- Erectile Dysfunction (ED)
ED is the inability to achieve or sustain a penile erection sufficient for satisfactory sexual performance. Up to 50% of men older than 40 years of age have some degree of ED.
Causes include low testosterone levels, poor blood flow in the penile arteries as a result of atherosclerosis, poorly controlled diabetes, smoking, performance anxiety, stress and medications.
Treatment includes:
Lifestyle changes such as cessation of smoking, stress management and a healthy diet, and regular exercise.
If one is found to have a low testosterone level, he may benefit from testosterone replacement therapy.
ED may be treated with phosphodiesterase-5 inhibitors (PDE 5I), of which the most well-known is sildenafil (Viagra®). However, men with existing heart disease should be careful when taking these medications.
When oral medication is not effective, second-line therapies include injections to the penis, vacuum-assisted erection devices, and extracorporeal shockwave therapy (ESWT).
When all else fails, patients may consider surgical implantation of a penile prosthesis, which has been shown to have good satisfactory outcomes.
2. Premature Ejaculation (PE)
Premature Ejaculation (PE) occurs when a man ejaculates sooner than he or his partner desires during intercourse.
It is common for a man to experience this once in a while. However, if ejaculation always or nearly always happens within one minute of penetration, or the man and/or the partner are distressed to the point that sexual intimacy is affected, PE can become a significant problem.
PE may be treated with distraction techniques and medication.
Do seek medical help if your psychological well-being and relationships are being affected by this condition.
3. Hypogonadism (low testosterone levels)
Testosterone is the male sex hormone which is central to the development of male reproductive tissues such as the testes and sexual characteristics such as muscle mass and facial/body hair. It helps maintain a normal mood and general sense of well-being. It is also important for health.
A low testosterone level can occur as part of ageing and is known as hypogonadism.
Treatment of hypogonadism can not only improve general sense of well-being, but can also improve the control of other medical conditions such as diabetes and high cholesterol.
Signs and symptoms include problems with erection, low sexual interest, fatigue and lethargy, increased body fat, mood disturbances, as well as infertility.
If you are experiencing these symptoms, it may be worthwhile to check your testosterone levels and undergo testosterone replacement therapy if needed.
