Dear Dr. G,
I am hoping you can help me for the trouble I am having in the bedroom.
I am in my early fifties and have been having some health troubles lately.
It all started in my late forties, after putting on weight and lack of exercise.
I started feeling unwell and the doctors realized I had hypertension and high cholesterol. Despite the medications, I also developed diabetes a year later.
In the bedroom front, I failed to rise to the occasions on most occasions.
I went to the doctors who reckon it may be the medications causing the ED (Erectile Dysfunction). After several changes of the tablets, as I still encounter the
same problems, the doctor decided to start me on the blue pills, which indeed “Awakened the Kraken!”
As I become too complaisant with the wonders of the pills, I continue to indulge in good life and not paying attention to a healthy lifestyle.
After the recent festivities, my diabetes worsened and I am now dependent on insulin. Incidentally, I also developed a minor stroke after the CNY.
My wife, who is much younger, is very concerned. She thinks I am too ill for sex. In fact, she thinks we should forget about the whole shebang completely!
I understand it’s my own fault but hoping to put Dr. G on the spot on association of sexual dysfunction and chronic illnesses?
Can a man get too ill for sex? What are the common myths about illnesses and sex?
How do individuals suffering from chronic illnesses cope with the end of sex life?
Is this truly the end of my “Kraken Era”?
The most common chronic disease that affects sexual health is cardiovascular disease. The co-morbidities such as dyslipidemia, hypertension, diabetes, and smoking tend to cause atherosclerosis of the vasculature to male genitalia. This in turn results in the narrowing of blood vessels causing erectile dysfunction. Other non-communicable diseases such as obesity and metabolic syndrome are also known to render sexual dysfunction, as they induce a decrease in sexual libido for men. The depletion of male testosterone, caused by the increase in bodily fat, results in low sex drive and erectile dysfunction.
The presentation of sexual dysfunction is believed to be the precursor of heart attacks and strokes, which obviously have a significant negative impact on the bedroom matters. Patients with strokes and myocardial infarctions (heart attacks) can also suffer from depression. The psychological impact results in low self-esteem and intimacy avoidance, as men fail to rise to the occasions. In addition, the treatment such as antidepressants itself can also render the patients getting sexual dysfunction.
The common myth about chronic illnesses is that sufferers are just too ill for sex, with fear of sex resulting in sudden death. Although many chronic non-communicable diseases such as diabetes, cardiovascular conditions and organ failures may be debilitating, most patients can have a normal life, including sex life, especially with adequate control of the disease. The other myth about sex and chronic diseases is the fear of worsening of renal impairment with regular sexual activities.
Research has shown that chronic diseases will have dampening of self-confidence and quality of life. The impact of chronic diseases on one’s sexual life is even more pronounced for younger couples. The decrease in libido and other sexual dysfunction will eventually take a toll on relationships and even family planning. Many people diagnosed with chronic illness feel grief and sense of loss, especially when intimacy is affected.
Sex is completely possible despite the diagnosis of chronic illness. In fact, intimacy is well known to help to decrease tension and boost immunity. Many studies have demonstrated couples with active sex life tend to have better disease control. Open communication of concerns between couples will allow different approaches to physical intimacy. This can build up to more intense intimacy with improved confidence. Disease awareness and good compliance of treatment will also allow better physical health for sex. As most sexual activities are non-strenuous (as opposed to the scenarios in porn), the risk of sudden death is minimal. The American Heart Association has a simple assessment of patient exercise tolerance, prior to the green light for worrisome couples. If one can tolerate several flights of stairs, then putting up with the strain of sexual intercourse should be effortless.
Nelson Mandela once famously said: “Even if you have a terminal disease, you don’t have to sit down and mope. Enjoy and challenge the illness that you have!” As the indulgence of the good life has it’s price to pay in the long run, many men who had abused their bodies in younger days will face being abused by their bodies in latter lives. Although the curse of impotency by non-communicable disease is a real threat, the miracle of the blue diamonds had lifted the spells for many over the last two decades. When men with chronic diseases and fearful of being too ill for sex put Dr. G on the spot, his advice to them is: “Never too late to stay healthy and compliant with treatment, even if you have a chronic disease. Enjoy the blue diamond and challenge the illness, and the Kraken will never be too ill for sex!”
Dr George Lee is a consultant Urologist and Clinical Associate Professor whose professional interest is in men’s health. The column “Ask Dr G” is a forum to help men debunk the myths and taboos on men’s issues that may be too “hard” to mention. You can send him questions at firstname.lastname@example.org
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