Home Health The REAL reason men should worry about erection problems revealed to me by a leading NHS doctor – and it has nothing to do with your sex life: PROFESSOR ROB GALOWAY

The REAL reason men should worry about erection problems revealed to me by a leading NHS doctor – and it has nothing to do with your sex life: PROFESSOR ROB GALOWAY

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What is the solution to erectile dysfunction? There has been a lot of talk about men needing testosterone therapy, as levels naturally decline with age.

In the past, when ER waiting lists weren’t very long (okay, this was 15 years ago), I saw a man who refused to tell the triage nurse what his problem was. He insisted that I had to see a doctor, I needed urgent help, so I saw him right away.

He then told me that he had spent the night with his new girlfriend and had not been able to get an erection. When she fell asleep, he snuck out and came to the ER, thinking we could help him.

As you can imagine, he was discharged with a brief lecture about waste of NHS resources and certainly no treatment.

I hadn’t thought much about this until last week when I spoke to a friend, Dr David Weinstein, an NHS GP specializing in men’s health: erectile dysfunction, low libido and low testosterone.

‘Didn’t you ask him about his general health?’ He scolded me.

David went on to explain that erectile dysfunction is the “canary in the coal mine” of cardiovascular disease, because it is often the first sign of other diseases, including heart attacks and strokes.

While I’m not suggesting that anyone who can’t get an erection should go to the ER, there’s no doubt that our views on men’s sexual health are changing. Poor circulation (whether as a result of diabetes, poor diet, smoking, high blood pressure, or being overweight) is a leading cause of erectile dysfunction, as well as heart attacks and strokes, hence the link.

Erectile dysfunction may also be linked to irritable bowel syndrome, according to a recent study published in the journal Sexual Medicine.

It showed a strong link between the two conditions; It has not yet been proven whether this is a direct link or a common underlying cause, such as anxiety.

What is the solution to erectile dysfunction? There has been a lot of talk about men needing testosterone therapy, as levels naturally decline with age.

So yes, erectile dysfunction is a more serious problem than we used to think. It can reflect your overall health and should not be kept hidden.

But what is the solution? There has been a lot of talk about men needing testosterone therapy, as levels naturally decline with age.

But another study, published in the journal Proceedings of the Royal Society B: Biological Sciences a few weeks ago, confirms that it is not that simple.

For the study, 41 men recorded their feelings of sexual arousal and desire, and their testosterone levels were measured from sputum samples. What surprised me is that if the man’s testosterone level was above a certain threshold, it didn’t matter if his level was high or low compared to other men in terms of libido. Since I’m not an expert in this area, I relied on David Weinstein to explain it to me.

“This evidence proves what we knew,” he told me.

‘When a man comes to see me and complains of feeling tired all the time, unable to have erections or having a low libido, one of the key

things to do is check your testosterone levels. But in many cases the levels are fine, so increasing them won’t work for erectile dysfunction, for example. We need to look at other factors.

‘This includes cholesterol, HbA1C (i.e. blood sugar levels), blood pressure and also assessing your lifestyle.

“Lack of erections often causes a decrease in libido, but the opposite is not always the case,” he explains.

“The most important thing is to consider overall well-being and mental health, and take a holistic approach to treatment, managing lifestyle risk factors such as diet and anxiety.”

Only then should the doctor consider taking ED medications, he adds. That, of course, includes medications like Viagra, which work by opening the blood vessels in the penis.

Topical gels are also used. Eroxon is a penis gel (available without a prescription in pharmacies) that creates a cooling, warm sensation that stimulates blood flow; Research suggests it may work in up to 60 percent of patients.

Otherwise, another novel new treatment is low-intensity shock wave therapy: essentially sound waves are launched into the tissue.

This has been shown to help other conditions, such as inflammation of the tendons in tennis elbow.

In the case of erectile dysfunction, it appears that sound waves can remodel damaged blood vessels, improve blood flow to the penis, and rejuvenate erectile tissue.

A study published in the journal Andrologia in 2022 showed that after weekly treatment for a month, patients had significantly stronger erections than men who received a placebo treatment. This effect lasted for at least six months.

There are other more cutting-edge therapies that may be useful in the future.

One example is platelet-rich plasma (PRP) injections, which is packed with natural growth factors and is often used by athletes after an injury. These are being tested for erectile dysfunction and the results of a study conducted by the University of Manitoba in Canada, which involved 660 patients, are expected by the end of the year.

Stem cell therapy, in which bone marrow cells are implanted into damaged tissue, also has potential. It is possible that in a few years it will have moved from the laboratory to the treatment room.

Eroxon is a penis gel (available over the counter in pharmacies) that creates a cooling, warm sensation that stimulates blood flow.

Eroxon is a penis gel (available over the counter in pharmacies) that creates a cooling, warm sensation that stimulates blood flow.

Some supplements like L-arginine and L-citrulline can help, because they increase blood flow in the same way Viagra does: by increasing levels of a natural compound, nitric oxide, which dilates blood vessels.

Research published in the journal Urology in 2011 showed that L-citrulline supplements improved erectile dysfunction symptoms in 24 men significantly more than a placebo.

But anything else you’ve read about on the internet, like this or that vitamin, salt injections, or baking soda, I would avoid.

Without a doubt, the fact that there is a huge market for these types of products online is largely due to timidity when it comes to raising this issue. And we need to get men to talk about their sexual well-being with the right experts.

That’s where people like David Weinstein can help: having the time and expertise to address problems and make a real difference in people’s lives.

While I have not seen another ED “emergency” in the ER, with my male patients (and when appropriate) I have begun asking them about their sexual health. Because it could be a sign of their overall health and, above all, they need to know how important it is to get a medical check-up.

So if it’s you or your partner, seek help; Not only will it help you with your sex life, but it could also save your life.

@drobgalloway

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