The link between sexual health and physical wellness

By WP BrandStudio

Erectile dysfunction is a common condition, but many men remain in the dark about its causes and solutions.

Like many diabetic men, Tom Waters, a retired contractor who lives in Lake Alfred, Fla., experiences erectile dysfunction as a direct result of his diabetes. But when Waters first developed the illness 30 years ago, his doctor barely mentioned the heightened risk it presented for ED. At the time, Waters was in his early 30s and had an active sex life, so he was shocked when he started having erectile issues almost immediately after his diagnosis.

Three decades later, despite the estimated 40 percent of men over age 40 with some degree of erectile dysfunction[1], there’s still a lack of awareness around what causes the condition, as well as its connection to other serious health problems like heart disease[2]—and, in Waters’s case, diabetes.

<em>Two in five American men face erectile dysfunction.</em>
Two in five American men face erectile dysfunction.

Many men worry that their ED is a personal or psychological failing, according to urologist Dean Knoll of Urology Associates, P.C., in Nashville, Tenn., but the vast majority of cases can be traced to physical causes. Moreover, many patients don’t know about the wide range of potential solutions for ED beyond oral prescription medications, which  which aren’t effective for one out of every three men with ED[3].

“Patients who have erectile dysfunction can always seek some form of treatment that will allow them to function [the way they want to],” said Knoll.

Understanding the causes of erectile dysfunction  

By some estimates, one in 10 adult males experience ED over a long-term period[4]. In every case, when a patient experiences erection changes, “it affects them mentally. They wonder why they have it,” Knoll said.

While anxiety and self-doubt often accompany ED, more than 90 percent of cases have physical, rather than psychological, causes[5]. Vascular diseases like hypertension and  atherosclerosis—the buildup of plaque in the arteries—account for 70 percent of the physical causes of ED by restricting blood flow to the penis (erections require a several-fold increase in blood flow)[6][7]. The condition can also stem from a host of other health problems, including neurological and hormonal disorders and prostate cancer or enlargement treatments[8].

<em>Erectile dysfunction is often a sign of other health issues, including heart disease.</em>
Erectile dysfunction is often a sign of other health issues, including heart disease.

And while the chances of having ED increase with age[9], “there’s a misconception that it only happens when you get older,” according to Knoll. A 2013 study found that one out of every four male patients newly diagnosed with ED is under 40 years old[10]. As for older men, many assume that because ED is a natural part of aging, they should just deal with it, according to Kory Hamel, director of research and development for men’s health at Boston Scientific, a medical device manufacturer.

“They don’t actively seek treatments because they feel like it’s natural to have [ED]. They don’t realize there are countermeasures you can take,” Hamel said.

Finding the right solution

Other men are deterred by the misconception that there’s no effective solution for them, according to Knoll, but in reality, “they can always be made potent. It’s just a matter of how you want to get there.”

Most men start with oral prescription medication and assume it will work, according to Knoll, but about 35 percent of patients don’t respond to pills[11]. The next step is often a nonsurgical option, such as a vacuum device, a suppository placed in the urethra, or penile injections. For many men, these options are either unappealing or eventually stop working, Knoll said . That’s when men will begin to learn about penile implants, which can provide a long-term solution to ED, instead of a temporary treatment for the symptoms.

<em>ED treatment is not one-size-fits-all.</em>
ED treatment is not one-size-fits-all.

It’s common for patients to try different options before landing on a long-term solution , said Hamel. Often, “It’s a [matter] of how aggressive their cardiovascular disease is,” because such diseases often lead to men having progressively weaker erections, he added. The severity of the ED, and whether it’s linked to another condition like diabetes, can also determine which solution works best.

Tom Waters spent more than two decades exhausting nonsurgical options, until the day when injections stopped working. Then he got an implant supplied by Boston Scientific, and he is still happy with it nearly 15 years later. He only wishes he hadn’t waited so long.

“You really don’t have to go through 20 plus years of fighting this,” said Waters.

What erectile dysfunction can reveal about overall health 

Several months after getting his implant, Waters started noticing sleepiness and weakness, which at first he attributed to his diabetes. But he was aware that diabetes could also lead to heart problems, so in 2008, Waters saw a cardiologist; there, he learned that he had several “severely clogged” arteries and needed five-way bypass surgery.

His having both ED and cardiovascular troubles is not uncommon. Multiple studies suggest that men with ED are at a greater risk of having heart disease—ED poses as much risk as smoking or a family history of coronary artery disease—and the risk is stronger among younger men[12][13].

Now age 63, Waters sees his cardiologist regularly for minor testing like ultrasounds and to monitor the blood flow to his brain. He understands that blood flow is the thread linking all of his major health conditions—something he strives to impress upon other men.

“I tell them, ‘If you’re having erectile dysfunction, you need to go see a cardiologist, because it all has to do with blood flow. If you don’t have blood flow to your penis, you probably don’t have blood flow to the other parts of your body,’” said Waters.

An emotional journey

Even though the vast majority of ED cases have physical causes[14], “there’s always psychological repercussions from that,” said Knoll. “Patients are upset that they don’t have good quality erections.”

<em>Waters advises men to focus on finding solutions, rather than blaming themselves for their disorder.</em>
Waters advises men to focus on finding solutions, rather than blaming themselves for their disorder.

Waters can attest to the journey being an emotional one, for both him and his wife. “You and your partner are going through this together, and you have to address it together and be willing to talk about it,” he said.

Now, Waters and his wife travel around Florida giving seminars on ED and sharing their experiences, creating a relaxed space where people can open up about what they’re going through. It’s a much different atmosphere than the one they experienced decades ago, when “[even] most doctors didn’t like talking about [ED] because it made them uncomfortable,” said Waters.

Mostly, he wants men with ED to stop beating themselves up and obsessing over their perceived role in the condition.

“I spent years trying to figure out what was wrong with me,” said Waters. Now, he tells patients, “It doesn’t matter why you have ED. You have ED. Here are some of the solutions to fix that.”

Take this simple quiz to help you assess how erectile dysfunction may be impacting your life.

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Sources
MH-811404-AA MAY 2020
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