New Year resolution for prevention of ED

Dear Dr. G,

I am a sales executive who just turned 30 at the peak of my life.

I am also in a sexual relationship with my partner for the last three years.

We are hoping to get married in the auspicious Year of the Rabbit.

However, one issue terrifies me, is the occasional inability in bed.

There is no real specific trigger I can recall that end up with a soft erection, I guess I can always blame it on the stress of work and tiredness.

I noticed the weak erection is getting more common in recent months, despite being away from all the stresses of life.

I think I am a healthy individual, apart from being slightly on the heavy side for bodily weight, not exercising much and always eating junk food.

I am determined to overcome this issue of sexual dysfunction with better lifestyle.

Therefore, I would like to put Dr. G on the spot to guide me for a new year resolution for many “hard” years ahead, between the sheets.

Firstly, what constitute an erectile dysfunction?

What are the causes of ED? Are the causes mainly psychological?

How common is ED? And how common does ED affect the youth?

Do young men really get erectile dysfunction? Isn’t that old men’s disease?

Finally, I am determined not to get ED, can you tell me the way to prevent this horrible condition?

Regards,
Wilting William

Erectile Dysfunction, or ED, is defined as the inability to achieve or maintain an erection for satisfactory sexual intercourse. Before the turn of the century, ED is also derogatively called impotency, causing shame and embarrassment for men to discuss the subject. Despite having more disease awareness in the recent decade, Erectile Dysfunction remains a taboo subject amongst many societies.

Malaysia Health and Morbidity Survey published in 2019 revealed three in ten men suffer from ED in our country. Although most of the affected men are older, ED can also affect the younger generations of men. Unsurprisingly 64.1% of men above the age of sixty reported sexual dysfunction, the shocking finding is that ED also affected more than 36.9% of men aged 18 to 29 years old. Occasional “hiccups” is very common in young men, however, persistent failure to perform is generally abnormal.

The causes of ED amongst youth were initially thought to be associated with stress and anxiety. However, experts also believe it to be associated with the rising non-communicable diseases in younger men. These include hypertension, dyslipidemia, diabetes, obesity and depression. Other causes of ED also include side effects of medicine, alcohol and smoking. In fact, ED is three times more likely to affect diabetic men, two times more likely in hypertensive men, twice more likely in men with high cholesterol, and twice more likely to affect men who smoke and drink. In addition, nearly 80% of obese men are also likely to be affected by ED. And all these non-communicable diseases are on the rise amongst youth in Malaysia, as we “pride” ourselves on being one of the most unhealthy nations in Asia-Pacific.

Stress and anxiety can result in Erectile Dysfunction, however other causes are thought to be equally, or more important. The normal physiology of erection is quite straightforward. The arousal in the brain is influenced by the male hormone, testosterone. This in turn will generate the stimulation of the blood vessels and nervous systems. The combination of both will subsequently induce an erectile rigidity that will be ready for sexual activity. The emotional state of mind can also adversely affect sexual functions, despite a perfectly functioning brain, blood vessels, nerves and hormones.

Stress and anxiety can produce the enhanced circulation of adrenaline, which is the complete antidote for a normal erection. Unfortunately, unhealthy eating habits can also contribute towards poor sexual performance. High salt intake and fatty food can often induce hypertension and dyslipidemia, respectively. High blood pressure and high cholesterol are both known to induce the hardening of the blood vessels, by causing atherosclerosis. This can result in the occlusion of the penile blood flow. On the other hand, high carbohydrate intake such as rice,

cakes and sugary drinks can increase the risk of diabetes. Apart from damaging the blood vessels (vasculopathy), diabetes can also induce neuropathy, which are equally detrimental to healthy erectile performance.

There is no question the challenges faced by the youth these days are mounting. Apart from more stress and anxiety in the modern digital world, data also reveal a declining state of health amongst the youth. The silver lining is that open discussion of sexual health is less of a taboo these days. Additionally, the effectiveness of the blue pills is also making ED less of a “hard’ issue to get it “hard”. Early health interventions are the key to ensuring better sexual health and overall health. In many ways, preventive measures are also the cure for ED.

Baron Stanislaw Jerzy Lec, the Polish aphorist and poet once said: “Youth is a gift of nature, but age is a work of art.”

Young men with unexpected ED often put Dr. G on the spot for a cure for ED. His response is: “Youth is a gift of nature because of the state of health, healthy preventive ageing is definitely the cure to ensure the perfect work of art!” On that note, wishing all a Youthful New Year and the Sustained Healthy New Year Resolution.