“When the patient arrives at the consultation, it is important to create a good bond to welcome their concern and make it known that there are different alternatives to solve their pathology in order to support the improvement of their self-esteem and the relationship with their partner if that is the case. would have”, says the doctor Francis Pinto, urologist at the San Borja Arriarán Clinical Hospital and Redsalud.
Erectile dysfunction or sexual impotence refers to the inability to achieve or maintain an erection firm or rigid enough to achieve satisfactory sexual intercourse, a condition that must be repetitive and be present for at least the last three months, explained the specialist. In addition, he indicated that during the consultation with the urologist it will be possible to rule out if there are other pathologies associated with this condition.
Regarding the prevalence of erectile dysfunction in Chile, Dr. Pinto estimated that “the figures are quite high in men because one in three patients over 60 years of age has this problem and it reaches more than 50% in men over 70 years coinciding with international figures”, he highlighted.
In relation to the symptoms, the most frequent are less rigidity of the penis or not being able to maintain an erection and sometimes these symptoms can be associated with low sexual desire or ejaculation disorders.
In this context, for the specialist a very important aspect of health corresponds to sexual health, so this condition requires adequate treatment, with effective and safe alternatives.
“When the patient arrives at the consultation, in the initial evaluation it is important to create a good bond to welcome their concern and make it known that there are different alternatives to solve their pathology in order to support the improvement of their self-esteem and the relationship of partner if there is one”, he expresses.
Then, it is important to rule out cardiovascular risk factors in the patient, investigate habits, if they take medications and mental health symptoms that may be associated.
Regarding treatment, it is essential to advise lifestyle changes such as diet, increased physical activity, smoking cessation, weight loss, control of chronic diseases and in some cases, also referring the patient to other specialists if required.
Regarding oral pharmacological treatments, Dr. Pinto points out that the most widely used and available in Chile are sildenafil, vardenafil and tadalafil. The latter drug is approved for daily use (5 mg version) in cases of erectile dysfunction and/or for patients with benign prostatic hyperplasia.
In addition, he explains that “among the benefits of this drug taken daily is that in some patients it decreases the anxiety of having to be prepared to take a medication prior to the sexual act, thus helping the issue of spontaneity”.
Similarly, he points out that “it is important to emphasize that the use of these oral drugs has an important safety profile and that there must be a sexual stimulus for them to have an effect.”
Regarding how confinement and situations such as stress affected erectile dysfunction, Dr. Pinto states that consultations related to this condition increased during the pandemic.
He adds that, “the advantage in this context was that the consultations were carried out online and the men apparently felt more confident being behind a screen to ask about their illness. This is because patients are usually embarrassed to consult about sexual health issues. Therefore, the message is Go together with your partner if necessary and face this issue as a central reason in the consultation”.
As for whether it is possible to associate erectile dysfunction with some pathology, he assures that, in general, erectile dysfunction is associated with risk factors and cardiovascular diseases such as hypertension, dyslipidemia, obesity, smoking, sedentary lifestyle, diabetes, metabolic syndrome and obstructive sleep apnea, as well as pathologies in the area of mental health so the recommendation is always to consult a specialist.