Last week in England, I read an article in The Gleaner's The Voice newspaper in which a Bristol lady wrote to 'Dear Sherry' about her partner's sexual problems. In the article entitled, 'Out of Order', she claimed he was 'not performing well' but was blaming her.
Sherry advised her to be sensitive and to seek help to identify the root cause of the problem. She added that sex was a source of power and proof of a man's masculinity. To a man, she stated, sex meant that he could move a woman, that he's an athlete, a provider and a lover.
"When he satisfies you he feels like Superman," she wrote. He wants his woman to see him in that light.
Common problem
Erectile dysfunction (formerly called impotence) is a common sexual problem with a variety of options for treatment. It is the inability of a man to achieve and maintain a firm erection long enough to penetrate and have sex, at least 25 per cent of the time.
An occasional inability to maintain an erection happens to most men and is normal, but when this becomes a regular situation, it is a sign of erectile dysfunction (ED) and should be evaluated. It may be the first sign of a more serious health problem which when treated may correct the ED. Unfortunately, even in relationships which are deeply affected by ED, and where there is usually good communication, little is said about this challenge, little is done about it, and ED remains untreated.
Male sexual arousal is a complicated process or system. When a man becomes sexually aroused, penile blood vessels (arteries) supply a large amount of blood to the penis to cause it to expand and toughen in preparation for sex. Other penile blood vessels (veins) which would normally drain that blood away from the penis get pressed upon due to growing pressure on them by the hardened tissue. This guarantees that once blood flows into the penis it will not flow out for a while. An erection is thereby maintained.
After ejaculation or the passing of sexual excitement, the veins drain the excess blood away from the penis and the erection fades. Anything which affects this system - brain, hormones, emotions, nerves, muscles, blood vessels - or the delicate balance among them, can cause ED.
Anxiety and depression
Physical or psychological issues may cause ED. Psychological factors include depression, anxiety, stress, fatigue and poor communication with a partner. The physical and psychological causes interact. For example, a physical problem which slows down a man's sexual response may cause an-xiety about maintaining an erection and this anxiety in turn can worsen the erectile dysfunction.
Physical risk factors for ED include getting older, having a chronic health condition like heart disease, clogged blood vessels (artherosclerosis), hypertension, diabetes or obesity. Other physical risk factors include prolonged bicycling, substance abuse, taking some medications for example, sleeping tablets, medications for hypertension, pain and prostate cancer. Surgery for bladder, rectum or prostate cancer, or injuries to the hip area and spinal cord are additional risk factors.
Part 2 will be dedicated to the treatment options for ED, which are many. They include oral medications (for example, Viagra), medications injected or inserted directly into the penis, penis pumps, surgery, implanting devices into the penis, or counselling and sex therapy. Susan Vaughan, American psychiatrist, has stated, however, that we should appreciate that people, not pills, are what makes sex great. When the people involved are loving, pills can help make lovemaking possible. If they are not loving, no pill in the world will help.
Dahlia McDaniel is a pharmacist and final-year doctoral candidate in public health at the University of London; email: yourhealth@gleanerjm.com.
