Erectile dysfunction: Who initiates conversation?

BY: Dr. Samuel Amanamah
The writer
The writer

Studies have shown that 50 per cent of men between the ages of 40-70 years have various degrees of erectile dysfunction (ED).

This is either mild, moderate or severe.

Out of that, only 10 per cent report this to conversional medical set up for treatment, though treatable.

What could be the reason for such few patients reporting for ED treatment?

Is it that these patients who constitute about half of adults do not patronise the health facilities?

If half of men between 40-70 years who are in the millions, stop patronising our health facilities, the facilities would have been visibly empty.

Is it possible that they come with other conditions and fail to voice the sexual issues?

Let's interrogate this possibility. Let's turn our attention to the diabetic clinic.

About 50 per cent of diabetics, after five years of diabetes would experience various degrees of ED.

Diabetic clinics are all over the country's health facilities with good patronage.

Why is ED reporting still low?

What issues are discussed at these clinics? What issues do the patients raise as their complaints?

Are they just talking about sugar levels (numbers), which are within normal ranges, or out of the normal ranges? Is the sugar level the only concern of the patient?

If diabetics alone raise issues about sexual dysfunction at their clinics, the number of reported patients with ED will not be 10 per cent as it stands. There is definitely a cover up at these clinics.

Let's look at the urological clinic.

Prostate cancer is still the most common cancer among men.

Being black puts you at a higher risk of prostate cancer than the Caucasians.

So, Urologists working within the black community see quite a number of prostate cancer patients.

Whatever form of treatment a patient with prostate cancer undergoes comes with the risk of ED. Are ED seen as major complain at these clinics?

What is discussed at these clinics? Is it their Prostate-Specific Antigen (PSA) levels, which serves as a marker of the success of their treatment, the major discussion at their reviews?

Truly, every Urologist gets excited when the PSA level of their prostate cancer patients starts to drop.

But do our patients share our excitement? Are we surprised when they do not look that excited as we are? Definitely we will not be talking about 10 per cent reporting if prostate cancer patients raise their ED issues.

Let's look at the hypertensive clinics.

Hypertension on its own without treatment will cause ED, and some of the medication for hypertension will also cause ED.

Hypertension brings millions to our health facilities, meanwhile general complain of ED is still low.

Can we then confidently say millions are passing through our health facility telling the physicians just part of their health challenges? Or is it that ED is no more a bother to men? Look at how concoctions purported as treatment for ED keeps rising on the market every day.

Physicians, by their training, ask patients questions to help them establish a diagnosis based on the patients presenting complain or "based on the patients’ complain".

Should physicians be asking about issues patients have not brought up?

If very few men are raising sexual dysfunction issues at the clinic, and it's an undeniable fact that many men who come to the health facility have this issue, then who should really be initiating the conversation?

Your guess is as good as mine.

What if the one you guess to initiate the conversation fails to do so? Should the other party not do so? Who turns out to be the final loser? Your guess is as good as mine.

The writer is a Consultant Urologist at the Kumasi South Hospital