Manly problem
Iam currently visiting family in the United Kingdom. As I raced around the massive local supermarket yesterday, filling my trolley with all sorts of English delights, I was suddenly faced with a huge billboard advertising Viagra.
It wasn’t on my shopping list but, as I read the information in front of me, it became clear that you can now buy Viagra (and some other related drugs) over the counter.
Although we don’t seem to have the same level of advertising, this issomething that you have been able to do in New Zealand for several years, provided you visit an approved pharmacist and you don’t have any complicated medical issues.
I am delighted that we are making changes on both sides of the globe to permit this medication to be more available. We don’t really know the exact figures but studies all agree that a large number of men suffer from erectile problems (known as erectile dysfunction or ED) at some stage in their life, with estimates varying from 20 to more than 50 per cent. The rates increase dramatically with age.
Unfortunately, we also know that very few men – approximately one in 20 who suffer from ED – will ever talk about this problem with their doctor or another health professional.
So, for me, anything that enables a discussion about this issue, and helps men get the help and support that they need, has to be a large step in the right direction.
Erectile dysfunction is when you are unable to get or maintain an erection sufficient to have satisfactory sexual intercourse. It can present in several ways:
❚ Inability to get an erection at all;
❚ An erection that doesn’t last as long as you would like it to, or;
❚ Only getting a partial erection.
However or whenever it happens, ED can be a problem that men, and their partners, find distressing, embarrassing and stressful. If left untreated, ongoing issues with erectile function can lead to anxiety, depression, low self-esteem, loss of confidence and, ultimately, if communication isn’t good, relationship issues.
ED is usually caused by physical or psychological factors, or a combination of both. To become erect, the blood vessels in the penis need to dilate to allow more blood in to the area – if this doesn’t happen, your erection will be either softer than you would like, or won’t last as long as you would like it to.
As it is related to your circulation, many of the risk factors for ED are the same as those associated with cardiovascular disease – so obesity, smoking, high blood pressure, high cholesterol and diabetes. Other things that we know can lead to ED include:
❚ Neurological conditions, such as a stroke, Parkinsons disease or multiple sclerosis;
❚ Excessive use of alcohol;
❚ Drug use, including marijuana and cocaine;
❚ Some types of surgery including treatments for prostate cancer;
❚ Certain medications – there is a long list of medicines that can interfere with your erectile function, including antidepressants, heart medications, ulcer treatments, and hormones, so ask your pharmacist about your medicines if you are concerned.
In terms of the psychological factors that play a part, these can either be causative or secondary to the ED. There may be an underlying issue such as untreated depression, anxiety, or previous sexual trauma, which leads to ED in the first instance. In other cases, the condition may have resulted from a physical issue initially but the resultant stress and worry about erectile function can cause it to perpetuate, creating a chronic ongoing problem. Either way, addressing the issue early, getting help, advice and support as needed, from your partner as well as a health professional, is likely to limit the problem.
If you do get ED and would like to know what to do, I would encourage you to discuss your concerns with your GP. They can do a physical checkup to address any underlying causes: depending on your symptoms and age, this might include a check of your blood pressure, your weight, some basic blood and urine tests, as well as an examination of your genital area and prostate. They will also be able to help you identify and manage any psychological stressors that might be contributing.
Depending on the cause of your problem, your GP will either suggest more testing, refer you to a specialist, or a trial of a medication from the Viagra ‘‘family’’. This group of medications includes sildenafil, tadalafil and vardenafil and enables the blood vessels in the penis to relax, helping maintain a satisfactory erection. They are successful for 7 out of 10 users, so are definitely worth considering – and if you’re not planning a visit to an English supermarket in the near future, your local pharmacy may be able to help.
If you would like more information, visit: www.healthnavigator.org.nz
Dr Cathy Stephenson is a GP and mother of three.