Get familiar with ED, don’t be shy

One may wonder, if it is normal for a 70-year-old man to complain about the inability to maintain an erection. But in the course of attending patients, erectile dysfunction (ED) is a common concern I grapple with from both young adults and the elderly.
Let me talk of a patient’s concern whom I had encountered last year during my work in Dar es Salaam.
I met a young adult at the out-patient department (OPD), who asked whether his tendency to masturbate had contributed to his problem of failure to achieve an erection. I didn’t quickly reply to his question; rather I had to allot some time to give him a bullet by bullet account over the subject.
I had to be a bit meticulous while I was jotting down this information, as many victims do fail to tell apart between loss of libido and erectile dysfunction.

What is ED?
So what exactly is an erectile dysfunction? It is the failure to achieve and maintain an erection suitable for sexual intercourse.
But many of my clients at the hospital are interested about what causes it. While the young adults are interested in knowing whether masturbation causes it or not, the elders are interested in treating it.
However, some of them want to know whether hypertension or diabetes is the cause.
The problem is that many people upon visiting hospitals for medical care mention it as a supplementary matter or an addition, whilst in actual sense they want doctors to grossly fuss over it.
It’s a known aspect that many feel shy to talk about this problem hence sometimes when I talk to them, I have to be non-condemnatory, friendly and give them rapt attention.

Does ED link to aging?
I do recall an old patient of mine who asked, “swali langu ni kwamba je ni kweli kuwa uzee ndo unasababisha mimi kushindwa mambo huku chini?”  Meaning, does aging make me incapable to function underneath? I retorted with a ‘no’.
In real sense, he wanted to know the relationship between aging and ED. In fact ED is not a normal part of aging as some people will want you to believe. While it’s a gospel truth that older men may need more stimulation (such as touching, stroking) to attain an erection but remember ED isn’t supposed to be a part of getting old.
But it’s important to discuss what causes ED:
Causes or risk factors might include: depression, alcohol, anger, stress, anxiety, obesity, diabetes, hypertension, cardiovascular diseases smoking and drug abuse/illicit drugs. Let’s look at each in detail.
1. Obesity/overweight takes a toll on your sex life, however, you should remain feeling bold after reading this.
It is said that obese men are two times more likely to experience ED than men of normal weight. When you are overweight, you are more likely to have high levels of cholesterol and diabetes, which can lead to erection problems. When cholesterol builds up in the blood vessels, it causes it to narrow and hence causing less blood flow to your penis.
2. Hypertension: High blood pressure (BP) causes narrowing of your blood vessels hence lessening blood flow through your body. Consequently if insufficient blood flows to the penis you may experience difficulty to attain an erection.
3. Diabetes or high blood sugar can damage blood vessels and nerves in your penis, thus bringing about a similar outcome as narrated above.
4. Smoking will hurt your sex life since it leads to narrowing of your blood vessels. Those men who smoke are twice more likely to grapple with erection difficulties than those who don’t, but what is more daunting is that ED medication may not work as well for those who smoke.
5. Alcohol, excessive drinking and sex do not often make a great mix; alcohol can dampen your libido. If you get ED because of alcohol, reduce or stop it to get back to the groove.
6. Illicit drugs such as marijuana or cocaine may cause ED problems. These drugs have a tendency to slow down your central nervous system and some of them may damage the blood vessels.
7. Control your anger, stress, depression and anxiety: You know sexual excitement starts in your head/brain, thus depression can dampen your urge but it’s also important to know that it’s not easy to feel romantic when you are raging, let alone the fact that when you are angry.

Treatment
There are different treatment options including oral medication, sex therapy, some say even penile injection and surgery may be required.
I advise all with ED concerns to first visit your doctor to determine the best treatment depending on the cause of the problem instead of the current trend in Tanzania where people either seek treatment from Maasai street herbalists/other traditional healers or some others will self-prescribe the famous medicine ‘Viagra’.
ED is one among the much-touted problems by those who have baptised themselves as doctors, entertaining the current impunity.
It’s not strange that you may find a placard in Tanzania with words “Docta Hapendeki kutoka Sumbawanga anatoa dawa za kuongeza nguvu za kiume.” (Dr Hapendeki  based in Sumbawaga prescribes medicines for ED).
Please do not seek help from those self-acclaimed street doctors and self-made street viagra prescribers!
Go to the hospital and meet a relevant person to help you in lieu of falling prey to those inept self-made specialists.
The author is a medical doctor based in Dodoma.