When you see an 85 year old man shuffle to the pharmacy counter, frail and ill-looking, virtually hanging on to his last breath, and you hear him softly ask to buy a drug that costs 98 cedis per tablet for one night’s sexual escapade, you immediately appreciate the importance of sex to men.
If elderly men feel the need to satisfy their sex drive, then you can imagine that young men (less than 40 years) will have an even greater need to be potent. A diagnosis of erectile dysfunction is therefore one that no man, not less a young man (in his prime), wants to have in his medical records. The diagnosis is so emasculating that it is usually coded as ED, to make it easier on the tongue and make it sound less ominous.
But besides feeling like a man with complete virile attributes, young men now have another reason not to want to be bankrupt in the coital department; recent studies have demonstrated ED in young men to be a good predictor of future morbidity and mortality. This morbidity and mortality was specifically found to be with respect to cardiovascular disease (heart attacks, strokes, arterial insufficiency, etc.)
ED was thought to be the preserve of the elderly, but in a recent study by two Italian Universities, it was found that 1 out of 4 adults with erectile dysfunction were under the age of 40, a statistic hitherto an absurdity.
This trend is particularly worrying because unlike in the past where psychogenic factors (like anxiety and depression) were mainly to blame for ED in young men, organic factors (like diseases of the vessels, hormonal abnormalities and problems with the nerves) are now more to blame. Some studies have found that up to 70% of cases of ED in young men are of organic causes.
Dimitri Papagiannopoulos and his colleagues’ in their 2014 study noted that, “ED and coronary artery disease (CAD) may result from similar underlying vascular insults. Blood vessel abnormalities and male sex hormone levels have all been proposed as possible contributors to this phenomenon.”
The identified risk factors for organic ED include smoking, diabetes mellitus, hypertension, high cholesterol, perineal trauma, spinal cord injury, and drug consumption. With the exception of the cases of trauma, all of these risks are lifestyle-related in one way or other. Sadly, young men are developing hypertension, diabetes and high cholesterol much earlier than previously, due to poor life-style choices.
Since the underlying causes of the organic factors for erectile dysfunction intersect with the underlying causes of cardiovascular and other lifestyle-related diseases, it only makes sense that ED in young men is a good predictor of future illness and death.
Another major factor for ED in young men not yet mentioned is the excessive consumption of alcohol. Ironically, some take these alcoholic beverages to enhance sexual performance, lured by the suggestive advertisements that abound in the media. Yes, alcohol may decrease one’s inhibitions and make you apparently more self-confident, an attribute that increases the chances of finding a sexual mate. However, excessive alcohol consumption has depressive effects on the nervous system, making it difficult to achieve and maintain an erection. Also, alcohol destroys the liver, where the sex hormones that modulate an erection are produced, making ED a significant problem in the long term for heavy drinkers.
It is heart-breaking to see young men spending a fortune on a natural phenomenon like erection, enriching big pharma in the process. Pfizer’s Viagra alone generates about 2 billion dollars in revenue each year. Pfizer, by the way, is not the only player in the industry; even our very own local herbalists are cashing in. With the current state of affairs, this trillion-dollar industry is going to grow even bigger. Some may ascribe it to kinky old men, but there is no doubt a good number of young men patronize these products, frequently.
As always, prevention is better, and as it turns out in this case, cheaper, than cure. The steps to prevent ED are not new, but I guess they must be reiterated. These points are as outlined by the Mayo Clinic:
- Work with your doctor to manage diabetes, heart disease or other chronic health conditions.
- See your doctor for regular checkups and medical screening tests.
- Stop smoking, limit or avoid alcohol, and don’t use illegal drugs.
- Exercise regularly.
- Take steps to reduce stress.
- Get help for anxiety, depression or other mental health concerns.
Dimitri Papagiannopoulos and his colleagues’ in the aforementioned study opine that “The presence of ED may be the first manifestation of poor future health. For this reason, it is imperative to increase awareness within the younger population. Making an early diagnosis can allow clinicians to target at-risk men, and help them curb poor health habits or diagnose co-morbid conditions at a younger age.” and I concur.
It is time for young men with ED, even the mildest degree, to have a conversation with their doctors. It will be uncomfortable, but it is necessary. In helping you manage your ED, we may be helping you prevent illness and death in the future.
Man up, now!
By: K.T. Nimako (MB ChB)
Dr. Kojo Nimako is a private medical practitioner with an interest in public health and Citi FM’s Chief Medical Correspondent. He is also the Executive Director of Helping Hand Medical Outreach, an NGO focused on health education.
E-mail: [email protected]
Twitter: @KTNimako