Erectile dysfunction: From prevention to cure

BY SYLVESTER OJENAGBON

Erectile dysfunction affects millions of men all over the world, and prevalence rates vary based on age, with older men being more likely to experience it. Studies indicate a significant rise in prevalence from around 22% at age 40 to 49% by age 70. The World Health Organisation (WHO) estimated that in 1995, over 150 million men worldwide had erectile dysfunction, and projections for 2025 were around 320 million.

Although it is often associated with older men, erectile dysfunction can also affect younger people due to a variety of physical and psychological factors. Studies suggest that between 1% and 14% of men under 40 experience erectile dysfunction.

Erectile dysfunction, also known as impotence, is a medical condition characterised by a consistent or recurrent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Occasional difficulty getting or keeping an erection is not usually a cause for concern, but persistent erectile dysfunction is a problem that needs attention.

Now, erectile dysfunction can be caused by physical, psychological, or other factors. Conditions like high blood pressure, heart disease, and atherosclerosis (plaque buildup in arteries) can restrict blood flow to the penis, making it difficult to achieve or maintain an erection. Diabetes can damage blood vessels and nerves and lead to erectile dysfunction. Conditions like spinal cord injuries, nerve damage from pelvic surgery, and multiple sclerosis can disrupt nerve signals necessary for erections. Low testosterone levels or thyroid problems can affect sexual function and contribute to erectile dysfunction.

In addition, Peyronie’s disease, which causes curvature of the penis, can make erections painful or difficult. Some medications, including certain blood pressure drugs, recreational drugs, and antidepressants, can list erectile dysfunction as a side effect. Smoking, excessive alcohol consumption, and obesity can negatively impact blood flow and hormone levels, increasing the risk of erectile dysfunction.

Furthermore, high stress levels and performance anxiety can interfere with the body’s natural sexual response, and depression can equally decrease libido and affect erectile function. Conflicts or dissatisfaction in a relationship can also impact sexual desire and performance, while past sexual abuse or trauma can similarly contribute to erectile dysfunction. Pelvic or prostate surgery, or injuries to the pelvic area or spinal cord, can sometimes lead to erectile dysfunction.

The truth is that erectile dysfunction can lead to a range of consequences, affecting not only a man’s physical health but also his mental well-being and relationships. It can significantly affect a man’s self-esteem and confidence, leading to feelings of inadequacy and shame. The inability to achieve or maintain an erection can also trigger or worsen anxiety and depressive symptoms.

In addition, erectile dysfunction can create tension and strain in relationships, leading to communication problems, decreased intimacy, and feelings of rejection for both partners.
The constant worry and frustration associated with erectile dysfunction can equally cause significant stress and emotional distress. In some cases, erectile dysfunction can make it difficult or impossible for couples to conceive naturally. Men with erectile dysfunction may withdraw from social interactions altogether, further affecting their relationships and social life.

Erectile dysfunction can similarly be linked to metabolic syndrome, a cluster of conditions that increase the risk of stroke, type 2 diabetes, and heart disease. Furthermore, it can be an early warning sign of cardiovascular disease, indicating potential blockages in the blood vessels. Studies suggest that men with erectile dysfunction may be at a higher risk of experiencing heart attacks and strokes.

To prevent or minimise the problem of erectile dysfunction, there is a need to focus on maintaining a healthy lifestyle through a balanced diet, stress management, regular exercise, and avoiding smoking and excessive alcohol consumption. It is equally important to address any underlying health conditions.

So, engage in moderate-to-vigorous physical activity, especially cardiovascular exercises, to improve blood flow and overall health. Consume a diet rich in vegetables, whole grains, fruits, and lean protein; limit saturated and trans fats; and adopt a Mediterranean-style diet.

Also, maintain a healthy weight, as being overweight or obese can contribute to erectile dysfunction, and stop smoking, as it damages blood vessels and can significantly impact erectile function. Excessive alcohol intake can negatively affect erectile function, so minimise or stop your alcohol consumption, and find healthy ways to manage stress, such as exercise, meditation, or spending time in nature, as chronic stress can impact hormones and mental health, both of which play a role in erections.

It is crucial to manage underlying health conditions, if any. So, work with your doctor to manage your blood sugar levels, as diabetes is a major risk factor for erectile dysfunction. Control your cholesterol, blood pressure, and other risk factors for heart disease, as these can affect blood flow to the penis.

You equally need to address any other medical conditions that may contribute to erectile dysfunction, such as hormonal imbalances or neurological issues, and schedule regular checkups with your doctor to monitor your overall health and address any potential issue early on. In addition to lifestyle adjustments, your doctor may recommend medications, and surgery may be necessary to address underlying vascular issues or to implant a penile prosthesis in some cases.

Furthermore, it is important to communicate openly with your partner about any concerns and experiences, as this can improve your overall sexual health. Also, consider seeking therapy or counselling to address whatever issues you may be struggling with if anxiety, stress, or depression are contributing to your erectile dysfunction.

Erectile dysfunction can impact not only physical intimacy but also emotional well-being and overall quality of life. The good news, however, is that it is neither unavoidable nor untreatable. With the right lifestyle choices, regular health checkups, and open conversations with healthcare professionals, many can reduce their risk, and those already struggling with it can have access to a growing range of effective treatment options.

Ojenagbon, a health communication expert and certified management trainer and consultant, lives in Lagos.