After last week’s article on erectile dysfunction (ED), my e-mail was inundated with questions about the topic and surrounding issues. It looks like this is a festering problem without avenues for redress. I have therefore decided to do a sequel to the first article with questions sampled from my inbox. I hope the answers help someone in need of them.
Q: Please, I want to know if there is help for someone having ED
A: Yes there is help, but the kind of help depends on the specific cause of the ED. In some cases, all that is necessary is some counselling. In other cases, medication may be required, and in a few, surgery is necessary.
The first point of call should be your primary care physician, who will direct you to a psychologist, urologist or other specialty as necessary.
Q: I will really appreciate it if you educate me more on premature ejaculation and how to prevent it. Is it the same as ED?
[contextly_sidebar id=”jOmIHQsPS3sIg5GsLTGhf3lMuqwlsYN5″]A: Premature ejaculation is when ejaculation occurs even before penetration has occurred or immediately after. It is common in young men who are having their first sexual activity, but it resolves with time and experience. It may also be a persisting problem, caused by an underlying medical condition or psychological state (e.g. an anxiety disorder). If every sexual encounter results in premature ejaculation, it is cause for a medical review.
Premature ejaculation and ED are two separate problems. In ED, you cannot achieve or maintain an erection, while in premature ejaculation, you do have an erection, but the release of semen occurs before or soon after penetration.
Q: I am a young man of 35yrs and I have realized my sexual intercourse is diminishing gradually without any idea of the cause. I am also a father of three struggling to impregnate my wife to have a fourth child. What should I do?
A: As you age, it is natural to have a decrease in your capacity for sex. You may not last as long and may not be able to engage in multiple rounds, like you used to, especially when the stresses of work and family are present. However, you do not have ED if you can achieve and maintain an erection.
Your inability to have another child has nothing to do with erection. It may be related to problems with your sperm or problems with your partner. You, together with your wife, will benefit from a thorough medical evaluation.
Q: Can untreated gonorrhea cause erectile dysfunction (ED)?
A: Untreated gonorrhea will not cause erectile dysfunction per se, but it can make life so unbearable, you may not have the urge for sexual intercourse. Untreated gonorrhea can lead to infertility, which is much more problematic than ED, along with complications of the blood and joints, which are sometimes life-threatening. So as you can see, you have no business walking around with untreated gonorrhea, whether it causes ED or not. Avoid gonorrhea by practicing safe sex (abstinence, being faithful or condom use).
Q: Please, I have low sperm count. Any assistance? How is low sperm count related to ED?
A: The two are not directly related. One does not cause the other. You may have a normal erection, with normal coital activity, but be “firing blanks”. On the other hand, you may have a pristine compliment of spermatozoa, yet not have the “gun to shoot” them with.
In very few cases, there is a similar underlying cause for the two conditions, as seen in certain hormonal abnormalities.
Q: I had sex with a lady three months ago and after climaxing it was difficult for me to achieve another erection for the second round. This has been happening sporadically since then. Is this also ED?
A: The period between ejaculation and the next erection is what we call the refractory period. It can last from a few minutes to hours, and a long delay does not necessarily mean there is an abnormality. As men grow this refractory period lengthens. Is that your lot?
What I advise is this: make sure you do not have any prevailing stress at home or at work and if you are being treated for any medical condition make sure you follow through with treatment. All of these can be contributors.
Bottom line, you do not have erectile dysfunction if you can achieve a satisfactory erection for the first round. If you want a second round, you may just need to be more patient.
Q: Can you prescribe for me a medicine which I can use to boost my sexual activities?
A: Before any medication can be prescribed, we need to find out exactly what is causing your sexual dissatisfaction. For all you know, you do not need medication, but rather some education and counseling. You need to see your physician.
Q: I am 38 years and suffer from ED. I have been seeing my doctor and other doctors, but to no avail. Please, is there any other advice you can give because in line with recommendations from your article, I exercise regularly, have cut down on alcohol, manage my stress levels and don’t smoke at all, but I still experience this ED problem. Is there something that I’m not doing right?
A: There is always a cause for ED, and if we look hard enough we will find it. However, the process may be tedious, and sometimes expensive, and the affected person may lose hope when the expected results do not come speedily. Moving on to the next doctor only means the cycle will be started all over again, leaving him in a state of perpetual dissatisfaction.
So far, you seem to be doing the right things with lifestyle management. I advise that you stick with one management team and not go doctor shopping. Stick with your GP and he will guide you to resolution of this problem. Some referrals may be necessary though.
I appreciate that this is by no means exhausts the concerns surrounding ED. As such, an extended version of the Citi Health Chat will be dedicated to discussing ED this Wednesday, from 12:30pm. Let’s make it a date.
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