ERECTILE dysfunction, also known as impotence, is a male sexual disorder whereby the male organ fails to get erect after adequate stimulation or loses the erection during sexual intercourse.
For you to understand erectile dysfunction it is imperative that you understand the science of an erection first.
An erection simply comes about because of increased blood flow to the muscles of the male organ (namely the two Corpora cavernosa and the corpus spongiosum). Once the blood flow to the male organ has increased, there will be reduced venous return to the body from the male organ and that maintains the penis erect.
What triggers this increase in blood flow to the male organ is a complex interaction of psychological, neural (nerve related), vascular (blood vessel related) and hormonal factors usually on the backdrop of some sexual arousal though there are some instances where a spontaneous erection occurs without any sexual stimulation.
For someone to have erectile dysfunction there should be an underlying cause. In 80 to 90 percent of cases, the cause is physical. Meaning there is an underlying medical problem that is causing the erectile dysfunction. In about 10 to 20 percent of cases, the cause is psychological.
The common medical problems that may result in erectile dysfunction are diabetes mellitus, heart diseases, prostate diseases, nerve problems, especially after an operation of the prostate or spine.
Alcoholism, smoking and substance abuse can also lead to erectile dysfunction. Psychological issues that lead to erectile dysfunction are usually issues to do with thinking a lot before the act.
At times pressure to perform can also lead to psychological erectile dysfunction. If your partner has or once gave you a sexually transmitted infection, your brain can subconsciously tell you there is danger in there so your body will switch off and erectile dysfunction ensues.
To minimise your chances of developing erectile dysfunction, we encourage people to exercise. People who exercise have a less chance of suffering from erectile dysfunction. The kind of exercise we encourage is aerobic or cardiac exercises more than weight lifting. Eating more fruits and vegetables also minimises your chances of suffering from erectile dysfunction.
Our traditional dishes like muboora (pumpkin leaves), derere (okra) and nyevhe have been postulated to improve sexual performance. In addition people who drink plenty of water (at least 2L a day) have also been seen to attain and sustain a better erection.
With all this in mind, we encourage men of 18years and above to minimise intake of fast fatty foods and to eat more natural food stuffs, in particular fruits and vegetables to improve the attainment and sustenance of an erection.
The problem with erectile dysfunction is not just the failure to attain an erection or to sustain it. It goes beyond just an erection because it takes away your self-esteem and you feel like a lesser men compared to your fellow brothers.
The psychological effects can lead to depression which can ultimately lead to suicide. Also note without an erection there is no ejaculation so at the end of the day you fail to make babies because of erectile dysfunction.
All these issues can lead to infidelity and ultimately divorce. As such, we encourage all men that suffer from erectile dysfunction not to be shy to visit a doctor and get assistance before it’s too late.
To make a diagnosis of erectile dysfunction, we generally analyse what the patient tells us. We may need to do a couple of tests to try and find the underlying cause since up to 90 percent of cases are secondary to an underlying cause.
Some of the tests we can do include a full blood count which can show us if you anaemic. Anaemia can slow down blood flow to the penis and hamper oxygen delivery to the penile muscles, which in turn will cause erectile dysfunction.
We can also test your blood sugar levels. Diabetic patients can have challenges with attaining and sustaining an erection. We can also check your blood cholesterol levels. Individuals with high cholesterol levels can also have challenges in attaining an erection due to clogged arteries. An ultrasound scan of the penis could be requested to see if there are any blockages impairing the flow of blood into the male organ.
There are certain medical drugs such as anti-hypertensive drugs that can also cause erectile dysfunction. On the issue of drugs that may cause erectile dysfunction, I would like to stress an important point. If you develop erectile dysfunction and you are on medication, please don’t always assume it’s the drugs and definitely never stop taking your medication before consulting your doctor. So, please if you develop erectile dysfunction and you are on blood pressure medication or any other condition visit your doctor and discuss with him/her first. At times we can give you an antidote or a drug to help with erectile dysfunction as we continue you on your medication depending on your particular case.
If there is an underlying physical condition like diabetes, the solution to erectile dysfunction will be to stabilise the blood sugar first and normally erectile function will be restored. In cases where there are no physical conditions underlying, treatment is mainly psychological counselling and at times we also give placebos (a “fake” drug that has no therapeutic benefit physically). If the erectile dysfunction is persistent despite treating the underlying cause then we escalate treatment to give you therapeutic drugs like sildenafil popularly known as Viagra or its analogues.
Lastly, as medical practitioners we don’t encourage the use of herbs and unlicensed drugs to treat erectile dysfunction. This we do because we have had cases of people who take some of these concoctions and they present in casualty with an erect male organ that is not remitting to any form a remedy (a condition called priapism). So please desist from using unlicensed products to treat erectile dysfunction.
By Josephat Chiripanyanga
(Chiripanyanga is a Harare-based medical doctor contactable on joechiripanyanga@gmail.com).