Impotence Easily Treated, Physicians Say : Health: The problem can be a side effect of other medical conditions. Language barriers and cultural mores often keep men from seeking help.
With age and increasing prostate problems, Sam Brown noticed his sex drive starting to decline. At first he ignored it. At 62, he expected his urge for sex to drop. But he didn’t expect the lack of desire to last for 12 years.
“I had written it off to age and my prostate problem, but I knew there was something more serious, so I went to get checked out,” said Brown, now 74, of South Los Angeles, who asked that his real first name not be used.
What Brown discovered was that his prostate problems led to impotence.
Eddie Rodriguez of East Los Angeles never had trouble having sex until circulatory problems left the East Los Angeles native impotent.
“I couldn’t have sex,” Rodriguez said while looking around to see if anyone could hear during an interview at a local hospital. “It was embarrassing. I’m only 22 and have problems with having sex.”
Although impotence crosses age and racial lines, it is becoming increasingly evident among men of color as other medical problems are discovered that contribute to impotence cases. For many, cultural mores and language barriers often prohibit them from discussing the issue and lead to years of carrying a burden of inadequacy for a problem that doctors say is easily treatable.
“This isn’t a new problem, but (more men are seeking treatment as they) become aware that it’s curable and that they don’t have to live five to 10 years with impotence before getting it treated,” said Dr. Miguel Martinez, a urologist at White Memorial Medical Center.
Impotence can result from physical or psychological problems, or both. The most common physical conditions linked to impotence include diabetes, vascular disease, hypertension, neurological disorders and side effects from prescription medications, such as those used to treat high blood pressure, and illegal drugs. Cigarette smoking also can be a risk factor by worsening the effects of those other conditions.
Psychological factors can include depression, anxiety and loss of self-esteem. Psychological causes of impotence are most often found in men younger than 50 who are not diabetic. Impotence from physical complications result more often in men over 50.
Impotence affects about 30 million mostly older men in the United States, according to the American Urology Assn., but no accurate figures exist because of inhibitions about discussing it.
“Most men who I’ve met who have the problem are hesitant to talk about it, even though I’ll tell them about my problems with it,” said Joseph, 65, of Hawthorne, who had been impotent for about three years before being treated. Joseph asked that his last name be withheld.
The numbers are especially difficult to determine among ethnic and racial groups because of cultural biases and the dearth of studies on impotency’s impact on minority males, according to the urology association.
For men of color, a greater risk for impotence exists because of higher rates of diabetes, hypertension, heart disease and prostate cancer, especially among African American men, who have a 30% higher rate of diabetes or hypertension, Martinez said. These problems are additionally compounded by stress.
Martinez said men of all ethnic groups living in low-income areas suffer from stress and a variety of health problems that can lead to impotence.
“In the inner city, with the more people you treat, you find out that stress is more prominent than people realize” in exacerbating the root causes of impotence, said Martinez, who treats several dozen Latino and black men for the problem.
Another problem recently discovered by urologists was that former prostate cancer patients were finding they could no longer have sex after undergoing surgery.
“The prostate is very close to a series of nerves that are vital for erections,” Martinez said. Doctors “were cutting off vital nerves. Now, they are aware and have formulated a different surgical procedure which does not harm those nerves.”
Brown’s problem was solved once he had surgery to correct difficulties with his prostate.
Once a man has realized there is a problem, the next issue is getting him to talk about it, doctors say. The stigma of impotence as being a sexual failure is still very common. Cultural mores, religion and family values also prevent patients from speaking more openly, doctors say.
It is not uncommon for men to wait six months to two years or more before seeking help, Martinez said. By then their medical condition is sometimes compounded by psychological problems caused by frustration, he said.
In some cases, to avoid embarrassment in seeing a doctor, Latino and Asian men will first go to herbal healers.
“There are a lot more people with problems than we Asian urologists see, but culturally they feel better trying for non-traditional medicine first to fix their problems,” said Dr. Eun-chil Park, a Koreatown urologist.
Most of the Asian men Park treats are over 65 and have been impotent for many years. Culturally, they consider it a part of aging and do not seek help.
Said Dr. Dominic Chu of Monterey Park: “Many will take medication to get their potency back, but if it doesn’t work, they forget it because they figure that’s the way it is.”
Chu said he treats men in their 40s, but many men are impotent for years and do not mention it to their doctors until they are past 50, when they blame the problem on age.
Machismo is a major problem for some Latino patients, said Dr. David Sulam of Family Care Specialists in Highland Park. Some patients will seek help but give inaccurate information and try to avoid questions about their sexual dysfunction.
Rodriguez, who works in construction, twice attempted to have his impotence problem solved at a hospital in Los Angeles. But when the medical staff asked him questions in front of a female staff member, he lied.
“I told them I wasn’t having as much sex as usual,” Rodriguez said. “But really, I couldn’t have any sex at all.”
After finally visiting a urologist, Rodriguez realized he was suffering from poor circulation largely in part to a poor diet and excessive smoking.
“When I quit smoking, I felt different in less than a month,” said Rodriguez, who is cured. “I was a new man.”
Language barriers and finding experienced medical workers who are bilingual are often problems in successful treatment for impotence for Asian and Latino men.
Many cures for impotency are not complicated and some are fairly new, Martinez said. Treatment includes increasing the flow of blood to the penis with injections of drugs that dilate blood vessels in the organ or an external vacuum pump used to create an erection.
Vascular surgery, another method used to increase blood flow, involves a bypass operation to route blood to the penis past blocked arteries. Penile prostheses, or implants, which can be rigid, malleable or inflatable, are also available for patients who refuse other forms.
“Once more men realize that this is a treatable problem and can be easily reversed, I think we’ll begin to see more people breaking those cultural barriers and getting some help,” Martinez said.
