Sexual and reproductive health is not much appreciated for an open discussion in our country. Perhaps this is why sexually transmitted infections and reproductive issues continue to be major public health concerns. Medicircle is conducting a series on sexual and reproductive health awareness to educate the society to seek doctors for problems related to their sexuality and reduce the spread of sexually transmitted diseases which is caused due to either casualness or unawareness.

Dr. Sumit Mehta is a Consultant Urologist (laser, minimally invasive surgery) and Transplant Surgeon with 23 years of experience. He primarily focuses on urinary stone, prostate, infertility, and urogynaecology. He is skilled in medical devices, oncology, healthcare information technology (HIT), and healthcare management. Currently, he is associated with the well-known chain of hospitals like Reliance Hospitals, Fortis Hospital, Wockhardt Hospital, Apollo Hospitals, and Apollo Spectra Hospitals. He is based in Mumbai.

Anatomical Sexual Health Problems of Males 

Dr. Mehta sheds light on the common sexual health problems of males in India:

• “Phimosis – It occurs when the foreskin is too tight to be pulled up to the head of the penis. This is a situation in many males since childhood that their parents have somehow failed to identify in their growing up years. This is a very common cause of sexual dysfunction in men in our country. Added to this, males of many religions do not go for circumcision due to religious reasons. Later on, this leads to problems in sexual intercourse and sexual health. 
• Premature ejaculation – premature ejaculation and erectile dysfunction are two different parts of the same spectrum. Premature ejaculation signifies that males are able to indulge in intercourse but are not able to sustain the erection and ejaculate early.
• Erectile dysfunction - it signifies that males either have weak erections or they lose their erection during intercourse before actually ejaculating,” says Dr. Mehta

Physiological Sexual Health Problems of Males

 Dr. Mehta explains:

• “Just like the heart, the penis also has a huge amount of blood supply going into it. Just as the arteries of the heart get blocked and one gets a heart attack; with age, hypertension, and poor lipid profiles males can get blocks in the arteries of the penis resulting in erectile dysfunction, inadequate erections or enlargement of the penis during intercourse leading to impotence.
• There is the other kind of impotence wherein males are unable to sustain an erection. A lot of men have leaking veins, so they have a disease of the veins and not of the arteries, in such cases. 
• And the third form of erectile dysfunction, which is organic is with men who have a neurological disease that means they have had an injury or they have had certain kinds of diseases affecting the nerves causing erectile problems.” 

Causes of Erectile dysfunction

Dr. Mehta points out “erectile dysfunction is a common problem today because we have a lot of stress. Males generally find an escape to this in the form of smoking, they consume tobacco and alcohol; all these eventually add to the problem of erectile dysfunction. There is a root cause of such problems. Very often, many of the males might be suffering from phimosis, or they have underlying problems like diabetes, hypertension, or high blood pressure. which is interfering with their erections. Many of these men are obese, they have a problem with their lipid profiles too.”

Men shy away from approaching specialists 

Dr. Mehta mentions “men have not been in the habit to talk about or consult specialists for their sexual issues. There have been several movies on this topic of late which are gradually bringing these problems out in the open. However, most men, even today are pretty much sceptical and shy to come out and speak about it in the open. They are in denial mode about it. So, when they finally come to the doctor, they have usually had the problems for a long period and they have already tried self-medication with herbal remedies or sildenafil or many other options. They come to doctors in already delayed situations.”

Treatment Options

Dr. Mehta emphasizes, “It's not that one medicine or one solution suits all erectile dysfunction problems. In the initial phase drugs like sildenafil or changes in lifestyle are prescribed to patients. If these do not work then they are eventually advised for surgical treatments to overcome the problem.  

Premature ejaculation is something completely different. It is not related to an erectile problem, it is just that a man is unable to hold on to his ejaculation, so he is experiencing early ejaculation. And that leads to dissatisfaction of both the partners in most of the cases. So, this is very treatable. There are a lot of local agents available. There are certain kinds of barriers too that are used to help in increasing the timing of the sexual pleasure in the man so that he ejaculates late. And of course, there are medications available too,” adds Dr. Mehta.

Sexual experts are important to solve problems

Dr. Mehta advises having faith in doctors by mentioning, “that doctors are super-specialists who have spent a good number of years treating problems related to sexual health. They have solutions in the form of medications and surgical treatments to help patients with sexual dysfunction. Hence instead of searching huge amounts of unreliable information available on the Internet which is confusing and depressing, people should immediately consult a specialist. You can use the internet as a guidance tool but ultimately follow your doctor's advice. Going to quacks would not help either because people suffer from side-effects instead of getting cured the majority of the time,” says Dr. Mehta. 

(Edited by Amrita Priya)

 

Contributed By: Dr. Sumit Mehta, Consultant Urologist