The first step in treating sexual dysfunction -- a common couple's disease -- is to go as a couple to see a urologist, says Dr. Lawrence Hakim, head of sexual medicine and surgery at Cleveland Clinic in Fort Lauderdale, Fla.

"It's a very trying issue" affecting 20 million to 30 million people in the United States, Hakim says. "Some wait years suffering in silence. It destroys intimacy, marriages, relationships. It's nothing to be ashamed of.

"It's often due to other problems like diabetes, hypertension, prostate cancer therapies. . . For many men it can be the first sign of heart disease, which could be life-threatening."

Once the couple takes the first step and visits a urologist, they can discuss treatment options, including:

• Medications such as Viagra, Levitra and Cialis. These are effective for many men, but they don't work for everyone, Hakim says. Also, they could prove fatal to someone with heart disease taking nitroglycerin.
• Injection therapy. This involves the man injecting himself in the penis before sexual intercourse, a turn-off for men who prefer spontaneity.
• Penile prothesis. During a 30-minute operation, a device is placed into the penis, completely concealed. After four to six weeks of healing, the man can can get a full, rigid erection anytime for as long as he wants, without interfering with sensation and urination, Hakim says.

  After ejaculation, he can maintain the erection. He can deflate the device by activating a pump that sits inside the scrotum. With this, there is no risk of priapism, an often painful erection lasting hours that can lead to permanent erectile dysfunction.

"No one treatment is right for everybody," Hakim says. "There's no magical pill."

Source: The Miami Herald. Distributed by McClatchy-Tribune Information Services. Powered by YellowBrix.