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ERECTILE DYSFUNCTION SYMPTOMS

The four most common symptoms of men seeing their doctor with erectile dysfunction are:

  1. difficulty getting an erection
  2. difficulty sustaining or maintaining an erection
  3. premature ejaculation
  4. low sex drive (libido).

Most patients have a combination of two or more of these problems. They are usually first given a thorough medical history and examination to determine the extent of the prob­lem and to hopefully pinpoint a cause. I want to briefly outline the nature of these four symptoms so that your problem will make more sense to you as a patient if you are experiencing any of them.

Difficulty getting an erection

One of my patients described his dilemma as 'trying to stuff a marshmallow into the coin slot of a vending machine'. Another explained proudly to me how 'I used to be able to hang a wet towel on the end of it'. The nostalgic ones say, 'What I used to be able to do all night now takes me all night to do.'
Most people remember what they were doing when they found out Kennedy was shot. More recently, most would remember where they were when they heard about Princess Diana's accident and subsequent death. Similarly, a man will always remember the first time his penis failed him, what he was doing, and with whom. When erection problems start to set in, a man will always remember the period in his life, however brief, when he was able to have intercourse several times in one day. He will compare his current performance to this period for the rest of his life, believing that 'anything less than this is inadequate'.
I define adequacy in intercourse as 'the ability to obtain an erection sufficiently strong enough to penetrate your partner during sexual intercourse and which remains erect for an "adequate" period of time'. I will discuss the term 'adequate' in the section titled, 'Difficulty in sustaining an erection'. For the meantime this 'adequate period of time' refers to a period long enough to attain personal satisfaction, often related to the point of ejaculation.
The cause of poor erectile strength is either physical or psychological, or both. Medical practitioners previously thought that the majority of symptoms had a purely psychological cause. As specialists in the field of erectile dysfunction, we have now been able to prove that the majority of causes of this condition are a combination of both physical and psychological factors. The physical problem is most commonly only the initial problem—the psychological consequences are usually more debilitating.
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EPILEPSY AND PREGNANCY

Women with epilepsy are quite often concerned about getting pregnant. There appear to be five reasons for this concern. They wish to know:
if they are likely to hand their epilepsy on to their children;
whether their fits will get worse during pregnancy;
whether it is safe for the baby that the mother should take anticonvulsants drugs during pregnancy;
if there will be any problems in the newborn baby from these drugs;
if they can safely breast feed the baby.
With regard to handing on epilepsy to one’s children – as mentioned earlier, if one parent has epilepsy, the chances of one of the children having epilepsy are no greater than in the population at large. If both parents have epilepsy, it would appear that the risk of a child having epilepsy is about 10 per cent. So in fact the chance of a child inheriting epilepsy, particularly idiopathic epilepsy, is negligible.
As far as seizures during pregnancy are concerned, the situation is not as clear as it might be. There is evidence that for some women, seizure control may deteriorate, while for others there may in fact be no change or even an improvement. A patient told me recently that “she would like to remain pregnant forever” as she had not had a single fit during her pregnancy, compared with six fits in the preceding nine months!
As a general working rule, it is suggested that people who have more than one grand mal fit a month are those who are most likely to have a deterioration in seizure control during pregnancy. The deterioration, if it occurs, is most likely during the first three months of pregnancy. There are a number of theories why this may happen, but none has been proved. It may be of value to check the blood anticonvulsant levels during pregnancy, especially if there is a deterioration in seizure control. The blood levels may fall, necessitating an increase in dosage during the pregnancy.
The main concern for parents is whether the anticonvulsants can harm the unborn baby (foetus). It is known by most people with epilepsy that this is a potential hazard. The effects include physical abnormalities in the baby, a process known as teratogenesis. Abnormalities have been reported in the offspring of mothers on all the commonly used anticonvulsants with the exception of carbamazepine. This is particularly applicable to phenytoin, barbiturates and sodium valproate. Babies born to mothers who have been on carbamazepine have not been shown to have any physical abnormalities, but have a smaller head size than other babies. This has not been shown to be any handicap to the babies who have been followed up for five years.
The risk of abnormalities in the baby is difficult to assess, but it seems to be most common in mothers on polytherapy (receiving numerous drugs), especially if they are on three or more anticonvulsants. The risk in mothers on phenytoin, with or without other medications, appears to be about a 10% chance of the baby showing features of the ‘foetal hydantoin’ syndrome. This syndrome consists of cleft palate, abnormalities of the fingers, possible heart abnormalities and mild mental retardation. Thus, at present, if it is possible, it would seem wise to try to change patients over to carbamazepine before conception. This may not be possible in all patients and, of course, many women will first visit their doctor when already pregnant, at which time there is no purpose in making the change.
Anticonvulsants taken by the mother during pregnancy may have some effects on the baby immediately after birth, as they are transmitted to the baby across the placenta. These include the possibility of a mild bleeding tendency and some drowsiness. In mothers who have been taking barbiturates, the infant may occasionally show features of a withdrawal reaction with irritability, jitteriness and poor sucking. None of these features is [...]

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ERECTILE DYSFUNCTION SYMPTOMS

Most patients have a combination of two or more of these problems. They are usually first given a thorough medical history and examination to determine the extent of the prob­lem and to hopefully pinpoint a cause. I want to briefly outline the nature of these four symptoms so that your problem will make more sense to you as a patient if you are experiencing any of them.

PRESCRIBED DRUGS

Taking prescribed medications with most vitamins is safe as is taking herbal complexes that are available through health food stores. However, you should always check with your doctor, your pharmacist or your naturopath. They are all trained to know what can go with what.

Weight loss

Overweight is most commonly a result of overeating and lack of exercise. Overweight and fluid retention often go together with people who have glandular problems or under-active thyroids. In such cases an iodine and phosporous deficiency may be the cause.