Erectile Dysfunction: Prompt counselling leads to good outcomes

SIR: Erectile dysfunction is a common, but rarely discussed topic affecting men and it influences greatly a man’s ego and self-esteem. It may be very embarrassing to confront and express with spouses and even medical practitioners. 

It is best, however, to discuss such delicate matters with trusted health practitioners who can offer timely advice, counseling and prompt interventions when necessary to achieve good outcomes.

Erectile dysfunction also known as impotence is characterised by difficulty in achieving and maintaining an erection firm enough for the sexual act.  The quality of erection is determined by good blood circulation and a functional nervous coordination. Any condition or group of conditions that interfere with circulation or nervous coordination may also impact erections. 

The condition affects more than half of men 40-70years of age and may be distressing with associated depressive symptoms especially when no help is in sight. 

Erectile dysfunction may be a sign of a physical or psychological condition. It may be associated with stress, relationship strain, performance anxiety, arousal problems, low self-confidence and andropause (55-65years) – a phase of age-related natural decline in the male hormone testosterone levels). 

Andropause presents with low libido, low energy levels, sleep problems with behavioral changes in men. It is essential that patients be thoroughly evaluated for any underlying conditions like Diabetes, high cholesterol, obesity and also addictive substance abuse of tobacco and alcoholism.  If treatment of underlying conditions are not effective, medications (vasodilators) and assistive devices such as pumps or implants may be recommended. 

The treatment is individualised and what works for a person may not necessarily be ideal for another.  Pornography and habitual masturbation have established links with erectile dysfunction as the body gets accustomed to hyper-stimulation in a certain way that may not be reproducible in real life hence, the level of arousal needed to elicit a good sexual response may not be achievable from years of addiction to these vices.

Recommendations: Timely presentation at a health facility to see a licensed medical practitioner, treat underlying conditions effectively, maintenance of a healthy body weight, alcohol restriction, cessation of smoking, regular exercising, stress management, quality sleep, good healthy relationships and regular comprehensive health screenings for early detection of chronic medical conditions. 

It is also of paramount importance to quit emotionally and psychologically detrimental habits like pornography and replacing them with genuine bonding and connection with their spouses. It is possible for men to age gracefully and have a beautiful transition into their senior years.
• Charles Adeogun, medical doctor, writes from Lagos.