Male erectile dysfunction Pt:1

Over the next few weeks I will be discussing male sexual dysfunctions. These include issues such as this week’s topic of erectile problems (can’t get it up) but also priapism (can’t get it down), premature ejaculation (shooting too fast), delayed or no ejaculation (shooting too slow), loss of desire or libido or too much libido.{{more}}

This week I will be looking at a very tabooed but a topical subject. The subject is tabooed because it has to do with male potency and how man views himself; topics, which until recently were not discussed. Fortunately with the advent of computers, the Internet, women’s independence from the home and the metrosexual male, this subject is now topical. Unfortunately, the forces of tradition and the bastions of ignorance in this country will prefer that I not touch this subject, however, to do this will be to neglect my duty as a doctor and more so as a urologist.

Erectile dysfunction (ED) or impotence is the inability of a man to initiate or sustain an erection to allow satisfactory penetrative intercourse. Surprisingly, ED is more common than thought as most sexually active men will experience periods of ED associated with events such as tiredness, grief and loss, periods of separation from loved ones, etc. However, pathologic ED occurs when this is persistent and interferes with the relationship. Unfortunately, it is the woman who usually complains about the man’s impotence, because when the man realizes that he is becoming less sexually potent, he will avoid sex with his partner. He will use excuses such as tiredness, work stress and even fake illness. The woman is usually suspicious and thinks he has another woman, she will nag and he will become more withdrawn, sometimes even using her nagging as an excuse for avoiding sex. This can be a major source of marital and relationship dysfunction, even leading to separation and divorce. For this article I prefer to use the word impotence instead of ED.

Interestingly if a man lives to be 50 he has a 40% chance of suffering from impotence.This figure rises to 60% at age 60 and 80% at age 70. In other words, for each decade above 40, the incidence of impotence rises by 20%, so virtually all 80-year-old men have it, that does not mean that 80-year-olds have no interest in sex, actually on the contrary. I am still prescribing Viagra to men in their 70s and a few men in their 80s! The incidence of impotence mirrors that of diabetes and hypertension in the Black population. The magic figure is 50, i.e. 50% of all blacks at 50 years old have diabetes or hypertension or both. The prevalence of these precursors of cardiovascular disease is so rampant in this age group that the greatest cause of impotence is actually the presence of diabetes (sugar), hypertension (pressure), high cholesterol and aging. It is impossible to separate age from the presence of these diseases because as I mentioned above, the older one gets the higher the risks of these diseases and the higher the risks of impotence.

So does impotence occur in a man under 50? Actually, it does and also in men under 40! Really? Yes, really! Impotence can occur in men in their 30s. Because of the high risk of diabetes and hypertension in the over 50s and the risk that these diseases can cause impotence in this age group, when we see a man under 50 with impotence, we search for the presence of these diseases. In other words, impotence is an indicator or a pointer to the possibility of these diseases, hence it is called an index disease. So the presence of impotence predicts the presence of cardiovascular disease in the form of sugar, pressure, obesity and high cholesterol. So women, when your men find it difficult to “rise to the occasion” frequently, do not accept the excuse of “tiredness”, instead insist that he sees his doctor to get a check up. This is important because with the advent of Viagra when men think they can just “pop a pill” to “get up the hill”, they might actually be harbouring latent cardiovascular disease.

Next week, we will look specifically at ED in men in their forties and fifties.

For comments or question contact:

Dr. Rohan Deshong

Tel: (784) 456-2785

email: deshong@vincysurf.com