Men’s greatest fear—inability
to rise to the occasion.
By
Dr Peter Ng
Mr. Chan, a successful
textile merchant, had all the trappings of success. He lived in an exclusive
residential enclave, sported a brand new BMW and could afford to send his kids to
college in the UK. His exceptional skill in wheeling and dealing had kept him
ahead of the competition. Equipped with the latest state of the art security systems,
his mansion seemed impregnable to intruders. Or so it seemed … until one day,
an intruder came and stole that which he and his wife cherished so much—the
joys of conjugal bliss.
At first it was just some
difficulty in achieving an erection but gradually it got worse. His zest for
life disappeared. Sure, his business, his house, his wife and kids brought him fulfillment
but life seemed incomplete. His confidence deflated, he found solace in the
arms of other younger women; he thought that might do the trick as his wife
seemed less attractive now after twenty years of marriage. Even so, his manhood
still would not rise to the occasion. In quiet desperation, he searched for countless
remedies (herbs, gadgets, injections), only to be met with promises that were as
empty and flaccid as his organ. Soon he reasoned that life has much more to
offer than just sex, so in resignation he plunged deeper into work.
Mr. Chan is not alone. Thousands
of men in our country have resigned themselves to leading bland sexless lives
because of this silent thief in the night called Erectile Dysfunction
(ED), a medical term for the inability to achieve or maintain an erection
sufficient for satisfactory sexual performance. In a recent survey involving 351 men above 50
in Subang Jaya, the self-reported incidence of ED was an astounding 71% (1).
Similar figures were found in Penang (2).
While the snatch thief targets
vulnerable women clutching handbags, ED often targets macho successful men in
the prime of life (though ageing males are more vulnerable). It makes no
distinction between tycoons or pauper—none is exempt. Hence the major problem in our society is not just snatch thieves!
In ED, the tiny arteries supplying
blood to the penis become “stiff”, unable to dilate fully (endothelial
dysfunction) to accommodate the increased blood flow needed to trigger an
erection when a man is sexually aroused. In addition, progressive layering of fats
and cholesterol within the arteries over the years further compromises the vital
blood supply.
What many fail to realise is
that ED shares the same underlying cause as chronic diseases like hypertension,
heart disease, diabetes or stroke: endothelial dysfunction and layering of
fats. Patients with the chronic diseases mentioned above often have ED as well.
In fact this thief in the night is like a “Robin Hood” (a good guy) because ED
blows the whistle on other more sinister events. ED typically precedes the
first signs of a heart attack by two years because the arteries supplying the
penis, being much smaller, get affected first before the ones supplying the
heart. If a man seeks medical attention for ED, he might get his heart checked as
well. Hence ED alerts the patient to heart disease and may preempt a heart
attack two years in advance.
Even younger men are not
spared as anxiety and depression may lead to ED, wreaking havoc to their sex
lives. Those brought up believing sex is
dirty, and those who struggle with their sexuality or had traumatic
experiences (like being caught masturbating by their parents) are more
vulnerable to ED. Toss in morbid preoccupation with organ size and myths about
sexual potency … and we have a perfect recipe for ED.
Men with problems relating to
their wives are also prone to ED as it is not possible to have good sex in a
bad marriage. Resentment can dampen a man’s sexual ardour. These relational
elements are so powerful that I have even seen men fail to respond to the most
powerful drugs for ED. Sex in the beginning (Genesis 2), as designed by the
Maker, was meant to be a blissful “one flesh” experience where the couple were
both naked and unashamed, completely transparent to each other and willing to
accept each other fully. I guess sex will never be as good after the Fall as
sin has entered into and marred many marriages.
Men with past injuries like pelvic
fracture or surgery to their pelvic organs which severs the nerve supply to
their penis become victims of ED. Those who smoke, consume excessive alcohol
and take certain prescription drugs for hypertension are more likely to have ED.
Finally, as men age, their
testosterone (male hormone) level declines, sparking off a host of symptoms:
loss of sexual desire, insomnia, lethargy, less hard erection and finally
complete inability to have an erection. Testosterone, which also drives sexual
desire, is vital for erection. But these symptoms are treatable and reversible
after hormonal replacement together with an accurate assessment.
ED wreaks great havoc to
marriages—psychological and spiritually. Men’s ego is often tied to the quality
of their erections; even the occasional failure results in feelings of
inadequacy and loss of confidence. When he attempts sex, the spectre of his
past failure raises its ugly head and weighs down on him. If he fails to get a
satisfactory erection, his self-doubt and worst fears would be confirmed. The
emotional trauma of this failure creates a vicious cycle which jeopardises
successful erections in future. In sexual counselling, this cycle must be
broken for healing to occur.
The sidekick to ED is Premature Ejaculation (PE) whereby, in
his anxiety to secure an erection, the man over-compensates: He forgets how to
delay his ejaculation because he concentrates so much in getting his much
sought-after erection. Men with PE typically fire off in less than a minute!
Increasingly frustrated, the
man with ED will find excuses not to have sex with his spouse because each
attempt forces him to confront his inadequacy when he falls flat on his pants
before his unimpressed wife. I have come across some men who pick fights with
their wives in order to avoid sex. One patient of mine even called his drop-dead
beautiful wife “fat” to avoid shouldering the blame for being unable to give pleasure
to his wife.
The hapless wife, on the
other hand, either suffers in silence or is secretly celebrating her freedom from
sex (conjugal duties) which she never really cared about anyway. A recent study
showed one in three women in KL suffer from some type of sexual dysfunction (orgasmic
or arousal disorders, or plain dissatisfaction) (3). So the problem of ED can
be compounded.
Some women, thinking he is
“expending his ammunition” elsewhere but not at home, might even respond by
aggressively demanding sex. However, others may pressure their husbands to seek
medical attention for fear of underlying disease.
For all its detrimental
effects in society, ED is not unstoppable. It can be beaten. In fact, almost
everyone who has ED will be able to overcome it with proper counselling and
medical intervention. I believe sex is vital to the health and well-being of a couple
no matter how old they are because God meant for us to celebrate sex within
marriage.
Let your wife be a fountain of blessing for
you.
Rejoice in the wife of your youth.
She is a loving deer, a graceful doe.
Let her breasts satisfy you always.
May you always be captivated by her love.
(Proverbs
5:18-19).
The above article was first published in
Asian Beacon magazine, August 2009, issue 41.4
Biodata:
Dr Peter Ng, a Consultant Urological Surgeon in
private practice, is the President of the
Continence Foundation of Malaysia. He
is also a lay preacher at the First
Baptist Church, Petaling Jaya.
1.
Khoo EM, Tan HM, and Low WY. Erectile dysfunction and comorbidities in aging
men: An
urban
cross-sectional study in Malaysia. J Sex Med 2008;5:2925–2934.
2. Mariappan, Paramananthan;
Chong, Wooi Loong. BJU International. 98(6):1264-1268, December 2006.
3. Hatta Sidi et al J Sex
Med 2007;4:311-321
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