Male sexual arousal is complex. It involves the senses, emotions, the brain, hormones, nerves, muscles and blood vessels. Even so, most men should be able to enjoy sex to a ripe old age.
Erectile dysfunction (ED) is the medical term for impotence – when a man cannot get an erection to have sex or keep it long enough to finish having sex. It can occur at any age but is most common in men over 75. Specialists estimate half of New Zealand men over 40 experience some erection problems.
For many men, the condition is a constant concern causing extreme stress and anxiety, marital or relationship problems, low self-esteem or depression and the inability to get a partner pregnant. Yet only about 5% of men with erection problems seek help.
Occasional ED isn't usually a cause for concern but ongoing problems can be a sign of an underlying health condition that needs checking out, such as heart disease, high blood pressure or diabetes which can restrict blood flow to the penis. But other contributing factors include medicines for depression and high blood pressure, smoking, drinking alcohol, prostate cancer, obesity, some psychological barriers to sex or previous bad experiences of ED.
Cyclists can suffer temporary erectile dysfunction because the bike saddle can compress nerves.
Treatment varies depending on the cause but including your partner in any therapy is recommended.
If the problem is health related rather than psychological, remedies include lifestyle improvements and medication to make the blood vessels work more efficiently. But this medication cannot be taken by men with certain heart conditions.
Only men who are are deficient in testosterone require hormone replacement.
Treating psychological problems such as depression, stress or anxiety, can also be enough to reverse ED.
Sufferers should try to overcome any embarrassment and get a check-up at their GP as soon as they notice erection problems.
A healthier lifestyle, including cutting down on alcohol, stopping smoking and reducing stress can reduce ED problems. Treatment can enable sufferers to regain sexual fulfilment quickly. But if this is not possible, couples can still maintain intimacy.
Sam, 73, says: "I have always been a rugby, racing and beer man. I was 55 the first time I talked to my GP about my impotence and I was scared. He told me to trade my wife in for a newer version and I think he meant it.
"After many months of no sex, my wife couldn't take it anymore. We both went to the new doctor – a woman – she was terrific. If you can talk to a woman about this stuff then you can talk to anyone. You have to, otherwise your life stops."
For more information on all aspects of men's health visit www.everybody.co.nz
Barbara Docherty is a registered nurse and clinical lecturer at the University of Auckland School of Nursing. Read her My Health archive at everybody.co.nz
- © Fairfax NZ News
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