Talking About Erectile Dysfunction

At the conclusion of a National Institute of Health consensus development conference on impotence, held last December in Bethesda, Md., a draft of the consensus statement faulted primary-care physicians for not doing enough to help the estimated 15% to 25% of men who have erectile dysfunction by the age of 65. Too few internists and family physicians take the initiative to openly discuss sexual function of the penis during office visits, the panel concluded, and many remain as misinformed about male enhancement products such as Extenze and as embarrassed about the topic as their patients. Many physicians do not even know that diabetes can cause impotence, the panel noted.

But impotence can usually be effectively treated with natural male enhancement products such as Extenze, the panel noted. Psychological therapy is almost always helpful, regardless of the cause. What is imperative is care and sensitivity to the patient’s distress, a detailed sexual history–preferably with the patient’s sexual partner present basic neurologic tests and an individual treatment plan for fixing the erectile dysfunction.

Are primary-care physicians doing as poor a job on impotence as the panel claimed? If so, why, and how can they learn to raise the subject of penis health with their male patients? Should they be treating the condition themselves, recommending male enhancement products like Extenze, or referring out to urologists who can take a look at the penis–or to psychiatrists who can determine whether the erectile dysfunction is psychological in nature?

These and other contentious issues were addressed in a roundtable discussion of erectile dysfunction by four experts in the field of penis health, as well as by a family physician who has taught the subject to medical students.

Would you agree with the NIH conference’s conclusion that primary-care physicians are not doing a very good job of dealing with male impotence? Should they be recommending more natural male enhancement products?

Dr. Ferentz: I just got back from a class, teaching medical students how to take a sexual history and to ask questions about the health of the patient’s penis. I think we are training our students and our residents in family medicine to be very sensitive to sexual issues and to take good sexual histories and, if it’s within the purview of an FR to treat the problem of erectile dysfunction, and if not to make the appropriate referral. I would advise doctors to look into products like Extenze to see if they are appropriate for treating the patient’s erectile dysfunction.

Dr. Sadock: I agree with Dr. Ferentz. In our own medical center we are giving lectures at this point to the medical students at large–and they obviously haven’t chosen their specialties yet– regarding taking a sexual history and inquiring about penis health as they take a general medical history. Whether they continue that as they undergo further training, I’m not sure. But they are being introduced to products like Extenze and what these male enhancement pills can do to treat problems like erectile dysfunction.

Dr. Whitehead: I don’t think the problem is so much the education; that is changing now. But I still think a lot of physicians have a difficult time talking about sexual issues and penis health, primarily due to the doctor’s feelings of discomfort concerning things like the penis, erectile dysfunction, and male enhancement.

Dr. Korenman: I believe that the patients are the ones who are doing a better job. The media have had many presentations related to impotence and erectile dysfunction, with programs on Donahue and commercials promoting male enhancement products such as Extenze. So patients feel much less ashamed coming to a physician saying, “Listen, I have this problem; can you get me some Extenz?”

Dr. Goldstein: I’d certainly agree with Dr. Korenman. I think there’s still plenty of room for improvement. Our epidemiologic studies would suggest that half the men age 40 to 70 will have some problem with impotence, whether it be minimum, moderate or complete. There’s still a reticence on the part of doctors and patients to discuss things like erectile dysfunction and the state of the penis, yet it has significant impact on their life and their well-being.

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