It's good to get men talking about their sexuality. But being sexual is different than having an erection, says Jeanne Shaw, PhD, an Atlanta-based clinical psychologist and certified sex therapist.

"What I see as a problem is the public has been educated to believe that good sex requires an erect penis that stays hard through the entire sexual encounter," Shaw tells WebMD. "This definition of good sex changes the basic nature of an encounter from intimacy and pleasure to achievement and performance."

This focus on performance, Shaw says, robs men and their partners of the opportunity to deepen their relationships -- and their sexuality. The sexual needs of adolescents, she says, are different that those of adults. Yet by making erections the be-all and end-all of sex, grown men are retreating to adolescent sexual values.

"Having an erection does not mean you are being sexual. Being sexual comes from inside your sense of yourself," Shaw says. "You can be sexual, you can feel sexual, you can behave sexually without an erection. A penis is not the only part of a man's body that can be used sexually."

Shaw makes a distinction between genital behavior and sexual behavior. Mistaking one for the other, she says, leads to dishonesty and dissatisfaction.

"You can behave genitally whether you feel sexual or not," Shaw notes. "Women and men can fake it. Lots of men get an erection, penetrate, and lose the erection and pretend they have had an orgasm because they want to be perfect. They don't say, 'Hey, I didn't have an orgasm but maybe next time. Being near you is enough.'"

In her practice, Shaw finds that physical problems don't lie at the heart of most men's sexual problems.

"Actually, it is psychological distress associated with not measuring up rather than physiological problems that causes most sexual dissatisfaction," Shaw says. "For many, many men -- maybe most -- problems with sex are due to ignorance, anxiety, and inability to communicate with their partners. I think sexual dysfunction is the inevitable result of the effort to attain perfection."

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Reviewed by Brunilda Nazario, MD on December 17, 2003

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Prescribing Information

Indication
Uroxatral® (alfuzosin HCl 10 mg extended-release tablets) is an alpha1-blocker for the treatment of the signs and symptoms of BPH.

Important Safety Information
Do not take UROXATRAL if you have liver problems or if you are taking antifungal drugs like ketoconazole or itraconazole, or HIV drugs like ritonavir.

UROXATRAL can cause a sudden drop in blood pressure, especially when starting treatment. This may lead to fainting, dizziness, and lightheadedness. Do not drive, operate machinery, or do any dangerous activity until you know how UROXATRAL will affect you. This is especially important if you already have a problem with low blood pressure or take medicines to treat high blood pressure. There may be an increased risk of low blood pressure and fainting when taking UROXATRAL in combination with blood pressure medication or nitrates, or erectile dysfunction medication.

If considering cataract surgery (clouding of the eyes), tell your eye surgeon that you are currently taking UROXATRAL or have previously been treated with an alpha-blocker.

Before taking UROXATRAL, tell your doctor if you have kidney problems.

Also, tell your doctor if you or any family member(s) have or take medications for a rare heart condition known as congenital prolongation of the QT interval.

BPH and prostate cancer can cause the same symptoms. However, UROXATRAL is not a treatment for prostate cancer.

The most common side effects with UROXATRAL are dizziness, upper respiratory tract infection, headache, and tiredness.

Please see UROXATRAL full prescribing information.