Sex For Dummies. Dr. Ruth K. Westheimer

— is the prostate. The prostate gland, located below the man’s bladder, produces some of the fluids that are contained in the semen, giving semen its whitish color. The urethra, which carries semen and urine out of the body, runs through the prostate, and any disease affecting the prostate can affect the urethra.

      Checking the prostate

      As a man ages, his prostate gland commonly becomes enlarged and causes him to urinate more frequently. This problem, called benign prostatic hypertrophy, is bothersome but not dangerous. However, the prostate also has a nasty habit of becoming cancerous, which can be quite dangerous, though it is easily treated if discovered in time.

      A doctor checks the prostate for changes that can signify a cancerous growth simply by palpating, or touching, it. In order for his doctor to get to the prostate, a man has to bend over and allow the doctor to stick his or her finger in the man’s rectum. This way, the doctor can actually feel the prostate gland.

Although I don’t necessarily blame any man for not wanting to rush off to the doctor to be examined in this manner, a prostate examination is no worse than the gynecological visits we women have to go through regularly, so I won’t accept any excuses for not doing it. Now, if you’re really concerned, you can speak to your doctor about a blood test that may reduce the odds of your having to undergo the actual physical exam. If a certain hormone, called PSA, is elevated, then that’s a bad sign. But because regular prostate exams can save your life, I absolutely recommend that you not put them off, especially if you’ve reached that 50-year milestone.

      Treating the prostate

      Doctors have various treatments for prostate conditions, some of which have side effects that impair sexual functioning. Some medications used to treat either an enlarged or a cancerous prostate can reduce sexual desire. Surgical removal of part or all of the prostate is another measure that can be taken, which also has potential side effects.

      The most common form of surgery for an enlarged prostate is called a transurethral resection of the prostate (TURP). Approximately 5 to 10 percent of men who are operated on experience erectile dysfunction after the surgery, and 80 to 100 percent experience something called retrograde ejaculation. This means that, during ejaculation, the semen flows backwards into the bladder instead of out of the penis. This condition doesn’t affect a man’s ability to have an orgasm, so some men find that retrograde ejaculation doesn’t bother them; others report sex to be less pleasant because of the lack of fluid. Retrograde ejaculation definitely poses a problem if the man is trying to impregnate a woman; in that case, artificial insemination may be necessary.

      Because the various treatments for prostate problems, particularly surgery, can leave a man with erectile dysfunction (inability to have an erection), many men avoid going to the doctor when they first sense that something may be wrong. Of course, the condition will only worsen, and by the time they do go for treatment, it may be too late. Luckily, thanks to erectile dysfunction (ED) drugs, such as Viagra, men who have prostate problems may be able to regain their ability to have erections even after surgery. I discuss drugs that treat ED in Chapter 22. While I certainly applaud this breakthrough in terms of sexual functioning, it would please me even more if it meant that more men would go to the doctor earlier so they could undergo successful treatment.

      In fact, going to see your doctor at the first sign of any erectile difficulties could be important because common reasons for ED include high blood pressure and diabetes, medical conditions that need to be treated as soon as any symptoms appear.

Chapter 3

      Demystifying the Female Parts

      IN THIS CHAPTER

      

Touring the female anatomy

      

Understanding the “men” words

      

Promoting good breast health

      On the subject of our genitals, we women face a conundrum (no, that’s not a new sexual term; it just means a puzzle). On the one hand, because our reproductive organs are for the most part hidden away, women in general don’t have the same type of familiar relationship that a man has with his apparatus. Some women even try their best to ignore their genitals. They touch themselves as little as possible and never really look between their legs.

      On the other hand, these hidden organs have a way of making themselves known with a certain regularity so, try as we may, they are impossible to totally ignore. And women have good reasons not to ignore these organs:

       A woman’s reproductive system can suddenly turn her life upside down if she becomes pregnant. The fact that almost half of the nearly four million pregnancies that occur in the United States each year are unintended pregnancies is proof that too many women still don’t know everything they should about how their bodies work.

       Another reason for women and men to become better informed about the female anatomy is that understanding our bodies is certainly key to good sexual functioning, which is the primary purpose of this book.

        Understanding female anatomy is important for having a healthy outlook toward women. The idea that a woman’s genitals are in some foreign, dank place — the black hole of Calcutta is one name that’s been used for it — denigrates not only a woman’s genitals but her status as a human being as well.

      Although these parts are private in our society because they relate to an individual, I can see no need to keep their general nature private as well.

      So whether you are a female or a male, I’m going to make sure that you no longer face a mystery when you contemplate a woman’s genitals. Instead, I’m going to imprint a topographical map in your brain that you’ll never forget.

Making Time for a Grand Tour

      If you’re a woman reading this, you have a definite advantage because you can examine yourself. Many women never take the time to look closely at their genitals, and I highly recommend the practice. Because your genitals aren’t as convenient to view as a man’s, you’ll need a simple tool: a hand mirror. Take off your clothes and seat yourself someplace where you can spread your legs easily. You can use available light or better yet, use a flashlight or the light on your phone to give you a clearer view. I suggest you do some exploring on your own, read the next few pages, and then go back and see if you can identify the various places that I mention.

      As far as you guys out there, if you have a partner who’s willing, sharing in this experience certainly won’t do you any harm, although I have a few words of caution:

       If your partner has never examined herself before, maybe you should give her some time alone to take this little tour first, because your presence will no doubt be a distraction.

       When your turn to explore comes around, do your utmost to keep the examination nonsexual, even if you do get aroused (which you probably will). If you can keep the moment on an educational plane, then you have a good opportunity to ask her some questions about how she feels about her genitals, as well as what pleases her and what displeases her when you have sex.

      If, after the grand tour is over, you’re both so aroused that you need to have sex, then be my guest — but only if you promise to put to use what you just learned and not go back to