Why do so many men find it hard to ask for help when something isn’t right?
The main barrier is not medical, but cultural. There is a long-standing belief that sexual performance is related to masculinity. Many men feel pressured to live up to unrealistic expectations around sex. Recognising you have a problem in this area is often considered as admitting to a loss of masculinity; leading to embarrassment and the fear of being judged.
There is also a tendency to talk up sexual performance while concealing vulnerabilities. This creates the false belief that ‘everyone else is fine except me’; strengthening the taboo and delaying a visit to a specialist, sometimes for years.
Sexual health problems can be a sign of broader health issues
For example, a man with some sexual health problems—especially erectile dysfunction—may be experiencing an early indicator of cardiovascular disease. The arteries in the penis are smaller than those that supply the heart; therefore, problems caused by cholesterol, high blood pressure or diabetes may show up first as erection difficulties, long before any heart symptoms appear.
Erectile dysfunction can therefore offer a valuable ‘window of opportunity’—often 2-5 years—to identify and treat cardiovascular problems before a heart attack or stroke occurs. So talking to a doctor about erection problems may not only be about sexual wellbeing, but also about preventing serious illness and improving long-term health.
How prostate cancer and its treatment affect sexual health
Prostate cancer and treatments such as radical surgery can have lasting effects, including urinary leakage and erectile dysfunction, which may be irreversible due to damage to the erectile nerves. Also, surgery to remove the prostate and seminal vesicles means that ejaculation no longer occurs.
However, this does not necessarily mean the end of sexual life. Even if sexuality changes, affection, desire and the ability to reach orgasm can still be preserved. With medical support and healthy emotional adjustment, many people are able to rediscover intimacy and enjoy a fulfilling sex life in this new phase of life.
What options are available if usual treatments do not work?
When lifestyle changes and oral medications are ineffective or contraindicated, there are other effective treatment options. These include injection therapy and vacuum erection devices. For more severe or permanent cases, a penile implant can offer a long-term solution.
Contrary to popular belief, modern penile prostheses are three-component hydraulic systems that are completely concealed within the body. They allow a firm erection whenever the patient chooses, can be maintained for as long as needed and then return the penis to a flaccid state, without affecting sensation or the ability to orgasm. It is a mechanical solution to a mechanical problem, with highly satisfactory results.
