ED and sexual dysfunction as markers for other major health problems
Improving ‘Men’s Health’ should be a major concern for all physicians. On average, a man’s life expectancy is 7 years less than that of a woman. They will often prematurely die, or become disabled by preventable diseases. This difference has traditionally been attributed to some unchangeable genetic susceptibility. However, the gap is slowly narrowing and the validity of this assumption is now highly questionable. In the developed world, women have frequent contact with healthcare services throughout their lives, from the cradle to the grave. ‘Women’s Health’ is perceived as a priority and access to it is considered an inviolable right for all women. After completing childhood health surveillance procedures, they will see a family physician regularly to obtain contraception, for ante” , peri’ and post-natal care, for cervical cytology screening, for advice about the menopause and hormone replacement therapy, and for mammographic screening. They will also bring along their children and grandchildren for advice, providing further opportunities for health screening and advice.
Some men will not see a doctor from the time of their last childhood health surveillance consultation until they have their first heart attack, or worse. They often consider themselves ‘immortal’ and unable to spare the time for health maintenance. Any opportunity to encourage men to participate in health screening and maintenance activities should be enthusiastically developed by primary care teams.
Men are concerned about their sexual health and function. A minority of men with sexual problems (30—50%) seek professional advice. Reasons for this include embarrassment, belief that ED is temporary or not important, and concern that the physician will not be interested. The increased public awareness and acceptance of sexual problems that followed the development of oral therapies for ED is improving this situation and, in the future, men are increasingly likely to ask their family physician for help.
ED is a symptom, not a disease. There are always underlying causes and it is clearly in the patient’s best interest to seek them out. ED is strongly associated with a range of important, potentially lifc’shortening disorders, and may be the first presenting symptom of those disorders.
Te association of ED with other disorders It occurs in up to:
20% of men w i t h untreated hypertension
4 5% of men with coronary artery disease
60% of men with diabetes
40%) of men with chronic renal impairment
50% of men with chronic arthritis
6 3% of men with chronic alcoholism
80%) of men with multiple sclerosis
70% of men with lower urinary tract symptoms (LUTS) 60% of men foUowing treatment for prostate cancer ED shares many of the same risk factors as coronary heart disease, including dyslipidemia, smoking, hypertension, diabetes, and sedentary lifestyle. All men who complain of ED should be offered a thorough cardiovascular risk assessment, including screening for dyslipidemia, diabetes and hypertension.
Tags: Childhood Health, Family Physician, First Heart Attack, Futu, Genetic Susceptibility, Health Maintenance, Health Problems, Health Screening, Health Surveillance, Healthcare Services, Hormone Replacement Therapy, Maintenance Activities, Major Health, Men S Health, Post Natal Care, Preventable Diseases, Professional Advice, Sexual Problems, Surveillance Procedures, World Women