By Richard P. Holm MD
Just last week a ninety-two year old man asked me to renew his prescription for Viagra. I gleefully responded, but it made me think how complex and difficult this issue can be.
There is probably nothing so personal, and maybe so important to a guy growing up than his ability to perform sexually. I mean we’re talking that part of the sexual ego of every young man that wishes to be superb, something that women crave to have, and every other guy would envy.
It is all covered up, however. Knowing what a man is supposed to do in the bedroom, and what constitutes normal male sexual function is something that is all too clouded in secrecy. When I was 14, the major source of information about male performance came to me at the roller-skating rink, when camping out, or late in the night from reading questionable literature with a flashlight, and I don’t think this kind of education has improved much since.
And with all the overblown expectation, and not knowing what is normal, comes the self-consciousness and hesitation to ask when there might be a problem.
A recent study indicated loss of erectile function or so-called impotence occurs in more than 50% of 40-70 year old men, and increases with age. The problem is twice as bad for smokers than for non-smokers, three times as bad for diabetics, and four times as bad for people with heart disease. It also increases significantly with psychosocial problems associated with hostility, suppressed anger, and depression.
But that’s not all. Men in poor physical condition, or with thyroid disease, B12 deficiency, sleep apnea, and other medical conditions may also present with a loss of desire for sex, or an inability to have an erection.
Bottom line: the loss of erectile function might indicate something is medically wrong, and men should expect more from their doctor than a prescription for Viagra. This is a problem that shouldn’t be kept under the covers.
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