Erectile dysfunction, low libido & Impotence

God have mercy. I was to do part two of my write up on Congestive Cardiac Failure(CCF), this Sunday, in continuation of last week’s heart failure. When out of no where I was persuaded by people I couldn’t say no to, who wanted me to revisit impotence ie erectile dysfunction and low libido.

As if by coincidence the social media was awash with a man, an elderly man who died on top of a woman because he took sex enhancing drugs. I also received anonymous video of a man who despite consummating practical mobilization of his organ by his partner, could not get it up.

Then juxtapose all these with daily complaints of my patients, mostly 90% of men above 50, who regularly complain to me of their inability to achieve a sustainable erection.

One man a Deacon, told me in a pathetic tone that he could give anything, including half of his kingdom, metaphorically speaking, just to achieve a two-minute-erection so as to penetrate his wife, after more than 3 years of non conjugal relationship. He was both obese and diabetic. Bad combination.

I have a standing rule and dictum. No man above 50,and with an incipient heart condition should take cardio-toxic-erectile dysfunction drugs like viagra, cialis etc. The Hausas euphemistically call such drugs – – bura ntashi

It has been scientifically proven, by post mortem, that most men above 50 who died on top of women had taken erectile dysfunction enhancing drugs, and most of them already had pre-existing cardiac complications.

Let me make a medical statement of fact – – – low libido and impotence are not the same.

Low libido – also known as low sex drive is a decrease in sexual desire. It is common and can be temporary or long term. When libido is decreased men have fewer sexual thoughts and fantasies, and less interest in sex, and they engage in sexual activity less frequently. Even sexual stimulants by sights, words or touch may fail to provoke interest. Men with low libido often retain the capacity for sexual functions and may sometimes continue to engage in sexual activity to satisfy their partner.

While impotence – – also called erectile dysfunction is an inability to have an erection of the penis adequate for sexual intercourse. Having erection trouble from time to time is not necessarily a cause for concern, this is because every man, without exceptions, once in a while experiences erectile dysfunction or impotence.

As I stated earlier impotence or erectile dysfunction is defined as the inability to achieve and maintain a penile erection adequate for satisfactory sexual intercourse.

You may have erectile dysfunction

If you can get an erection some times, though not every time.

If you can get an erection yet it does not last long enough for sex.

If you are unable to get erection at all, it is called erectile dysfunction or impotence.

An erection occurs when blood flow into the penis increases, making the penis larger and firmir. Hormones, blood vessels, nerves and muscles all work together to cause an erection. When your brain senses a sexual urge, it starts an erection by sending nerve signals to the penis. Touch may cause this urge. Other triggers may be things you see or hear, or sexual images or thoughts.

The nerve signals cause the muscles in the penis to relax, and let blood flow into the spongy tissue in the penis. Blood collects in this tissue like water filling a sponge. The penis becomes larger and firmer, like a blown-up-balloon. The veins then shut off to keep blood from flowing out. An erection requires healthy blood vessels. After orgasm, or when the man is no longer aroused, the veins open up and blood flows back into the body.

The term impotence has traditionally been used to describe the inability of the male to attain and maintain an erection, adequate for sexual intercourse as I earlier explained. Although the term has been used for centuries, it generates much confusion and has been replaced by erectile dysfunction in 1992.

Many people believe that impotence is a modern curse of man. In 1940 Prof Steke said that impotence is a disorder associated with modern civilization. However, man’s preoccupation with potency, or the lack thereof, has been present through the ages.

The word impotence is derived from the Latin word impotencia,, which literally translated means lack of power. The term was first used by Thomas Hoccleve in 1370, then in 1420 in his 5,500 verse poem – DE Reggimine Principum(The Government of Princes).

In the 1800’s sheep testis extract was injected as a source of testosterone to correct impotence. This was the standard, until testosterone was purified in the 1940s. In the United States in the 1920s and 1930s. Prof John R Brinkley attempted to cure the condition using medications. He recommend expensive goat gland implants and ”mercurochrome” injections alone with operations by Surgeons Serge Voronoff.

In the 1970s Surgeons started providing patients with inflatable penis implants. In 1960 Geddings Osbon invented a device which is called THE “YED or Youth Equivalence Device “. It is still being used today as the vacuum pump for erectile dysfunction.

All attempts to treat erectile dysfunction with medications failed till 1983 when British Physiologist Giles Brindley PhD literally showed an American Urologist Association audience the effect of phentolamine on inducing an erection. He had injected a non specific vasodilator alpha-blocking-agent in his own veins to cause corporal smooth muscle relaxation. This laid the path for the later development of oral agents, that could lead to a similar vasodilation and corporal smooth muscle relaxation.

This laid the path for the later development of oral agents that could lead to similar vasodilation and corporal smooth muscle relaxation in the penis leading to erection.

Treatment for erectile dysfunction was revolutionized with the discovery of sildenafil or Viagra. Pfizer employees Peter Dunn and Albert Wood were portrayed as the inventors os sildenafil now known as Viagra. Terrett was named in the 1991 British patent for sildenafil as a heart medicine and some experts consider him as the father of Viagra. Dunno and Wood however were responsible for bringing Viagra into it’s pill form.

Erectile dysfunction affects men of all races and in all parts of the world. Men are more likely to have erectile dysfunction as they get older.

For example erectile dysfunction occurs

About 12% of men younger than 60.

22% of men age 60 to 69.

30% of men of age 70 or older.

Erectile dysfunction often has more than one cause. Many disease can damage nerves, arteries and muscles. Some of the things that can lead to erectile dysfunction include :

High blood pressure.

Diabetes, when your blood glucose also called blood sugar is too high

Clogged arteries.

Heart and blood vessels disease

Chronic kidney disease.

Multiple sclerosis – a disease that affects nerves.

Treatment for prostate cancer including radiation, surgery to remove prostate and hormone treatments.

Injury to the penis, spinal cord, prostate, bladder or pelvis.

Surgery for bladder cancer.

Peyronne’s disease – in which a scar tissue called a plaque forms in the penis.

Unhealthy, lifestyle choices such as smoking.

Drinking too much alcohol and using illegal drugs – note that alcohol increases sexual desires but deteriorates performance