Prof Dr Haluk Kulaksizoglu, Specialist in urology and andrology at American Aesthetic Medical Center, sheds light on erectile dysfunction
Why is erectile dysfunction (ED) such a sensitive issue in the UAE and what can be done to make it less taboo?
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.
Does exposure to high summer temperatures impact the condition?
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.
Education of the conditions that cause ED and their effect on health and social life cannot be emphasised enough.
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 has a psychological burden on him for performance, and vice versa if there is a psychological issue that affects the electrical system. This is a chicken-and-egg situation — whichever 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? Is it true that oysters can improve its primary symptom?
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 does 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.
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