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ANDROLOGY : The Science of Dysfunctions of the Male Reproductive System

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Before the advent of andrology, it was both thought and taught that impotence was psychological in origin. Epoch-making andrologic research in the past decade has shattered this myth and today it is known that in 80-90% of such cases, there is a physical (organic) cause rather than a purely psychological (functional) one.


The vacuum device is an external, non-invasive treatment option for impotence.
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We've all heard of the barren wife. But what of barren husbands ? Can male infertility be cured ? The wife visits her gynecologist...so who is the husband supposed to consult ?



Help for the CompanionIf you haven't had sex in months or years, remember you are not alone. As much as 10 % of the male population is impotent which means not only that they cannot have sex, but also that their partners cannot have sex. There are many silent women sufferers who find themselves in relationships with impotent men.

Also remember that 15-20 % of couples are childless, and that the male is responsible for the childlessness in nearly half of these cases.

Read about others with similar problems and how they have gone about managing them. You can send an email - either for advice from Dr.Sudhakar Krishnamurti, Andrologist and Microsurgeon, or to share your views with others on this page. In strict confidence. Because if your message is published here it will be under a false name, and under no circumstances will we divulge e-mail addresses of people who write in.

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My husband is having occasional problem with ejaculating, not erection. He said he's always done this. He's 43 fair health, smokes,libido-good, loving relationship. I feel this is phycological. He concentrates on pleasing me so much I don't think he can concentrate on himself. I don't want this to become a problem for him & then maybe have erectile problems if it is concentrated on too much. It does bother me to an extent, feeling he has not been satisfied, not to mention I love it when he comes.

Two months married and love him very much. Can you enlighten us?

Dr. Sudhakar Krishnamurti replied

This is not a problem at all if it is only occasional. It is, in fact, quite common and should not be an area of concern. However, if it bothers you so much that he has not been brought to orgasm, try and initiate sexual activity a couple of hours later. He might be ready then to go "all the way".

PEYRONIE'S DISEASE - Seema, Calcutta, India

My husband who is 46 years old has noticed a slight curve of his penis developing over the last 2 years. However, the last 2 months it has quickly become more pronounced. Near the base on one side is like an indent when erect. So far he has no pain and has full erections. Actually all that is wrong is he has been more tired lately and feels weaker. Background: He had a heart attack when he was 40 years old. On a daily basis since then he takes Vasotec, Atenolol and Lipitor. This week he had his yearly stress test which was fine. He asked the heart doctor about this and his only answer was to see a Urologist.

My question to you is do you think this could be a side effect from any of the medicines he is on? I have looked up Peyronies Disease and it mostly says that this curvature occurs from trauma - but he has not had any.

Any information would be very helpful, but most of all appreciated.

Dr. Sudhakar Krishnamurti replies...

The real cause of Peyronie's disease is not known. It's unlikely that drugs are the cause. If erections are normal and penetration is possible, where's the problem ? In any case, straightening can be achieved only by surgery. The drugs that he is taking can affect erectile function, esp. atenolol. His fatigue etc. could be due to low testosterone.

ANY IDEAS? - Betty, Canada

My husband had the excision-grafting procedure done by a plastic surgeon who has done other urological surgery (such as hypospadius). I do not know how many of these he has done, but it seems to have failed. Not only is he smaller, but he cannot acheive a full erection. Any ideas?

Dr. Sudhakar Krishnamurti replies...

I'm not surprised at all. As you might have read on our website, this is invariable with this operation. That's why I only perform the Krishnamurti operation on my patients. All I can say is that your husband will require a re-operation.


My husband has not been able to perform sex for the past few weeks because he can't get an erection. I was very upset, thinking he did not see me as sexally attractive. He said it was not that. I then said that I have noticed this happening over the past times we have tried to have sex. He has a bad back and said this was the cause plus one time we got chilled, laying on top of the bed and not under covers and said this was the problem. His back has never stopped him from performing before. Now I have noticed that he doesn't want to have sex. He is 50 and I am 40. We have been married for 19 years. He has an appointment to get some blood work done and also a complete physical this and next week. I am afraid that he will not tell our doctor that he has been having this problem. He does not go to the doctor very often, hardly ever. He made this appointment by himself. Do you think he thinks something is wrong? What do you think could be the problem? What can I do to help him with this?

Dr. Sudhakar Krishnamurti replies...

Unfortunately, there's little you can do unless your husband understands and accepts that there's a problem and chooses to do something about it. He must tell his doctor about his problem and seek a suitable specialist's opinion.


My husband is 56 years old. For past one year he is unable to have complete erection. He cuddles me, hugs, kisses and the penis does become bigger but not strong for penetration. I feel bad and satisfy him by oral intercourse. He has been hypertensive for past 8 years. No other problem. Is taking Covergyl tablets.

Dr. Sudhakar Krishnamurti replies...

If your husband has been all right all these years and has developed this problem only over the last year, then it's most likely to be physical in origin. There could be a combination of factors viz. reduced arterial blood flow to the penis (inevitable in hypertensive patients), drug-related (what is Covergyl ?), low testosterone etc.. The cause and severity need to be diagnosed. After that, treatment can be planned. I can assure you that it is a curable situation. 56 is a young age.


My partner experiences premature ejaculation everytime we have intercourse. His penis is small but once he gets a full erection, I can feel him. It's just that he can not hold on once he penetrates. I presume to make it up, he'd have a second round and no ejaculation but just thrusting his penis in and out. I have not gotten myself to discussing this issue with him. I love him very much and I have an emotional satisfaction which to an extent overcomes my physical satisfaction. My fear is, will this hinder us from having children? I have read some of your articles on how to address the issue with him, but it becomes more difficult when one needs to act in reality especially with a partner who behaves like all is well.

Please advise and thank you for your kind attention.

Dr. Sudhakar Krishnamurti replies...

Premature ejaculation should not be difficult to treat provided the patient accepts he has a problem. Many techniques are available for its treatment. These are discussed in standard sex manuals (by Helen Singer Kaplan, Masters & Johnson etc.). In addition, some drugs are also available.

Talk it over with your partner. I'm sure he is aware of the problem but a bit embarrassed or shy to confront it right now. Maybe, he thinks it'll just "go away". I'm sure if it means more satisfaction to you, he'll be willing to try anything. And, no, this won't come in your way of having children.


I am 40 and my husband is 42. We have not had sexual intercourse since he became completely impotent 6 years ago. It took him several months then before he explained that the problem was with him, not me, and I have been very supportive and understanding. Ironically, though, my level of sexual desire has been steadily rising during these last 6 years, after a rather slow start at the beginning of our marriage when sex was new to me and unfamiliar.

My husband is diabetic, extremely overweight (always has been), and now has heart problems as well. He often falls asleep right after supper, a result of diabetes and andropause. He was prescribed testosterone for awhile, but has since been taken off because of contraindications. The testosterone managed to elevate his energy as well as his absent interest in sex, but nothing else. Viagra did nothing either, and Muse, the penile suppository, just caused a burning sensation - an experiment he has no wish to repeat. Any suggestion of 'pump' implants make both of us shudder, and given his diffuculties in healing, I'm not sure anything remotely surgical would be advisable.

Even when I perform oral sex on him he remains completely soft and often doesn't ejaculate. I don't know if I am giving him the kind of pleasure he wants; all he can tell me is that the sensation is 'duller' now than it was before. My own sexual experience is limited to within this marriage and I am growing increasingly frustrated, physically and emotionally.

What can I do to enhance our dwindling sex life?

Dr. Sudhakar Krishnamurti replies...

Contrary to your apprehensions, patients like your husband are most suited for penile prostheses. The operation is very safe and the satisfaction ratio is very high. Especially since he is young and has many years of sex ahead of him (and you too). It is definitely an option worth considering. The only other option is the vacuum device. But you may not find this quite as spontaneous. There is definitely no need for you to feel guilty since this is certainly no fault of yours. With all his medical problems, your husband is (unfortunately) a sitting duck for erectile dysfunction.


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