November is over! But that doesn’t mean that men’s health should stop being a priority.  I’ll be discussing a few things that men may or may not have or might even be afraid of having. This is the first of a 3-part post.  Below are the topics I will be discussing to keep men’s health at the fore front of December too. Men’s Health: Erectile Dysfunction (ED) Benign Prostatic Hypertrophy (BPH)

Men’s Health: Erectile Dysfunction (ED) BENIGN PROSTATIC HYPERPLASIA -BPH
  1. Erectile Dysfunction (ED)
  2. Benign Prostatic Hypertrophy (BPH)
  3. Prostatic Cancer

Erectile Dysfunction (ED)

According to the National Institute of Health (NIH), ED affects about 30 million men in the US.  One thing I was taught in medical school is that there are two types.  One is organic, this means that there is an actual issue with the processes that allow an erection.  Second, is psychological.  This means that the man should be able to get an erection because there is nothing physically wrong that would prevent the man from getting one.

       But how can you tell the difference between the two?One very important question a doctor may ask you is this               

            “Do You Still Have Morning Erections?”

If the man still gets morning erections, meaning they wake up with “morning wood” or a “woody” then there is nothing organically wrong, and the man should be able to get an erection.  Odds are, something else is going on preventing the man from being able to get an erection. I’ll list a few in a minute.

If however the man doesn’t get any morning erections anymore, or rarely, or less and less, then there is likely something organic going on.

So if there is no physical reason why a man doesn’t get an erection, here’s a list of a few things that may cause erectile dysfunction:

Stress: any, can be sexual, can be family, work, friends, any kind at all.
Fatigue
  • Stress: any, can be sexual, can be family, work, friends, any kind at all.
  • Fatigue
  • Relationship Issues
  • Depression
  • Anxiety from inability to perform on previous occasions
  • Low self esteem
  • Certain behaviors can also lead to ED or impotence:
    • Alcohol use (how many of you have found difficulty getting an erection or keeping one when you’re drunk?)
    • Smoking
    • Other drug use
    • Being overweight
    • Having a sedentary lifestyle (meaning you are not physically active)

What if something actually is wrong, what kinds of medical conditions can lead to ED?

Men’s Health: Erectile Dysfunction (ED) BENIGN PROSTATIC HYPERPLASIA (BPH)
  • Diabetes
  • High blood pressure
  • Peronei’s disease
  • Previous surgeries in the areas of the bladder, the prostate or pelvis
  • Any injury to the penile area, spinal cord, bladder, pelvis and prostate
  • Blood vessel diseases

                                Why?

An erection depends on blood flow.  To get an erection blood must flow to the penis and stay there; pool there.  The penis is not a bone or a muscle.

An erection depends on blood flow.  To get an erection blood must flow to the penis and stay there; pool there.  The penis is not a bone or a muscle.  You might laugh, but this is actually a question both men and women have asked while I did my clinical rotations in med school.

This is a safe space, so if you’re embarrassed by a certain question feel free to ask me privately through IG @doctor. Vero or email me. I won’t give you medical advice, but I will give you some info!

         Medications can also cause impotence or ED:

  • Blood pressure medications
  • Anti-depressants
    • These can often be changed to avoid the ED side effect.
  • Ulcer medications
  • Appetite suppressants
    • Are sometimes amphetamines which is why “illicit” drugs can lead to ED too
  • Sedatives
    • Used to make you sleepy or calm you down
  • Anti-androgens (used to treat prostatic cancer).

                      Can it be treated?

Depends on the cause. If its vascular, meaning low blood flow, then there are options.  You can be prescribed Nitrates like sildenafil (Viagra).  If it’s a nerve issue caused by diabetes or previous surgeries that damaged them, then surgery may be an options.  

Overall, erectile dysfunction is not due to old age.  So if you’re experiencing this, make an appointment.  If you’re embarrassed, don’t be. It’s easy to say that, I know but a few awkward minutes in a doctor’s office can lead to a prescription, an erection and a very happy ending.

Let me ask you this, is this a weird topic to write about? Not for me.  Why? A balanced life is about everything there is in life.  This includes family, friends, alcohol, traveling, exercise, healthy foods and unhealthy foods, mental health and sex.  Sex is a huge part of many people’s lives.  It helps you connect to your spouse, express your feelings.  For many men, it boosts their confidence and helps them identify.  I have met men who begin to experience ED and their confidence drops, their masculinity is affected, it can cause anxiety, depression, relationship issues etc. ED is a problem not because of the ED itself, but because of what it does to the man and the women they are with.  Both parties begin to suffer, and there are things that can be done by a urologist or family doctor that can improve the situation.

Would I be embarrassed if a man told me they can’t get an erection? No. Would I judge them? No! Would I mock them or laugh? Definitely No! Would I do whatever necessary to improve their sex life? 100% YES! Sex is a huge part of life, and everyone should be able to have that.

So if you’re a guy, or the partner/gf/wife of a guy who is having erectile dysfunction let them know it’s a very common thing.  That there’s nothing to be embarrassed about, and that there are things that can be done to help improve the way things are going at the moment.

Benign Prostatic Hyperplasia (BPH)

This is a very common condition! Usually affects men older than 50 and according the National Institute of Health (NIH) it affected about 14million men in the US in 2010.

It affects about 50% of men between age 51-60, and about 90% of men older than 80 years old.

So if you’re an older man, and you have been diagnosed with this, you are not alone.What exactly is the prostate? It’s a small gland that can be reached through the rectum and examined.  Running through it is the beginning of the urethra, which is how the pee exits the bladder and into the toilet!

            When this glad gets bigger, it makes it difficult to urinate. 

What are some of the symptoms?

Feeling of incomplete voiding: this means they feel as though they didn’t empty their bladder entirely

Urgency: or a feeling that they really gotta go pee!

Frequency: Men may need to go pee multiple times a day, especially during the night.  This is called Nucturia.

Weak stream: because of the pressure the gland puts on the urethra, the urine comes out with little pressure and the urinary stream is weak and can even be interrupted.  Peeing in short bursts of urine.

Urinary retention: not all the urine leaves the body, some stays.

Are there any complications to this condition?   Sure

 

  • Retention of urine can lead to urinary tract infections (UTIs)
  • Blood in the urine called hematuria
  • Damage to the bladder, kidneys
  • Bladder stones

 BUT most men don’t actually get any of these according to the NIH.

What should you do if you are diagnosed with BPH?

Few things

  1. Change your lifestyle
    1. Don’t drink liquids before going to bed
    2. No coffee.. makes you pee more
    3. Don’t drink alcohol either
    4. Train the bladder to hold urine
    5. Do things to prevent constipation
    6. Careful with taking decongestants, anti-histamines, anti-depressants and diuretics = this doesn’t mean don’t take any of them, it means talk to your doctor and ask them reason why you should watch out. It can make your BPH symptoms worse.

 

  1. Take medications

    1. There re a bunch of meds you can be given. Since most men diagnosed are over 50 and many may also have high blood pressure, a very common medication given is tamsulosin or Flomax.
    2. Another one is oxybutynin. This reduces the reactivity of the bladder so reduces the urgency feelings.
    3. There are others, its not just these two so definitely don’t think you’ve been given the wrong ones or you prefer these. If you do have concerns just talk to your doctors and voice them, ask your docs what the drugs do and what to expect.

There are others things that can be done like surgery but those are all last resort.

Lastly, a very common question I have heard is:

       “Does BPH become Prostate Cancer?”

The answer is NO.

BPH does not progress to cancer. It may increase your chances of getting prostate cancer according to a few studies, but It does NOT become cancer.