What’s up Doc? Or rather, what isn’t up? Impotence, simply put, is the inability to get or maintain an erection adequate for intercourse. But, it is important to distinguish between an inability to get an erection and a loss of desire for intercourse. Lack of desire may be a testosterone deficiency and this can be determined by a simple blood test. It is also treatable by taking testosterone in a number of different ways. Impotence on the other hand is treated not with testosterone as much as it is with medicines that we have all come to know such as Viagra, Cialis or Levitra to name a few. One of the key questions I ask as a physician is whether the patient ever wakes up with an erection. If he does, then at least all the plumbing is working and that is a good sign.

Stress, fatigue, guilt, alcohol and other reasons can contribute to impotence. It can also be fleeting so don’t panic. Ask your physician for samples of one of the above medicines and give them a try. If they fail to work, then I would see a Urologist (a physician who specializes in this field). And, if you get an erection lasting for four hours, don’t call me. Call your wife.

“Do I have a Sexually Transmitted Disease?” Well, if you had intercourse last night and you think you have an STD this morning, probably not. You have anxiety. Or you may just have inoculated yourself with a good dose of guilt. That’s not as contagious but just as worrisome. Let’s talk specifically about the actual sexually transmitted diseases themselves.

The main STDs are bacterial (Gonorrhea), viral (Herpes simplex 1 or 2, Hepatitis B, Cytomegalovirus or HIV), spirochetes (Syphilis), protozoan (Trichomonas) or intracellular parasites (Chlamydia). If you want to know the details of these, you may want to enroll in medical school. Otherwise, to just give your mind some ease or to get you started down the road to treatment, let’s just look at some basics.

There is usually a period of time between when you first get exposed (that may have happened last night when during the passion of the moment you forgot about all the risks) and when you eventually get the disease itself (that may be soon). This is what we refer to as an incubation period. This can be a few days to a few weeks but usually not a few hours. An exception to this would only be an infestation of the body louse or crabs. You usually see these crawling around the pubic areas. Don’t try to burn them out. They are easily treated so we will get to them a little later.

One of the scariest questions you may have is whether or not you have developed genital herpes. Let’s look at a quick and easy way of figuring this out. Think cold sores (Herpes 1). If you have ever had a cold sore on your lip then you can relate to genital herpes (Herpes 2) as well. The virus that causes genital herpes is the same, or rather a cousin. But the most important feature is PAIN. Cold sores hurt. You feel them coming a day ahead of time and then you break out with a cluster of fluid filled sores that eventually progress into painful ulcers. This is exactly the way genital herpes presents. If you have a sore that is not painful, then it is probably not herpes. It is probably a zit or an infected hair. These can be tender but not painful.

If you think that you have herpes, this can be confirmed by going to a physician who can swab the sore and send it for testing. Fortunately, herpes is treatable (not curable) with oral medicine that you can take either daily, weekly or just during outbreaks. This will be determined by how often you have an outbreak. Just like cold sores, some of us get one every year or so while others may get them more often. Stress may be a factor that triggers them so try and relax.