I have a crystal ball in my office; it is a sulfur glass ball that my brother-in-law offered me 8 years ago, when I moved in. When I think of time passing, I remember my uncle André who always said: “You get old before you know it. You don’t even have time to figure out it’s happening.” I always thought that was the bullshit end-of-a-family-meal-everyone-had-a-little-too-much-to-drink thingy. Except that, when I look back… it’s been 22 years since I enrolled in medical school… 22 years!
This famous crystal ball delights children. I tell them I ask the magic ball how to treat them when I don’t know what they have. It makes parents laugh, but sometimes I really need powers of super knowledge because my job teaches me humility every day.
Knowing the name of a molecule is good, but real medicine applied to each patient’s needs looks different than the books. The same symptoms have different interpretations depending on the situation and the people…
– Hello, doctor!
– Hello, young man, how can I help you?
– I’m Sarah’s boyfriend. She told me to come to see you; you know about it, I think.
– Ah yes, I no longer remember your first name.
– Yes, that’s right, Dylan! She told me you had diabetes, type 1, I guess, on insulin…
– Yes, that’s why I came. I want to stop my treatment and begin a ketogenic diet because various resources I found online say it can stabilize insulin effectively. Do you follow me on this?
– No, Dylan, I refuse to do this for two reasons: I know nothing about this diet, and I wouldn’t want to lie to you. And from the little I do know, this is a terrible idea: the risks are poignant, so I advise against it! Talk to your diabetologist.
– Okay, I like people who speak their minds frankly.
– Can I do anything else for you?
– Yes, it’s embarrassing, but hey, you’re a doctor: I sometimes have trouble getting erections. I think it’s because of diabetes; what can we do?
– First, steer clear of keto because you risk diabetes decompensation. Then start by investigating if there is an organic cause… Does it happen to you each time? Do you still have morning erections?
– It stresses me out, but I still have erections in the morning. Do you think it’s serious?
– You put a lot of pressure on yourself and feel like a lesser person because of your diabetes, which you think is causing all your problems. So, it may not be so simple!
– Yes, and it bothers me for Sarah; I know she feels guilty. She thinks that if I sometimes have trouble, it’s because I want her less after she’s gained weight! That’s not it at all…
– Don’t worry; we’ll manage it, but first one thing: Sarah is a cool girl. Don’t mess with her too much, or I’ll have to kick your ass!
– Okay, Doc.
Erectile dysfunction affects one in ten men and is a common reason for a urologist consultation. The demand has increased exponentially among young men (under 40) or even among very young men (20-40)!
What are we talking about?
We define an erectile disorder or erectile dysfunction as an inability to have or maintain an erection long enough for quality sexual intercourse! We retain the diagnosis when:
- Disorders last over three months
- They repeat with every sexual intercourse
Quality of life and psychological impact are essential. It is, however, necessary to differentiate these disorders from the simple “erectile failure.” This “affliction” is temporary, banal, without consequences in the long term, and has no pathological value!
How does it work?
The penis has two functions: urination and sex. It comprises two cavernous bodies (corpora cavernosa) and a spongy body. Erection is a multi-step mechanism:
- Sexual desire linked to hormones and libido
- Sexual arousal, which transmits information to the brain via the nervous system
- The influx of blood into the corpora cavernosa allowing the penis to harden to perform the act
Erectile disorders can occur because of problems at these different stages.
What causes erectile dysfunction?
Erectile dysfunction has three causes: physical, medicinal, and psychological. As often in medicine, the origin can be multifactorial. Drug-related causes will not be discussed here because the area is vast and requires the support of a professional.
The consumption of
DRUGS, ALCOHOL, TOBACCO
increases the risk of erectile dysfunction regardless of age.
Physical causes (often affect men over 50)
- Vascular disorders that do not allow good blood circulation: hypertension, diabetes, hypercholesterolemia, tobacco
- Neurological disorders: cerebral pathologies, alcohol
- Hormonal disorders: thyroid disease, low testosterone levels
- Overweight and obesity
- Chronic illnesses that have a significant impact on the proper functioning of the body
Psychological causes (concern men under 40)
- Anticipatory performance anxiety
This anxiety defines the fear of not measuring up when you attribute great expectations to your partner. In this case, the man wants to be over-performing. This psychological pressure harms the realization of the sexual act and does not allow the complete fulfillment of the couple, leading to long-term erectile disorder.
Unfortunately, many people confuse sexuality and pornography! Nowadays, the consumption of pornographic content gives a distorted view of reality. One of my young patients (around 21 years old) once admitted to me he was stressed about not being as good as the “monsters on the internet,” referring to the high-flying performances of certain actors. I told him that with the special effects they could do these days, he should be careful what he believes! This idea of special effects surprised him as something reserved for Hollywood blockbusters.
We must rethink sexuality not as a performance but as a moment of sharing between the couple, an intimate, very personal moment responding to everyone’s desires. Therefore, a balance between communication and sexual engagement is essential for the couple’s harmony.
- The depressive syndrome
Depression is a classic reason for erectile dysfunction and loss of libido. It is essential to differentiate between the two: erectile disorder refers to the inability to have an erection, and libido disorder to a failure to feel desire, which can lead to erectile dysfunction.
Depression manifests itself through various psychological and physical symptoms. The purpose of this article isn’t to describe depression exhaustively because its manifestations differ for each person. However, the lack of desire, anhedonia, the urge to cry, chronic fatigue, insomnia, and loss of appetite are usual.
This mental and physical state is often incompatible with erection and the realization of the sexual act. In addition, you can enter a spiral of negativity where guilt and loss of self-esteem follow after erectile disorder episodes, thus increasing your depressive symptoms!
- The relationship/problems of the couple
Achieving a satisfying sexual act for both parties depends on the couple’s understanding and harmony.
The general idea is that “we solve marital problems under the duvet.” This way of thinking is both simplistic and reductive. A fulfilling relationship is based on mutual feelings, shared plans for the couple’s future, sexual harmony, quality communication, acceptance, and supporting each other’s desires (even the ones that don’t benefit you directly!).
A relationship is a whole based on different fundamental elements that are interdependent and allow fulfilling cohesion. Therefore, a long-term argument can lead to erectile dysfunction because the existing tensions aren’t conducive to loving sexual intercourse.
- Previous problematic relationships
Whether we like it or not, our past experiences model us: the “us” of today is the sum of the previous “us” and what we have experienced until the present!
Previous stressful or traumatic relationships can haunt us. So, an ending relationship should offer an opportunity for reflection to redefine our objectives. Unfortunately, we live in a time of racing forward, trying to bury the old. We also think – it’s a utopia – that a new relationship will save us from the previous one.
This is fear talking! Fear of being alone, fear of no longer being capable, fear of being abandoned, etc. There is nothing more paralyzing than fear. So wanting to move forward at all costs can have the opposite effect, making us feel agitated, riveted, and listless. The emptiness you feel is a sign that you must put yourself first. Me, Myself and I!
Erectile Dysfunction: 7 Healthy habits to Prevent It
- Limit alcohol consumption: The feeling of omnipotence after drinking follows the inhibition of higher cognitive functions. In fact, when you’re drunk, you’re not an excellent shot.
- Limit tobacco consumption: Tobacco increases the risk of arterial obstruction, while the influx of blood into the penis is necessary for a quality erection.
- Do not use drugs: Cannabis and heroin reduce alertness, preventing quality sexual relations! Cocaine is a drug that gives energy, but the “high” is followed by a “low,” mixing anxiety, depression, and malaise. This combination does not allow sexual fulfillment.
- Having regular physical activity, a quality diet, and sufficient hydration: A healthy lifestyle creates the best possible conditions to flourish in all aspects of your life, especially your sex life.
- Work on self-confidence: Many psychological disorders stem from low self-confidence, which is linked to the value we place on ourselves. In turn, that value is linked to our self-love: love yourself as you would like us to love you!
- Accept yourself as you are: Strengthen your character to assert yourself as you are with the heaps of flaws that characterize you. The pursuit of a supposed perfection is utopian. Many agree that if you don’t chase your perfection/ ideals, you end up chasing the perfection that others should see in you. “I don’t care about being perfect,” yet “I publish 20 filtered selfies per day on social media” is an absolute contradiction. If you want to be accepted and flourish as you are, you have to accept and even value your supposed flaws!
- Don’t focus on yourself; focus on your partner. Think “Erotism.” Forget your performances. The search for performance, even for the sake of another, is selfish. In reality, you perform to receive (high) praises in return: “you are a great shot,” “no one has ever made me cum like you,” etc. We lock ourselves in a spiral where we become slaves to what others think of us. The fear (again) of no longer being this exceptional person paralyzes and does not allow fulfillment. To focus on the other is to intimately know their desires, pleasure, erogenous zones, and temporality during the sexual act. This wide range of things cannot be learned through pornographic videos showcasing a degrading version of sexuality.
No matter the situation, a healthy lifestyle and a mindset true to who you are, are simple ways to improve your sexual experiences.
Simple erectile failure is a common phenomenon without gravity and repercussions for your future development. However, in the event of persistence or recurrence, a medical consultation would be the most logical option before using substances with supposedly miraculous virtues sold online. Most often, the advertising is misleading, and we cannot guarantee the absence of harmful effects on your health.
A couple’s relationship built on mutual trust, communication, and acceptance has the foundation of fulfillment, especially during hardships.
PS: What about sexual enhancers?
The issue is similar to taking painkillers when you are not in pain! Sexual stimulants are drugs that have a place in the condition’s management strategy. The search for performance has caused the consumption and sale of these products to explode. Some men, seeking to become supposed “dominant males” to flatter their Egos, risk their health. It is your responsibility to value and love yourself enough to avoid taking this type of risk: Talk to your Doctor.
«Aucune grâce extérieure n’est complète si la beauté intérieure ne la vivifie.» Victor Hugo.