To conclude Movember, we’re talking about the most common sexual problem amongst men – erectile dysfunction.
It may be a taboo subject, but it’s important to talk to your doctor about it for the sake of your health, including your fertility. This blog is designed to break the taboo and give you the basic knowledge to start the conversation. No embarrassment necessary.
What is erectile dysfunction
Erectile dysfunction (ED) is defined as the inability to have and sustain an erection sufficient for satisfactory sexual intercourse. You might feel like the only one, but about half of men between 40 and 70 will experience ED at some point, with 10% of cases being severe.
ED and fertility
Beyond its effects on sexual pleasure and relationships, many men suffering from ED worry about its long-term effect on their ability to build a family.
Even though this is a common concern, many men don’t seek proper treatment due to the embarrassment of “underperforming” sexually.
We’re here to break this taboo and give you some basic knowledge to help start the conversation with your doctor. Speaking to a medical professional early is critical to determining whether your ED could have a lasting impact on your fertility.
What causes ED
ED can be caused by vascular, neurologic, psychological, and hormonal factors. Most organic causes are related to vascular insufficiency, and only 10–20% are purely psychological.
The risk of ED naturally increases with age. ED is commonly linked to diabetes mellitus, hypertension, hyperlipidemia, obesity, testosterone deficiency, and prostate cancer treatment. It can be caused or made worse by using medications and substances like antidepressants or tobacco.
From a psychological perspective, it’s common for relationship issues, anxiety, and depression to interfere with erectile function. Neurological conditions like Parkinson’s disease are also commonly responsible.
You can find a full list of the organic causes of erectile dysfunction in Table 1 of this article.
Getting a diagnosis
Part of the reason it’s important to investigate ED is that it’s often a symptom of another health issue, including cardiovascular disease.
If you can get an erection sometimes, but not every time you want to have sex, or not lasting long enough for sex, you may want to talk to your doctor.
To investigate the cause, your doctor will ask about your other medical conditions, your medications, when your erection problems are happening, and what form they take. They may use standardized questionnaires or surveys to determine the nature of your erectile dysfunction. It’s common to undergo blood pressure tests, blood tests, and ultrasounds to track the blood flow in and out of your penis.
There are a number of things you can do to be proactive in preventing ED, including the following:
Quit smoking if you smoke, as smoking is associated with heart and blood vessel disease, which can lead to ED.
Eating a healthy diet can help maintain a healthy weight and manage blood pressure and diabetes. This includes avoiding excessive alcohol consumption.
Physical exercise is also recommended to increase overall blood flow, including through your penis. This means at least 30 minutes, most days of the week.
Avoid using illegal drugs, as they could inhibit you from having or maintaining an erection. They could also mask other psychological, emotional, or physical factors causing your ED.
If you’ve identified ED, the first thing you can do is make changes to your lifestyle. Exercising regularly, quitting smoking, losing weight if you are obese or overweight, and better control of diabetes, hypertension, and hyperlipidemia, are all advised. Some research suggests that Kegel exercises to strengthen the pelvic floor can improve erectile function as well.
The first-line treatment which your doctor may recommend is medication, particularly oral phosphodiesterase-5 inhibitors. Four comparable FDA-approved pills are avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).
The second-line of treatment is alprostadil (Caverject) and vacuum devices to establish an erection before sexual stimulation.
If other treatment methods have not been effective, your doctor may suggest surgically implanted penile prosthesis as a third-line of treatment.
If your ED is psychologically caused, counseling is recommended.
If you are able to have an erection with masturbation, but not for intercourse, you may consider asking your doctor about artificial insemination, or intrauterine insemination (IUI). This involves masturbation to obtain a semen sample around the time of your partner’s ovulation, and insertion of the washed semen sample into the uterine cavity using a very fine catheter. This can be done by a Gynecologist or Fertility Specialist.
You can talk to us at Dr. Tanya Williams Fertility Centre about your fertility options as a man struggling with ED.
Anyone with a penis can practice the healthy lifestyle habits that help to prevent ED.
If you think you might have erectile dysfunction, don’t wait to talk to your doctor. It could be a sign of another medical condition, and it could have a long-term effect on your fertility.
In short, talking to your doctor is the first and most critical step you can take to safeguard your sexual, reproductive, and overall health.