There are several forms of male sexual dysfunction, including poor libido and problems with ejaculation. Erectile dysfunction (ED) is a common disorder that brings men to see their doctor, but in Anguilla many men with erectile dysfunction feel embarrassed and are reluctant to seek medical attention. ED can cause many emotional problems and also lead to relationship problems if not adequately treated.
What is erectile dysfunction (ED)?
Erectile dysfunction (ED) occurs when a man has consistent and repeated problems sustaining an erection. Without treatment, ED can make sexual intercourse difficult. Worldwide, the problem is reported by 1 in 5 men and that number increases with age.
What are the symptoms of ED?
When men with ED come to see their doctor the main symptoms reported include the following:
• Erections that are too soft for sexual intercourse.
• Erections that are too brief for sexual intercourse.
• An inability to achieve erections.
Men who cannot get or maintain an erection that lasts long enough, or is rigid enough to complete sexual intercourse are considered to have erectile dysfunction.
Who gets ED?
Sexual dysfunction and ED become more common as men age. The percentage of complete ED increases from 5% to 15% as age increases from 40 to 70 years. But this does not mean growing older is the end of your sex life – indeed men in their 70s have normal sexual activity. ED can be treated at any age. Also, ED may be more common in men with a history of diabetes, obesity, smoking and hypertension.
What are some of the causes of ED?
In some cases the cause for erectile dysfunction cannot be identified, but in many other cases a cause is known.
Chronic disorders is an underlying cause in a number of men with ED. The link between chronic disease and ED is most striking for diabetes. Men who have diabetes are two to three times more likely to have erectile dysfunction than men who do not have diabetes. Among men with erectile dysfunction, those with diabetes may experience the problem as much as 10 to 15 years earlier than men without diabetes. Yet evidence shows that good blood sugar control can minimize this risk. Other conditions that may cause ED include cardiovascular disease, atherosclerosis (hardening of the arteries), kidney disease and multiple sclerosis. These illnesses can impair blood flow or nerve impulses throughout the body.
Lifestyle – Lifestyle choices that impair blood circulation can contribute to ED. Smoking, excessive drinking and drug abuse may damage the blood vessels and reduce blood flow to the penis. Smoking makes men with atherosclerosis particularly vulnerable to ED. Being overweight and getting too little exercise also contribute to ED. Studies indicate that men who exercise regularly have a lower risk of ED.
Surgery, including treatments for prostate cancer, bladder cancer or BPH, can sometimes damage nerves and blood vessels near the penis. In some cases, the nerve damage is permanent and the patient will require treatment to achieve an erection. In others, surgery causes temporary ED that improves on its own after 6 to 18 months.
Medication – ED may be a side effect of various medications including certain blood pressure drugs, antidepressants and tranquilizers. Men should talk with their doctor if they suspect a prescription or over-the-counter drug may be causing erectile problems. Never stop any medicine without first consulting your doctor.
Psychological – ED usually has something physical behind it, particularly in older men, but psychological issues can be a factor in many cases of ED. Various studies have shown that stress, depression, poor self-esteem and performance anxiety can short-circuit the process that leads to an erection. These factors can also make the problem worse in men whose ED stems from something physical.
Bicycling – Research suggests avid cyclists around the world suffer more ED than other athletes. The trouble lies in the shape of some bicycle seats that put pressure on the perineum. This area between the anus and scrotum contains arteries and nerves vital to sexual arousal. Cyclists who ride for many hours each week may benefit from seats designed to protect the perineum.
How is erectile dysfunction diagnosed?
If you suspect that you might be having erectile dysfunction, you should see your doctor. To diagnose ED, your doctor will ask you questions about your symptoms and medical history. A complete physical exam is carried out to discover signs such as poor circulation or nerve trouble. Your doctor will look for abnormalities of the genital area that could cause problems with erections.
Several lab tests can help diagnose male sexual problems. Measuring testosterone levels can determine whether there is a hormonal imbalance which is often linked to decreased desire. Blood cell counts, blood sugar levels, cholesterol levels, and liver function tests can reveal medical conditions that may account for ED.
Treatment
Treatment will vary from one individual to another but most doctors would first suggest various lifestyle changes. Stop smoking is often recommended, but losing weight and exercising regularly can be beneficial. If you suspect a medication could be contributing to ED, talk to your doctor about adjusting the dosage or switching to another drug.
Various medications are now available for treating ED, but individuals must be aware of the various side effects and know who should not use them. Talk to your doctor before using that blue pill.
Other forms of treatment, such as injections and vacuum devices, are available. Surgery is considered in some individuals.
Psychotherapy – Even when ED has a known physical cause, psychotherapy can be beneficial. A therapist can teach the man and his partner techniques to reduce performance anxiety and improve intimacy.
Alternative Therapies
Talk with your doctor before trying supplements for ED. They can contain 10 or more ingredients and may complicate other health conditions. Asian ginseng and ginkgo biloba are popular, but there is not a lot of good research on their effectiveness.
Can you reduce your chances of getting ED?
Various studies have shown that in some men it might be possible to decrease the chances of getting erectile dysfunction. The things that have been shown to work include the following:
• Exercise and maintain a healthy weight.
• Stop smoking.
• Avoid excessive alcohol and substance abuse.
• Keep diabetes mellitus under control.
Conclusion
Erectile dysfunction can be a very embarrassing condition for many men. In recent years there have been much advancement in treating this disorder at all ages. Men with ED are encouraged to see their doctor as in most cases this condition can be treated.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
