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00:00It's Guardian Talks with Temi Tayo Olumofi and today we are driving into a topic many shy away from,
00:06erectile dysfunction. What it is, why it happens and how can it be treated?
00:13Joining us to have this conversation today is no other than Dr. Sheyi Anyo Kogbe.
00:19We will be having an important conversation on that. Stick around.
00:30Welcome to Guardian Talks, Dr. Sheyi Anyo Kogbe.
00:35Thank you very much. That's correct.
00:37Yes, yes. Okay, so like I said, we are looking at erectile dysfunction and it's a sensitive topic that is not, you know, commonly talked about.
00:48So first thing first, to begin with, what exactly is erectile dysfunction and how common is it?
00:57Thank you very much. Erectile dysfunction, simply defined in layman's terms, is the inability, the sustained inability to get or keep an erection suitable for sexual activity.
01:11That's basically it. And it's more common than people realize.
01:16Though some people have it chronically and some people have it at some point in their lives.
01:21So usually it's estimated about 150 million men globally have, at one time or the other, either have suffered or are suffering from sexual activity.
01:32And it goes as high as one in two men in higher age groups.
01:36Oh, what do you mean higher age groups? Like 50s?
01:4070s, 80s, those age groups.
01:42Oh.
01:43It could be, it could be that common. But again, there is always a geographical distribution to it. But by and large, that's the age range.
01:51Age range.
01:52Okay, so what are the main physical and psychological causes of erectile dysfunction?
01:56When we talk about physical causes, we are looking at the key issue with erectile dysfunction is blood flow.
02:06And which trails back to the understanding of how an erection comes to take place in the first place.
02:13We have what we call spongy tissue that forms the bulk of the tissue of the penis.
02:18So it's the blood flow that rushes into the penis that creates the erection.
02:24So anything that tampers with the ability of, you know, blood to rush in and fill those spaces will lead to an erection not happening or not being sustained as it should be.
02:36So anything that affects that is what we call the physical factors.
02:42So things like chronic hypertension, diabetes, narrowing of the arterial walls due to other factors like high blood, cholesterol, those are the direct...
02:55I was going to ask, does high blood pressure affect it too?
02:59Yes, it could affect if untreated.
03:02And then sometimes even the drugs, some drugs used to treat high blood pressure can also lead to it.
03:08So that's about the physical factors.
03:11They're talking about other factors like the psychological factors.
03:14We talk about stress, which is really the main one.
03:17Because stress brings out a hormone called cortisol.
03:20That's the hormone of stress.
03:21And once that happens, cortisol is known to be able to interfere significantly with sexual function generally.
03:27So that's how that comes to be.
03:30So stress is really the main thing.
03:32And other psychological factors, anxiety, depression, performance anxiety can also impact on those.
03:40Right.
03:41Okay.
03:42Now, how can lifestyle choices such as diets, exercise, and stress, like you mentioned, affect erectile health?
03:50Okay, the key thing here is people usually don't link these things.
03:58So they tend to focus on, oh, this is the issue I've had at the moment I'm about to perform.
04:04And they most times won't link it to, oh, could it be the diet?
04:08Could it be the lifestyle?
04:09And they have to understand that when trying to put together the picture, that could be the causing factor.
04:17You have to look at all those things.
04:18So diets, high sugar diets, high processed foods diet, not enough fiber, not enough natural intake can be a problem.
04:28Okay, so when you say natural intake?
04:28Natural foods intake.
04:30Okay.
04:31I mean, having a healthy diet that includes, you know, balanced blend of carbohydrates.
04:36Proteins.
04:37Proteins, yes, fats and oils.
04:39The healthy fats, the healthy oils, fruits.
04:41And then also in the domain of exercise, exercise is very important because exercise improves blood flow to the body generally,
04:49which of course would impact on erectile health as well.
04:57So those key factors.
04:58And another key thing, again, that people don't usually connect with is lifestyle factors like smoking and drinking,
05:04severely detrimental in having good erectile health.
05:08So those should either be minimized at the barest minimum or completely eliminated where possible.
05:14They directly have been found to greatly impact on erectile health, both short, medium and long term.
05:20Wow.
05:21Now, are they medical conditions that often lead to erectile dysfunction?
05:24Oh, yes.
05:25The key ones, diabetes, because part of the byproduct of having that kind of high sugar in the blood is,
05:36it affects the blood vessels.
05:39And of course, we know that anything that affects the blood vessels affects blood flow.
05:43So it's going to impact.
05:45Diabetes also impacts on the nerves generally of the body, especially the, what we call the peripheral nerves,
05:52the nerves that control at the, at the endings of the body.
05:56So that too could also impact.
05:58And then also high cholesterol, because high cholesterol will narrow the blood vessels and again impact blood flow.
06:09So those are the key conditions.
06:12And of course, sometimes prostates related conditions in older men could one way or the other impact.
06:18Prostates?
06:19Prostates, yes.
06:20Oh, so does it mean that maybe if there is any issue with your prostate?
06:24Enlarge prostates.
06:25Prostates.
06:26Sometimes it could impact, not always, but sometimes it could impact.
06:29Because it will impact urination, it will impact ejaculation, it will impact just a lot of things.
06:33Okay, so can erectile dysfunction be hereditary?
06:41Not really.
06:43Factors that increase the risk of erectile dysfunction, such as diabetes and hypertension, are hereditary.
06:51Okay, so the factors can be hereditary?
06:53Yes, but not erectile dysfunction itself.
06:57Not really.
06:58So those are the causes, right?
07:00Okay, what treatment options are available today, both medically and non-medically?
07:09Okay, so the key issue when it comes to treatment is narrowing down the cause, which means you have to go on a case-by-case basis,
07:18which means if I have a patient coming to me and he has complained of this issue, I want to do a thorough investigation, basic blood work, check his blood pressure, check.
07:28Of course, his age, too, is a factor.
07:32What is his lifestyle like?
07:33Is he drinking?
07:34Is he smoking?
07:35Is he an older person or a younger person?
07:37And of course, I want to run basic tests to check what is his blood work like, the sugar level, the blood pressure level, cholesterol, things like that.
07:47So you want to, first of all, rule out any obvious, immediate possible cause.
07:54Is he hypertensive?
07:55Is he diabetic?
07:56Does he have high cholesterol?
07:58So if all those are in the clear, and maybe his BP is also fine, his blood pressure is also fine, then you want to go deeper.
08:05Okay, this person is not having any of those common physical pointers.
08:09Let's look into his psychology.
08:12Is he stressed?
08:13Does he drink?
08:14Does he smoke?
08:15What has his sexual history been before now?
08:18Has there been a history of this in the past?
08:21Or is something coming up newly?
08:23Has his lifestyle changed in some way?
08:25Is he being more stressed at work?
08:27Is he having some other issues on the home front?
08:29So you want to look at it more holistically.
08:32And then once you're able to narrow the possible likely causes, then you can now say, okay, this will be the treatment plan.
08:39So that's if the person is not having any medical condition, from the high blood pressure, hypertension, diabetes, and the likes, that you can look at the psychological part.
08:48Psychological part.
08:49Okay, what is going on?
08:50Let's delve deeper into that.
08:52Okay.
08:52So a lot of times, it's usually a combination.
08:55So you may have somebody who maybe has high sugar and then is stressed.
08:59Stressed, right?
09:00So sometimes there could be one physical factor and one factor that you have to now take in combination where you say, okay, let's deal with the blood pressure while we also deal with some other factors, maybe stress or psychology or other things.
09:14So at the beginning of the show, you made mention of the age range where maybe this ED happens to some men.
09:21Have we had any experience of men that are younger who experience erectile dysfunction?
09:27Definitely.
09:27The issue we have with younger men is younger men tend to want to, they are more in denial.
09:38So what do you mean by denial?
09:39Denial means that so they will talk to their friends.
09:41They will probably want not to believe that I'm having this.
09:45So they will probably try all the options, you know, both over the cancer.
09:53They'll probably go for Viagra.
09:54They'll probably go for some other natural, I mean, herbal medications or some other things.
09:59So maybe when all that has failed, then they realize that, okay, this is a bigger problem.
10:04And they now come to the hospital.
10:05For the older man, he's usually more willing to admit, probably because of his age, that, okay, I mean, age experience.
10:15Let me just go and see a doctor and trash this out.
10:18So most times we don't get younger men coming in to report or to present as much as we do.
10:26So sometimes it could be difficult to actually say, okay, how many younger men are really having this problem?
10:30Because the doctor is ready for a younger person, 30s, 20s, the doctor is ready at the last resort when all else has failed.
10:42Right.
10:43But yes, I mean.
10:44It's possible.
10:45Yeah, it's not just possible.
10:47It's happening.
10:48Okay.
10:49And then let me bring this in.
10:50The other issue now where we have, there's a rise in pornography among the youth.
10:56And it's known that in some percentage of them, they get carried away by what they see online and then are unable to perform.
11:11Or when they get to be with a physical person, then maybe anxiety or some other factors.
11:16And then in some, not all, they are now not able to either get or sustain an erection.
11:24And, you know, I mean, there's a cycle of shame around that.
11:28They find it very difficult to actually bring that issue up to a medical practitioner.
11:33So there is that.
11:34So a lot of young people have to be encouraged to seek medical help earlier so that they don't risk, you know, going to take some herbal concoction that will cause damage that could have been avoided by just reporting earlier.
11:48Before I move to my next line of question, does it in any way, erectile dysfunction, does it affect the self-esteem of a man?
11:56Oh, definitely, definitely, because anywhere in the world, especially in a country like, sorry, in a society like Africa, a man's sense of self-esteem is tied very, very deeply to ability to perform in the bedroom, satisfy a woman.
12:15So if that area is problematic, it's definitely very, very, yes, going to affect the self-esteem of a man.
12:23And it could affect how early they seek for professional help because some don't even want to admit to themselves or their partners there's an issue.
12:32So to get a man to agree that, look, there's a problem that needs, you know, take some courage.
12:37Right, to talk about.
12:39That brings me to how should men approach this conversation about erectile dysfunction with their partners?
12:46First of all, the man has to admit to himself that there's clearly a problem that he cannot solve entirely by himself.
12:55He's going to need some outside help.
12:57Very important.
12:58So once a man can agree with himself that, look, there's a problem that needs to be solved, then he can now have a honest conversation with his partner.
13:07Look, this, which, of course, sometimes is the woman that would have observed that, look, there seems to be a change in your performance from previous times to now.
13:20What could be going on?
13:20And on the side of the woman or the partner, she has to be very empathetic because, of course, it's a subject that's very close to the ego of any man.
13:30And the way it's approached has to be with empathy and with non-judgmentalness, as it were, not being judgmental and being open and creating the safe space for the man to, you know, be honest and express himself.
13:46And then with that kind of synergy, a solution can be found, which many times might not be.
13:52I mean, sometimes the fear of what is going on might even be worse.
13:58We find out, oh, this is a stressor or maybe there's a drug that he started using that he didn't even know.
14:03I mean, there are just so many things.
14:04But once you are in your head thinking, oh, this is the end of everything, it's so bad out, and then it becomes like a vicious cycle of perpetuating something that may have just been easily solved by one or two interventions.
14:20Now, before I move to my final question, you know, there's these drugs that people sell.
14:26You hear, oh, you can last one hour, 45 minutes, 35 minutes, just get it, you'll be man enough.
14:32Do they have side effects to people, to men especially, who consume it?
14:37In the marketplace, people come up with all sorts of claims that are most times you cannot scientifically or empirically verify.
14:47And under that banner, there are so many formulations.
14:51Some of them might just be Viagra thrown in there and masqueraded as something special, which is not.
14:58Some might just be what we call placebo.
15:01Some people make sure that greed doesn't do anything.
15:04But, you know, because of the psychological belief that, oh, I'm taking some performance enhancer, they may actually see some improvement.
15:12And then some of those things could be downright dangerous, toxic to the person.
15:17But there is no way to substantiate it.
15:18I mean, some will say, oh, some ancient Chinese herb.
15:21Some might say this.
15:22I mean, they will just concoct all sorts of fantastically sounding things to make any unsuspecting man believe that, oh, there must be something special in this.
15:31And, of course, for someone who has suffered low performance, it just sounds like, oh, yes, this must be the magic drug or magic thing that will cure all.
15:40Meanwhile, his case might just be that, oh, you have untreated BP.
15:45Sort that out.
15:45Right.
15:46And you'll see a change.
15:47So, in all this, I say, if you are having, if a man is, and you are having performance issues, seek medical help early.
15:55Right.
15:55So that the precise cause or source can be traced and then treated, rather than exposing yourself to potentially harmful chemicals that, in the long run, might even worsen the situation that may have been easily solved by doing something different.
16:13So maybe the person just needed to quit smoking or quit drinking or use those things and now has gone to go and involve himself with some things that could damage the kidney, damage the liver.
16:24Right.
16:24And lead to other problems that he never had in the first place.
16:26So the man might actually not even have any issue.
16:28But because of the consumption he had, it might bring.
16:32Yes, it might lead to some other things because you don't know what has been put into some of those things.
16:39Some might be harmless, some might be placebo, which means there is really nothing there, and some might just be dangerous.
16:45But you won't be able to tell which is which.
16:48Right.
16:48So is there a difference between men with low performance and erectile dysfunction, men with erectile dysfunction?
16:57In this society, most times people tend to lump it together.
17:02And what the public usually calls impotence, the layman will call his impotence, most times they are referring to this thing we are talking about,
17:13which is the inability to either get an erection or sustain an erection long enough for sexual activity to happen.
17:23So most times they are put under the same umbrella because it's a physically obvious thing that the man cannot do.
17:34But in the medical field, when we talk about impotence, that's something else entirely.
17:38We are talking about, oh, maybe a man who has a very low sperm count or a man who can't even produce sperm at all,
17:44but he may be performing well in the bed.
17:47So there are different things, but the public sees them as all the same thing.
17:51All embedded together.
17:53So what preventive steps can men take to maintain good sexual health as they age?
17:59That's a fantastic one.
18:02The interesting thing with questions like this is the things men should be doing to improve their sexual health are the things men should be doing anyway.
18:12Okay.
18:12So when you talk about good diets, avoid processed sugars, drastically reduce that.
18:21Everyone should be doing that, actually.
18:24You know, so exercise, quit drinking, quit smoking.
18:28Exercise is particularly good for maintaining erector health.
18:32It's humanizing part of it.
18:33Humanizing.
18:35Yes, like womanizing.
18:37Womanizing.
18:39That's controversial because it's controversial because, I mean.
18:45It's not proven.
18:45There are people who womanize out of, because if they believe, oh, I have to be with so many women to improve my performance, that's something that is in their head.
18:56And it may be completely unrelated to the issue at hand.
19:01So that one is neither here nor there.
19:05It's a societal construct as far as I'm concerned.
19:07But when you talk about the actual actionable things that have been proven to improve, exercise is very important because blood flow improves.
19:16And then, of course, blood flow, diet, exercise, diet, don't drink, don't smoke.
19:23And then on the psychological side.
19:26So maybe that's where that comes in because at least before someone can womanize, he has to be very, very socially.
19:32You can be someone who is not socially outgoing and, you know, have that kind of experience.
19:37So being someone that is having a vibrant social life, should I say, definitely improves the psychological aspect and finding ways to reduce stress, which is, which can be a hard one because we are in a very stressful.
19:52World.
19:53Country.
19:54World.
19:56You know, so, I mean, finding, being intentional about finding ways to reduce stress and those kinds of things.
20:03Yeah.
20:03So these are things we should be doing anyways.
20:07So.
20:07Right.
20:08Oh, it's been an intelligent conversation with Dr. Sheyi and your cookbook, right?
20:15Yeah, you got it.
20:16Yeah.
20:17Perfectly.
20:18Thank you so much for sharing your expertise with us.
20:20I mean, I want to believe that this is going to be so useful to men out there and even to their partners to enlighten them about, I mean, erectile dysfunction.
20:29Remember, the first step to solving a problem is talking about it.
20:34And this has been Guardian Talks with Timmy Tayo, Olumovere.
20:38Remember to stay healthy and stay safe.
20:41Bye for now.
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