By Dr. Michael Kemper
I was recently invited to co-host a radio segment for “The Weekly Check-Up” on 95.5 FM WSB. We discussed several topics, but I was most struck by the questions and feedback I received from listeners regarding erectile dysfunction or ED. I believe the candid conversation I had with the host, Dr. Bruce Feinberg, about the pervasiveness and realities of ED was valuable to listeners, so I wanted to highlight some of the key takeaways and “what people really want to know but are too embarrassed to ask” answers from our talk.
- How is ED defined and when should you get help for it? When does ED warrant treatment? There are all kinds of answers and qualifiers to this question. The textbook definition of ED is the inability to achieve or maintain an erection during sexual activity. If it becomes a persistent problem, it could be a sign of an underlying medical condition that needs attention and at that point you should discuss it with your doctor. For seeking treatment, however, this is not just a medical condition, it’s a quality-of-life issue. I recommend defining it by your own “bother barometer” — when it becomes a “bother” for you, come on in and we can work together to take care of it.
- How prevalent is ED? There’s a bunch of research out there about ED and estimates are all over the place because doctors and researchers use different definitions about how often erectile issues must occur to be considered ED. What we can agree on is that it’s common—a good ballpark is that ED might even occur to 50% of men between the ages of 40 and 70.
- Do the “quick fix” pills, injections, and creams advertised on TV work? What are the risks? Fortunately, and unfortunately, there are a ton of treatments being advertised on TV and even in gas stations. I say it’s fortunate because the awareness of ED and available treatments has transformed a historically taboo subject into a mainstream and conversational topic: “Yep, men have ED—lots of them—but it’s a condition that can be treated.” At the same time, it is also unfortunate because the over-promising “quick fix” pills, creams, and injections can cause more harm than good, and be very costly for patients. While many of the medicines are the same, they are more expensive, and these clinics aren’t always good at managing potential side effects. For example, I had a patient who recently came in with priapism, or prolonged erection, caused by a penile injection he received from one of these “men’s health clinics”. Not only was it very painful for him, but it can be extremely costly and potentially quite dangerous. If left untreated, priapism could lead to permanent scarring, fibrosis, and worsening erectile dysfunction. The good news for this guy is that we were able to treat it with a draining and irrigation procedure, but I wish he had come to us first because we could have saved him tremendous suffering and expense.
- What is the best course of treatment for ED? There are several safe and effective treatments available, ranging from pills to surgical implants. But the key is to get the right help to correctly diagnose the source of the issue and the treatment that works for you, specifically. Start with your primary care provider. Don’t be afraid to speak up if your doctor doesn’t ask you about your ability to obtain and maintain an erection because, trust me, you are not the only patient with the issue. Alternatively, make an appointment with a urologist who has the knowledge and expertise to diagnose and treat erectile dysfunction accurately. I partner with primary care physicians to address the entire health of the patient, not just their erectile dysfunction. Many underlying conditions such as diabetes, hypertension, and obesity can contribute to erectile dysfunction. Addressing these issues can significantly improve the chances of successful treatment.
- What to do if ED becomes “bothersome” to you? Bottom line: you do not need to live this way. There are tons of treatments available. Educate yourself about the options. I am conducting a webinar on March 16, 2023 and will be taking questions from the audience. Join me, Wed. March 16th at 6:30 p.m. EST (web link). Register here!
As a urologist specializing in erectile dysfunction, I try to educate and encourage men who are experiencing ED to get the help they need without wasting time, money, and frustration on some of the “quick fix” treatments being advertised frequently today.