In continuation of last week’s essay, Type 2 is the most common type of ED in men under 45. It is also the only type that has absolutely no mainstream treatment options. No pill targets it. No supplement addresses it. No standard medical check-up even screens for it.
You can go to five doctors, and none of them will press on your pelvic floor, test your bulbocavernosus reflex, or ask you how many hours you sit per day. They will check your blood, check your hormones, hand you a prescription, and send you home, but nothing changes for the better.
The penis gets hard, but it fails to stay that way. The first minute feels normal, then it slowly weakens. You may find that you need constant, direct stimulation to maintain firmness. The second that stimulation stops, even for 10 seconds just to get a condom, for instance, you feel the penis weakening.
Changes in position lead to unreliable erections afterwards. Morning wood has become inconsistent or disappeared entirely. You urinate right after sex because the same muscle that cannot hold blood also cannot fully clear your urethra.
Muscle failure usually comes about from one of two possible causes. Either there is atrophy because you have simply never trained these muscles, and they are now weakened from years of sitting and inactivity, or years of frequent sustained stress, bad posture, and unconscious clenching of the pelvic floor muscles have put those muscles into a state of chronic spasm.
This hypertonic state is the most common one. The muscles are permanently in an active posture, but they are functionally ineffective.
They cannot contract properly because they never relax. A muscle that never relaxes can never produce force because it simply does not manage to get oxygen into its cells and expel both carbon dioxide and lactic acid. You may have felt some or all of these symptoms and have probably been told that it is stress, age, or psychological. However, this is not the correct situation; it is a valve that has been mechanically broken.
This is why pills cannot solve the issue. The pill floods your system with blood, but the valve is still broken. Blood enters and leaks right back out. You get harder for an hour, but the structural problem remains. The moment the drug clears, you are back to the starting block, with the same softness and, sadly, the same panic. That is why, with increasing frequency, the aphrodisiacs in popular usage become progressively less effective.
This is also why random Kegel exercises gleaned from the internet make it worse. If your pelvic floor is hypertonic or already over-clenched, the very act of adding more squeezing deepens the spasm. Accordingly, you are merely tightening the cast already applied on a cramped muscle. At this point, it is no more contractive force that you need. What you need is release first, followed by controlled rebuilding.
When there is inadequate appreciation of these linkages, anxiety continues to drive reactions to what is going on, which then worsens the overall picture in such a fundamental way that medications are unable to help. It is the appreciation of these basics that encouraged us to deal with these issues in this and last week’s essays, with the hope that many of the questions currently being asked on this page will diminish in number and similarity.
Type 3 is the neurological variant. This is the one man whom everyone blames everything on, usually by saying that it is all in their head. But they are half right about that. This type is the anxiety loop.
After one or more experiences of going soft, which were caused by Type 2 muscle failure, your brain subsequently flags sex as a threat. The next time you are in a sexual situation, your nervous system activates a stress response before arousal even begins. The heart rate spikes and adrenaline levels rise. Cortisol secretion also rises. With all these systems activated, you enter Spectator Mode, monitoring your responses instead of feeling pleasure.
Adrenaline constricts blood vessels. Cortisol, which is the stress hormone, suppresses the parasympathetic nervous system, the exact branch of your nervous system responsible for erections. Your brain is now chemically preventing your body from getting hard because it is trying to protect you from the embarrassment it predicts.
The cruel part is that the anxiety did not arise in a vacuum. It was triggered by real physical failure, which is Type 2. Your body failed that one time, or perhaps serially, and your brain noticed. Now your brain is making it worse.
This is why therapy alone does not deal with the problem. A therapist can help you understand the loop. You can intellectually map the anxiety, trace the trigger, and practise mindfulness. But the moment you are in bed and your body starts to go soft because the valve no longer works effectively, that becomes reinforced by the negative impulses being broadcast by your brain.
At this point, your brain fires the threat response again. You cannot convince your nervous system to trust a body that keeps failing. Understanding the loop, however, does not repair the muscle damage that started it.
So, in summary, the pill is able to treat Type 1, which has to do with blood flow problems. The only issue with that is that your blood flow was probably good enough. The blood actually got into the penis. It only leaked out because Type 2 developed. But you were still blessed with a chemical erection that felt synthetic, and the moment it wore off, the anxiety (Type 3) came back harder because it now seemed to you that you needed drug administration in order to function normally in the bedroom.
Therapy or “just relax” addresses Type 3, the anxiety state. But the anxiety was not the root cause. The root was Type 2, the damaged muscle. As long as the muscle keeps failing, your brain nearly always goes into panic mode, which tends to make the problem worse.
Supplements will address nothing because they often give you more of what you probably already have enough of. Your testosterone was probably normal even while you were busy taking testosterone supplements. Your circulation was probably adequate, too, but no capsule can rebuild a hypertonic pelvic floor.
Random Kegel exercises will fail in attempting to fix Type 2 ED and will probably make it worse because, without knowing whether your pelvic floor is hypertonic or hypotonic, you were likely clenching an already properly energised muscle deeper into dysfunction.
In each case, every failed solution was directed at treating the wrong type of ED, or one type out of the three, but never the full picture. Now, for a better understanding of how this problem can be resolved, consider that Type 2 is the foundation.
Repair the muscles, and everything above that pelvic floor level starts to resolve. When the valve holds blood properly, erections stop failing. When erections stop failing, the brain stops registering imagined threats. When the brain stops logging threats, the anxiety loop breaks on its own.
Fixing Type 2 will sort out Type 3 with it. But the required repair has to follow a specific sequence. It is not possible to strengthen a muscle that is in spasm.
The protocol must start with release in the following way: do reverse Kegels, engage in targeted breathing, followed by slow decompression of the chronic tension your pelvic floor has been holding for years.
Only after the tension is released can you begin to rebuild the proper sequence of responsiveness. This should start with isolated contractions of the bulbocavernosus muscle, progressive loading of urine in the bladder, sustaining such holds, and eventually engaging in real-world simulation to ensure that firmness is maintained through pauses, transitions, and position changes.
However, it is prudent that any man who wants to start this range of exercises should consult a physician, under whose direction a physiotherapist can properly guide the process.
Dear doctor, what are the causes of someone’s body itching just after bathing? What is the solution? Thanks, and God bless you. +2348121779000
Many reasons are responsible for such occurrences:
Recent change of bathing soap.
Change of body lotion or cream.
Using a dirty or damp towel to dry your body.
Certain contaminants in the bathwater.
Sharing bathroom items with others.
So, if you recently changed your soap, lotion, or cream, you should go back to the one that did not disturb you. If that is not the case, then wash your towel and dry it properly in the sun.
Also, dry your sponge in the sun if it is always wet. Lastly, depending on how you get your bath water, you can add Dettol or Izal to it and bathe twice a day with it for five days and observe your response.
And if you share your bathroom items with others, especially your towel or sponge, you will have to stop that.
Good evening, Doctor. Please, what can be done to solve the problem of feet swelling in a woman with recurrent fibroids? Thanks. May God continue to bless you and all yours. +2347055751000
Good morning, madam. Amen to your prayers, and God bless you, too. Recurrent fibroids do not have a connection with swelling of the feet. What is more likely to cause such swelling includes the following:
High blood pressure.
Advancing age.
Long periods of sitting or standing.
Heart failure or kidney disease.
If any of these problems is the cause, then the treatment will depend on what is causing it. If you do not suffer from any of these, then you can get compression stockings for your legs and wear them whenever you are likely to sit or stand for a long time.
Good day, Sunday Doctor. Recently, I have been suffering from a lot of abdominal pain, especially around my navel. I have also lost some weight, about 4kg, over the last six weeks. My doctor first told me to do a scan, and it showed that I have gallstones.
He said that was the cause of the pain. But I then went to another doctor who said he suspects that I have endometriosis. I just had my third baby six months ago. I used to think that endometriosis is related to infertility. Is it possible for me to have endometriosis after three children? 08139745000
Yes, you can have endometriosis even after you have had children. That is possible. However, with respect to your abdominal pain, it is useful to properly situate the onset of the pain and determine whether it began before or after your delivery. That should provide some guidance about what is wrong with you, but more investigations will be needed to deal with your current problem. In the end, you should know that it is possible to have more than one disease condition at the same time, so having both endometriosis and gallstones is possible.
Good evening, doctor. Please, sir, what is the treatment for cancer? I really want to know, sir. Thank you. 08085849000
This is a major question, but we shall make it as simple as possible for you to understand. Cancer treatment depends on the type and behaviour of the particular kind of cancer being evaluated, meaning that a biopsy must first be obtained to define its nature.
Then, depending on what the results say, a decision is taken on whether to surgically remove it or not. Successful removal is usually followed by chemotherapy, which employs the use of certain drugs to destroy the remaining cancer cells that the eyes cannot see, and later by irradiation of the cancer bed with specific kinds of X-rays. Frequently, a decision may be taken not to operate if the cancer is too advanced for safe surgery.
Good morning, Sunday Doctor. I don’t know why my urine is always foaming. I have done numerous urine and blood tests and even done a scan. My doctor said the results are normal. So I am worried about this because it has gone on now for more than two years. I am a 63-year-old man. Thank you. 08035053000
Good morning to you. The issue of passing foamy urine is one we have discussed extensively before on this page. You did not disclose what kinds of urine and blood tests you were asked to conduct or what the results were. Therefore, it is practically impossible to determine whether the tests you conducted were relevant to your condition or not. And even though you seem certain about your claims, there is no way to know whether you actually saw a doctor. However, if you did see one and he has assured you that there is nothing wrong, perhaps you should concentrate on drinking a lot of water, at least three litres daily, to see if anything changes.
Question:
Good evening, doctor. Please, I no longer know what is wrong with me. I had fever, body pain, and headache three weeks ago and went to the hospital. They did some blood tests for me and told me that I had malaria. So, the doctor prescribed Camosunate for me. I used it as prescribed and felt better, but my mouth was still bitter, so he told me to use Fansidar, three tablets, which I also used. After about two weeks, I started having a very bad headache on the left side of my head, and it was affecting my left eye. So I went back to the hospital, and they did some more blood tests and told me that I still had malaria parasites, two pluses. What should I do? +2347086347000
Answer:
Once malaria is proven in your system like this, you will have to obey your doctor’s instructions and obtain further treatment. The possibility is that your previous attack of the illness was not completely treated, hence the apparent treatment failure you now have. At this stage, you may require injections to treat it because there are various reasons why medications taken by mouth can sometimes fail to work.
Question:
Doctor, good day to you. My left upper eyelid is always twitching. What is the cause? What should I do about it? 08163601000
Answer:
An eyelid twitch is usually just a tiny spasm of the muscle around your eye. It is called myokymia, and it is almost always harmless and goes away on its own. The most common triggers are:
Stress and fatigue – When you are tired or run down, the nerves that control the eyelid become a bit irritable.
Too much caffeine – Coffee, energy drinks, and even a lot of tea can overstimulate those nerves.
Dry eyes or eye strain – Staring at screens for too long, not blinking enough, or having dry eyes can trigger it.
Lack of sleep – Your nerves do not recover well when you are sleep-deprived.
Alcohol and stress – Both can make twitching worse.
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