Impotence in middle-aged men linked to undiagnosed diabetes
Many men suffering from erectile dysfunction may have diabetes, schizophrenia or heart diseases. PHOTO | FILE
What you need to know:
In men, the risks of getting type 2 diabetes, a chronic illness resulting largely from excess body weight and physical inactivity, increases as they grow older, usually above 40.
The disease reduces production of male hormones (testosterone), blood supply and causes nerve injury to reproductive organs.
Middle-aged men with erectile dysfunction are likely to have undiagnosed diabetes, doctors have warned.
Diabetes cases in Kenya are on the rise with about 775,000 people suffering from the disease, but only a quarter of those affected are aware of their status.
As a result, complications such as impotence, blindness and kidney stones, among others are now common.
In men, the risks of getting type 2 diabetes, a chronic illness resulting largely from excess body weight and physical inactivity, increases as they grow older, usually above 40.
The disease reduces production of male hormones (testosterone), blood supply and causes nerve injury to reproductive organs.
“High blood sugars in type 2 diabetic men affect the body organs including blood vessels and since it is a neurological issue if not attended to early enough it can be chronic,” said Dr Nicola Okech, a consultant physician at Medanta Hospital.
Dr Okech said impotent men should be screened for type 2 diabetes, although obesity could also be trigger sexual malfunction.
In other cases erectile dysfunction stems from underlying mental disorders like phobia, stress or schizophrenia. It is also linked to high blood pressure, a common condition in diabetics.
Stroke, heart attack and kidney failure lead to severe cases of erectile dysfunction.
Historically, non-infectious diseases such as diabetes, cancer or asthma have been more prevalent among the rich and the elderly than the poor and young. But that is fast changing with men and women in mid-life having diabetes which in itself a risk factor for heart disease.
Type 2 diabetes is a lifestyle disease linked to over indulgence in alcohol, smoking, unhealthy diets with high fats and sugars.
When erectile dysfunction is diagnosed early in people suffering from diabetes, it is easily curable.
“One can decide to take steps to cope with the disorder and get his life back on track by talking to his partner about it and seeking medical attention— that is the first step of healing from erectile dysfunction,” said Dr Okech.
“In an African setting many men consider it taboo to discuss such conditions with their wives, leave alone doctors. But do not let embarrassment keep you from getting help,” she said.
There are different stages of erectile dysfunction — mild, moderate and severe.
Dr Okech said for every male diabetic patient there is an international index of erectile functions that can be used to evaluate whether one has the disorder or not.
The diagnosis has five standard questions that grade the severity of erectile dysfunction and determines whether someone should seek medical attention as well as the type of treatment to be offered.
Oral medications such as Viagra and Revatio, may be prescribed for mild to moderate erectile dysfunction.
“These pills, which cost Sh700 per tablet, help ease blood flow, making it easier to get and keep an erection — but they have to be prescribed by a doctor. A patient should take one pill one hour prior,” said Dr Okech.
If pills do not work, the doctor may recommend an erectile dysfunction injection and just like the Viagra, it increases the blood flow.
The injection is administered only once a month and costs Sh4,000 per dose.
“The other option for this could be the insertion of a prosthesis device in the tip of the penis or a vacuum-constriction device that is battery-powered and uses a pump to create an erection by drawing blood in the penis,” she said.
In severe cases where the above treatments fail, Dr Okech said, then a surgical operation for a penis implant would be recommended.
“Penile implant is a safe and very effective treatment for many men with erectile dysfunction. We currently do not have such treatment in Kenya, but it is available in India and US at a cost of between $8,000 (Sh800,000) and $20,000 (Sh2 million),” she said.
To keep such health complications at bay, the doctor advises men as well as women to make good lifestyles choices, especially avoiding alcohol or moderate intake of liquor.
Doctors recommend two beers for men and one for women a day as safe amount of alcoholic beverage intake to avoid health problems.
Dr Okech also advises against smoking, maintaining a good body mass index (weight), eating balanced diet and engaging in physical exercises.
“Over indulgence in alcohol, tobacco products, being overweight, narrows one’s blood vessels which worsens erectile dysfunction. Exercise for 200 minutes per week translating to one hour a day helps,’’ she said.
For effective results, split the daily work-out to include 30 minutes of cardio exercise and 30 minutes for body toning, said the doctor.
Dr Okech is currently leading a team to conduct a research to collect local data on the extent of erectile dysfunction among Kenyan men and raise awareness on the problem to ensure more patients open up about the condition and get help.
She said men with erectile dysfunction men are encouraged to attend clinic sessions with their partners to better understand the condition to avoid conflicts in marriage or relationships that may worsen the problem.
Although it is a bit difficult to explore sexual dysfunction in diabetic women, Dr Okech said that the disorder cannot be ruled out in females not unless they talk about it. It is easier to identify the problem in males than females because of the physiological differences.
“The treatment goes both ways. Spouses should create an open environment for easier communication. In most cases it is the women who report such cases to their doctors simply because they are more expressive than men,” she said.
