Just the other day, I saw a 52 year old man in my office for what I thought was a routine prostate issue. I walked in the exam room, introduced myself and immediately knew his prostate was fine. His eye contact was non-existent. He was nervous and his handshake was clammy and brief. I see these patients everyday. Their prostates are just fine. It’s their love life that’s the issue. This patient came in because of erectile dysfunction.
Erectile dysfunction is a disease just like diabetes or hypertension or coronary artery disease. And just like these traditional diseases, ED can have a profound impact on a patients life both physically and emotionally. Ten years ago it was commonly thought that ED affected 30 million men in the United States. Now, with the burgeoning baby boomer population, estimates are closer to 50 million. And over the next ten years that number will continue to increase. But the question remains for both patients and doctors: is ED really a big deal? If you ask the majority of these 50 million men I think the answer would be a resounding yes.
But what about the doctors? Well, you might be surprised to discover that most doctors would now agree with the patients and that’s a huge change in attitude. This is the result of important basic science research that has flooded the peer-reviewed medical journals from the Journal of Urology to the New England Journal of Medicine. Doctors have discovered that ED can be an important sign of other potentially life threatening diseases, such as coronary artery disease, and that discussing and treating a patient’s ED might just save their life. In my practice, I typically address ED in every male patient over the age of 40. These are usually simple questions that allows a patient to feel comfortable with this important issue. If nothing else, it strengthens my relationship with my patients and lets them know they can discuss any of their health concerns.
Most men have two very small blood vessels that supply blood to the penis. These blood vessels are about one- third as large as the blood vessels that supply the blood to the heart. These small blood vessels that go to the penis can become clogged as a result of atherosclerosis or high blood pressure. If these blood vessels become clogged then blood can’t get to the penis and this results in ED. What physicians have discovered and written about in hundreds of medical journal articles is that a man who has erectile dysfunction from clogged penile arteries is at an increased risk of clogged heart arteries which puts him at risk for a heart attack which could be fatal.
The bottom line is relatively simple: physicians need to ask their patients about sexual dysfunction and patients need to be aware that ED is as important as chest pain or shortness of breath.
John Ludlow is a urologist.
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