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This program describes the most common sexual problems men face after transplant, and some effective treatments. Presenter: Christian Nelson PhD, Memorial Sloan Kettering Cancer Center. Meet Dr. Nelson: https://www.mskcc.org/cancer-care/doctors/christian-nelson To read the transcript, go to: https://www.bmtinfonet.org/video/mens-sexual-health-after-transplant-1 Highlights: - Transplant recipients report more sexual problems than the general population, such as erectile dysfunction. - Erectile dysfunction is associated with depressive symptoms and can undermine a core sense of masculinity for many men. - Consulting with appropriate specialists in urology and, more specifically, sexual medicine may be the most effective path for treating problems of sexual health. Presented at the 2021 Celebrating a Second Chance at Life Virtual Symposium, April 17-23, 2021 Presentation is 40 minutes long plus 16 minutes of Q & A Key Points: (01:36) Common problems men experience after transplant include erectile dysfunction, difficulty reaching orgasm, dry orgasm, painful ejaculation, urine leakage, and penile curvature. Problems in sexual functioning are often interrelated; having one problem may trigger others as well. (03:45) Without treatment, sexual difficulties can persist long after transplant. (06:30) Poor overall physical health increases the chance of sexual problems. (11:19) Erectile dysfunction may also cause emotional withdrawal from an intimate partner which can create conflict and difficulties in the relationship. (12:15) There are good treatments for erectile dysfunction, and a standard sequence for trying them until each man finds what works best for him. These include pills, injections, vasodilators, and penile implants. (19:43) The vast majority of men who keep trying options find something that works for them. The real problem is a high rate of men who drop out of treatment before finding a successful therapy. (21:36) Men tend to drop out of treatment because of a cycle of frustration and avoidance. Avoidance of sexual situations temporarily resolves anxiety but fails to address the underlying problem. (26:35): Men can benefit from coaching about why sexuality is important to them and how to overcome performance anxieties. This can lead to a positive cycle of acceptance and commitment to find effective remedies to sexual dysfunction. (30:29) A reduction in non-sexual intimacy can be more damaging to a relationship than a lack of sexual intimacy. (33:02) There are non-pharmacological strategies such as sensate focus that can recreate intimacy between partners and promote more healthy sexual functioning. 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