Erectile
Dysfunction
Erectile Dysfunction / Sexual Health
All adults, including elderly, should have the opportunity to enjoy a satisfying and fulfilling sex life. With age, the interest in sex and sexual activity declines to some extent in few of the adults and this is normal. Understanding the sexual responses and managing accordingly with help if needed is part of healthy aging.
Unfortunately, patients may feel uncomfortable talking to the doctors about their sexual problems. This is not uncommon, especially in women. But a satisfying sexual intimacy is an important and rewarding aspect of healthy aging, and treatment can often help.
The common Sexual Problems which people face are:
- Decreased sexual performance
- Reduced arousal
- Pain during sex
- General lack of interest
- Loss of orgasm
- Worry or anxiety that interferes with sex
- Reduced frequency of sex
- Physical obstacles arising from a disease or health condition.
In men it is mostly erectile dysfunction, which is also called as impotence. And in women it is lack of interest, difficulty with lubrication, inability to reach a climax (orgasm), lack of pleasure, reduced sensation, pain during intercourse. Sexual problems are very common.
Erectile dysfunction by far is the most common sexual difficulty in men, and it increases with age. Nearly 75% of men have problems with erections at some time by the age of 70 years. Also, older men take part in sexual activity much more rarely than they did when they were younger. While young men normally engage in sex 3-4 times per week, only 7% of men in their 60s and only 2% of men over age 70 report having sex this often. Sexual problems are common even in women but women usually avoid to talk about the sexual problems with the health providers.
Causes & Symptoms
- Psychological problems with anxiety, depression etc.
- Medicines that reduce sexual arousal, response or desire, including certain antidepressants, antipsychotics, antihistamines, medicines for blood pressure, stomach ulcers heart medicines (beta blockers), diuretics (water pills)
- Decreaed testosterone (in men), estrogen (in women after menopause )
- Long standing medical conditions like diabetes, heart problems, arthritis , urinary tract infections, , vaginal infections, urethral infections (cystitis), or lung diseases
- Circulatory (blood vessel) diseases, including atherosclerosis, high blood pressure , high cholesterol , diabetes that increase the risk of erectile dysfunction
- Pain
- Addictions like smoking or alcoholism or other drugs
- Nerve diseases or conditions (e.g. spinal cord injury from a “slipped” or herniated disc, Parkinson’s disease , multiple sclerosis , stroke
- Anxiety about body image and desirability
- Relationship problems
Symptoms and Warning Signs:
In Men
- Weak erection (Not satisifed)
- Longer time to reach an erction
- Cannot penetrate during the sexual act
- Early ejaculation
- No ejaculation
In women
- Less lubrication and more vaginal dryness during sex
- Painful sexual intercourse
- Slower sexual arousal and general loss of libido (interest in sex)
- More difficulty achieving orgasm
- Reduced sexual sensation – leading to lower response
- Fewer and weaker orgasms
- Painful contractions during orgasm in some older women.
Diagnosis & Tests:
Although you may feel hesitant about talking to a healthcare professional about a sexual problem, remember that you are not alone. Your sexual health is an important aspect of your overall well-being and a critical aspect of your relationship with your partner. Your healthcare provider will begin by asking about your sexual problems. Try your best to answer the questions as clearly and honestly as you can. Remember that everything said during the appointment will be held in strict confidence permanently.
In Women, after a detail history, other tests that may be needed include:
- General physical exam
- Pelvic examination
- Neurological tests to check your nerve responses
- Lab tests – e.g., urine tests to check for infection or diabetes, and blood tests to check for diabetes and hormone levels
In Men, after a detail history
- General physical exam
- Examination of the external genatalia
- Neurological tests to check your nerve responses
- Lab tests – e.g., urine tests to check for infection or diabetes, and blood tests to check for diabetes and hormone levels
Few may need radiological tests to assess the blood flow in the penis.
- General physical exam
- Examination of the external genatalia
- Neurological tests to check your nerve responses
- Lab tests – e.g., urine tests to check for infection or diabetes, and blood tests to check for diabetes and hormone levels
Treatment:
Treatments can be very simple and effective. The choice of treatment depends on the underlying cause of the problem.
- Altering certain habits
- Treating mental health problems
- Drugs for Erectile Dysfunction : Tablets, injections, Vacuum pumps for erectile dysfunction.
- Medication changes
- Treatment of underlying medical conditions
- Vaginal lubricants
- Talk therapy or counseling – is the important part of the treatment.
- General health as a whole is very important to achieve a good sexual intimacy.
Lifestyle & Management
- Deaddiction and healthy life
- Adequate rest and sleep
- Diet and Exercise: Keeping fit is one of the best ways to stay healthy in every way, including sexually healthy.
- Management and Monitoring : To understand the disease and the medications and regular expert advice.
Complications:
It is rare to have complications from treatments for sexual problems, but since some can be very serious, make sure you are fully informed. Priapism – if left untreated – can result in irreversible damage to the penis. Sudden serious low blood pressure which can occasionally accompany treatment with erectile dysfunction pills – especially if taken with nitrates for heart disease – can even be fatal. Make sure to report any side effects as soon as they occur. Sexual activity with non-permanent partners always carries the risk of an unwanted sexually transmitted disease.