– Obstetrician



What is erectile dysfunction?

Erectile dysfunction is the failure of satisfactory erection in either initiating or maintaining it, which is persistent and it affects 45 per cent of men aged between 60 and 69.

What are the causes of erectile dysfunction?

Erectile dysfunction could be psychological, for instance, emotional trauma, mental health issues, depression, cardiovascular such as veno-occlusive disorder, hypertension and it could be neurological, such as neuropathy, stroke and multiple sclerosis.

The signs and symptoms of erectile dysfunction are basically the history of failure to initiate and sustain erection.

When is it appropriate to see a doctor?

It is appropriate to see a doctor when it becomes worrisome in initiating erection for a period of time despite the urge to have intercourse or when the partner begins to complain.

The different categories of doctors that can handle the condition are family physician, urologist, gynaecologist, endocrinologist and more often a multi-disciplinary team involving the various disciplines. The psychologist/psychiatrist, general physician may also be involved.

What are the types of erectile dysfunction?

The two main types of erectile dysfunction are psychogenic and organic. Psychogenic impotence is impotence caused by anxiety, guilt, depression or conflict around various sexual issues. It is the persistent inability to achieve or maintain erection for satisfactory sexual performance owing predominantly to psychological factors, while organic impotence, the more common of the two categories of erectile dysfunction, is caused by physical problems such as heart disease, diabetes and obesity.

What are the physical and psychological issues that can cause it?
The physical issues are obesity, spinal cord injury, trauma to pelvis, while psychological causes can be marital discord, family/social problem, partner dissatisfaction, etc
What is the nexus between Parkinson’s disease and erectile dysfunction?

Parkinson’s disease itself is a form of organic cause of erectile dysfunction. It can get worse by affecting the nerves responsible for erection. Anti-Parkinson’s medicines are also culprits. No motor disorder does occur in Parkinson’s disease, for instance, depression, low self esteem, stress, grief, anger and unsatisfactory body image.

The risk factors that contribute to erectile dysfunction are attitude to sex, satisfaction of relationship, marital status, sleep satisfaction, mental health, organic diseases, especially cardiovascular, alcohol intake, hypertension, obesity, diabetes, trauma to spine, enlarged prostate, genital infections, high cholesterol, hormonal disorder, smoking, alcohol, social drugs, medications, among others.

How is erectile dysfunction prevented?

To prevent erectile dysfunction, one needs to prevent the psychogenic causes such as depression, anxiety disorder and the organic causes, such as obesity, hypertension, lack of exercises, infection, and so on.

In making diagnosis of erectile dysfunction, the specialised doctor will start by taking a detailed medical and psychosexual history and conducting a thorough physical examination. From history, psychological assessment, sexual health inventory for men is an objective measurement of the degree of dysfunction.

Tests of the various organic causes highlighted e.g. blood count, renal tests, infections, endocrine tests, glucose tests, liver tests, sex hormones tests, follicle-stimulating hormone tests, luteinising hormone tests, testosterone, prolactin, ultrasound of blood flow to the penis (Doppler) and X-ray arteriogram testing for impaired flow of blood to the penis.

How is it treated?

Patients suffering from erectile dysfunction should first be evaluated for any underlying physical and psychological conditions. If treatment for the underlying conditions does not help, medication and assistive devices such as pumps can be prescribed. For organic cause, there is the need for treatment for prostate.

For the psychogenic causes: we have psychosexual therapy, hormone therapy, low fat/cholesterol diet, avoid smoking, exercise, use of adjunct devices, etc.

There is also the need for vacuum erection device, transurethral injection, injection to cavernosal muscle of the penis, penile prosterin surgery to revascularise the penis.

What foods are good for someone suffering from erectile dysfunction?

The diet for erectile dysfunction includes high fibre, low carbohydrate, low fat, high alkaline, low acidic diet, vegetables and fruits.

Are online treatments recommended?

Online treatment cannot be encouraged as they are not substantiated in most instances. Consult a physician instead for evidence-based treatment.

Can erectile dysfunction be a signal of other ailments?

Yes, it is a signal of diabetes, hypertension, Parkinson’s disease, high cholesterol, sleep apnea, respiratory disease, kidney disease, liver problem, neuropathies, and so on.

There is a misconception that erectile dysfunction is the normal part of growing older and men have to live with it. Is this true?

It is normal to drop interest in sex as you grow old but it is not normal to ignore it as there are remedies to the problem.

There is a myth that erectile dysfunction does not affect young men. Is that correct?

Erectile dysfunction does affect any age based on all above; young men can be depressed, can have cardiovascular disease, can be obese and can have diabetes.

It is also believed that if one has trouble having an erection, it is because one is not attracted to one’s partner. Is that true?

There is a degree of truth in this assertion as erection is also a factor of the mind.

Can erectile dysfunction lead to death?

Depending on the cause attributed to the particular erectile dysfunction, for example, if the cause is organic, death can ensue from it e.g. diabetes, kidney disease and airway disease. If it is physiological, say depression, they can commit suicide.







 – Copyright PUNCH.

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