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Men’s Sexual Health: Putting Impotence in the Spotlight

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At some point in their lives, almost all men may experience impotence, or Erectile Dysfunction (ED), especially as they age. But some may get it earlier, even those in their 20s, and their lifestyle and other factors related to modern living could be inadvertently increasing their risk. 

As the world marks Men’s Health Awareness Month this whole of November, putting impotence in the spotlight anew is vital. Medical Channel Asia (MCA) talks to an expert from the Philippines to look into some unhealthy lifestyle habits and other factors that are contributing to this medical condition that has been preying on males across the world.  

Who is Susceptible to ED?

Impotence is defined as the inability to achieve and maintain a penile erection during sexual intercourse. What needs to be emphasised though is that ED is a symptom, not a cause, of underlying health conditions. As with any other medical concerns, your doctor will get to the root cause of the problem to better address this health concern.   

Some could be more susceptible to ED than others. According to a 2020 study, the prevalence of ED amongst Asian and non-Asian male populations alike is above 40% after the age of 40 years old. It is part of ageing, for the most part, noted Filipino Urologist Dr Roderick Arcinas, Head of the Genito-Urinary Unit of Benavides Cancer Institute at the University of Santo Tomas Hospital.  

“Almost all men at some point will experience ED. It is actually part of ageing. There are just men who will get it earlier than others. The most susceptible group is the sexually active ageing men, usually starting as early as the 40s,” Dr Arcinas told MCA in an email interview.

Three Types of ED By Cause

Several factors are causing ED to occur. Dr Arcinas, who trained and attended seminars in Singapore, China, Italy and England, explained that the causes are grouped into three major categories as follows: 

  • Psychogenic

    This pertains to ED triggered by psychological factors, including anxiety, fear, work-induced stress, insecurities, relationship problems, traumatic experiences, and so on.  The sudden onset of ED is usually attributed to these factors. 

  • Organic ED

    This is caused by problems with the organ system or systemic diseases such as age, diabetes mellitus, medications, and many more. 

  • Mixed type (psychogenic+organic)

      This refers to ED caused by both psychological and organic factors.

In a contemporary age, the most common reasons behind impotence aside from age include comorbidities such as diabetes mellitus, obesity, cardiovascular disease (heart and blood vessel issues), stroke, hypertension and lower urinary tract problems such as prostate enlargement.

“Aside from these, we also all know that we are living in an industrial and technological age wherein people are exposed to the competitive working environment at an earlier age, resulting in work-related stresses, [in addition] to social media-related issues and so on. I have seen patients in their 20s with ED, and it took me some time to improve or reverse their impotence. Patients like these are very hard to treat because of intense psychological influence,” Dr Arcinas said.

Impotence and Unhealthy Lifestyle Habits

Lifestyle factors could trigger ED as well. Many studies have proven how leading an inactive, unhealthy lifestyle can affect your sexual health. Dr Arcinas pointed to these unhealthy habits as some major contributors to the condition:  

  • Smoking – According to a WebMD article, men who smoked before or are still smoking were about 30% more likely to suffer from impotence.
  • Poor diet Overeating or intake of unhealthy meals may lead to obesity or extra pounds that are known to increase the risk of ED. 
  • Lack of Exercise – This increases the risk of cardiovascular disease. 

Committing to a healthy lifestyle has been linked to the maintenance of erectile function. Modifications such as engaging in moderate physical exercise such as walking and eating nutritious meals can influence your sexual health in a major way. 

For example, moderate brisk walking can lead to nitric oxide production vital to replenishing the body and keeping the arteries open, with the latter being necessary to increase the blood flow to the penis every time you get excited. Additionally, healthy physical activities are known to make your heart strong, thus keeping some cardiovascular diseases at bay.  

A study by Harvard University suggests that a 30-minute of daily walking could result in a 41% reduction in ED risk.  Exercise is also one of Harvard’s all-natural tips to improve one’s sexual life. 

Breakthroughs

There are many ways to prevent or address ED, from being as simple as making lifestyle modifications to taking prescription medicines. According to Dr Arcinas, here are some breakthroughs or developments that have been found to improve erectile function:

  • The use of supplements such as herbal medicines containing Korean ginseng may boost male sexual performance. 
  • Staycation is a good way of minimising stress, which is ideal for patients suffering from stress-related ED.
  • The intake of prescription medications such as sildenafil as opposed to over-the-counter drugs. Sildenafil is effective for almost all types of ED, including psychologically induced impotence.

He added: “I discovered that previous EDs can trigger another ED, which makes it a vicious cycle; for example, an ED-related anxiety [may cause] subsequent ED.  So, the doctor needs to break that vicious cycle in order to successfully treat the condition.”

Fighting the Stigma by Raising Awareness

Admittedly, men’s sexual health, including impotence, remains in part an uncomfortable topic in many Asian communities. Interest and studies on this topic have nonetheless been growing, which is crucial given that impotence is not as common as it is now compared to 50 years ago.  

Raising awareness makes for a critical and effective method to debunk myths and correct common misconceptions that include the following:

  • Lack of practice causes impotence.
  • Impotence is inherited.
  • Impotence is normal in old age. Dr Arcinas explained: “Although this is partly true, not all elderly men have impotence. The same is true with young men. Not all young men are potent.”

The celebration of Men’s Health Awareness Month this November is an ideal opportunity to fight the stigma associated with impotence. It is a period when we can create a safe space for men to bravely tackle the issue that is impacting their mental health and overall psyche. 

Impotence can affect married couples’ sexual and reproductive health. By normalising the discussion on ED, men will be more comfortable talking about it, especially to their doctors, for earlier and proper treatment. As Dr Arcinas underscored, this should be the goal. Removing shame attached to ED once and for all is the first crucial step to empowering men when it comes to their overall health.

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