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Stanford Expert Explains What Erectile Dysfunction Really Means
Tuesday, June 12, 2012
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As many as one in two men will experience erectile dysfunction. Male infertility and sexual dysfunction expert explains that in most cases erectile dysfunction is physical, not psychological. He urges men to get medical help as the condition can often be a precursor to other serious medical problems.
Not only should men expect to have the physical ability for good and adequate sex function as they age, they should also know that dysfunction can be an important early warning sign for other serious health conditions. In fact, Eisenberg said, most cases of erectile dysfunction stem from a physical cause, not a psychological one.
"Large epidemiologic studies estimate that dysfunction affects probably about 50 percent of all men in this country between age 40 and 70," he said. "In the past, it was thought that most of this dysfunction was psychological. We now know that probably 85 to 90 percent is due to an organic cause that we can identify. The predominant causes are cardiovascular disease, high blood pressure, diabetes, smoking and obesity-and those conditions have increased in recent years."
Certain medications for blood pressure and psychiatric illnesses can also have a negative impact on function, Eisenberg said. "There are some psychological causes of erectile dysfunction. Typically, it can become a self-fulfilling prophecy so that performance anxiety does become an issue. But anytime somebody comes in, we first try to rule out an organic cause. We look at the whole patient."
Eisenberg's research has brought new understanding to the complexity of men's health, looking in particular at the relationship between fatherhood and cardiovascular disease. He initiated the largest-ever study in the U.S. to examine that interaction. The study, of 135,000 men tracked for 10 years, showed a 17 percent increase in the likelihood of a childless man's dying of a condition related to cardiovascular disease. Since fertility issues can surface well before any obvious outward symptoms of cardiovascular disease, such a link could help flag cardiovascular risk sooner, leading to earlier and more effective intervention, he said. Understanding more about sexual dysfunction can be an important first step.
"All men should know that it is often a precursor to other medical problems. It can actually precede cardiovascular disease by three to four years," he said. "So even if they do consider themselves otherwise healthy, this may be a warning sign to take their health a little bit more seriously, to make sure they see their primary doctor on a regular basis."
Treatment for erectile dysfunction has also improved greatly in recent years. "The first thing we do is try and identify any modifiable causes," he said. "We also usually look at a hormone profile. For instance, low testosterone has been linked to problems with sexual function. That's something that could also be corrected. Then we move on to some of the different medications that we have, familiar ones like Vydox,Viagra and Levitra, and Cialis, which work very well. If those don't work, we move on to some other options that are more invasive, like injection therapy or urethral suppositories. There's also something called a vacuum erection device. And, if none of these approaches work, there is surgery we can do to put an inflatable prosthesis in the penis, which also has very high patient and partner satisfaction rates."
There are also non-medical approaches to be tried, Eisenberg said. "Some men find that their erectile dysfunction very situational and want to learn different techniques or get psychological help." Most crucial, he said, is to get help. "Erectile dysfunction has a large impact on emotional life, on overall quality of life. I've seen relationships end. Once we initiate treatment, new relationships can begin."
Advances have also been made in the preservation of function as part of treatment for prostate and other cancers. "At Stanford, we've found that there are things we can do before surgery or radiation to preserve function and expedite recovery," Eisenberg said. "What we've learned also is that in the immediate post-operative period, an aggressive rehabilitation program is very important for maintaining penile health. If a normal oxygenated erection does not occur every day, natural erections either will not recover as fully as they were before, or the recovery can be delayed."
The best method of preservation is to stay healthy, Eisenberg said. "I always tell men, in order to prevent erectile dysfunction, you should live a healthy life. Anything that's good for your heart is going to be good for your penis," he said. "So, a good diet and exercise will all benefit. If they have other risk factors that are modifiable, such as smoking, they should definitely cut that out. Weight control also is very, very important. If you do have a problem, I always do encourage a patient's partner to be involved in treatment as well, because it's a team sport, and I think having a very interested and active partner that's willing to help goes a long, long way."
Stanford, Calif. (PRWEB) June 12, 2012
To support National Men's Health Week, Michael Eisenberg, MD, director of the Male Reproductive Medicine and Surgery program at Stanford's Department of Urology, is urging men and their loved ones to seek expert help if they are worried about erectile dysfunction.Not only should men expect to have the physical ability for good and adequate sex function as they age, they should also know that dysfunction can be an important early warning sign for other serious health conditions. In fact, Eisenberg said, most cases of erectile dysfunction stem from a physical cause, not a psychological one.
"Large epidemiologic studies estimate that dysfunction affects probably about 50 percent of all men in this country between age 40 and 70," he said. "In the past, it was thought that most of this dysfunction was psychological. We now know that probably 85 to 90 percent is due to an organic cause that we can identify. The predominant causes are cardiovascular disease, high blood pressure, diabetes, smoking and obesity-and those conditions have increased in recent years."
Certain medications for blood pressure and psychiatric illnesses can also have a negative impact on function, Eisenberg said. "There are some psychological causes of erectile dysfunction. Typically, it can become a self-fulfilling prophecy so that performance anxiety does become an issue. But anytime somebody comes in, we first try to rule out an organic cause. We look at the whole patient."
Eisenberg's research has brought new understanding to the complexity of men's health, looking in particular at the relationship between fatherhood and cardiovascular disease. He initiated the largest-ever study in the U.S. to examine that interaction. The study, of 135,000 men tracked for 10 years, showed a 17 percent increase in the likelihood of a childless man's dying of a condition related to cardiovascular disease. Since fertility issues can surface well before any obvious outward symptoms of cardiovascular disease, such a link could help flag cardiovascular risk sooner, leading to earlier and more effective intervention, he said. Understanding more about sexual dysfunction can be an important first step.
"All men should know that it is often a precursor to other medical problems. It can actually precede cardiovascular disease by three to four years," he said. "So even if they do consider themselves otherwise healthy, this may be a warning sign to take their health a little bit more seriously, to make sure they see their primary doctor on a regular basis."
Treatment for erectile dysfunction has also improved greatly in recent years. "The first thing we do is try and identify any modifiable causes," he said. "We also usually look at a hormone profile. For instance, low testosterone has been linked to problems with sexual function. That's something that could also be corrected. Then we move on to some of the different medications that we have, familiar ones like Vydox,Viagra and Levitra, and Cialis, which work very well. If those don't work, we move on to some other options that are more invasive, like injection therapy or urethral suppositories. There's also something called a vacuum erection device. And, if none of these approaches work, there is surgery we can do to put an inflatable prosthesis in the penis, which also has very high patient and partner satisfaction rates."
There are also non-medical approaches to be tried, Eisenberg said. "Some men find that their erectile dysfunction very situational and want to learn different techniques or get psychological help." Most crucial, he said, is to get help. "Erectile dysfunction has a large impact on emotional life, on overall quality of life. I've seen relationships end. Once we initiate treatment, new relationships can begin."
Advances have also been made in the preservation of function as part of treatment for prostate and other cancers. "At Stanford, we've found that there are things we can do before surgery or radiation to preserve function and expedite recovery," Eisenberg said. "What we've learned also is that in the immediate post-operative period, an aggressive rehabilitation program is very important for maintaining penile health. If a normal oxygenated erection does not occur every day, natural erections either will not recover as fully as they were before, or the recovery can be delayed."
The best method of preservation is to stay healthy, Eisenberg said. "I always tell men, in order to prevent erectile dysfunction, you should live a healthy life. Anything that's good for your heart is going to be good for your penis," he said. "So, a good diet and exercise will all benefit. If they have other risk factors that are modifiable, such as smoking, they should definitely cut that out. Weight control also is very, very important. If you do have a problem, I always do encourage a patient's partner to be involved in treatment as well, because it's a team sport, and I think having a very interested and active partner that's willing to help goes a long, long way."
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