Erectile Dysfunction and what can we do about it?
Dr. Gautam Allahbadia, a Dubai-based IVF expert talks about Erectile Dysfunction, and how can it be cured?
The struggle or inability to reproduce has been more associated with women than men. However, male factor infertility is a common problem that can affect up to one in three infertile couples. With the available information on infertility written and directed for women, by women, it is time to look at it through a male’s perspective.
Dr Gautam Allahbadia, a Mumbai-based IVF expert says that erectile dysfunction is one of the most common causes for distress in men— both from a sexual as well as reproductive point of view. Talking about what erectile dysfunction is, Dr Gautam Allahbadia explains, “Infertility affects up to 12% of all men, and sexual dysfunction occurs frequently in men of reproductive age, causing infertility in some instances. In infertile men, hypoactive sexual desire and lack of sexual satisfaction are the most prevalent types of sexual dysfunction, ranging from 8%-70%. Erectile dysfunction and/or premature ejaculation, evaluated with validated tools, has a prevalence of one in six infertile men, and orgasmic dysfunction has a prevalence of one in ten infertile men. In addition, infertile men can experience a heavy psychological burden. Infertility and its associated psychological concerns can underlie sexual dysfunction. Furthermore, general health perturbations can lead to male infertility and/or sexual dysfunction. Erectile dysfunction and male infertility are considered proxies for general health, the former underlying cardiovascular disorders and the latter cancerous and noncancerous conditions. The concept that erectile dysfunction in infertile men might be an early marker of poor general health is emerging. Finally, medications used for general health problems can cause sperm abnormalities and sexual dysfunction. The treatment of some causes of male infertility might improve semen quality and reverse infertility-related sexual dysfunction. In infertile men, an investigation of sexual, general, and psychological health status is advisable to improve reproductive problems and general health.
The doctor also says that while both infertility and its treatment is on a rise, the research is still dominated by women more than the male reproductive health. When talking about what causes male infertility, the doctor stresses on how women treat sexuality and reproduction as separate, whereas men sometimes conflate sexual prowess and reproduction. The reality is that it’s 50/50. More people who come to us have a malefactor for infertility than ever before.
What causes Erectile Dysfunction?
There is not one or a set of factors that can lead to male infertility. With a number of physical and psychological issues, erectile dysfunction is often not understood and warrants medical attention.
Physical causes of erectile dysfunction
Common causes include
1. Heart disease.
2. Clogged blood vessels (atherosclerosis).
3. High cholesterol.
4. High blood pressure.
7. Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol.
8. Certain prescription medications.
10. Peyronie’s disease — development of scar tissue inside the penis.
11. Alcoholism and other forms of substance abuse.
12. Sleep disorders.
13. Treatments for prostate cancer or an enlarged prostate.
14. Surgeries or injuries that affect the pelvic area or spinal cord.
Psychological causes of erectile dysfunction:
The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include
1. Depression, anxiety or other mental health conditions.
3. Relationship problems due to stress, poor communication or other concerns
Erectile dysfunction (ED) can be diagnosed with a medical, and sexual history, and mental health and physical exam. It can also be self-diagnosed but one must visit a doctor to gain more certainty, says Dr Gautam Allahbadia. On discussing how doctors diagnose the condition, he states “We initially start with asking personal questions from the patient to know about ED problem.”
The medical history tells us about the preclusive factors of fertility in a male. Reviewing your sexual activity can help your doctor diagnose problems with sexual desire, erection, climax, or ejaculation. The doctor might also do a physical examination if the need is, which will include:
- Blood tests to disclose if the patient has diabetes, atherosclerosis, chronic kidney disease, and hormonal problems
- Tests to evaluate if the patient has any pituitary tumors
- Urine test
- Fasting blood glucose test
- Serum creatinine test
- Morning serum testosterone test
- Prolactin level test
There are psychological, and neurological tests too if the problem’s source remains inconclusive. However, based on the results, treatments are suggested as per the doctor’s discretion, some of which may include:
ED non-invasive Treatments
Non-invasive treatments are often tried first as the problem is usually curbed through them. Most of the treatments for ED are subtle, that work well, and are safe.
Intracavernosal (ICI) and Urethra (IU) Therapies
If oral drugs don’t work, the intracavernosal injection “ICI” or “IU” therapy can be used through the urethra
In those rare cases where a low sex drive and low blood levels of Testosterone are the factors behind ED, testosterone therapy may help produce normal erections, making it easier for the male to conceive.
If you think you have ED, a good first step is to talk with your doctor. The treatment you need – ranging from lifestyle changes to medication to surgery will depend on your goals, preferences and further diagnostic and therapeutic options.