It is not easy for a man to admit he has a sexual problem. A survey recently carried out by the Men’s Clinic International showed that it can take a man between 8-12 months before they go to the clinic.
The main concern for men is erectile dysfunction, ED, (weak erections or impotence), premature ejaculation, PE, (ejaculation before one desires for that to happen) and low libido. Contrary to popular belief, these problems often do affect men in their 20s and 30s – and is not just a problem of elderly men.
Dr Nevon Ramsunder from the clinic says men are often aware they have a problem but will not seek help and that is the main obstacle. “Once the patient is at the clinic he realises he is not alone.” Statistically 25% of men will have ED before the age of 30. By the age of 45, 60% of men will be affected. Patients undergo all the physical checks at the clinic; blood pressure, diabetes, hypertension and testosterone levels, to determine if the problem is physical or psychological. “It could start off physical, however over time and repeated failures performance anxiety sets in and then the average man would rather not try then try and fail because they have big egos,” says Ramsunder.“ For a reasonable erection one needs adequate blood flow to the penis, so if you are diagnosed with something that is vascular in nature then you will find the erection will be weak.” At least 60-70% patients are aware of an underlying pathology with diabetes being a common diagnosis for ED. In many cases simple lifestyle changes such as diet and exercise prove very successful. Doctors and counsellors have seen a definite change in the mind set of those affected. Media and educational initiatives have all helped in fighting the stigma linked to ED. But the major challenge is still getting the man to admit to needing help. Men’s Clinic International tries to make the man feel as comfortable as possible so when he does take that step, the process is easy. They have waiting cubicles to try help with anonymity and a full male staff.
Men generally do not talk to their friends about their sexual problems; so as a result, many suffer in silence, believing they are the only ones affected by such problems
Dr Pritesh Modi works at two branches of the Men’s Clinic, six days a week, and sees an average of 8 patients a day from all age groups, 18-90. He believes there are many men suffering from sexual dysfunction, but are too ashamed and embarrassed to seek treatment. “Majority of the patients that we seehavebeen struggling for years before coming for a consultation. They first tend to try over-the-counter pills,traditional remedies, etc. and consult a doctor only when all else fails, and in some cases wheretheir relationships areat the brink of being totally destroyed. Men generally do not talk to their friends about their sexual problems; so as a result, many suffer in silence, believing they are the only ones affected by such problems.”
Modi adds: “Some of the causes are stressful lifestyles, lack of exercise, poor eating habits, excessive use of alcohol, smoking and drugs, and chronic diseases such as hypertension(high blood pressure), diabetes and high cholesterol. Many medications including those used to treat hypertension have the side effects such as lowering libido and causing ED.”
Sexual health counsellor Marilet Kotze sees men aged between 25 and 35 with ED and PE, normally in high pressured jobs. She says it is a very sensitive issue because many men feel this makes them less of a man. “The first thing it impacts is his relationships and his image. I deal with the psychological fallout of this. If their penis is not working what does that say about them as a man. Anxiety and stress is the worst thing for this. The first thing I do is ask if you have been to a men’s clinic or GP just to check if there is no medical reasons behind the problem.”Stress is terrible for sexual health, affecting your drive and desire. It gives you a lack of libido but not a weak erection. Kotze says patients should be aware of what medication they are taking and their side-effects because many of them, especially anti-depressants, directly affect the erection and are a huge factor in ED.
Kotze has a 100% success rate with her therapy. The longest she had to work with a client was three sessions. “If there is no medical cause, therapy works very well. I mainly use cognitive behavioural therapy (CBT). You help them deal with the stress and the thoughts – you teach them how to make love without needing their penis. So that takes the pressure and anxiety off. They recover functioning quickly.”
Because of the various treatment options available to doctors, Modi says they have a high success rate. Even extreme cases such as quadriplegics who have not had an erection for many years have beentreated successfully.It is unfortunate to think that some partners don’t see ED as a medical problem but rather take the lack of performance personally. Modi says some patients come in because they are “forced” by their partners, others are sometimes accompanied by supportive partners, “but majority, I believe, come on their own – mostly out of desperation.”It is not uncommon for Modi to hear his patients talk of their partners accusing them of being unfaithful due to their inability to perform sexually. This is a sad reality especially when you consider thathaving ED is recognised as an early symptom for cardiovascular disease and should be taken seriously.Treatment can be carried out successfully no matter how long you wait. But why wait when knowing your sexual health status and addressing the issues can give you a better life now.
– By Tanja Bencun
