Wednesday 17 July 2019

Dr Ciara Kelly: 'Erectile Dysfunction affects half of all men so ask for help'

And talking about erectile dysfunction is a good start.

Speak out: At the launch of the HardWords.ie Website in 2012 were, from left, Mark McAllister with Karen Rafferty, Mick Beecher, Marjorie Crowley, Tony Murphy, and Frances Langan. HardWords.ie, developed by Pfizer Healthcare Ireland, is for men and their partners to help understand, accept and take action on erectile dysfunction
Speak out: At the launch of the HardWords.ie Website in 2012 were, from left, Mark McAllister with Karen Rafferty, Mick Beecher, Marjorie Crowley, Tony Murphy, and Frances Langan. HardWords.ie, developed by Pfizer Healthcare Ireland, is for men and their partners to help understand, accept and take action on erectile dysfunction

Ciara Kelly

Unless you're George Hook - the first rule of the erectile dysfunction club is that you don't talk about erectile dysfunction. ED, formerly known as impotence can affect men of any age, but is mainly associated with getting older. About half of all men aged 40 to 70 suffer with it to some extent - rising to seven out of ten men aged 70 and older.

ED means you can't get and/or maintain an erection. Most men have it occasionally when they're tired, stressed or with excess alcohol use, but for some it's persistent and recurring. There are multiple causes of ED, which break down broadly into physical and psychological, but reduced blood flow to the penis is responsible for seven out of ten cases. Circulation to the penis is reduced by narrowing of the arteries, so it is associated with high BP, smoking, raised cholesterol and age. It often occurs, therefore, in men who also have heart disease and problems with circulation to their legs.

Read more: Study on penises reveals the average size... and it's smaller than you think

Diabetes - which effects both your nerves and circulation is another common cause. But there are many neurological or hormonal conditions that can cause it. Other less common causes include injury - including post-op injury - and cycling! So all you MAMILs (Middle-Aged Men In Lycra) beware. Certain medications like anti-depressants and beta blockers can also cause it. As, of course, can alcohol.

With physical causes, ED tends to occur slowly, over time. Psychological cases - which account for about 20pc - can develop quite suddenly. And stress, anxiety - particularly if related to sex - depression and relationship difficulties can all be factors.

One indicator that the cause may be psychological, is if you can get or maintain an erection at certain times, such as with masturbation or in the early morning.

Read more: Dealing with Erectile Dysfunction: 'Having an erection is an integral part of your masculinity'

As with most things, the cause should be identified and treated. As 70pc of cases are due to narrowing of the arteries, that's where we start. First thing is stop smoking. Smoking doubles your risk of ED. Get your BP checked yearly. Keep it normal with lifestyle - or medications if necessary.

Maintain a normal body weight. Keep your cholesterol down with a low fat diet or again medication if indicated. Moderate your alcohol intake.

If you do have diabetes, good blood sugar control can reduce the impact of diabetes on blood vessels and therefore on ED.

Its worth noting that men often develop ED years before they develop the related, similar condition of heart disease - if you have ED, it should be viewed as a possible warning sign and you should have a cardiovascular check-up.

Read more: Prostate cancer could be 'halted' by injections

Treatment options primarily involve tablets that increase blood flow to the penis - these can be taken orally before you plan to have sex. They don't give you an erection unless you are aroused.

These work well for most people. It's important to note they interact with certain other medications and should only be taken on advice, by prescription. But for those who don't respond to them there are other treatments like injections or urethral tablets (tabs inserted into the penis) and also vacuum devices and surgical rods that can be used - some of these may give you an erection even if you aren't sexually aroused.

Read more: Why Irish couples shouldn't be afraid to talk about Erectile Dysfunction

If the cause is psychological, psycho-sexual counselling can help. This examines the issues surrounding your sexual difficulties and attempts to deal with them. One approach involves taking full sex out of the equation altogether while encouraging other physical intimacy such as kissing or massage - essentially everything except sex itself is allowed. This alleviates the pressure and can help overcome a psychological hurdle that may in fact mean paradoxically that sex occurs.

ED affects huge numbers of men, is not spoken about and causes difficulties physically, psychologically, and in relationships. There is treatment - you just need to open up and ask.

@ciarakellydoc

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