Addressing Urological Concerns: Seeking Effective Solutions for Erectile Dysfunction

Q: Addressing Urological Concerns: Seeking Effective Solutions for Erectile Dysfunction

Fisherman： Hello, zinc can be found in the prostate and semen, which suggests it is related to these functions. <br>Preliminary research on selenium (Se) indicates it has significant benefits for health, cancer prevention, and anti-aging. <br>As for the effects, since it addresse

Please feel free to ask again?

Dr.
Hsu: Thank you for your reply and explanation.
It's a pity you are not in Taipei or the northern region...
Based on my years of medical experience, it's truly hard to express.
Every visit to the doctor has been quite disappointing.
After waiting a long time, when it's finally my turn, the consultation lasts less than two minutes.
The doctors are often indifferent, or they are too focused on typing into the computer.
At most, they instruct me to get blood tests and come back in two weeks for an injection of hormone therapy, which has no real effect.
Over the years, I have lost confidence in doctors and hospitals...
I wonder if this is a common issue among doctors in the northern region or if it's a sign of "professional burnout" among all physicians? (They have never suggested that I undergo Doppler ultrasound or tests for blood sugar, liver, or kidney function, let alone anything else...) *Currently, I am certain that I have a deficiency in hormones, which prevents me from achieving an erection, and I have no signs of sexual arousal.
My whole body feels sore.* After seeing reports on medical care and health seminars, I became interested in taking testosterone (or hormone) supplements.
I consulted you, Dr.
Hsu, to be cautious.
However, after several twists and turns, I feel like I'm still going in circles...
You mentioned that I could buy a multivitamin containing zinc or selenium.
But is it effective? Since you couldn't say it outright and seemed reserved, I struggled to ask at the pharmacy.
The staff searched and searched but still seemed unsure...
Based on the "dysfunction situation" I described above, please help me find a solution.
I hope to gain benefits from this without having to trouble you again...
I have learned a lot from consulting you, and I sincerely thank you again!

Yu Weng, 60~69 year old female. Ask Date: 2009/07/07

Dr. Xu Weikai reply Urology

Fisherman: Hello, zinc can be found in the prostate and semen, which suggests it is related to these functions.
Preliminary research on selenium (Se) indicates it has significant benefits for health, cancer prevention, and anti-aging.
As for the effects, since it addresses the root cause, it cannot provide immediate results like medications such as Viagra.
Additionally, lifestyle changes are necessary: quitting smoking, getting adequate sleep, exercising, and maintaining a regular schedule, among others.
These are common recommendations, yet patients often struggle to accept this concept, which I find concerning.

Regarding your mention of physicians being reluctant to perform the tests I previously suggested, many hospitals, including ours, lack the necessary equipment to conduct a full range of examinations.
Typically, one would need to go to a medical center to access such facilities.
Smaller hospitals cannot afford the high costs of equipment that sees limited use.
Therefore, only major medical centers like National Taiwan University Hospital, Tri-Service General Hospital, Veterans General Hospital, Chang Gung Memorial Hospital, and Shin Kong Wu Ho-Su Memorial Hospital have these setups.
Moreover, these examinations are very time-consuming, making it impossible to complete everything in one day.
Of course, due to budget constraints from the National Health Insurance Bureau, these tests generally require out-of-pocket expenses.
Various factors contribute to physicians' reluctance to refer patients for these tests, especially if the hospital is small and lacks specialized personnel to conduct them (as physicians would have to do it themselves).
Explaining the testing process and interpreting the results can take over an hour, and often, after the explanation, patients are unwilling to proceed due to the out-of-pocket costs.
Realistically, this can waste the physician's time and potentially affect the schedules of other staff members (such as nurses, billing, laboratory, and radiology personnel), leading to possible resentment from colleagues and future difficulties in practice.
Such patients typically have seen many doctors and have numerous issues.
Continuing to ask questions can lead to complaints from subsequent patients, even if the physician is eager to help.
Therefore, some hospitals or physicians establish special clinics, such as "Happy Clinics" or "Sexual Function Clinics," to limit patient numbers, allowing sufficient time for explanation and communication.
Regarding hormone deficiency, if it truly exists, supplementation should lead to improvement.
However, some of these medications may have carcinogenic potential, so it is essential to choose drugs approved by the Department of Health or the FDA for safety.
My recommendation is to seek a larger hospital with specialized clinics, as I mentioned earlier.
If unsure, you can call various medical centers to inquire about special clinics.
To my knowledge, National Taiwan University Hospital has a special clinic, but you must first see a general urologist before being referred to the special clinic.
Other hospitals have their own regulations, which can be inquired about via phone or online.
If there are any unclear points, feel free to ask again for further discussion and research.

Sincerely,
Director of Urology, Taitung Hospital, Department of Health, Executive Yuan, Xu Wei-Kai

Reply Date: 2009/07/07

More Info

Addressing erectile dysfunction (ED) can be a complex issue that often requires a multifaceted approach. Based on your concerns and experiences, it seems that you have faced challenges in receiving effective medical care and have lost confidence in the healthcare system. This is not uncommon, and many patients share similar frustrations. However, it is crucial to understand that ED can stem from various underlying causes, including hormonal imbalances, psychological factors, and physical health issues.

Understanding Erectile Dysfunction
Erectile dysfunction is defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. It can be caused by a variety of factors, including:
1. Hormonal Issues: Low testosterone levels can significantly impact sexual function. Testosterone is essential for libido and the physiological processes that lead to an erection.

2. Vascular Health: Conditions affecting blood flow, such as diabetes, hypertension, or atherosclerosis, can impede the ability to achieve an erection.

3. Psychological Factors: Stress, anxiety, and depression can contribute to ED. Mental health plays a crucial role in sexual function.

4. Neurological Conditions: Disorders affecting the nervous system can interfere with the signals necessary for an erection.

5. Lifestyle Factors: Smoking, excessive alcohol consumption, obesity, and lack of physical activity can also contribute to ED.

Diagnostic Approach
Given your symptoms and the lack of thorough evaluations by previous healthcare providers, it is essential to advocate for a comprehensive assessment. This may include:
- Hormonal Testing: Blood tests to check testosterone levels, as well as other hormones that may affect sexual function.

- Vascular Assessment: Doppler ultrasound can evaluate blood flow to the penis and identify any vascular issues.

- Psychological Evaluation: If psychological factors are suspected, a referral to a mental health professional may be beneficial.

Treatment Options
1. Testosterone Replacement Therapy (TRT): If low testosterone is confirmed, TRT can help restore hormone levels and improve erectile function. However, this should be done under medical supervision due to potential side effects.

2. Oral Medications: Phosphodiesterase type 5 inhibitors (e.g., Viagra, Cialis) are commonly prescribed for ED. These medications enhance blood flow to the penis and can be effective for many men.

3. Lifestyle Modifications: Improving diet, increasing physical activity, quitting smoking, and reducing alcohol intake can significantly improve erectile function.

4. Supplements: While some vitamins and minerals, such as zinc and selenium, may support overall health, their effectiveness specifically for ED is not well established. Always consult with a healthcare provider before starting any new supplements.

5. Counseling: If psychological factors are contributing to your ED, therapy can help address these issues and improve sexual function.

6. Vacuum Erection Devices (VED): These devices can help create an erection by drawing blood into the penis.

7. Penile Injections or Implants: In cases where other treatments are ineffective, injections or surgical implants may be considered.

Moving Forward
It is crucial to find a healthcare provider who takes your concerns seriously and is willing to conduct a thorough evaluation. If you feel that your current provider is not meeting your needs, consider seeking a second opinion or finding a specialist in urology or sexual medicine.

In summary, addressing erectile dysfunction requires a comprehensive approach that considers hormonal, vascular, psychological, and lifestyle factors. With the right evaluation and treatment plan, many men can regain their sexual function and improve their quality of life. Don't hesitate to advocate for your health and seek the care you deserve.

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