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© 2019 by Brookfield Centre For Lifestyle Medicine.

Men’s Health III

 

Sexual Dysfunction

 

Sexual dysfunction sometimes known as impotence is a distressing condition for men who suffer from it. There are several reasons why men experience sexual difficulties. In the most part there tends to be a decline in sexual functioning with age. This decline tends to occur in different areas such as frequency of intercourse, sexual desire, satisfaction with sex, frequency of orgasm, problems with erection.

So you have made this decision to go to your family doctor for your periodic health check. Congratulations!

 

You must  feel free to discuss issues around embarrassing body functions with your doctor such as your sexual health, hair loss, your pot belly, snoring that sends your partner out of your bedroom at night, stubborn facial acne, the list goes on. I will encourage you to utilise your visit to your doctor to trash out issues that you will feel otherwise awkward to discuss with anyone else. You help you out of these disconcerting topics, this week we’ll be looking at one of the most distressing, yet humiliating health problems in men. It is a very common condition especially in older men. It is one of the conditions that can make nonsense of a man’s entire feeling of wellbeing if not tackled head on. This is one condition that makes a man wish he could turn back the hands of time in order to enjoy his useful days once again. This is the dreaded condition called Erectile Dysfunction.

 

Erectile Dysfunction (hereafter ED) is the inability of a man to attain or maintain an erection sufficient to permit satisfactory sexual intercourse more than 75% of the time. It can be a one off occurrence especially during times of acute stress from any cause or it can be a long term problem from underlying diseases. It is estimated that half of all men between 40 and 70 years of age will experience ED at least once in their lifetime. ED was once thought to be an inevitable consequence of advancing age for which little could be done and it was rarely addressed by healthcare professionals. It is estimated that 20-30 million American men suffer from ED. In the United Kingdom, 1 in every 10 men suffers from ED. Although the frequency of ED increases with age, it must be stressed that ageing itself is not a cause of impotence. Although the amount and force of ejaculation as well as the need to ejaculate decreases with age, the capacity for erection is retained. Men are capable of retaining their sexual virility well into their 80s. As difficult and as embarrassing as it may be for you to discuss this with anyone, the good news is that treatment is available. These days a variety of effective treatments are available and widely in magazines and on television. A glance at your email spam filter will show you that ED is now big business. Smart traders cash in on this extremely distressing complaint in men to sell all manner of products with a promise of the return of sexual fulfilment.

 

So what causes ED in so many men?

 

First of all, contrary to general belief that ED only affects elderly men, in a study of adults aged 18-59 years carried out in 1992 in the USA, 31% of men had sexual dysfunction. Having said that, many more studies, notably the Massachusetts male ageing study (MMAS) was a land mark study in determining the prevalence of sexual dysfunction among American men. A very large cohort study of 1,709 men ages 40-70 years from 1987-1989, with a follow up phase in 1995-1997 showed that of men in their 40s 40% admitted to some degree of sexual dysfunction. This statistic increased by 10% by each decade advance with age. Overall 35% of men had moderate to complete ED. At the follow up study in 1995 these changes where confirmed.

 

The causes of ED can generally be due to psychological and physical causes sometimes with one leading to the other. Until a few years ago, ED was thought to be caused almost entirely by psychological factors such as stress, tiredness, anxiety, depression, we now know that physical cause are present in over 70% of sufferers. What tends to happen in worrying about this problem sets a more persistent problem of performance anxiety due to ‘’fear of failure’’. Some of these physical causes include diabetes, hypertension, smoking, stroke, and excessive alcohol to mention but a few.

 

It is important to note that there are several factors that would put you at risk of developing ED. These include stress, non-marital status, history of sexually transmitted illness, history of same sex activity and history of adult-child sexual contact. Other risk factors are hormonal problem anxiety chronic kidney failure, prolonged pressure on the male organs from cycling, depression, diabetes, cholesterol problems, injury to the male organs, hypertension, thyroid problems, heart disease, obesity, sedentary lifestyle, substance and tobacco use and abuse, unresolved relationship conflict. In addition, there are certain commonly used medications that can increase the risk of ED; notably medication used to treat hypertension and depression amongst others. A complicated issue now arises where many of the medicines used to treat the risk factors for ED can themselves cause ED.

 

The good news! The prospect of full recovery from ED is generally good. Many men will experience episodes of ED that improve without the need for treatment. However where there is persistent ED as a result of an underlying health condition, treatment will be needed.

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