HOW TO BEAT Health problems no one likes to talk about
TODAY: SNORING AND LOST LIBIDO
There’s nothing funnier to most five-year- olds than the word ‘bottom’, and the fact is, most adults aren’t immune to a chortle over a ‘below the belt’ joke.
But while Brits are famously open about their enjoyment of lavatorial humour, when it comes to health problems in that area, embarrassed, we tend to clam up.
It’s costing us dear, with one of the lower survival rates for bowel cancer in europe, for instance. And it means many miss out on treatments for conditions such as incontinence, that could transform their lives.
To break down the taboos, today we launch a five-part series focusing on embarrassing problems, seeking experts’ views on the latest thinking and treatments. In this pullout, we look at two major bed-time predicaments: problems with sex and snoring.
IMPOTENCE
FEW men, if any, will get through life without suffering an embarrassing failure at some point. The Nhs estimates that approximately half of all men aged 40 to 70 suffer a degree of erectile dysfunction.
The causes can be both psychological and physical but, either way, says sex and relationship therapist Victoria Lehmann, ‘your body is trying to tell you something — and you should listen’.
The occasional lack of performance is one thing, and is often put down to having had too much to drink — alcohol acts as a depressant — however, frequent erectile dysfunction, or impotence, can be a sign of serious underlying health problems, says Mike Kirby, a professor of men’s health at the University of hertfordshire and a consultant urologist at The Prostate Centre in London.
‘That’s why it’s important to see a doctor as soon as possible,’ he says. ‘ Men are very bad at this. research shows that only two out of ten will seek medical help with erectile dysfunction. It’s a macho thing and, of course, there’s a lot of embarrassment.’
But talking about a failure to perform could save a man’s life. ‘ erectile dysfunction can be caused by vascular disease, so talking about it with your doctor can alert them to the fact you may have high blood pressure, high blood sugar or high cholesterol,’ he adds.
In a study led by Professor Kirby and published in the International Journal of Clinical Practice in 2007, seven in ten male cardiac patients had erection problems up to five years before their heart attacks, but few sought help.
A more recent study found men with erectile dysfunction between the ages of 40 and 49 are 50 times more likely to suffer a cardiac event. The blood vessels feeding the penis can become blocked by fatty deposits in the same way as those carrying blood to and from the heart. The difference is that coronary arteries are about 25mm in diameter, while those in the penis are tiny — about 2mm — making it an early warning system to tackle high cholesterol and blood pressure before they damage the heart. ‘You need to lose 75 per cent of the diameter of the coronary artery before you get cardiac pain,’ says Professor Kirby.
‘ Whereas with the small penile artery you need only a little bit of obstruction, or inability to relax the artery, and erections become affected.’
Impotence can also be caused by low testosterone, often linked to being overweight. Abdominal fat produces toxins that effectively ‘switch off’ production of the hormone, while body fat converts testosterone to the female hormone oestrogen, ‘which is why men get manboobs’, says Professor Kirby.
Testosterone also plays a vital role in maintaining major organs, such as the heart, kidneys and brain. That’s why it’s doubly important to take erectile dysfunction seriously.
But don’t turn to testosterone supplements bought over the internet without first seeing an endocrinologist and having the levels in your blood tested, as these can be potentially harmful, says Tet Yap, a urological surgeon at st George’s hospital, London.
Ironically, excess testosterone ‘can render you infertile as it suppresses the sperm count’, he warns. Other side-effects include acne and swollen breasts.
Patients put on the hormone by a doctor are monitored ‘ as they can also have high red blood cell counts, which could increase the risk of clotting’, he adds.
To be absolutely sure low testosterone is your problem (in the UK the official — though controversial — view is that testosterone deficiency affects only 8 per cent of men aged 50 to 79), a series of daily blood tests will be carried out at about 9am, as levels fall during the day.
In most men, testosterone is best raised naturally, says Professor Kirby, with a healthy lifestyle, exercise and weightloss. But because it’s hard for men to lose the 10 per cent of weight needed to kickstart production of the hormone, testosterone is often prescribed to get them going again and to get fit.
It is then stopped when they are back to an ideal weight.