Erectile dysfunction and emotional well-being: Concluding Part

We started with the story of Toby and Agnes who fell in love in the University and subsequently got married and were living happily together until Toby started facing challenges with his job in a bank. He was heavily indebted and was facing imminent sack that would ruin his financial standing.

His new boss had given him a six months ultimatum to prove his worth or be released. He did not share his worries with his wife but tried to put a brave face while he was internally racked with anxiety and worries over his uncertain future. He was also beginning to have difficulties getting aroused or sustaining his arousal for any meaningful intercourse.

This development was very frustrating to his wife, who felt he probably was having affairs outside the home and perhaps no longer considered her attractive enough for him. Thus, she felt very upset and humiliated. Toby, on the other hand, did not also understand what was going on. He was equally confused, embarrassed and felt guilty somehow. He considered himself a failure as a man and he could not bring himself to discuss it with his wife. In any case, she was behaving very coldly towards him these days, so he did not even feel he had the opening. A crack had appeared in their previously happy marriage, and was threatening to set them apart. We conclude the story today.


What is Erectile Dysfunction (ED)?

It is defined as the persistent or recurring inability to achieve or maintain erections sufficient for satisfactory sexual activity. It is the commonest sexual complaint of men and is often, an age-related phenomenon.

It occurs in about 5 – 10% of men below the age of 40 years; about 40% in men aged 40 – 50 years and rises to a peak of about 70 -80% of men by the age of 70 years.

It significantly affects the self-esteem, mood, family relationships and overall quality of life of the majority of affected men.


What are the causes of Erectile Dysfunction?

It may be caused by physical health problems, lifestyle or psychological health challenges.

The commonest physical health problems implicated as causative factors for ED are diabetes, hypertension, obesity, side effects of some medications etc. Other factors include abdominal or pelvic surgery, hormonal problems, and spine or back injuries.

Lifestyle factors that may predispose to developing ED include cigarette smoking, lack of regular physical exercise, and alcohol consumption.

Lastly, psychological factors such as stressful situations, excessive fatigue and tiredness, worry and anxiety, depression, and substance use may result in ED.

It is more likely to be psychological ED when you still get aroused or experience early morning erections while asleep or still drowsy. This is often because, in such states, the individual is relaxed and not stressed out.

Anxiety and stress cause our body to react as if we are in danger, the internal alarm bells go off, and our body triggers the fight-flight in-built system. This stimulates the release of stress chemicals that cause our muscles to become tense; and diverts blood supply from the rest of the body towards our muscles. This is aimed at enabling the muscles to help us fight the danger, or escape as fast we can. More so, as arousal also requires increased blood supply to the genitalia which fails to occur in the anxious or stressed state.

The ED results in the man feeling even more anxious, embarrassed and ashamed – all of which further worsens the stress reaction, and the ED becomes even more difficult to overcome. This was clearly the case in Toby’s case.


What should you do if you have ED?

Every good relationship should have effective and open communications. It is a fundamental step towards surmounting any and all problems, and potential misunderstandings. So open discussions around the issue should be the first step.

There should be no shame or anxiety over a normal and quite common occurrence among men. We will do well to remember that getting anxious and stressed about it; or the partner taunting him will only worsen the situation.

It is also not advisable to simply walk into a chemist and buy a medication or buy a local concoction from the streets. Otherwise, one may take the concoction or Viagra; and if there is a background heart condition, the person may simply just die.

Thus, the best approach is to seek medical evaluation, perform tests to rule out physical causes, which if present, can be easily treated – eg hypertension or diabetes.

If the cause is psychological, then therapy and relaxation techniques may be very beneficial. Physical exercise, aiming to lose weight, cutting down on smoking and alcohol are also very useful strategies to improve.

Ultimately, the quality of the relationship and the intimacy nurtured, trump everything else, with respect to overall quality of life and satisfaction.


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