Erectile dysfunction: What you should know

Erectile dysfunction is a major defect in the male gender, directly linked to sexual dissatisfaction. In this interview with consultant urologist, Dr Jeje Ajibola, Medinat Kanabe explores the possible causes.

Erectile dysfunction is when a man cannot initiate an erection to get sexual satisfaction. To get an erection, he has to first initiate it, in order to penetrate his partner to get satisfaction. A man can only be said to have erectile dysfunction if he continuously cannot initiate an erection for at least three months.

When a man feels like he wants to make love, there is what is called erectile properties. The arteries that supply blood to the penis opens and allows more blood to enter the corpora cavernosa faster than blood can leave through the veins. As the corpora cavernosa fill and grow in size, the veins get compressed, trapping blood in the penis, causing it to stiffen until one achieves an erection which is when the penis enlarges and elongates.

According to Dr Jeje Ajibola, Consultant Urologist, Lagos University Teaching Hospital, LUTH, a man cannot come to me today and say he wasn’t able to get an erection yesterday and is worried that he has erectile dysfunction; I will not take him serious because he has to experience it for three months before one can say he has erectile dysfunction.”

Debunking claims by some that pot belly can cause erectile dysfunction, he explained that having a pot belly does not cause erectile dysfunction directly, as he said that pot belly in men shows that they are overweight, which makes them prone to some medical conditions, not limited to erectile dysfunction.

“You are not likely to find pot belly in a slim man. Pot-bellied men are prone to diabetes, hypertension, high cholesterol level; as a result of bad eating habit and bad exercise habit, which can cause erectile dysfunction. It is a feature of the general feature.

“Anything that interferes with the normal process that leads to erection can cause erectile dysfunction.”

He noted that there are erectile dysfunction that occur in younger age group that are psychologically induced, and erectile dysfunction that occur in older age group because old age comes with hypertension and other medical conditions.

“There is also erectile dysfunction that can be situational; situational in the sense that when you are at home, you don’t have an erection but when you go outside, you have an erection.

“Most of the time, for younger age group, their erectile dysfunction is psychological. For some of them, it may be their experiences in life. If his first sexual experience was traumatic, he may carry that on in life and then develop psychological fear of having erection and it is a vicious cycle. He begins to run away from his girlfriend because he is having a belief that if he goes near her, he can never have an erection. The farther he runs away from his girlfriend the more the depression comes in.

“Another reason may be that the person may have had an unprotected sex the first time and then contracted an infection. That goes on in his head as a young man and may make him become scared of having an erection because he is scared of having an infection.”

Asked if there is a cure for erectile dysfunction, the doctor said before it can be cured or managed, the cause of the problem primarily must first be found.

“Even if we feel that it is psychological, some tests will still be run to make sure that there is nothing wrong with them. If there is nothing wrong with them, then we give them some drugs.

“If the cause is etiology, for example, if the man is diabetic, then we have to control the sugar; if he is hypertensive, we have to control his blood pressure; if he has high bad cholesterol, we also have to control that, and while we are giving them drugs for the primary cause, we also give them some drugs that will help them get good erection. They will need to swallow the drugs before they have sexual intercourse.”

He advised men who feel they are having erectile dysfunction to seek a physician, so that they can be able to find out what really is the cause of the problem, whether it is psychological or an underlined disease.

“He will be treated for that disease and he will continue with his life. For the sake of their future and their life, they should not patronise herbal gins before consulting a doctor. What I also expect a doctor to do when a young man comes to him is that he should refer him to a neurologist. He is a young man and has a long life to live, so the doctor should not mess up his life. I have told you I will not say a young man’s problem is psychological until I have ruled out any underlying disease. He can even be referred to a psychologist, if it is necessary.”

First published in The Nation of February 21, 2016