The cause of weak erections is either psychological or physical. Physical causes include diabetes, high blood pressure, and lifestyle practices such as cigarette smoking. Weak erections may also be the side effect of treatments for high blood pressure and prostate cancer. Common treatments for the condition include simple counselling and the use of medication, the best of which is viagra. If medications do not work, an injection may be given directly into the penis. The doctor may also advise the use of a vacuum device. Alternatively, a penile implant may be done surgically.

The medical profession believes that the cause of premature ejaculation is really psychological more than physical, but there is some evidence that there may also be a physical component. The treatment is sex therapy exercises, the most popular which is Masters and Johnson technique which your doctor will tell you about. But, medication is also used with significant results. Topical agents, applied to the skin, can also be used. The success rate in solving this problem is quite good.

Infertility is a common problem in Jamaica. About 15 per cent of couples are infertile, Dr. Wan says. Among this group, one-third is caused by infertile women, one-third by infertile men, and one-third because both have problems. A low sperm count is the problem usually found in men, due usually to a problem with the testes. Occasionally it is due to problems with the male sex hormone or a blockage in the tube which conveys the sperm. Treatment is based on causation. Medication may include hormones or other drugs to improve sperm quality. This has a very limited rate of success. There are some patients who require surgery to correct varicose veins in the scrotum. In addition, some patients require surgery to relieve blockages of tubes. What is used with increasing frequency is invitro fertilisation. Locally, this is being used more and more for men with low sperm count.

A lot of men who have urinary infections, usually prostetitis ­ an inflammation for the prostate ­ are concerned about the presence of STDs. Almost always the tests do not reveal an STD. But, the first thing that they want to know is if they got it from their wife or if they can give it to them. Some men have warts, commonly called "venereal warts". They are treatable and it is advised that condoms should be worn until these are removed.

If this sore does not heal within three weeks, then the doctor must exclude cancer by doing a biopsy. As educational standards improve along with hygiene, notes Dr. Wan, penile cancer is appearing less and less. At the same time, however, prostate cancer is on the increase. It is recommended that all men do an annual rectal examination and a blood test or PSA to test for cancer of the prostate.

All the treatments for prostate cancer can lead to erectile dysfunction in a significant percentage of patients. Jamaica has the highest published rate of infection worldwide. Treatments include radical surgery to remove the entire prostate gland, or radiation if the cancer is confined to the prostate. For cancer which has spread outside the prostate, treatment includes the manipulation of male hormones. The main method here is used to stop or reduce testosterone production. Patients should be counselled to have realistic expectations. Most men, when advised that their sexual function will be affected by treatment for prostate cancer, still accept treatment.