One would think that every single man with erectile dysfunction would rush off to get a prescription for Viagra, Levitra or Cialis. But nine of ten men don’t, and their reluctance can lead to the late diagnosis of life- threatening diseases. Why don't men go for treatment? And what can be done about it?
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The difficulty to get or maintain an erection could be an early warning sign that something is amiss with a man’s health.
"The media, by giving much publicity to anti-impotence drugs, has created the impression that ED is an overtreated condition. But this is simply not true. Of the 100 million men worldwide who are thought to suffer from erectile dysfunction (ED), only 10% have sought or received therapy," says Dr Raymond Rosen, Professor of Psychiatry and Medicine and Director of the Human Sexuality Programme at Robert Wood Johnson Medical School in New Jersey, USA. Dr Rosen addressed health professionals before the start of the 1st Congress of the Southern African Sexual Health Association (SASHA) and the Congress for the Advancement of Sexual Health & Rights in Africa, which started on February 26 2004 in Johannesburg.
ED figures are staggering. By the year 2025, 200 million men worldwide are expected to suffer from the condition. This expected increase is the result of an ageing population, unhealthy eating habits and the earlier onset of diabetes and obesity. In studies worldwide, the incidence of ED is never less than 10 percent and often as high as 30 percent, depending on who took part in the study, says Rosen.
ED associated with other risk factors
ED is strongly associated with other risk factors, and this association has positive implications. When men seek help from their doctor, an underlying - sometimes serious - health problem, such as diabetes, heart problems and stress, can be identified. In fact, ED can be seen as a barometer of cardiovascular health and it is this factor that makes early treatment so essential.
Other factors that can cause ED include nerve damage or other neurogenic factors, hormonal factors, medication side-effects, penile injuries, depression, performance anxiety, relationship problems, psychosocial problems and psychological distress.
Why men don't go for ED treatment
"Men simply don't raise this issue with their GPs," says Dr Rosen. "In a US survey, in which 500 men aged 25 and over were questioned as to their reluctance to raise this issue with their GPs, some interesting statistics emerged:
71% thought that their doctors would dismiss sexual concerns
68% feared the GP would be embarrassed
76% thought there would be no treatment available
There seemed to be misconception about the available treatment. What also played a role in this reluctance to go for treatment was the patient or partner's lack of interest or fear of treatment. It must also be said that sexual prowess is highly prized in our society and men are often reluctant to admit to problems in getting and maintaining an erection, added Dr. Rosen.
Another factor is the perception that taking anti-impotence medication will change sexual patterns and relationships. Many men are also under the impression that these drugs would give them erections for hours on end, which is not the case. They will merely make them more responsive on a sexual level.
How to get men to go for treatment
The solution probably lies with more forthrightness between doctors and patients.
"Any man who visits his doctor for a checkup, should be asked about his sexual health. In this manner, many health risks associated with ED can be identified. It is also essential that this dialogue between patient and doctor should increase the options for shared decision-making, for therapeutic options and specialist referral”, Dr Rosen said in an interview with Health24.
"Effective treatment of ED can go a long way to strengthening the relationship that exists between a man and his doctor. This could lead to serious conditions being diagnosed in their early stages,” said Dr Rosen.
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