Mr LB is fast sinking into depression; the feelings of low self esteem, hopelessness, loss of interest in things once pleasurable, fatigue, trouble concentrating/ remembering details/making decisions and sleeplessness have all increased in multiple fold over the last few months. It all started a year and half ago when he was diagnosed with diabetes (there is a family history of same), there was a self denial period of about 6 months that he turned down orthodox medications to seek alternative therapy. 8 months into the unorthodox option, he initially noticed weakness of erection which progressively worsened until there was total loss! The ensuing marital disharmony has just been too much to bear. He’s increased his spouse’s upkeep allowance, bought expensive gifts, and planned a dream vacation (which had to be cancelled!) but the poor lady was not impressed a bit. As supportive as she’s been that is not what she wants! She needs much more…she wants her man back!! LB is emotionally bruised, it’s a matter of honour, one that money cannot buy!!!
What it is
Erectile dysfunction aka ED aka Impotence is the inability to attain or sustain an erection satisfactory for sexual intercourse. It affects men of all ages but becomes increasingly prevalent with age. Every man occasionally has a problem achieving an erection, and such occurrences are considered normal as long as it is temporary (usually happen during periods of stress). Erectile dysfunction occurs when a man is • Never able to achieve an erection • Achieves erection briefly but not long enough for intercourse • Achieves effective erection inconsistently ED is called primary if the man has never been able to attain or sustain an erection (in life). ED is called secondary if after achieving it initially, it was later lost, that is, acquired later in life by a man who was previously able to attain erections.
What causes an erection?
An erection is the result of increased blood flow into the penis. Blood flow is usually stimulated by either erotic scenes, sexual thoughts or direct contact with the penis. When a man becomes sexually excited, muscles in their penis relax. This relaxation allows for increased blood flow through the penile arteries. This blood fills two chambers inside the penis (corpora cavernosa). As the chambers fill with blood, the penis grows rigid. Erection ends when the muscles contract and the accumulated blood can flow out through the penile veins. ED can occur because of problems at any stage of the erection process. For example, the penile arteries may be too damaged to open properly and allow blood in. In essence normal erectile function is affected by blood flow, nerve supply and hormones.
Could be Physical or Psychological
• heart disease and narrowing of blood vessels; atherosclerosis causes a narrowing or clogging of arteries in the penis, preventing the necessary blood flow to the penis to produce an erection.
• high blood pressure
• high cholesterol
• obesity and metabolic syndrome
• Parkinson’s disease
• multiple sclerosis
• hormonal disorders including thyroid conditions and testosterone deficiency
• structural or anatomical disorder of the penis, such as Peyronie disease (development of scar tissue inside the penis) • smoking, alcoholism, and substance abuse, including cocaine use • treatments for prostate disease
• surgical complications
• injuries in the pelvic area or spinal cord
• radiation therapy to the pelvic region
• Medications implicated include;
• drugs to control high blood pressure
• heart medications such as digoxin
• some diuretics
• drugs that act on the central nervous system, including some sleeping pills and amphetamines
• anxiety treatments
• antidepressants, including monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), and tricyclic antidepressants
• opioid painkillers
• some cancer drugs, including chemotherapeutic agents
• prostate treatment drugs
• hormone drugs
• the peptic ulcer medication cimetidine Physical causes account for 90 percent of ED cases, with psychological causes much less common.
In rare cases, a man may always have had ED and may never have achieved an erection. This is called primary ED, and the cause is almost always psychological if there is no obvious anatomical deformity or physiological issue. Such psychological factors can include:
• fear of intimacy
• severe anxiety Most cases of ED are ‘secondary.’ This means that erectile function has been normal, but becomes problematic. Causes of a new and persistent problem are usually physical. Less commonly, psychological factors cause or contribute to ED, with factors ranging from treatable mental health illnesses to everyday emotional states that most people experience at some time.
It is important to note that there can be overlap between medical and psychosocial causes. For instance, if a man is obese, blood flow changes can affect his ability to maintain an erection, which is a physical cause. However, he may also have low self-esteem, which can impact erectile function and is a psychosocial cause.
As advised by the managing doctor Complications
• An unsatisfactory sex life
• Stress or anxiety
• Embarrassment or low self-esteem • Relationship problems
• The inability to get your partner pregnant
The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health conditions. For example:
• Work with your doctor to manage diabetes, heart disease or other chronic health conditions.
• Stop smoking, limit or avoid alcohol, and don’t use illegal drugs.
• Exercise regularly.
• Take steps to reduce stress.
• Get help for anxiety, depression or other mental health concerns.