why it’s better to talk about your erection problems, even if it’s embarrassing

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Erectile dysfunction becomes more and more common with age. Before the age of 40, it is relatively rare, but after age 69, it affects 50 to 70% of men. While very few of them receive adequate care.

“It is therefore important to know how to manage this frequent problem,” underlines Dr. Charlotte Methorst, urological surgeon in Saint-Cloud (Hauts-de-Seine) and member of the French Urology Association (AFU).

Because beyond unsatisfactory sexuality, erectile dysfunction is symptomatic of cardiometabolic disordersharbingers of cardiovascular events and the cause of psychological disorders.

Erectile dysfunction, why it’s important to worry about it

The management of erectile dysfunction is multidimensional, as it is often associated with other comorbidities, such as diabetes, high blood pressure or obesity, due to a common pathophysiological mechanism. all cardiovascular and metabolic diseases.

Because erectile dysfunction is a warning sign of clinical cardiovascular events, particularly in cases of diabetes, its presence must lead to the search for and management of cardiovascular risk factors (controlling diabetes, controlling high blood pressure or dyslipidemia, etc. .).

The other advantage of treating erectile dysfunction is that it also improves the management of concomitant pathologies. “A man treated for his erectile dysfunction will in fact be more inclined to follow his treatments for diabetes, or for cardiovascular pathologies, for example,” explains Charlotte Methorst.

But the impact of erectile dysfunction being direct on a man’s overall health, it also affects his psychological health. “It can cause mood disorders, including depression and anxiety, accompanied by a loss of self-esteem,” she adds.

Treating erectile dysfunction, because sexual activity helps you stay in shape

Sexuality plays a determining role in overall health. “Having regular sexual intercourse helps improve mood and reduces the risk of mortality,” assures the urologist. Indeed, sexuality has beneficial effects on many hormones (oxytocin, endorphins, testosterone) and constitutes an excellent aerobic exercise. »

Furthermore, physical exercise reduces the risk of erectile dysfunction. While a sedentary lifestyle triples the risk of erectile dysfunction, practicing moderate physical activity reduces this risk by two thirds, while high activity reduces it by 80%!

Exercise promotes the release of nitric oxide (NO) and is the lifestyle factor most strongly linked to erectile function, ahead of diet in particular. It is estimated that 30 minutes of moderate exercise per day is necessary to maintain or improve erectile health.

“To improve your risk of erectile dysfunction, the first thing to do is to start exercising regularly,” summarizes the expert. Aerobic exercise is good for cardiovascular health, the immune system and weight maintenance. »

Treatments, but always associated with sex therapy

According to the new recommendations of the French Association of Urology (to be published), sex therapies must systematically be mentioned in addition to medicinal, mechanical or surgical treatments.

This includes cognitive behavioral therapy and behavioral counseling:

• Hygiene and diet rules must be applied as best as possible, in particular smoking and cannabis cessation, regular physical activity, a balanced diet and a sharp reduction in alcohol consumption.
• The management of comorbidities and curable causes is also part of the priorities.
  For men at low cardiovascular risk, treatment with phosphodiesterase type 5 (IPDE-5) inhibitors, such as Viagra or Levitra, may be initiated.
  Testosterone supplementation is indicated for hypogonadal patients (in whom the synthesis of sex hormones is insufficient).
• In the event of hypertension or psychiatric pathology that could be the cause of erectile dysfunction, a possible modification of the treatment should be considered, especially if drug-induced iatrogenicity is strongly suspected.
• In diabetic patients, glycemic balance must be optimized, and for people with obesity (BMI greater than 30 kg/m²), weight reduction must be an objective.
• Finally, for patients suffering from sleep apnea syndrome, treatment must be maximized, with continuous positive airway pressure in moderate to severe cases.

These future recommendations indicate that these treatments can be prescribed by the general practitioner or, if necessary, in association with a urologist.

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