A question about climax

[TruthBTold]

If you have a medical condition, for example as has been mentioned, you cum in small amounts, do you mention that prior to the whole encounter? Or just that just seem weird? Even if it will make you more comfortable because then when you do cum and it is a small amount you won't be embarrassed by the whole thing?

[WolfRamNHard]

That's exactly what I found. When I first started the alpha-blocker, it caused retrograde ejaculation, which I wasn't happy about, but I noticed the improvement in orgasm. One of the things that I really enjoyed is that I could really control orgasm - let it build slowly and hang out right at the edge for an incredibly long time. I also noticed an enjoyable sensation throughout my mid-section - my abs would maintain sort of a tension that was extremely pleasurable - it felt almost like a full-body orgasm that didn't want to stop. Eventually, the retrograde ejaculation cleared up and I was left with all of the benefits. Downside of it all was that the alpha-blocker drove my diastolic pressure sometimes into the 30s, so I had to stop it.

 

The orthostatic hypotension really gets me in the mornings when I get up to pee.

 

DBP in the 30s sounds pretty serious. Apparently it can also cause serious arrythmias. Multiple intense orgasms notwithstanding, maybe I'll be better off without it overall.

[Rudynate]

The orthostatic hypotension really gets me in the mornings when I get up to pee.

 

DBP in the 30s sounds pretty serious. Apparently it can also cause serious arrythmias. Multiple intense orgasms notwithstanding, maybe I'll be better off without it overall.

 

It freaked me out when I took my BP and saw a diastolic number below 40. I didn't need to be told that I needed to stop the alpha blocker. I called the uro, and, of course, he said, "Stop the alpha blocker." It all worked out though. I was able to get cialis covered by health insurance because I had failed on the alpha blocker and the cialis was one of the few alternatives.

[TruthBTold]

Isn't an alpha blocker for high blood pressure (or whatever the more current term is)?

[WolfRamNHard]

Isn't an alpha blocker for high blood pressure (or whatever the more current term is)?

 

This isn't my specialty per se. But from what I recall (having learned it years ago), alpha blockers can be selective or not. While they are sometimes used to treat hypertension, I believe the ones that are being discussed here (terazosin, tamsulosin, doxazosin etc.) are used primarily for urological issues (prostate etc.). I can only assume that their predilection for the genitourinary system is somehow also responsible for their significant sexual side effects. Maybe someone who's more current on this topic can correct me or provide more info as needed?

[LivingnLA]

This isn't my specialty per se. But from what I recall (having learned it years ago), alpha blockers can be selective or not. While they are sometimes used to treat hypertension, I believe the ones that are being discussed here (terazosin, tamsulosin, doxazosin etc.) are used primarily for urological issues (prostate etc.). I can only assume that their predilection for the genitourinary system is somehow also responsible for their significant sexual side effects. Maybe someone who's more current on this topic can correct me or provide more info as needed?

 

Good info. Thanks for sharing.

 

Yes, alpha-blockers are primarily for hypertension and urination problems for men with enlarged prostates.

 

http://patient.info/health/alpha-blockers

 

Some interesting research has explored the ejaculation side-effects. Here's a pretty good article discussing the 5 approved alpha-blockers at the time and their impact on ejaculatory function, especially retrograde ejaculation.

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812888/

 

Alpha-blockers are one group of drugs in the on-going male-contraceptive-pill race.

 

http://www.malecontraceptives.org/methods/contraction_inhibitor.php

[jjkrkwood]

This isn't my specialty per se. But from what I recall (having learned it years ago), alpha blockers can be selective or not. While they are sometimes used to treat hypertension, I believe the ones that are being discussed here (terazosin, tamsulosin, doxazosin etc.) are used primarily for urological issues (prostate etc.). I can only assume that their predilection for the genitourinary system is somehow also responsible for their significant sexual side effects. Maybe someone who's more current on this topic can correct me or provide more info as needed?

 

 

I have been on Tamsulosin for about a year, prescribed for frequent urination issues, and while I don't see any affect on my urination, the 1 side effect is the inability to CUM, although you do still have the sensation of orgasm, without the muss and fuss.... I stopped it recently for a brief spell and the creamy reward returned, but doc wants me to continue on it.

[TruthBTold]

Thanks for all the info. I will definitely read the articles as the side effects seem similar to the effects that I am having. I probably will have to stay on my current meds so I had just wondered what the best way to deal with the side effects when you have to ejaculate and there is someone other than yourself that has to deal with the situation.

[LivingnLA]

@jjkrkwood, Are you on .8 or .4mg? Or another dosage? For the .8 dosage, about 1 in 6 men will see ejaculatory side effects with tamsulosin. On .4, around 1 in 12 will see such side effects. If it's not helping your urination issues after a year, I'm surprised your doctor hasn't tried another medication or treatment.

[LivingnLA]

@TruthBTold, it depends on your dosage. Roughly 2% of men switch off tamsulosin to another drug because the lack of ejaculate bothers them. If it's important to you, talk to your doctor. There are other drugs you can try or your dosage can be adjusted.

[jjkrkwood]

@jjkrkwood, Are you on .8 or .4mg? Or another dosage? For the .8 dosage, about 1 in 6 men will see ejaculatory side effects with tamsulosin. On .4, around 1 in 12 will see such side effects. If it's not helping your urination issues after a year, I'm surprised your doctor hasn't tried another medication or treatment.

 

I am on the 04mg. And my doctor is an Asshole. I am looking to switch but its difficult since all my referrals were not taking in new patients... And my insurance is an HSA plan which is basically out-of-pocket discount services plan, which is still VERY costly.

[LivingnLA]

I am on the 04mg. And my doctor is an Asshole. I am looking to switch but its difficult since all my referrals were not taking in new patients... And my insurance is an HSA plan which is basically out-of-pocket discount services plan, which is still VERY costly.

 

Damn, that sucks. Sorry he or she is an asshole. They're committing a disservice to you by not treating your issues. I hope you're able to find a better doctor.

[+ honcho]

I am on the 04mg. And my doctor is an Asshole. I am looking to switch but its difficult since all my referrals were not taking in new patients

 

I offer my genuine sympathies...

[TruthBTold]

@TruthBTold, it depends on your dosage. Roughly 2% of men switch off tamsulosin to another drug because the lack of ejaculate bothers them. If it's important to you, talk to your doctor. There are other drugs you can try or your dosage can be adjusted.

 

Thanks for your reply. Believe it or not, I am at the end of the road as far as medications go. So I think that I am going to have to live with the side effects. I suppose that doctors also have a certain perspective. Because the meds are maintaining the major disorders, I think that they just can't understand how the fact you can no longer cum during a sex act should bother you. They sometimes give you that "at least its not cancer look." But as a wise woman once told me, "Comparative suffering is never helpful."

[+ WmClarke]

But as a wise woman once told me, "Comparative suffering is never helpful."

Agreed.

[LivingnLA]

Thanks for your reply. Believe it or not, I am at the end of the road as far as medications go. So I think that I am going to have to live with the side effects. I suppose that doctors also have a certain perspective. Because the meds are maintaining the major disorders, I think that they just can't understand how the fact you can no longer cum during a sex act should bother you. They sometimes give you that "at least its not cancer look." But as a wise woman once told me, "Comparative suffering is never helpful."

 

While I certainly don't speak for all doctors, it's not their fault that meds tend to be more maintenance and less cure. If you wish to blame someone, blame the unethical and amoral neoliberal capitalism we have in America. It's in drug company's profit interests to create medications and treatments that are maintenance oriented as opposed to curative because it enables them to create a large number of customers with multi-decade buying needs.

 

Yes, doctors have their own opinions, they're human after all, but generally speaking GPs, FPs, and IMs don't stay in the profession for the money. Being a PCP is brutal and the pay--while very good compared to the economy at large--is only so so considering the workload and education required.

 

Honestly, I think patients should stand up for themselves more. The inability to cum is a side-effect that can usually be addressed in these cases if the doctor takes the time to understand what's going on in the patient's body. The patient needs to help the doctor realize how critical it is for them as a quality of life issue fundamental to their psychological concept of masculinity and manhood.

 

But, that's my overpaid opinion and it plus a buck won't buy ya a cup of coffee in many places nowadays.

 

Take care of yourself and life as well as you can.

[TruthBTold]

Living, of course I agree that physicians are placed in uncomfortable situations and our society hamstrings them in many ways, from insurance companies to drug companies. And the monetary necessity of 15 minute appointment times does not aid in the development of doctor/patient relationships. Really what I was originally discussing is that if one accepts that you are going to suffer from this particular side effect, i.e., an extremely small amount of semen on ejaculation, and you are going to be embarrassed because of it, should you mention this to the escort at the begin of session or wait until it happens. Will escorts generally have come across this sort of thing and not care if you do one thing or the other.

[LivingnLA]

Living, of course I agree that physicians are placed in uncomfortable situations and our society hamstrings them in many ways, from insurance companies to drug companies. And the monetary necessity of 15 minute appointment times does not aid in the development of doctor/patient relationships. Really what I was originally discussing is that if one accepts that you are going to suffer from this particular side effect, i.e., an extremely small amount of semen on ejaculation, and you are going to be embarrassed because of it, should you mention this to the escort at the begin of session or wait until it happens. Will escorts generally have come across this sort of thing and not care if you do one thing or the other.

 

Ah. Well, sorry for derailing or hijacking your thread then.

[BasketBaller]

Ah. Well, sorry for derailing or hijacking your thread then.

 

LOL. The original point of the thread was a bit different!

[LivingnLA]

LOL. The original point of the thread was a bit different!

 

I imagine you've surmised by now that my conversational--and thinking style for that matter--can meander along branches and snap-back to the trunk topic frequently.

 

Wait! Didn't YOU start this thread? So I should be apologizing to you! Doubly sorry I am.

[+ Funguy]

 

Yes, doctors have their own opinions, they're human after all, but generally speaking GPs, FPs, and IMs don't stay in the profession for the money. Being a PCP is brutal and the pay--while very good compared to the economy at large--is only so so considering the workload and education required.

 

Honestly, I think patients should stand up for themselves more. The inability to cum is a side-effect that can usually be addressed in these cases if the doctor takes the time to understand what's going on in the patient's body. The patient needs to help the doctor realize how critical it is for them as a quality of life issue fundamental to their psychological concept of masculinity and manhood.

 

But, that's my overpaid opinion and it plus a buck won't buy ya a cup of coffee in many places nowadays.

 

Take care of yourself and life as well as you can.

 

AMEN, brother!!!!

[BasketBaller]

I imagine you've surmised by now that my conversational--and thinking style for that matter--can meander along branches and snap-back to the trunk topic frequently.

 

Wait! Didn't YOU start this thread? So I should be apologizing to you! Doubly sorry I am.

 

It's all good! Conversations wander.

[LivingnLA]

It's all good! Conversations wander.

 

http://imghumour.com/assets/Uploads/Stay-on-target2.jpg

[WolfRamNHard]

I am on the 04mg. And my doctor is an Asshole. I am looking to switch but its difficult since all my referrals were not taking in new patients... And my insurance is an HSA plan which is basically out-of-pocket discount services plan, which is still VERY costly.

 

JJ, please do fire your doc as soon as you are able. A few bad docs out there make all the rest of us look bad and I have no sympathy for them.

[WolfRamNHard]

Really what I was originally discussing is that if one accepts that you are going to suffer from this particular side effect, i.e., an extremely small amount of semen on ejaculation, and you are going to be embarrassed because of it, should you mention this to the escort at the begin of session or wait until it happens. Will escorts generally have come across this sort of thing and not care if you do one thing or the other.

 

TruthBTold - in response to your question, I can almost never cum when I'm with another person. It's not so much a physical issue for me, just all in my head (in order to make it happen, my mind has to wander to a very private place, and just can't get there with someone else in the room).

 

Coming back to the point, I've always let my partners know about this so they know what to expect and not take it personally. All of my hires to date have been completely ok with that (or if they weren't they never let it show).

 

With my Scruff dates on the other hand, the responses have been more mixed. Some have been understanding, some are a bit puzzled but not too bothered, others seem to take it personally and assume that the reason I don't cum is because I'm not really into them. For this I have found that it often helps to not have sex on the first couple of dates, but just use that time to make out, build rapport and convince the other person that I really do like them. Then when it's time for the disclosure they are more likely to believe me when I tell them that it's not about them and that I really do find them attractive.

 

My suggestion is to be open about it. I would expect that good escorts will be understanding and not hold it against you.