Monday, March 30, 2020
Orgasm

Sexual problems are more common in postmenopausal women, which suggests that menopause can reduce libido.

The reduced sex drive is often caused by decreased estrogen levels, which can dampen arousal and result in sex being more painful.

In this article, we look at how menopause might affect someone’s sex drive, along with what can be done to improve libido.

Menopause and libido

What is menopause?

Menopause refers to when a woman stops having her period permanently, but it can affect more than a woman’s menstrual cycle.

Menopause can cause physical and emotional changes that impact a woman’s life, including her sex life.

Some symptoms and side effects associated with menopause include:

  • anxiety
  • bladder control issues
  • decreased sex drive and desire (libido)
  • depression
  • difficulty sleeping
  • thinning hair
  • weight gain

Each of these effects can impact a woman’s quality of life and relationship with her partner.

What is libido?

Libido refers to sexual interest and sexual enjoyment.

Some women going through menopause report reduced libido, but the causes vary from person to person.

According to one review, the reported rates of sexual problems in postmenopausal women are between 68 and 86.5 percent.

This range is much higher than in all women in general, which is estimated to be between 25 and 63 percent.

Why does menopause affect libido?

Decreased estrogen levels can result in reduced blood flow to the vagina, which can cause the tissues of the vagina and labia to become thinner. If this happens, they become less sensitive to sexual stimulation.

Decreased blood flow also affects vaginal lubrication and overall arousal. As a result, a woman may not enjoy sex as much and may have difficulty achieving orgasm. Sex may be uncomfortable or even painful.

Fluctuating hormone levels during perimenopause and menopause can also affect a woman’s mental health, which in turn, may cause a decrease in her libido.

Stress can also impact a woman’s libido, as she may be juggling a job, parenting, and be caring for aging parents. The changes in hormone levels a woman may experience during menopause may make her irritable or depressed, so dealing with everyday stress may feel more difficult.

According to an article published in the Journal of Women’s Health, women who have more significant side effects associated with menopause are more likely to report lower libido levels.

Examples of these side effects include hot flashes, depression, anxiety, trouble sleeping, and fatigue.

Other factors that make a woman going through menopause more likely to experience a reduced libido include:

  • history of chronic health conditions, such as heart disease, diabetes, or depression
  • history of smoking
  • engaging in low levels of physical activity

A woman should talk to her doctor about how these conditions could affect her sex drive.

Tips for improving libido

There are several steps a woman can take to increase her libido. These include medical treatments, lifestyle changes, and home remedies.

Medical treatments

middle aged couple enjoying a bike ride
Spending time together on shared hobbies, exercising, and planned dates will help increase a couple’s intamacy.

If a woman experiences changes to her vaginal tissue, such as thinning and dryness, she may wish to consider estrogen therapy.

Prescription estrogen can be applied directly to the vagina in the form of creams, pills, or vaginal rings. These usually contain lower doses of estrogen than regular birth control pills.

Some women may wish to take estrogen pills that contain higher levels of hormones. This treatment, known as hormone replacement therapy, might help reduce symptoms, such as hot flashes and mood changes, but may also carry risks.

A woman thinking about hormone replacement therapy should discuss it with her doctor before starting to take any medication.

One study found that women using hormone therapies reported higher levels of sexual desire compared with women who did not.

Less commonly, a doctor may prescribe testosterone therapy. However, not all women respond to this treatment, and the United States Food and Drug Administration (FDA) do not approve it for treating sexual disorders in women.

A woman may not experience any changes in her sex drive after using estrogen or testosterone therapies.

A woman may also choose to see a therapist who specializes in sexual dysfunction or enhancing sex. Sometimes, couples may want to attend therapy together.

Lifestyle changes

Some women may benefit from using water-soluble lubricants during sex. These can be purchased over-the-counter at most drugstores.

However, women should avoid non-water soluble and silicone-based lubricants, as these can break down condoms used to protect against sexually transmitted infections (STIs).

Increasing physical activity, such as getting 30 minutes or more of exercise on a routine basis, may help reduce menopause-related symptoms, including a low libido. Eating a healthful diet can also enhance a person’s overall sense of well being.

Changing sexual habits

There are many ways a person can foster a sense of intimacy with their partner, including:

  • Changing sexual routines: Try spending extended periods on foreplay, use vibrators or other sex toys to enhance an intimate experience, or engage in sexual activity or touching without the goal of orgasm.
  • Relieving stress together: There are many stress-relieving techniques a couple can do outside of the bedroom to increase intimacy. Examples include going on planned dates together, taking a walk, or spending time doing hobbies together, such as exercise, crafts, or cooking.
  • Practicing masturbation: Spending time alone and exploring what types of touch and sexual stimulation work well for an individual can help them talk to a partner about their needs and preferences. It can also help a person feel more comfortable with sexual activity without the pressure of a partner.

Natural remedies

Some women use natural supplements to try to increase their libido. It is important to keep in mind that the FDA do not regulate herbs and supplements, so women should be sure to choose a reputable brand.

Some natural remedies used to increase libido in women include:

  • black cohosh
  • red clover
  • soy

A woman should discuss these remedies with a doctor before taking them to ensure they will not interact negatively with other prescriptions and supplements she may be taking. Soy contains estrogen, so it may react with other estrogen therapies.

When to see a doctor

A woman should speak to her doctor whenever perimenopause or menopause is having a significant impact on her day-to-day activities, including sexual activity.

Sometimes, a doctor can recommend changes in health habits as well as discuss whether prescription medications may help relieve the symptoms, including a low libido.

Speaking with a doctor can also rule out any other underlying medical conditions that may cause a reduced libido. These conditions include urinary tract infections, uterine prolapse, endometriosis, or pelvic floor dysfunction.

Outlook

While some women do experience a decreased libido in menopause, others do not.

Some women may even experience a heightened libido after menopause. This can be due to reduced stresses over pregnancy and fewer child-rearing responsibilities.

If a woman’s libido is impacted after menopause, she should talk to her doctor about treatments that could enhance her quality of life.

Certain foods and drinks contain compounds that may improve vaginal health and symptoms of vaginal conditions. These include probiotics, prebiotics, and fermented food and beverages.

The vagina uses natural secretions, immune defenses, and “good” bacteria to keep itself healthy. Eating a healthful, balanced diet might also further prevent infections and improve vaginal conditions.

This article discusses what little research there is into the effects of diet on vaginal health, looks at dietary choices for common vaginal conditions, and identifies other ways to improve vaginal health.

People should speak to a doctor before using diet to address any health concerns.

Balancing pH levels

The vagina is a moderately acidic environment with a pH of around 4.5. This acidity helps healthful bacteria to grow and prevents harmful microbes from developing.

Some good bacteria, such as probiotics, may help balance vaginal acidity levels.

Probiotics

Lactobacillus species bacteria is the most dominant type of “good” bacteria found in a healthy vagina.

Research has suggested that Lactobacillus could benefit vaginal health in the following ways:

  • regulating the microflora in the vagina
  • improving the vagina’s acidity levels
  • stopping harmful microbes from attaching to the vaginal tissues
  • working with the body’s immune system

2016 study indicated that using vaginal Lactobacillus supplements after taking antibiotics hindered bacteria growth in people with bacterial vaginosis (BV), and significantly reduced vaginal pH.

2015 review study found “no significant evidence” that probiotics were more beneficial than using a placebo or no treatment. However, the authors noted that due to a lack of evidence, “a benefit cannot be ruled out.”

Probiotic supplements are available, but some nutritionists recommend getting them from fermented foods and drinks, such as:

  • yogurt and kefir
  • kimchi and sauerkraut
  • pickles
  • tempeh
  • kombucha

Prebiotics

Prebiotic compounds may also help stabilize vaginal pH by promoting the growth of healthy bacterial populations. Foods rich in prebiotics include:

  • leeks and onions
  • asparagus and Jerusalem artichoke
  • garlic
  • whole wheat products
  • oats
  • soybeans
  • bananas

It is important to note that prebiotics can worsen bowel conditions, such as irritable bowel syndrome (IBS).

Preventing UTIs

Urinary tract infections (UTIs) occur when bacteria enter parts of the urethra, bladder, or kidneys, causing symptoms such as burning or pain during urination and bad smelling or cloudy urine. According to the Urology Care Foundation, about 60% of women will experience a UTI at some point.

Drinking lots of fluids might help prevent a UTI.

Cranberry juice

According to the Urology Care Foundation, drinking cranberry juice or taking cranberry tablets may prevent UTIs from developing.

Research supports this idea — in a 2016 study, researchers found that drinking 8 ounces (oz), or 240 milliliters (ml) of a 27% cranberry juice drink each day for 24 weeks lowered the rate of UTIs in adult women who had recently had a UTI.

Cranberries are rich in antibacterial compounds that kill bacteria. These include antioxidants and organic acids, such as:

  • proanthocyanidins and anthocyanins
  • organic and phenolic acids
  • vitamin C
  • flavanols and flavonols

Research into diet and UTIs has mainly focused on cranberries, but many fruits, especially citrus fruits and berries, are also rich in antioxidants and may have similar effects.

Reducing candida infections

Candida infections, or yeast infections, are the second most common cause of vaginitis, or vaginal inflammation.

There is no scientific proof that any foods can reduce candida infections. However, some foods contain ingredients that the fungus uses to grow. These ingredients include refined sugar, preservatives, yeasts, fungi, allergens, and trace antibiotics. People may benefit from avoiding these foods.

Researchers are studying the possible benefits of natural remedies with antifungal, anti-inflammatory, or antioxidant properties for candida infection, including tea tree oil, coconut oil, and garlic.

Other ways to improve vaginal health

Regularly eating a healthful, balanced diet that contains fermented products with probiotics and prebiotics can improve vaginal health.

Following some of these lifestyle habits might also help:

  • cleaning the genital region with mild, unscented soap before rinsing well and patting dry daily or as needed during menstruation
  • wiping from front to back
  • using antibiotics appropriately and only when necessary
  • reducing sweat around the vagina
  • exercising regularly
  • maintaining a healthy weight
  • staying hydrating
  • reducing stress
  • wearing loose-fitting cotton underwear

Avoiding or limiting things that can imbalance the body’s systems or irritate the vagina can help, such as:

  • douching
  • holding in urine or rushing urination
  • personal care products with dyes, flavors, or fragrances
  • spermicidal foam or diaphragms
  • tight pants or underwear
  • smoking
  • prolonged exposure to moisture
  • alcohol
  • processed or heavily refined foods
  • foods or drinks with artificial hormones

Summary

Many nutrients contribute to vaginal health. Eating a healthful, nutrient-rich diet can improve all body systems.

Certain nutrients, antioxidants, and probiotics may have particular benefits for vaginal health. However, researchers need to do more studies to work out which nutrients help boost vaginal health and prevent vaginal infections.

The muscles, ligaments, and tissues of the pelvic floor support the bladder, rectum, and sexual organs. When the supportive structures weaken or become especially tight, doctors describe it as pelvic floor dysfunction. It is a common health issue.

When a person has pelvic floor dysfunction, the organs in the pelvis may drop. They often press down on the bladder or rectum, causing a leakage of urine or stool. Or, a person with this condition may have trouble urinating or passing stool.

Keep reading to learn more about pelvic floor dysfunction — including the symptoms, treatments, and some exercises that may help.

What is pelvic floor dysfunction?

The pelvic floor is made up of muscles, ligaments, and tissues that surround the pelvic bone. The muscles attach to the front, back, and sides of the bone, as well as to the lowest part of the spine, called the sacrum.

The function of the pelvic floor is to support the organs in the pelvis, which can include the:

  • bladder
  • rectum
  • urethra
  • uterus
  • vagina
  • prostate

People with pelvic floor dysfunction may have weak or especially tight pelvic floor muscles.

When the muscles tighten, or spasm, people may have trouble urinating or passing stool. When they weaken, the organs within the pelvis may drop and press down on the rectum and bladder.

The table below outlines several common types of pelvic floor dysfunction.

Type of pelvic floor dysfunctionDescription
Obstructed defecationThis occurs when stool enters the rectum, but the body cannot fully evacuate the bowels.
RectoceleThis involves tissue from the rectum protruding into the vagina. Stool may get caught in this pocket, forming a bulge in the vagina.
Pelvic organ prolapseThis refers to the pelvic floor stretching and the pelvic organs dropping as a result of age, childbirth, or a collagen disorder.
Paradoxical puborectalis contractionThis involves a pelvic floor muscle called the puborectalis contracting. When it happens, trying to pass stool may feel like pushing against a closed door.
Levator syndromeThis involves the pelvic floor muscles spasming after bowel movements. It can cause lasting dull pain or achy pressure high in the rectum.
CoccygodyniaThis refers to pain in the tailbone that worsens during and after bowel movements.
Proctalgia fugaxThis involves painful spasms of the rectum and muscles in the pelvic floor.
Pudendal neuralgiaThis refers to irritation or damage to the pudendal nerves, which help the pelvis function.
UrethroceleThis refers to the urethra pressing into the vagina.
EnteroceleThis involves the small intestine descending and pushing into the vagina, forming a bulge.
CystoceleThis involves the bladder dropping and pushing into the vagina.
Uterine prolapseThis refers to the uterus descending and pushing into the vagina.

Symptoms

Pelvic floor dysfunction can cause a variety of symptoms, and some can interfere with daily life.

Depending on the type of pelvic floor dysfunction, a person may experience:

  • pelvic pain
  • pressure
  • a bulge somewhere in the lower pelvic region
  • stress urinary incontinence, which involves a small amount of urine leaking from the body due to an activity such as coughing
  • involuntary leakage of stool
  • incomplete urination
  • bowel movement dysfunction
  • pain during sexual intercourse

Also, some people who see their doctors about bladder overactivity find that pelvic floor dysfunction is responsible.

Causes

Many issues can cause the structures of the pelvic floor to weaken, including:

  • age
  • systemic diseases
  • lasting health issues that cause increased pressure in the abdomen and pelvis, such as a chronic cough
  • pregnancy
  • trauma during delivery
  • multiple deliveries
  • large babies
  • operative delivery

Research indicates that stress urinary incontinence, pelvic organ prolapse, or both occur in about half of all women who have given birth. These issues are closely associated with birth-related injury to the pelvic floor muscles.

The pelvic floor muscles can also stretch naturally with age. Stress urinary incontinence and pelvic organ prolapse become more common with increasing age in females, for example.

Collagen disorders can also affect the muscles’ ability to support the pelvic organs.

Meanwhile, coccygodynia usually stems from trauma to the tailbone, such as from a fall. That said, in about one-third of people with the condition, the cause of coccygodynia is unknown. The pain can make having a bowel movement difficult.

Exercises

Doctors recommend pelvic floor exercises in various situations.

They may particularly benefit pregnant women because the pelvic floor muscles can stretch and weaken during labor. Strengthening these muscles may help prevent incontinence after the baby is born. Some doctors recommend that women who wish to become pregnant start the exercises ahead of time.

Males can also benefit from pelvic floor exercises, though the dysfunction is more common in females. In males, these exercises can help prevent pelvic organ prolapse and urinary incontinence and improve sexual intercourse.

To exercise these muscles, a person should be sitting comfortably. Then, they should attempt to squeeze their pelvic muscles without holding their breath.

It is important to isolate the correct muscles without tightening those of the stomach, buttocks, or and thighs.

Doctors recommend that females aim to do 10 long squeezes — holding each for 10 seconds — followed by 10 short squeezes. However, initially, it may be a good idea to practice holding a squeeze for a few seconds at a time.

By practicing frequently, a person should be able to add more contractions to their routine week by week. It is important to do this gradually and to avoid overworking the muscles.

Within a few months, a person may notice a reduction in their symptoms. Even if symptoms resolve completely, a person should continue strengthening these muscles.

There are physical therapists who specialize in pelvic floor dysfunction. A person may find that consulting one of these professionals leads to a better outcome.

Treatment

Doctors determine the cause of pelvic floor dysfunction before recommending treatment because different types of dysfunction require different approaches.

The purpose of treatment is to relieve or reduce symptoms and improve the person’s quality of life. For some people, a combination of treatment methods works best.

Doctors may recommend:

  • Dietary changes: For example, eating more fiber, drinking more fluids, and taking certain medications can make bowel movements easier.
  • Laxatives: Taking a daily laxative may help people with pelvic floor dysfunction pass stool, but it is important to consult a healthcare provider first because not all laxatives are equally effective.
  • Pain relief: Some people require injections of pain relief or anti-inflammatory medication to relieve their symptoms.
  • Biofeedback: This involves electrical stimulation, ultrasound therapy, or massage of the pelvic floor muscles to help improve rectal sensation and muscle contraction.
  • Pessary: A doctor or nurse inserts a pessary into the vagina to support prolapsed organs. This type of device can help treat various symptoms of pelvic floor dysfunction, either as an alternative to surgery or while a person awaits surgery.
  • Surgery: When prolapse interferes with daily activities, a doctor may recommend surgery. Large rectoceles also require surgery if the person experiences symptoms.

Stem cell therapies

Researchers behind a 2016 study investigated whether a stem cell-based therapy could resolve pelvic floor dysfunction in rats.

The researchers engineered the stem cells to produce and release elastin and collagen into the pelvic floor and injected them into rats with pelvic floor dysfunction.

The elastin and collagen promoted the repair of pelvic floor structures and decreased signs of stress urinary incontinence.

In a final component of the study, the researchers developed stem cells that blocked a factor that stops the production of elastin. This promoted increased production and release of elastin into the pelvic floor.

With further studies, researchers may find that similar therapies are effective in humans.

When to see a doctor

Anyone who experiences painful bowel movements, difficulty urinating or passing stool, pelvic pain, or pain during sexual intercourse should speak with a doctor.

An unusual bulge in the lower pelvic region may also be a reason to see a doctor, though a bulge alone may not be a cause for concern.

People with pelvic floor dysfunction have plenty of treatment options. While the topic may be uncomfortable to bring up with a doctor, it is important to seek professional advice about these symptoms.

While some family doctors may not be familiar with pelvic floor dysfunction, specialists such as colorectal doctors, urologists, and gynecologists can help diagnose the issue and recommend the best course of action.

Summary

Pelvic floor dysfunction can affect anyone, but pregnant women have the highest risk.

The various types of pelvic floor dysfunction stem from different causes, and a doctor must identify the underlying issue before developing a treatment plan.

Exercises can help some people with pelvic floor dysfunction. Depending on the cause, a doctor may also recommend dietary changes, medication, a pessary, biofeedback, or surgery.

People may have heard that peeing after sex is beneficial, especially for women. This is because peeing flushes bacteria out of the body, which may help prevent a urinary tract from developing.

Here, we look at how peeing after sex may help to prevent urinary tract infections. We also discuss whether there are any other benefits to peeing after sex.

Benefits of peeing after sex

Sexual intercourse is a risk factor for urinary tract infections (UTIs).

During sex, bacteria can pass from the genitals to the urethra.

The urethra is the tube that connects the bladder to the urethral opening where urine comes out. Bacteria can then make its way from the urethra to the bladder, resulting in a UTI.

Peeing after sex helps to flush bacteria out of the urethra, helping to prevent UTIs.

How can it help prevent UTIs?

Females are up to 30 times more likely to get a UTI than males. This is due to two reasons: Firstly, the female urethra is close to the vagina and anus. This means that bacteria can easily spread from these areas to the urethra. Secondly, the urethra is shorter in females than it is in males. This means that bacteria that enter the urethra can reach the bladder more easily.

In women, peeing after sex can help to flush any bacteria away from the urethra.

For males, peeing after sex is less important. This is because males have a longer urethra. As a result, bacteria from the genital area is less likely to reach the bladder.

Although there is no solid evidence to confirm that peeing after sex can prevent UTIs, there is no harm in following this practice. It may help to reduce the risk of UTIs, especially in women and people who are more prone to UTIs.

Does it prevent pregnancy?

Peeing after sex will not prevent pregnancy. The urethra and vagina are separate parts of the female anatomy. As a result, peeing will not affect any sperm that enter the vagina. Using some form of birth control is the only way to prevent pregnancy during sex.

Does it prevent STIs?

Peeing after sex does not prevent sexually transmitted infections (STIs). People contract STIs by absorbing bacteria through the mucous membranes inside their bodies during sexual intercourse. Peeing after sex will not prevent these bacteria from entering the body.

Using a condom or other form of barrier contraceptives during sex can help to reduce the risk of STIs.

How soon after sex should you pee?

There is no recommended time to pee after having sex, although some anecdotal sources suggest peeing within 30 minutes after sex. In general, the sooner people pee after sex, the sooner they can flush out bacteria before it travels up the urethra.

If people are struggling to pee after sex, drinking a glass or two of water may help. A larger amount of urine will also be more effective in flushing out bacteria.

Other ways to prevent UTIs

The following tips may also help to reduce a person’s risk of getting a UTI:

  • drinking 8-10 glasses of water each day to ensure regular flushing of bacteria out of the urethra
  • peeing whenever the urge arises, rather than holding in urine
  • avoiding going more than 3 or 4 hours without urinating
  • always wiping from front to back after going to the toilet
  • cleaning the genitals with warm water each day
  • avoiding using scented female hygiene products
  • avoiding douching
  • avoiding using spermicides if prone to UTIs
  • wearing loose cotton underwear
  • avoiding tight clothing
  • avoiding staying in wet bathing or workout clothes that can trap moisture and harbor bacteria around the genitals
  • limiting baths to 30 minutes or less, or taking showers
  • drinking cranberry juice or taking cranberry extracts

When to see a doctor

People should see a doctor if they experience the following symptoms of a UTI:

  • painful or burning sensation when urinating
  • feeling the need to urinate often, despite passing only a small amount of urine each time
  • cloudy urine
  • foul-smelling urine
  • blood in the urine
  • pressure or pain in the lower abdomen
  • feeling tired, weak, or shaky
  • confusion

If people have a UTI, a doctor will likely prescribe antibiotics to clear the infection. People will usually start feeling better within a few days.

In some cases, a UTI can make its way up to the kidneys. A kidney infection can be severe and requires immediate medical treatment. Symptoms of a kidney infection include:

  • a fever
  • chills
  • nausea
  • vomiting
  • pain in the lower back

People should also see their doctor if they notice any unusual or painful symptoms during or after sex. These could be symptoms of an STI.

Summary

Peeing after sex may help to flush bacteria out of the urethra, thereby helping to prevent a urinary tract infection (UTI). It may be especially helpful for women, or people who are prone to UTIs.

However, peeing after sex will not prevent pregnancy or sexually transmitted infections (STIs).

People should see a doctor if they experience symptoms of a UTI or STI. Some people may require treatment with antibiotics.

Some people believe that masturbation can cause erectile dysfunction, but this is a myth. Masturbation is a common and beneficial activity.

While most men have trouble getting or keeping an erection at some point in their lives, frequent difficulties getting an erection is called erectile dysfunction (ED).

Learn more about ED and masturbation, if watching porn affects sexual function, and when to see a doctor.

Can masturbation cause ED?

No, masturbation cannot cause ED — it is a myth.

Masturbation is natural and does not affect the quality or frequency of erections.

Research shows that masturbation is very common across all ages. Approximately 74 percent of males reported masturbating, compared to 48.1 percent of females.

Masturbation even has health benefits. According to Planned Parenthood, masturbation can help release tension, reduce stress, and aid sleep.

A person may not be able to get an erection soon after masturbating. This is called the male refractory period and is not the same as ED. A male refractory period is the recovery time before a man will be able to get an erection again after ejaculating.

What does the research say?

Universally, researchers are confident that masturbation does not cause ED. However, difficulty getting and keeping an erection either while masturbating or while having sex may be a sign of other conditions.

Age is the most significant predictor of ED. Erectile dysfunction is common in men over 40 years old, with approximately 40 percent being affected to some degree.

Rates of complete ED, or the inability to get an erection, increase from 5 percent in men aged 40 to about 15 percent at age 70.

Other risk factors for ED include:

  • diabetes
  • being overweight
  • heart disease
  • lower urinary tract symptoms (bladder, prostate, or urethra issues)
  • alcohol and cigarette use

ED in younger men

Although ED generally affects older men, a 2013 study found that as many as a quarter of men under 40 years old received a new ED diagnosis.

In younger men, ED is more likely to be caused by psychological or emotional factors. Younger men also have higher levels of testosterone in their bodies and are less likely to have other risk factors for ED.

Anxiety about sexual performance or erection quality can lead to further stress, sometimes creating a “vicious circle.”

Factors that can contribute to ED in younger men include:

  • stress
  • anxiety
  • depression, post-traumatic stress disorder, bipolar disorder, or medications for these illnesses
  • being overweight
  • insomnia or lack of sleep
  • urinary tract problems
  • a spinal cord injury, multiple sclerosis, or spina bifida
  • having a high-stress job
  • relationship stress
  • performance anxiety

Porn and ED

There is no evidence to suggest that watching porn causes ED.

Internet porn usage rose at the same time that the rate of ED diagnoses increased in men under 40 years old.

This led some researchers to believe that porn might affect male viewers’ ability to get and maintain erections.

While it is true that internet porn access and diagnoses of ED in younger men increased at about the same time and rate, this does not prove a link between the two.

Until recently, there was little research into ED in young men, making numbers difficult to interpret. Also, due to stigmas and reluctance to speak to a doctor about sexual health, ED may be underreported in both younger and older men.

It is also difficult to separate the psychological effect of watching porn from other psychological factors, such as performance anxiety.

When to speak to a doctor

ED is sometimes a sign of underlying conditions, such as heart disease or anxiety.

Telling a doctor about ED can prevent potential problems that these conditions might cause, and also provide solutions to ED.

For example, doctors may recommend that men with ED who are overweight lose some weight. This is because maintaining a healthy weight can increase testosterone levels, making it easier to get an erection.

A doctor may also recommend stress-relief techniques or cognitive behavioral therapy for those dealing with ED due to emotional or psychological issues.

Summary

Masturbation does not cause ED, but many underlying health problems, including heart disease, urinary tract symptoms, alcohol use, depression, and anxiety, can.

Research does not suggest that masturbation using internet porn could cause ED. Some people who watch porn may also experience performance anxiety, resulting in difficulties with erections, but performance anxiety is common without porn use.

Anyone experiencing problems getting or maintaining an erection should speak to a doctor, as ED is often treatable.

The testicles, or balls, are oval-shaped glands that form part of the male anatomy. They sit inside a thin sack of skin called the scrotum. As a person ages, the scrotum loses elasticity, and the skin starts to sag. Certain medical conditions can also cause the skin to appear saggy.

Skin loses its elasticity over time as a person gets older, and the effects of gravity start to become more noticeable everywhere on the body, including the testicles.

Some treatments can help keep the scrotum from sagging too much, although there is no way to prevent or treat the issue completely. Sagging testicles, which people often refer to as saggy balls, are usually not a cause for concern. However, if they appear with other symptoms, such as pain on one side of the balls or in the prostate, a person should see a doctor.

In this article, we look at the possible causes of sagging testicles, as well as treatment options and when to see a doctor.

What is normal?

The testicles hang inside the scrotum, or scrotal sac. The looseness of the skin around the testicles varies among individuals, and in many people, it is naturally fairly loose. The scrotum helps protect the testicles and provides some impact resistance.

The scrotum also moves in response to heat to protect the delicate testicles and sperm inside. In doing so, it helps keep the sperm viable by preventing them from becoming too warm or too cold.

In cold weather, the skin tightens up as the cremaster muscle pulls the testicles toward the body to keep them warm. In hot conditions, the skin loosens to prevent the testicles from overheating. The looser skin allows the balls to hang away from the warm body and encourages airflow around the scrotum to keep the area cool.

As such, even in younger people, the testicles will typically sag a bit. A person will generally notice this once they start producing sperm during puberty.

As a person ages, the testicles will generally sag much more. The process may not be noticeable at first, but by the age of 50 years, most people will notice a drastic difference in how much their balls sag.

Causes

Sagging testicles are a completely normal part of the aging process. A study from 2014 verifies the decrease in skin mechanical properties with aging. The skin loses collagen with age, causing the layers of the skin to stretch more.

While this applies to the skin everywhere on the body, it may be more noticeable in certain areas, such as the face and testicles. The scrotum and testicles already hang away from the body, so more stretchy skin and the efforts of gravity can lead to the effect appearing more drastic.

Other times, sagging testicles may be the result of an underlying issue, such as a varicocele. A varicocele occurs when a vein near the testicles swells up. This swelling can cause an increased blood flow to the testicles, which heats them. The body then responds by dropping the testicles lower to prevent them from getting too hot.

According to a study in the Asian Journal of Andrology, varicoceles appear in up to 15% of males and may have an association with infertility.

Varicoceles may make a person feel as though their testicles are moving or squirming, and they may also notice pain in the area. Anyone experiencing these symptoms alongside sagging testicles should see a doctor. Sometimes, a person will not experience any other symptoms and will not notice that they have the issue.

Treatments

Although age-related sagging in the scrotum is normal, some people may be uncomfortable with its appearance or find that it gets in the way of their daily life — for example, by making it easy to sit accidentally on the testicles. Surgery is the only sure way to resolve the issue, but people can also try a range of nonsurgical methods, including those below.

Exercises

There are several different exercises that people claim can prevent or treat sagging testicles, although there is no scientific evidence to prove that they work. Still, many people perform exercises to help them work out the muscles in this area of the body.

Some people say that they feel better when doing these exercises, perhaps because they feel as though they are being proactive. Even if they are ineffective, testicle exercises are unlikely to harm the testicles or make the sagging any worse.

Two exercises that some people use are Kegels and testicular holding:

Kegel exercises

Doing basic Kegels, by finding and activating the pubococcygeal (PC) muscles, may help some people support their penis and testicle health in general. The PC muscles are the muscles that a person uses to hold back their urine stream.

The basic Kegel exercise involves contracting the muscles as though trying to cut off the urine stream. As this exercise activates the PC muscles, it may improve the strength of the pelvic floor and help with some issues in the testicles, prostate, and penis.

Testicular holding

Testicular holding is similar to weight training the testicles. Holding the testicles in one hand and pulling downward activates the PC muscles. Doing this for 5 minutes each day may activate the PC muscles more strongly than simple Kegels.

Keeping the skin healthy

As much of the sagging in the testicles is due to aging skin, it may help to keep the skin as youthful as possible.

The American Academy of Dermatology recommend several ways to protect and care for the skin, including:

  • avoiding sun exposure
  • quitting smoking
  • drinking less alcohol
  • maintaining a healthy weight
  • eating a balanced diet

These tips may help improve skin health in general, which may slow the progress of saggy testicles.

Surgery

Some surgical options are available to treat overly sagging testicles. These are largely for people who dislike how their testicles look. These treatments may also help in cases where the person has problems that arise from their saggy testicles, such as accidentally sitting on their testicles too often.

In these cases, a procedure called a scrotoplasty may help keep the scrotum from hanging down as far. During a scrotoplasty, the surgeon will carefully remove extra skin from the scrotum to let the testicles rest higher up toward the body.

Surgery works to treat saggy balls, but the results are not permanent. The effect is likely to wear off over time as the skin continues to stretch with age.

In the case of a varicocele, a surgical procedure called a varicocelectomy treats the underlying issue by tying off the swollen veins. The symptoms should go away as the area heals, and this may have a positive effect on the sperm.

Other methods

There is no miracle cure for sagging testicles. People may come across other methods — such as only wearing tight briefs and avoiding sex or masturbation — on internet forums and by word of mouth, but these are not effective methods.

Other sources claim that lotions, creams, hormones, or supplements can help. Although they are probably harmless to most people, there is no evidence that these methods will work.

When to see a doctor

People who notice troubling symptoms, such as pain in their groin or prostate, should see a doctor. Anyone who wants to discuss cosmetic surgery should talk to a doctor about a referral to a trusted cosmetic surgeon.

Summary

The majority of the time, sagging testicles are a normal part of the aging process. The testicles naturally sag, even at a young age, to protect the sperm inside and keep them viable.

Anyone worried about saggy balls or other associated symptoms should contact a doctor for a diagnosis. In some cases, there may be an underlying issue to treat. In others, cosmetic surgery may help a person feel better.