More men not quite ‘getting it up’

Dar es Salaam. Walking along streets of the capital city, one is no longer surprised by hand-made advertisements nailed to electric poles and trees claiming cures for a number of ailments by medicine men. Boosting male libido is one of the more popular services advertised.

Although it is not openly discussed even among men themselves, erectile dysfunction (ED) is a growing concern in the country.

In some cases of erectile dysfunction, one may be able to get an erection during masturbation, or may wake up in the middle of the night with an erection and that same person fails to get aroused with his sexual partner.

According to the Director of Research at Jakaya Kikwete Cardiac Institute (JKCI), Dr Pedro Pallangyo, “If any of the above-mentioned scenarios are the case, the underlying causes of the erectile dysunction would be psychological or stress related. If one is unable to get an erection under any other circumstances, the cause could be physical. Erectile dysfunction can also be a side-effect of certain medications.”

For a 50-year-old Frank Bahati, over 14 years ago his performance in bed had started detroriating as he no longer got it up with his long -time partner.

On seeing a doctor, he was shocked to find out he had diabetes. Having grown from a skinny graduate to a chubby man with a pot belly, his doctor on top of putting him on medication warned him to lose weight as a matter of urgency.

The physical causes of ED include the narrowing of the blood vessels around the penis – commonly associated with high blood pressure (hypertension), high cholesterol or diabetes hormonal problems, surgery or injury. The narrowing of the arteries (atherosclerosis) is one of the most common causes of ED.

According to experts lifestyle changes are inevitable in a bid to curb the odds, such as losing weight and reducing the risks of cardiovascular diseases.

Other psychological causes of ED may include anxiety, depression and relationship problems.

Erectile dysfunction is primarily treated by tackling the cause of the problem, whether physical or psychological.

At least 106 men out of 441 (roughly 24 per cent) aged above 18 years were diagnosed to have some form of ED in Kinondoni District, Dar es Salaam.

A community-based study on the prevalence erectile dysfunction among Kinondoni District males was conducted last month by specialists from Jakaya Kikwete Cardiac Institute (JKCI) and health workers at Mwananyamala Hospital.

The findings reveal that advanced age, obesity, a history of smoking, hypertension and diabetes are considered high risk factors.

At least 8.2 per cent of the men diagnosed with the condition had diabetes while 61.5 per cent had high blood pressure. Most of them were aged 55 and above while others had a smoking history and were obese.

The study indicates that men with a positive smoking history had a 40 per cent increased likelihood for ED compared to non-smokers.

Just over 30.4 per cent of the men with pre-diabetes and 9.1 per cent with normal blood glucose were found with ED.

Participants with pre-hypertension approximately 20.2 per cent and those with hypertension 29.3 per cent were significantly at a higher risk.

Other factors including excessive alcohol consumption, depression and low economic status have been associated with the increased risk of ED.

“The risk factors increase with age and furthermore it is associated with a number of medical conditions, including diabetes mellitus, hypertension, coronary artery diseasesa nd depression,” Dr Pallangyo said.

He notes that worldwide, the condition is projected to rise appreciably and by the year 2025, 332 million men would have some forms of ED.

“Similar to other developing nations, Tanzania is witnessing an upsurge of non-communicable diseases and as a result ED as an inevitable complication. Little was actually known about the community burden it causes in the country. To establish the prevalence rate and its associated factors in Tanzania we undertook this cross-sectional study among men in Kinondoni District,” he says.

JKCI Director of Paediatric Services Peter Kisenge says ED incidents are increasing globally and it is attributed to a larger ageing population, diabetes and hypertension.

“We wanted to determine the burden among male residents in Kinondoni District. We interviewed 441 men aged at least 18 years and utilised the five-item version of the International Index of Erectile Function (IIEF-5) scale for erectile dysfunction assessment,” he says adding:

“We defined diabetes and hypertension according to the International Diabetes Federation and the seventh Report of the Joint National Committee.”

He added: “In some cases patients are given medication to lower cholesterol levels and drugs to reduce high blood pressure.

A number of treatments have been successful in the treatment of erectile dysfunction.

Medications such as Viagra are used to manage ED in at least two-thirds of cases. Vacuum pumps are used to increase the flow of blood to the penis and are successful in 90 per cent of the cases.

Psychological treatments include cognitive behavioural therapy and or sex therapy.

Overall, treatment for erectile dysfunction has improved significantly in recent years and most men are eventually able to enjoy sex again.

A medical officer recommends that in order to boost one’s sexual performance, one should exercise regularly regardless of age, eat wholesome healthy fresh food and steer away from all types of junk food like chips and deep fried chicken