Urologist: What Men Need to Know About ED, Related Health Issues

Erectile dysfunction (ED) is an often misunderstood condition that affects many men. But few are willing to talk about it – even though ED can be a warning sign of serious underlying health issues.

Juan Cedeño, M.D., a urologist with Baptist Health based at Homestead Hospital, recently shared his expertise on ED during the Baptist HealthTalk Podcast: What Men Need to Know About ED, which was hosted by Willard Shepard, Emmy award-winning journalist. The urologist’s insights shed light on the physical and emotional aspects of ED, and how men can take proactive steps to address it.

One of the most persistent myths about ED is that it's simply a part of aging. Dr. Cedeño is quick to dispel this notion.

“One of the most common myths that I receive in my office is when I ask the patient about their erections, and they just say: Oh, I’m getting old.” Dr. Cedeño emphasizes that ED is not an inevitable part of aging, and is actually a medical condition that can affect men of all ages. “The reality is problem for all men. It’s a problem in general -- the same way as high blood pressure, high blood sugar, cardiovascular conditions.”

Dr. Cedeño suggests that maintaining a healthy lifestyle, staying active, and managing stress are all important factors in prolonging sexual health. He believes that the goal is to increase not just lifespan, but also the quality of life, which includes enjoying activities such as sports and maintaining a strong relationship with a partner.

ED as a Warning Sign for Other Health Conditions

While ED is often perceived as a separate issue, Dr. Cedeño stresses that it can be a symptom of underlying health problems. It’s rare when a patient “comes to our office complaining about erectile dysfunction, and when we do the workup we find that the patient has cardiovascular conditions,” Dr. Cedeño said. “But it happens. It is actually the consequence of these medical conditions that affect our sex performance.”

Conditions such as diabetes, hypertension, and cardiovascular disease can be all closely linked to erectile dysfunction. Dr. Cedeño explains that ED may be an early indicator of other more serious conditions that could affect overall health.

Certain medical conditions increase the likelihood of developing erectile dysfunction. According to Dr. Cedeño, the leading risk factors include diabetes and cardiovascular conditions.

“The vast majority of men who have erectile dysfunction are patients who have diabetes,” he notes. “The other big portion of the pie is patients who have cardiovascular conditions, including hypertension, atherosclerosis, and coronary artery disease.”

Dr. Cedeño adds that pelvic injuries, including those caused by surgeries for cancer (such as prostate or bladder cancer), can contribute to ED. Moreover, psychological conditions like stress and anxiety, though less common, can also play a role.

The Role of Testosterone

Testosterone levels are often associated with sexual health, but their relationship with ED is more complex. Dr. Cedeño clarifies: “If you ask me, for example, if having low testosterone will affect my degree of erection, it does not much. But it does affect the libido. So, if you don’t have the libido in order to engage, you may not get a strong erection.”

However, maintaining balanced testosterone levels is still important. Dr. Cedeño advises that men should have their testosterone levels checked, as imbalances can affect sexual desire and overall well-being.

Can ED Be Reversed?

Dr. Cedeño explains that while it is difficult to reverse ED entirely, it is possible to manage and treat it. “You can basically prolong your sex span,” he says. This involves addressing the root causes of ED, such as cardiovascular health, obesity, and stress, before it becomes too severe. Early intervention is key.

“At the beginning of the condition, when your degree of erection is still, let’s say, nine out of 10, having a good, healthy lifestyle will help,” he said. This means staying active, eating healthily, and getting enough sleep to help prevent further decline.

Once ED progresses, medical treatments can help. Dr. Cedeño says that by seeing a specialist early, men can explore different treatment options which may include medications, injections, or even surgical options, depending on the severity.

The good news is that many cases of ED are preventable. Regular physical activity, a balanced diet, stress management, and good sleep hygiene are all essential components of maintaining sexual health.

“It is crucial to have a good sleep in order to get good testosterone levels,” he adds. Additionally, reducing carbohydrate intake and eating foods rich in magnesium and zinc can help prevent conditions like hypertension and diabetes, which are often linked to ED.

ED Affects Younger Men Too

While many associate ED with older men, Dr. Cedeño explains that it can affect men at any age. “If you see the statistics, one in five men with the age of 20 have certain degrees of erectile dysfunction,” he says. This is partly because younger men are often less willing to seek help. “The problem is just being behind the shadows,” Dr. Cedeño observes, noting that many men avoid talking about their symptoms, either out of embarrassment or fear of being judged.

The stigma surrounding ED can prevent men from seeking help, which is why Dr. Cedeño encourages them to talk openly about the issue, whether with a specialist or their primary care doctor. “Even though they don’t come to the clinic for this and they come in for something else, I ask about ED.”

The Emotional Impact of ED

ED isn’t just a physical condition; it can also have a significant emotional impact. Dr. Cedeño acknowledges that many men experience feelings of embarrassment, frustration, and even depression as a result of ED. “The thing I see from them is a smile … and a thank you,” he said, describing the positive change many of his patients experience once they receive treatment.

Partners also play a crucial role in supporting men through this challenge. Dr. Cedeño encourages partners to approach the topic with sensitivity, offering support without adding pressure. “The partners are a very crucial part because this is the person who we got next to our side in order to encourage us to do everything in life, including our sexual health,” he explains.

In addition to medications, Dr. Cedeño said that other treatment options are available such as injections, suppositories, and even surgical procedures like penile implants. He stresses that seeing a specialist early allows men to explore the most appropriate treatment options for their unique situation.

One of Dr. Cedeño’s key pieces of advice is not to delay a consultation. “It’s important not to wait because there are treatment options, and there’s several of them.”

He also highlights the physical consequences of delaying treatment. “We lose penile length in general. So, a man can lose between 0.5 to 5 centimeters of penile length for every year they wait to get any treatments for ED.”

ED is a complex condition that affects men physically, emotionally, and psychologically. Dr. Cedeño encourages men to take control of their health by seeking professional advice and support. The key is not to ignore the issue or let it worsen over time.

“It’s a regular problem,” he said. “In the same way that hypertension can be fixed by taking medicine ... it's a problem that has a solution.”

Learn more about Baptist Health's Uroology Services.