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The Facts about Erectile Dysfunction

  • Restoring Sexual Health

  • It used to be that the word “erection” wasn’t spoken in public. Now, thanks to erectile dysfunction drug marketing, it shouts out to you from the radio and TV, in magazines and on the Internet.

    Men who have difficulty with erections know they are not alone and that help can be found.

    But what should men – and women – know about “erectile dysfunction” (ED) and the options to treat it?

    Santa Rosa sexual health specialist Dr. Robert James, M.D. is a urologist with Sutter Pacific Medical Foundation in Santa RosaOpens new window. He has treated men with erectile problems for decades, and spoke with MyLifeStages about this sensitive but important topic.

    Fact One: Some “erectile dysfunction” – or loss of the firmness of the penis – can be expected as men age.

    Dr. James notes that among men aged 40 to 70, you can expect that at least 50 percent will experience changes in their erections. And disuse can lead to more problems– the “use it or lose it” adage applies to the health of the penis, too.

    So when should a man be concerned and seek treatment? “If a man has recurrent difficulty in maintaining an erection and having successful sexual intercourse for more than a month, it will begin to impact his relationship,” says Dr. James. Seeking treatment can help a man restore “sexual self esteem” – of critical importance to males.

    The loss of nocturnal or first-thing-in-the-morning erections can also be a sign that physical changes are taking place. See Fact Two.

    Fact Two: Erectile dysfunction can be an important warning sign of serious health problems.

    An erection occurs when blood flows into the penis, so problems with an erection can mean problems with blood flow, overall. Dr. James says that erectile dysfunction can be the first symptom of vascular disease that, left untreated, can lead to a heart attack or stroke. “Young men, especially, should be aware that ED can be an early warning sign of heart disease,” says Dr. James. Seeking medical care for ED may result in a life-saving evaluation of the heart.

    Fact Three: Medical help is available for ED. And it’s not just in the form of pills.

    Dr. James states that if a man – of any age – really wants to achieve an erection, he can. In addition to Viagra, Cialis and other ED medications, there are pumps, injections and implantable devices that can help a man achieve an erection and have successful sex. “Unfortunately, some men will seek care for ED, run through the available medications, and give up,” says Dr. James. “Men – and their partners – should know that there are other treatments available. A urology expert can work with a man to explore all options.”

    While the pills can be the most discreet form of help, physical devices also work. They are especially good for men in stable, mature relationships, where the couple can make use of the erection device part of their foreplay.

    Fact Four: It’s not just about the pill or the erection.

    Well, we knew that, didn’t we? But to be clear, ED medications don’t increase sexual desire, enhance libido or fix relationships. They just increase blood flow to the penis, making sexual intercourse possible.

    Dr. James notes that a man’s erection is a barometer of his physical and mental health. But the frequency of sex is a barometer of the quality and intimacy of his relationship. However, the physical functioning is deeply entangled with emotional issues, for men and for women. Midlife in particular comes with a unique set of life and bodily changes that can impact a couple’s ability to have great sex at midlife. Many men also find themselves in the midst of male menopause, which can be brought on by testosterone loss.

    “Women should know that a man is also impacted by his emotions,” says Dr. James. “If he is angry, or has been made to feel inadequate, it will impact his sexual performance.”

    In the complex dance of a relationship, sex does play a vital role. Dr. James sees that in his practice. “For men, sex is a key part of intimacy. When sex disappears, they struggle to maintain intimacy. Women can then feel rejected. But when I work with a couple to restore the man’s erection, the smile on the women’s face is often as big as the man’s. They realize that they now have a chance to work on the entire relationship.”

    “I use the term ‘sexual self esteem’ to underscore how important this issue is for men,” says Dr. James. “Treatment for ED can be a part of restoring a man’s crucial sense of self.”

    Although there is a natural diminishing of many physical functions with age, sex does not have to disappear. Dr. James shares the story of a couple – he’s 92 and she is 88 – who use a device to assist them in sex. On Dr. James’ sexual activity score, this couple ranked a 24 out of a possible 25. Even though there are many paths to intimacy, a couple who wants sex to be a key part of their relationship can achieve that. At any age.

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