We may be living in a time when people speak openly about many topics, but there is still one that remains a taboo in many Asian countries: men’s sexual health (which includes the quality of a man’s erection and erectile dysfunction).
“This is true,” University Malaya Medical Centre consultant urologist Associate Professor Dr Ong Teng Aik says. “But more men are talking to us today than they did 10 years ago. And they tell me so many cerita dongeng (fairy tales).”
Amused, he recalls the story of a man who was certain that his entire sexual experience lasted hours. Challenged, he decided to use a stopwatch to time himself.
“When it was all over, he looked at the watch and, aiyah,” says Dr Ong, throwing his hands in the air. “The whole thing lasted less than five minutes!”
On a more serious note, erectile dysfunction (ED) is defined by the extent to which a man can achieve and/or maintain sufficient erection hardness for a satisfying sexual experience.
There are three main groups of men that Dr Ong treats. The first consists of men who suffer from chronic diseases like diabetes, hypertension and cardiovascular disease. Then there are those who have undergone surgery like radical prostatectomy or radiation therapy. The third comprises patients who have met with accidents and suffer from injuries to their pelvic region.
The Erection Hardness Scale (EHS) measures the standard for erection hardness and can be explained as follows:
- Grade 1 (Severe ED): Penis is large but not hard.
- Grade 2 (Moderate ED): Penis is hard but not hard enough for penetration.
- Grade 3 (Suboptimal Erection): Penis is hard enough for penetration but not completely hard.
- Grade 4 (Optimal Erection): Penis is completely hard and fully rigid.
Dr Ong illustrates the structure of the organ in the following way: “Take a cup and a straw. Imagine the femoral artery (which supplies blood to the leg) is the cup and the penile artery (which supplies blood to the penis) is the straw. Can you understand just how small the penile artery is in relation to the femoral artery? So, when a man leads an unhealthy lifestyle, one of the first arteries to become clogged up will be this penile artery. That means when a man suffers from ED, it is possible that this is an early manifestation of cardiovascular disease as the blood supply to the artery is impaired.”
Signs of ED can occur up to three years before cardiovascular disease is evident.
Professor Dr Low Wah Yun, professor of Psychology at University Malaya, says the problem is further compounded when men are reluctant to discuss the matter with a doctor.
She says: “They’ll go to the doctor and spend 20 minutes telling him all their problems from diabetes and hypertension to work stress or family issues. Then, as they are leaving the clinic, with one hand on the door knob, they’ll turn round and say, ‘By the way, doctor, I have this problem...’.”
Concurring, Dr Ong adds: “We would like to see more doctors initiating conversations with their patients about erectile function rather than waiting for the patient to do so.”
They both insist that treatment does not include taking traditional medicine. Low explains: “When they take these alternative medicines, there is no scientific proof that these work. Instead, their overall well-being increases. Naturally, when a man feels better, he’ll perform better as well.”
One of the worst lifestyle habits that contributes to ED is smoking. Low says: “When we tell them to stop smoking, they don’t bother. In fact, in one study, they found that putting the words ‘smoking causes cancer’ on the cigarette packet had no effect on sales. But, when they put ‘smoking causes erectile dysfunction’, they found the number of people who smoked decreased.”
But how do you know which doctor to discuss this matter with? Low shares a useful tip: If you see pamphlets about ED in the waiting room of a doctor’s clinic, you will know that this doctor treats this condition. In any event, even if your
GP cannot help you, he will be able to refer you to a doctor who can.
Sometimes, the reason for ED is not necessarily medical in nature. Low says: “Both parties in a relationship play a role in sexual dysfunction. I often say that relationship problems can lead to sexual problems and vice versa.”
Either way, both of them have found that one of the best ways to treat ED is to approach the woman in the relationship. Surprisingly, she is able to coax a man who refuses to seek treatment on his own, to visit the doctor.
This approach, the healthcare professionals say, underlies another message they are trying to impart: That there must be mutual respect between both parties in a relationship.
“The majority of men today are no longer interested in their own satisfaction. They are now interested in whether their partners are deriving pleasure as well,” says Low. “When a man’s emotional and psychological needs are fulfilled, he has a better self-image and confidence of himself. With a fulfilling sexual intimacy, his partner also feels more loved.”
Therefore, men should seek help early and not suffer in silence when they suspect that they may be suffering from ED. This is because the ability to maintain an erection to the end of intercourse is probably one of the most important aspects of achieving ultimate intimacy.
Says Low, “while the frequency of sexual activity may or may not decrease with age, for as long as you’re healthy you can still have sexual function”.
Being fit improves sexual health in many ways:
- Blood circulation improves and therefore, maintains vitality in men.
- Both stress and anxiety are reduced, which have a positive effect on a man’s sexual desire,
thereby, promoting optimal sexual well-being.
- Adrenal function is improved, leading to men having higher testosterone levels and an increased sexual drive.
- A man’s energy levels and endurance increase allowing him to maintain an erection for a longer time.
- A man’s self-esteem improves, which helps him maintain a healthy body image.
