Prof Dr Haluk Kulaksizoglu, Urology and Andrology Specialist, American Aesthetic Medical Center, emphasises the need for education on erectile dysfunction (ED) and its effect on health and social life
The key point to overcome this issue is to explain and educate people about how this is a normal function of the male body, why men may have problems and, above all, that this is nobody’s fault and it’s a medical condition.
What can be done to educate patients on ED so that it becomes less of a taboo subject?
Globally, ED is a difficult topic to discuss. The erection has been directly associated with manhood in nearly all cultures. The perception is that it should function if you are man enough. Therefore, men feel like it is a weakness to admit to having a problem in intimate life. The key point to overcome this issue is to explain and educate people about how this is a normal function of the male body, why men may have problems and, above all, that this is nobody’s fault and it’s a medical condition. The media and health professionals play the most important role in overcoming these taboos. Unfortunately, even medical professionals do not pay enough attention to ask their patients if they have erectile issues. Education of the conditions that cause ED and their effect on health and social life cannot be emphasised enough.
It is said that exposure to high summer temperatures impacts the condition. Is this true?
High temperatures do not impact erectile function. However, for sperm production it is a major problem. Testicles have two major functions: sperm production and hormone production. The cells responsible for hormone production are not affected by heat, whereas sperm-producing cells are very susceptible to heat.
What are some physiological and psychological causes of ED?
Over the past 20-25 years, enormous data has been gathered about the physiology of erections and what can affect them. As a rule, whatever is bad for your heart and vascular system is also bad for your erectile functioning.
The mechanism starts when the brain sends an electrical signal to the pelvis through nerves in the spinal cord. The arteries dilate and start filling the penile erectile tissues with blood. The organ gets fuller and a valve mechanism inside the tissues stops the incoming blood from returning to the body.
Any pathology or disease that affects nerve tissues, vascular systems, hormonal systems or the erectile tissue’s properties lead to ED.
If a man experiences difficulties due to organic causes, he also carries the psychological burden of performance, and vice versa if there is a psychological issue that affects the electrical system. This is a chicken-and-egg situation — which comes first is actually not important. Andrology aims to address these issues with full coverage. It has many side specialties that need to work in coordination such as psychotherapists, internists, endocrinologists, cardiologists and neurologists. This may provide a wide spectrum of treatment options ideally tailored to patients’ individual needs.
Is diet a factor in the condition?
Diet is important. It may cause ED and can sometimes solve the problem. Most dietary recommendations unfortunately don’t have scientific data to prove their effect, but anecdotal evidence recommends oysters, sea urchins, hazelnuts, walnuts and some honeys as a good adjunct to sexual performance. As long as they are not overconsumed, they might improve one’s performance.
What role do hormones such as testosterone play in ED, if any?
Testosterone is crucial in sexual functions. Latest studies show that it not only has a positive impact on sexual desire but also offers cardiovascular benefits in men. This is an endogenous hormone, meaning it is produced by our own bodies. It mildly decreases with age but never drops to very low levels.
If a man has low testosterone, it should not be accepted as a normal part of ageing. The role of testosterone starts with the electric signal production all the way to penile tissue longevity. The replacement of deficient hormones is also a double-edged sword; too much exogenous hormone might decrease our own body’s production, causing severe problems.
Everything that is more than normal in appearance is too much. We recommend normal measurements of all body parts to our patients.
Be rational when considering plastic surgery
Dr Hamid Karimi, Plastic Surgeon, American Aesthetic Medical Center, warns against trying anything more than normal.
If you’re considering plastic surgery for the first time, what would be your first tip?
Examine your face and try to find what is in excess or what is missing in your face or body, then consult with an expert plastic surgeon.
Tell us the craziest request you’ve ever had from a client?
A 45-year-old patient of mine once asked me to help her to gain an extremely narrow waist. Apparently, she had heard that removing some ribs would help her. One of my patients was a flight attendant with a very big bust and it was difficult for her to pass someone in the aircraft corridor. She asked me to reduce the size without scars, as the airline doctors would not accept scars and could fire her.
What are the main procedures you offer at the American Aesthetic Medical Center?
Stem cell fat grafting for rejuvenation of the face, eyelid surgery, liposuction and nose surgery.
What type of individual would benefit the most from plastic surgery?
Those who are rational and have some imbalance in their body and wish to improve the same.
When it comes to enhancing a patient’s body through plastic surgery, how much is too much?
Everything that is more than normal in appearance is too much. We recommend normal measurements of all body parts to our patients. The danger is, they sometimes ask for more.
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