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Managing SEXUAL health

By Dr Dennis Webster

Erectile Dysfunction (ED) can be defined as the inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. ED can have a serious effect on self-esteem, quality of life and interpersonal relationships. It is the most common disorder of sexual function in U.S. men of all ages. One report estimates it affects over 18 million men in the United States over age 20. According to a 2003 report from the US based Pfizer Incorporated, makers of the drug Viagra, over 60 percent of men in Trinidad & Tobago were suffering from some form of erectile dysfunction.
Causes can be both physical and psychological and risk factors include heart disease, high cholesterol, artherosclerosis (hardening and narrowing of blood vessels), high blood pressure and diabetes. Erectile dysfunction following radical prostatectomy for prostate cancer is a known side effect to this surgery. Other possible causes of ED include trauma to the pelvis or spinal cord, neurological diseases (Parkinson’s disease, Multiple Sclerosis), some prescription medication, tobacco, alcoholism, Peyronie’s Disease and low testosterone levels. Psychological causes include anxiety, different kinds of stress, depression and other mental health issues. One report states that temporary ED can also result from prolonged bicycling due to the impact on nerves and blood flow in the penis.
The International Index on Erectile Function (I.I.E.F.-5) questionnaire is useful in helping to determine whether you have erectile dysfunction as well as the possible severity of your condition. If you would like to know your present score, just send a blank email to iief@brachy4u.ca
When you see a doctor for ED complaints, you will generally have the following:

A Physical exam: This may include careful examination of your penis and testicles and checking your nerves for feeling.

Blood Tests: Checking for signs of heart disease, diabetes, low testosterone levels and other health problems.

Urine tests (urinalysis): To look for signs of diabetes etc.

An ultrasound: To check how the blood is flowing to your penis. A device called a transducer checks the blood vessels supplying the penis, producing a video image that can show if you have blood flow problems. This test is sometimes done together with an injection of medications into the penis to see if blood flow increases normally.

Overnight erection test: Most men have erections during sleep without remembering them. This simple test involves wrapping special tape around your penis before you go to bed. If the tape is separated in the morning, your penis was erect at some time during the night. This would mean the cause of your erectile dysfunction is most likely psychological and not physical.
Psychological testing: Your doctor may ask questions to check you for depression or any other possible psychological cause for your ED.
Treatment for ED could be
any of the following:

· Oral tablets (Viagra, Cialis, Levitra etc.)
· Injections into the penis (Alprostadil injections for example produce an erection in 5 to 20 minutes that lasts for about an hour).
· Vacuum erection devices
· Blood vessel surgery
· Penile implants
For information on two main types of implants and how they work, send a blank email to implants@brachy4u.ca
A psychologist or councilor may be suggested if the cause of your ED is felt to be a result of stress, depression or anxiety.
Some helpful lifestyle adjustments that have been suggested when dealing with ED include:
· Getting regular exercise
· Losing weight
· Getting help for alcohol or drug problems
· Quitting smoking if you smoke
· Trying to work through relationship issues and considering counselling
Ask your doctor for suggestions as to what may work for you.
Let us know your thoughts
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