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Men’s health: erectile dysfunction

Erectile dysfunction (ED or impotence) is defined as the inability to obtain or maintain an erection, and often made worse by the fear of knowingly having the condition. ED affects over half of men between the ages of 40 and 70 years old. During Men’s Health Week we would like to open the dialogue about ED, encourage men to discuss ED and to stop men suffering in silence.

Men who experience erectile dysfunction may show a gradual or a sudden onset of symptoms. Most men are reluctant to discuss ED but is something that will occasionally come up during urology consultations, explains Associate Professor Kamran Zargar; “Patients often present to urologists for a non-ED related urological problem and will subsequently raise issues relating to on-going erectile dysfunction. I hope that we can inform men that ED is common and to encourage them to discuss their concerns with their doctors and seek help in a timely manner.”

Kamran Zagar a/Prof
A/Prof Kamran Zargar

Ormiston Hospital’s surgeon Kamran Zargar is an Associate Professor of urology and a leading Urologist in the Auckland community with special interest in cancer treatment. “Erectile dysfunction is also an issue for men treated for with prostate and bladder cancer, however it is often overlooked during the course of cancer treatment. We need to highlight ED as important Men’s health issue and and appeal for better government funding for assessing and treating ED in Kiwi men”

Erectile dysfunction can be very upsetting and result in significant stress and anxiety. It may be embarrassing to discuss this with your doctor nevertheless it is important that you do so, as ED can be a sign of other important underlying medical conditions such as high blood pressure, high cholesterol or diabetes. In addition, ED is also seen in men with untreated depression or anxiety disorder so it is important that men who are experiencing ED to seek medical advice.

Nighty percent of men with impotence (erectile dysfunction) have at least one underlying physical cause for their problem. A psychological component, often called “performance anxiety” is common, however a purely psychological problem is only seen in 10% of cases. Of the 90% of men who have an underlying physical cause, the main contributors are: Cardiovascular disease (40%), Diabetes (33%) hormone problems (e.g. high prolactin or low testosterone levels) and drugs (e.g. antihypertensives, antipsychotics, antidepressants, antihistamines, heroin, cocaine, methadone) in 11%,  Neurological disorders (10%), pelvic surgery or trauma (3-5%) and anatomical abnormalities (1-3%).

A/Prof Zargar recommends that men discuss concerns regarding erectile function with their GPs. Initial family physician assessment may unmask important underlying medical conditions which can be followed up and easily managed in community. Improved lifestyle choices and reducing stress are important in treating ED.  There are also a selection of ED specific medications which can augment other non-pharmaceutical interventions, including sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) or avanafil (Spedra). The best step to take is to seek help from your GP or you may wish to book in and see a Urologist at Ormiston Specialist Centre.

Discuss this issue with your mates this week, and encourage open and honest experiences around erectile dysfunction to help normalise the problem and treatment.