Answers to Men’s Most Common Questions About ED, Low-T, and More
It’s no secret that men don’t like talking about sexual health issues. From concerns about privacy to the embarrassment of opening up to someone they don’t know well, there are numerous reasons men don’t come to their doctor to ask questions.
At MIU, we’re working hard to change that. Urologists receive the most extensive training available in physiology, anatomy, and treatments associated with men’s sexual issues.
We can assure you that your questions are not strange; they are not uncommon, and you are NOT alone.
These are some of the most common discussions we have about ED, Low-T, and more.
Erectile Dysfunction (ED)
Erectile dysfunction is the inability to get or maintain an erection firm enough to have sex. A bad night or two is not cause for concern (most men experience this at some point). But it becomes erectile dysfunction when this inability is a persistent and recurrent issue that is causing distress in your quality of life or your partner’s.
One of the questions a lot of men ask is how prevalent ED is. And the answer is simple – very. About 1 in 5 men over the age of 20 will experience ED in their lifetime, and as we get older, that number goes up.
Another common question we get is, what is it about me that is causing this? It’s not you. Getting an erection is a complex interplay of arteries, veins, and nerves in the penis, causing blood to flow into a penis, and there are numerous causes of ED. Medications are a big one. There is a whole gamut of medications – blood pressure medications, pain meds, diabetes meds, and medications to treat depression and anxiety – that can impact blood flow to the penis. Prior pelvic surgeries from prostate cancer or bladder or colon issues can also be a cause of ED. Chronic health conditions like obesity, diabetes, heart disease, and high blood pressure also can contribute to erectile problems.
One of the most common myths we hear about ED is that it is always caused by low testosterone (Low-T). In reality, Low-T may or may not be what is affecting your erections.
The good news is that there are lots of options for restoring erectile function, from simple lifestyle changes to eating better, exercising, and losing weight to oral medications, injections, and newer therapies like low-intensity shockwave therapy (LiSWT). It all comes down to which treatment is right for your lifestyle; your doctor can help you determine that.
Low Testosterone (Low-T)
Let’s talk about Low-T. In general, low testosterone is defined by a blood test, usually done first thing in the morning. Testosterone levels naturally decrease as we age, but that doesn’t necessarily mean a man has low testosterone. We do see higher rates of men with lab-confirmed low testosterone levels who are obese or who have a history of diabetes, high cholesterol, high blood pressure, and cardiovascular disease.
With Low-T, many men experience symptoms like fatigue, energy loss, difficulty keeping up with their workouts, difficulty concentrating, hair loss, or hot flashes. ED can also be a result of Low-T.
If your doctor does believes low testosterone is impacting your health, there are many options for hormone replacement therapy today.
- Oral medications
- Topical agents such as gels or creams
- Nasal sprays
- Injections
- Testosterone pellets placed under the skin
Treatments are usually dictated by lifestyle, what men prefer, and insurance coverage.
Here’s an essential thing for men to know – taking testosterone supplements when you already have normal testosterone levels is not going to result in better erections. Testosterone can cause side effects if not taken appropriately.
Peyronie’s Disease
Another common question men have is regarding the shape of their penis.
Peyronie’s Disease is a condition that causes penile curvature, indentation, or loss of length upon erection. What is happening is that plaque or scar tissue has formed in the penis, and the penis can’t expand symmetrically. When this occurs, men will see bumps, lumps, or an abnormal shape of the penis. The plaques usually form from microscopic trauma that occurs during intercourse.
One of the most common misconceptions about Peyronie’s Disease is that it is rare. Not true. About 10-15% of adult men experience some form of Peyronie’s. And just because you have Peyronie’s doesn’t necessarily mean you’ll have issues getting or maintaining an erection.
Treatments for Peyronie’s focus on breaking up the plaques that have formed in the penis. This can be done with oral medications, penile traction, or injections. Introducing injectable collagenase into penile plaques to break them up has dramatically broadened the options for safe and effective office-based treatment.
In more severe cases, surgery remains highly effective for correcting curvatures. Penile implants also may be a solution.
Your Questions Are Valid
The bottom line is that it is OK to talk about sexual health. Talk about it with your partner and, most importantly, a physician.
Physical, mental, and sexual health are closely related. Changes in sexual health may indicate underlying medical conditions and sexual health affects your quality of life and mental health. Don’t take your sexual health for granted. Make an appointment at an MIU office near you to get your questions answered today.
