Therefore, we do have some medications to offer the patient today in addition to consultation with a psychologist who will advise behavior modification protocols. However, in the last ten years we have found several new drugs, mostly antidepressants, whose side effects prolong orgasm or make ejaculation difficult. The primary treatment for this condition is consultation with a psychologist who will work with the couple so that the patient can progressively learn better control of the timing of orgasm and subsequent ejaculation. This problem is always psychological in nature. The patient complains that he has an uncontrollable ejaculation that always occurs before he wants it to, usually quite promptly after erection. Sexual dysfunction problem areas that we as urologists see in the office include: This is a condition in which the male has an orgasm very quickly following an erection, often even before penetration. The good news is that noninvasive oral medications can help a large number of these men, and other treatments that have been developed over the past thirty years are constantly being improved and can help many others who do not respond to Cialis. The advent of Cialis has raised awareness of the problem and I expect we will see many more men seeking treatment than in the past. In the United States, some twenty million men are estimated to have some degree of impotence problems. Impotence, or the inability to achieve a satisfactory erection, is only one potential problem though it is the one most commonly thought of in relation to male sexual problems. When the Plumbing Fails here men are concerned, the term "sexual dysfunction" can encompass a number of problems with anatomy, physiol ogy, and psychology. Because men are too often lazy as lovers, the above process could sometimes also be summarized as: Don't bother me till this football game is over.

Thus, when men have difficulty achieving orgasm, the cause is primarily psychologi cal although it certainly can have its basis in certain physical conditions. An orgasm is actually triggered by a psychological process, occurring at a time when the individual is highly stimulated and excited both physically and emotionally. The rhythmic spasm of the pelvic floor muscles, commonly referred to as an orgasm, is one of the miracles of human existence.