehand. These can include irregular bleeding, those infamous hot flashes, mood changes, insomnia, depression, incontinence, cognitive changes such as problems with attention and memory, and sexual changes like vaginal dryness, an increase in yeast infections, and lack of interest in sex.

That’s the bad news. But here’s the upside: Chances are you have years of fantastic sex to look forward to. “Seventy percent of couples at the age of 70 are sexually active,” says ob/gyn Dr. John McMurry of Spencer, West Virginia. Sure, women’s – as well as men’s – sexual responses change as they age, often around menopause, but these can be positive changes. Why? According to Dr. McMurry, there are a few reasons. Some women actually report an increase in desire during midlife or around menopause, while men of the same age have probably gained greater control over ejaculation, allowing them to last longer in bed. Also, couples tend to communicate better with one another, and are comfortable enough with each other to experiment with sex without feeling silly. And Dr. McMurry is quick to point out that, at any age, “the best foundation for a healthy sex life is a strong, loving relationship with your partner.”

But what if the symptoms of menopause are taking a toll on your sex life? You don’t just have to grin and bear it. Talk to your doctor about these non-prescription treatments:

·Zestra. Similar to lube, Zestra is a hormone-free, drug-free oil that you massage onto your clitoris and vagina just before sex. It creates a gentle warmth that helps you get aroused and stay aroused. Available at bettersex.com.

·Eros therapy device. Placing the device’s soft “cup” over your clit and vagina, creates a vacuum that encourages blood flow to the entire area, which increases sensitivity, helps you stay lubricated, and lets you reach orgasm more easily.

·Olive oil or vitamin E vaginal suppositories. Both olive oil and vitamin E increase sensitivity. Be careful, though; oil and condoms don’t mix!

Some prescription medications may also ease your symptoms. Ask your doctor about:

Hormone replacement therapy (HRT). Dr McMurry suggests using estrogen vaginally, so the hormone doesn’t circulate throughout your system.
Testosterone
Changing certain antidepressants and blood-pressure medications, if you take these medications regularly.

At the end of the day, though, sizzling sex happens when two people enjoy pleasuring each other! Check out these books and websites for more information on sex and menopause:

Sex Over 50 by Joel D. Block and Susan Crain Bakos (Reward Books: New York, NY, 1999)
Website for the American Society of Obstetricians and Gynecologists, http://www.acog.org
Website for the North American Menopause Society, http://www.menopause.org.

There are a variety of sex toys out there to pick from. Different styles, sizes and materials make it hard to figure out which one is best. There are some questions that you need to ask yourself first.

What do you want to use it for – clitoris, vaginal, or anal? Do you want something that will hit the clitoris and vagina at the same time? Then a dual action vibe like a rabbit or pearl panther is for you. If you want something for just anal play then remember to make sure it has a flared base so that it doesn’t slip all the way in. G-spot vibrators, glass dildos, and anal vibrators are for more advanced stimulation.

How strong do you want your vibration? If you masturbate with a firm rub on the clitoris rather than a light touch, you are more likely to appreciate a strong vibration. Picking a toy with variable speed control so that you can play with it to see what works for you would be a good way to go.

How big do you want it? If you are someone who travels a lot then maybe something small like a pocket rocket is the way to go. If you plan to use the vibe for penetration, the girth of the toy may be just as crucial as the vibrating intensity. If you are not sure how much girth you want, go smaller rather than larger so you will know your new toy will fit.

How much do you want to spend? A bullet or vibrating egg may be the least expensive option for you but don’t let their size full you. They are quite strong and can be used all over both of your bodies in all of your erogenous zones. Some people like to start off with the cheaper one if they have never had a vibrator before but if you talk to anyone who has had one they will tell you that the deluxe, spinning dual action vibes are the best way to go. These are what some people refer to as the pearl rabbit, pearly panther, or lickin lizard vibrators.

Sex toys have come a long way. They now have different materials to pick from too so get familiar with them and have fun trying out all kinds of different ones to see what works best for you.