Failure to launch: Relief for men with erectile dysfunction

In most Kenyan communities, sex is a taboo subject and most victims suffering a myriad of conditions rarely seek treatment in conventional health facilities. Instead, majority use hearsay, advice from quacks or traditional concoctions sold by the roadside and hawkers inside pubs.

Depending on the community one hails from, some people heed the call of their ancestors and resort to herbs and roots like mukombero, certain fruits like pomegranate and traditional foods like supu ya pweza (octopus soup) and vegetables like mrenda.

 Others are guided by advertisements staring down at them from electricity posts lining most streets and which promise bedroom wonders after visiting the traditional healer (read witchdoctor) from certain counties and neighbouring countries.

Indeed, the pressure on most men to perform has led to untold misery with low self-esteem limiting social interactions with the opposite sex.

Point to note: there are two types of sex; procreational and recreational sex.

In the former one can ejaculate within seconds but it is recreational sex where ‘performance anxiety’ becomes a reason to book an appointment at a sex clinic since it mostly arises from failure, and worsens with failure.

Young patients in search of quick fixes buy the “blue pill” to boost their performance, a feat which has led to death as several media reports attest.

With the advent of sexologists, sexual medicine experts and sex therapists, some Kenyan men are now vising the few sex clinics around.

Prof Joachim Osur, a sexology and sexual medicine expert says the barrier to seeking conventional treatment is borne out of the traditional perception of sex and attendant problems as issues that should not be discussed openly. To make matters worse, sexual conditions carry with them a stigma and hence the reluctance to seek medical help.

Prof Osur outlines the most common problems for those visiting sex clinics as ranging from erectile dysfunction, premature ejaculation, lacking desire and wanting skills.

Not all problems are sexual, as some also suffer intimacy issues, sexual performances, relationship and psychological issues and “basically they are not happy. They cannot satisfy themselves or their partners,” offers Prof Osur.

People with sex-related issues, he says, also suffer other underlying conditions like hypertension, diabetes or they are using other drugs and “when one has an erection failure it is better to seek help and not rush for the Blue Pill.”

About 15-20 per cent of men suffer from erectile dysfunction and premature ejaculation many of whom suffer in silence.

 Most men visit sex clinics alone before tagging along their partners from the perception that when the sex failure is their fault.

“Most of these problems are caused by sleep deprivation, abuse of alcohol and drugs, age difference, stress or sex beliefs,” explains Prof Osur. “There are those who believe that sex is a dirty act hence feeling guilty.”

“All these problems can be solved by one or all the options including medical treatment, surgery, counselling, sex therapy and coaching” but the treatment journey needs the couple working as a team.

Men suffering from erectile dysfunction got a reprieve recently after a man who had been suffering from the condition underwent a successful penile implant operation at the Aga Khan University Hospital, Nairobi.

The patient, in his 40s, had used other treatment methods but which came to nought.

Dr Ahmed Yousef, a consultant urologist and the lead surgeon during the operation that took an hour said the procedure that costs between Sh800,000 to Sh1 million involves “implanting a prosthesis device in the penis. The advantage of this surgery is that the man can have intercourse anytime they like without using medication.”

Tests conducted on the patient including a penile Doppler ultrasound showed that he had severe venous leakage causing the problem and an implant was the ideal treatment which eventually ensured “his erectile dysfunction condition has been treated,” said Dr Yousef. “If he had an issue with premature ejaculation, it will also be treated.”   

It was the first time an erectile dysfunction procedure – which requires specialised expertise in urology – was conducted in East and Central Africa.

Although most people who visit sex clinics are of advanced or advancing years, Prof Osur says every age has its own sex issues and “a person should be examined at birth, preschool, puberty, when they have their first sexual encounter, when they change partners and during pre-marital classes.”

Annual checkup is highly recommended for the sexually active in marriages or long-term relationships as “it is not just an examination for sexual organs, but also the psychological health of the person and the health of the relationship,” says Prof Osur. “All these things are interconnected.”

He adds that early examination prevents many long term problems including men who only later discover they have one testicle in their 40s or 50s after one testis remained inside the abdomen after birth.

“When a baby boy is in the mother’s womb, the testes are normally inside their bodies and only come out (descend) because the temperature inside is too high for them to function normally. If one testis remains inside (undescended) and is not corrected it will die off and if something is not done it might become cancerous. This can be corrected early enough,” he explains.

Prof Osur reckons that the sexually active live longer and “sex can be an indicator of good health, if your sex is failing at any age that is an indicator that you need to be examined, psychologically, socially and physically.”  

Dr Paul Saoke, a medical consultant, adds that other benefits of regular sex include managing stress and inducing quality sleep through release of sex hormones like oxytocin and endorphins besides helping the brain grow neurons, making it work better.

Then there are the sexually inactive who think they don’t need annual checkups and which, according to Prof Osur is a misconception as sex is lifelong.

Other patients suffer common Sexually Transmitted Infections (STIs) like Chlamydia, a bacterial infection without symptoms, but which leads to a lot of damage in both men and women including infertility.

Syphilis and gonorrhea are not as common, but HIV, herpes and hepatitis B still remain a big threat as people hardly do screening.   

Prof Osur says cases involving female patients are mostly from those complaining of itchiness, mostly caused by fungal infection, low immunity or sexually related. Others lack desire and are not easily aroused, experience pain during sex or don’t reach orgasm.

For women, sex is emotional and most women who are happy will not orgasm.

“A woman will fake an orgasm if she is in pain and she wants it to end. Sometimes she may not be in pain but she not there psychologically and she just wants it to end, or she just wants to make the man happy.”

When a woman has an orgasm, it is a confirmation that she is at peace and life is okay and is also happy with the relationship.

City sexologist Maurice Matheka says most of his clients are women as “men visit when they have reached a dead end while women come to fix a current issue mostly inability to orgasm. The biggest problem here,” says Matheka, “is that “women rely on men for orgasm while an orgasm is 90 per cent woman and 10 per cent man, the mind achieves what the vagina is feeling.

A vagina, elaborates Matheka, responds to stimulus not love, in the same way food is delicious because it was cooked well, not because of love. “That is why there are women who do not orgasm with their partners whom they love but orgasm with a stranger.”

Orgasm sessions in a sex clinic can set one back Sh25,000 and that includes the cost of conditioning the G-Spot as a woman’s trigger system is different from a man’s who only rely on stimulation “but for a woman her procreation design is different and sometimes cannot have a natural orgasm,” says Matheka. He says one should not have sex if they’re not enjoying it.

Other women who visit sex clinics are those who underwent Female Genital Mutilation (FGM) for which they carry psychological and physical scars and most visit “with an engraved notion that sex is supposed to be painful,” and which requires working on their stimulus levels.   

 Lesbians tend to have more orgasms than heterosexuals as women take time to learn each other “men just show up,” says Matheka. “What most men call foreplay is not foreplay.”

On challenges of being a sexologist Matheka says “it can only be challenging if a client does not come with her vagina.”  

Mothers, check your young son’s testicles  

Doctors have raised an alarm over the rising cases of boys born with undescended testes in Nyandarua and Laikipia counties, for instance. The condition, known as cryptorchidism, has the testicles not moving into their proper positions inside the scrotum. 

The Kenya Association of Urological Surgeons launched a research into the rising cases of cryptorchidism after 24 patients reported with the condition in the two counties.

The cases were higher than other regions and consultant urologist Dr Muigai Mararo explained that in a normal case undescended testes are normally a result of premature birth but there were other possibilities and “that is why we are pursuing other causes since it is not normal for such a rise in one month.”

Dr Mararo warned that when untreated, undescended testes posed a risk of one developing cancer of the testis besides trauma and a child should be treated before the age of two. He urged mothers to check on the testicles while bathing their young boys.