Many men are battling with Erectile Dysfunction (ED), but find it difficult talking about it. Why? They see it as a shame. Unknown to them, this condition can be treated if they speak up, says a urologist, Dr Wale Ojewola. WALE ADEPOJU writes.
It is a condition many men hide.
They see the problem as a shame. So, they feel it is better to manage it in silence. But in so doing they are going the wrong way. The problem has a solution. Erectile Dysfunction (ED), doctors say, is not something to feel ashamed of. It can be treated.
ED is man’s inability to maintain erection for sexual intercourse. It is a problem associated with men between age 40 and 65.
It also affects 70 per cent of men in their 70s and above.
According to a Consultant Urologist at the Lagos University Teaching Hospital (LUTH), Dr Wale Ojewola, “Erectile dysfunction, also called impotence, is the inability to achieve or sustain an erection of sufficient rigidity for sexual intercourse or during sexual performance. ED can make sexual intercourse impossible without treatment.”
Dr Ojewola spoke during the First Edition of Lagos Country Club Health Seminar Series, with the theme: ‘Erectile Dysfunction’ (ED).
Because the theme was a typical one, the hall was filled to capacity. Men of different ages, class and status were there. Some came with their spouses. The atmosphere changed from that of conviviality to surprise as the urologist delved into the secret of the ailment.
Dr Ojewola said the condition is common as it affects over 18 million men across the world, going by World Health Organisation (WHO) statistics.
The urologist said the problem could have physical or psychological basis depending on the diagnosis. But it is caused by, “Chronic diseases, especially diabetes mellitus (DM). Diabetes is a chronic disorder caused by insufficient production of insulin, resulting in abnormal metabolism of carbohydrates, fats, and proteins. About 50 per cent of diabetes mellitus patient will have ED. In addition, poor blood sugar control can inhibit nitric oxide production. ED can also be caused by cardiovascular diseases including hypertension, atherosclerosis (hardening of the arteries), kidney diseases and multiple sclerosis, among others.
“ED is not a disease but condition. The condition can be triggered by lifestyle choices such as smoking, alcohol abuse and obesity which impair blood circulation. Other causes are drugs such as antidepressants and tranquilisers.”
Causes
According to Dr Ojewola, surgical treatment for prostate cancer, bladder cancer, urethral stricture and benign prostatic hyperplasia can sometimes damage nerves and blood vessels near the male organ can impair an erection of the penis during a sexual performance.”
He said radiation treatment for prostate, bladder and colorectal cancers can also damage nerves and blood vessels near the male organ. Hormonal and psychological problems can also cause ED.
He explained: “The male organ has three chambers – one of them is called corpora spongiosum; it houses the urethra (urine pipe) while the other two known as corpora cavernosa are purposely for erection. Blood flows into these two chambers and causes the male organ to expand and stiffens much like a balloon as it is filled with water under pressure. This leads to erection. The process is triggered by nerves impulse from the brain and genital area. Anything that interferes with these impulses or restricts blood flow to the male organ can cause ED.”
Dr Ojewola said the symptoms is that erection is too soft for sexual intercourse or erection that lasts only briefly, or inability to have or maintain an erection at least 75 per cent of attempts to have an intercourse.
Treatment
Dr Ajewola said the first step is to see a urologist. “As urologists have special expertise in sexual health, some specialise specifically in erectile dysfunction. They can help assess your condition, determine its cause and identify safe and effective treatment. The urologist can also assess your mental health wellness. Stress, anxiety and depression can cause ED. Even the fear of having erectile problems can make them worse. The urologist would find out to see if these issues are playing a role in your ED.”
He said there is need to reduce cardiovascular disease risk. “Men with diabetes who also have cardiovascular disease, such as heart disease or high blood pressure, face an even greater likelihood of developing erectile dysfunction because of the added damage to blood vessel. Laboratory tests may be required. The urologist would also need to evaluate the situation by asking questions.”
Dr Ojewole said psychotherapy treatment can be beneficial for men with ED even when it has a known physical cause. “The therapist can instruct the man and his partner on techniques to reduce performance anxiety and improve intimacy.
“There should be lifestyle changes such as abstaining from smoking, minimising alcohol intake. There can also be medication such as Viagra. Injections and intra-urethral instillation, which is a medicated pellet that is inserted into the urethra and can, trigger erection within 10 minutes. But no medication should be self administered. All must be by prescription because some could have adverse effects on the heart, which can lead to heart attack or outright death, even while in the act.”
The urologist said: “ED can also be addressed through surgery if the condition is caused by blockage of the artery leading to the male organ. This surgery will restore blood flow to the manhood.”
