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Posted 1/20/2016 7:01 AM (GMT 0)
I am a tightly circumcised 70 year old with no history of health problems and a healthy sex life. Recently I started getting overnight erections that are very strong, so strong the blood pressure in my penis is high and it wakes me. It then takes 20 or so minutes to subside but the disturbed sleep over a long period is making me drowsy during the day. I do not need to get out of bed to pee overnight and when I do pee the stream is good. I would like to be able to stay asleep though. Is this something I need to worry about? I have never had a PSA test.
Posted 1/20/2016 3:19 PM (GMT 0)
snipped,

We have lots of guys here who would love to have your problem.

Nocturnal erections are normal and natural. They exercise the erectile tissues, keeping them oxygenated and stretched even if a man never has sex. Most guys sleep through them. If yours are waking you up because they are uncomfortable you might have something going on that a urologist could help you with. One of the things that can make for an uncomfortable erection is Peyronie's Disease. Men with PD develop hard "plaques" in the wall of their erection chambers that don't stretch normally when they get an erection. These can cause a painful tugging sensation and can cause the penis to bend when erect. Have you noticed any hard spots or a bend to your member during sex? If so you might talk to a urologist about PD.

There are other things that can cause daytime drowsiness. Since you mention a sex life there is probably someone you can ask if you snore. There is a condition called Sleep Apnea where snoring interferes with breathing and the victim (usually a man) will constantly wake up half-way to resume normal breathing. You might talk to your doctor about that possibility, too. It could be that you have some sort of a sleep problem and the nighttime erections are just something you noticed while you were looking around for a possible cause for your sleepiness.
Posted 1/20/2016 3:54 PM (GMT 0)
Are you taking anything that increases nitric oxide? For example, l-arginine taken at night can result in nocturnal erections.
Posted 1/20/2016 4:07 PM (GMT 0)

richh said...
Are you taking anything that increases nitric oxide? For example, l-arginine taken at night can result in nocturnal erections.

Mr.Snipped, I at first thought this might be a joke. But I guess it is not, and most of us need to know your secret as you are not even close to age 18.

But in addition to L-arginine, I assume you are not taking drugs like Cialis to help with erections. In the few months before my RP, Cialis certainly provided me with some impressive morning wood, first I had seen of that in a number of years. And no sign of it in the 2 years since RP. I doubt you are taking that, but if you are that could do it.
Posted 1/20/2016 4:10 PM (GMT 0)
I agree with everything Peter DA said in his reply. I would only add that I think the answer to your question is really pretty obvious. If this condition is causing you concern, talk to your physician or see a urologist. If you've never had a PSA test, you should probably have one done.
Posted 1/21/2016 2:54 PM (GMT 0)
Time to get a PSA test!

ETA - after more replies to this thread, maybe not!

Post Edited (Ken) : 1/25/2016 8:06:15 AM (GMT-7)

Posted 1/21/2016 5:49 PM (GMT 0)

aussisnipped2 said...
I am a ... 70 year old with no history of health problems and a healthy sex life. ... I have never had a PSA test.

Congratulations!

Those who know the most about prostate care and prostate cancer recommend that men who reach the age of 70 and have not had prostate issues should NOT start PSA testing, and if they have had PSA testing proceedures in the past, the recommendation is to STOP at age 70.

This is the recommendation of the American Urological Association, and the famed Mayo Clinic includes the AUA recommendation with their own (Mayo's) recommendation here at this web page; check it out:
http://www.mayoclinic.org/diseases-conditions/prostate-cancer/in-depth/prostate-cancer/art-20048087?pg=2

The reason for no PSA testing after 70 (for men who have had no prostate cancer issues) may be intuitively obvious...PC is typically a slow growing disease, and if you've made it this far with not issues it is highly improbable that anything other than a slow growing version might be found in you now, and a new discovery of a slow growing version at age 70 is generally nothing to worry about, so why test now? Fairly obvious.

One thing to know is that if you go looking hard enough, you (actually, a doctor would be the one looking) will likely find some indolent PC which is a natural part of aging. Roughly 50% of 50-year olds have some detectable level of PC, 60% of 60-year olds, and 70% of 70-year olds. Most are indolent, and most men will never know they had it.

People age differently, so if you have a strong family history of living to 100+ years a better cut-off point might be 75, but this is a point to discuss with your physician.

best wishes
Posted 1/21/2016 6:26 PM (GMT 0)
I might be a little slow (haha), but I just realized (following my previous reply) from your username that you might be from the land of Oz.


If so, then perhaps you'd like to hear from the experts a little closer to home (rather than the American Urological Association, or Mayo Clinic) about recommendations for men aged 70+. (Spoiler alert: they all pretty much say the same thing.)


Here's what the Royal College of Pathologists of Australia said:
    "PSA testing has no proven value in the management of prostate cancer in men over the age of 70 years when men in this age group often have co-morbidities that are likely to be of greater clinical significance than the risk of prostate cancer."

https://www.rcpa.edu.au/getattachment/37efcb2a-0844-4250-b9e7-a53a26eeafec/Prostate-Specific-Antigen-Testing-Age-related-inte.aspx

Here's what the Prostate Cancer Foundation of Australia said:
    "Men aged 70 years or older who have been informed of the benefits and harms of testing, and who wish to start or continue regular testing, should be advised that the harms of testing may be greater than the benefits for men of their age."

http://www.prostate.org.au/news-media/latest-news/psa-testing-guideline-recommendations-approved-by-nhmrc/


hope that's helpful!

best wishes
Posted 1/23/2016 7:21 AM (GMT 0)
Many thanks for the useful comments guys. While it may have seemed like a silly question to some it was actually beginning to bother me, and hence the first post. For one thing I now know that plenty out thee are having a wore time than me so maybe I should just be grateful. The latter comments on starting PSA testing are echoed in Australia with men now being told not to bother after reaching the age of 70. Unfortunately with our Government I wondered if that was based on sound medical advice or the need to save money. I'll be generous and stick with the first option. Thanks for listening though, your responses have helped.
Posted 1/23/2016 3:12 PM (GMT 0)
The reasons for not PSA testing beyond 70 (when there have been no prior issues) are universally accepted and published (above) by the professional medical societies and prostate care professionals, not "the government." They are a solid mix of good medical advice and common sense.
Posted 1/23/2016 8:22 PM (GMT 0)
Not universally Jack. In Sweden the recommendation is: "Therefore, it is between 50 and 75 years of age you may consider PSA test , even if you do not have any symptoms suggestive of prostate cancer." But average life is longer in Sweden (and also in Australia?) than in the US I assume.
Posted 1/23/2016 9:17 PM (GMT 0)
Same concept. The concept of not testing elder men in this category is universal because of the same truism: no proven value in the management of prostate cancer in elder men.

It's a guideline, not a rule. As previously mentioned, each individual should have a conversation with their doctor about when is the best time to stop (or whether to start) PSA testing, and in most cases co-morbidities and/or overall life expectancy may dictate an EARLIER or LATER age than the guideline of 70 (or 75).
Posted 1/23/2016 11:34 PM (GMT 0)
I'll go with Sweden over North America, personal experience, just saying!

Cheers, Doug
Posted 1/24/2016 12:07 AM (GMT 0)

aussisnipped2 said...
in Australia with men now being told not to bother after reaching the age of 70. Unfortunately with our Government I wondered if that was based on sound medical advice or the need to save money.

That is consistent with the American Urological Association recommendation: "The Panel does not recommend routine PSA screening in men age 70+ years or any man with less than a 10 to
15 year life expectancy. (Recommendation; Evidence Strength Grade C)
Some men age 70+ years who are in excellent health may benefit from prostate cancer screening."

"Evidence Strength Grade C" means the evidence for that recommendation is poor quality. Also, note their language: "routine PSA screening." What that means is that while they are making a recommendation that all men over 70 should not be routinely screened, there may be good reasons to make exceptions.

They are not trying to save money (a PSA test does not cost that much), they are trying to avoid the harms associated with overdiagnosis and overtreatment.

- Allen
Posted 1/25/2016 2:46 PM (GMT 0)
Snipped...

There was this comment

Somebody said...
should be advised that the harms of testing may be greater than the benefits for men of their age."

I don't quite understand what harm there is in the actual testing for PSA (or maybe they meant Biopsy afterwards -- but that is not really very dangerous either). Maybe the quote was just projecting the likely chain of events. 1) You get tested 2) it finds something 3) you get treatment you might not need 4) You might have some adverse outcome.

On the original subject of your SuperHards. The only other thing I can think of is that there is some blockage in the return veins that was not there before. A natural blockage that is enough to restrict the outward flow enough to give you a spectacular woody. (There are controversial surgical procedures for venous leak that do nip off veins to do the same thing). As someone said, maybe peyronies/plaque could cause such a thing.. but never read about peyronies causing woodies.

J
Posted 1/25/2016 3:38 PM (GMT 0)
JStars,

Yes, it is the projected (or expected) chain of events that causes the harm of PSA screening for men over a certain age. A diagnosis of prostate cancer causes a great deal of emotional distress. For a younger man that can provide a spur to get him to seek treatment. But, for men whose remaining life expectancy is less than the time it would take for the disease to progress to the point where it would cause him any trouble at, all no treatment is worth the side effects and he is most likely better off not knowing.

My point about the possibility of Peyronie's Disease is not that it causes the nocturnal erections but that it might make them uncomfortable so they wake him up.
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