The Tribune

By DR GREGGORY PINTO

A less firm, unsatisfactory erection...it is a common complaint of adult men of various ages but more commonly a dreadful state of affairs for middle-aged men and older.

There are multiple potential causes for a weak erection, and often there is more than one cause at work.

An erection requires an intact blood supply, intact nerve supply, the all-important male hormone testosterone, and never underestimate the important emotional and psychological components.

Numerous long-term multi-centre studies have shown that there is a strong link between the onset of erectile dysfunction and potential early cardiovascular disease.

Impaired penile blood supply due to the blockage of small or large blood vessels can negatively affect the quality of a man’s erection.

Diabetes and, sadly, poorly controlled or undiagnosed diabetes mellitus is prevalent in the Bahamas and the unfortunate consequences for many diabetic Bahamian men is an impaired nerve and blood supply to the penis.

Low T – testosterone – is a little known medical phenomenon that thousands of Bahamian men suffer from, and unfortunately very few seek medical therapy. Only three percent of American men seek help for low testosterone.

Hypogonadism, low testosterone, can have a man feeling 20 years older than his chronological age. The symptoms of low testosterone are numerous and include a poor quality erection and difficulty maintaining an erection, low sexual interest, low sperm volume, unwanted difficult to lose weight gain, a loss of ambition, fatigue, loss of body hair, potential depression and irritability.

A simple blood test can determine whether you have low testosterone and whether it is a primary or secondary type of hypogonadism/low testosterone.

Testosterone supplementation if needed can safely improve the strength and rigidity of erections with improved sexual drive, lead to wanted weight loss and gain of muscle mass, with a greater drive and ambition in life and improved energy levels.

Several medications can potentially have the side effect of poor erections and low sex drive. High blood pressure medications are far too often dangerously discontinued by Bahamian men because of the negative impact of the antihypertensive medications on their sex life.

Antihypertensive medications can be changed to another class of drug or another drug within the same class that will not negatively impact erectile function, but still effectively control hypertension.

An erection lost can always be regained. You can always rise again.

Determining the cause(s) of erectile dysfunction is the role of the urologist and regaining you to your former glory is the goal.

Life style changes, behavioural modifications, improving control of hypertension, hypercholesterolemia and diabetes are the starting point on the road to restoring full good quality erections.

Safe regulated medications like the PDE5 inhibitors Cialis, Viagra, Levitra may be prescribed if there are no contraindications. However, if low testosterone is the cause then solving that issue can negate the need for medications like Cialis.

The last resort available is the FDA approved penile prosthesis, which allows a man to achieve a firm erection for as long as he wants with the simple press of an activating button in his upper scrotal sac.

An intact nerve supply and blood supply is Not required for the penile prosthesis to perform.

Bahamian men, never give up hope! Compassionate, confidential and advanced urological care is readily available to restore your manhood to the former glory of your young adulthood.

Young men who suffer from sickle cell disease or diabetes often unfortunately face erectile dysfunction.

Every man faces erectile dysfunction at least once in their lifetime. The saddest part of the ordeal is suffering in silence and due to unnecessary embarrassment, not seeking the medical consult of an urologist.

• Dr Greggory Pinto is a Bahamian urologist who has trained in South Africa, France and Germany under the world-renowned prostate minimally invasive pioneer, Professor Andreas Gross in Hamburg. He has a wealth of experience with all forms of minimally invasive endoscopic prostate procedures including bipolar transurethral resection of prostates and Thulium and Holium laser prostate vaporisation and enucleation, and the UroLift procedure. Dr Pinto can be reached at Urology Care Bahamas at the Surgical Suite, Centreville Medical Centre, Collins Avenue and Sixth Terrace. Call 326-1929, e-mail welcome@urologycarebahamas.com, or visit urologycarebahamas.com.