ASK DR ZOE
We used to have sex twice a day, now it’s once a month – will he ever get strong erections again?
Dr Zoe also helps a reader who is suffering from ulcerative colitis for more than a year
IT turns out people often only take their health seriously after a scare or if aches and pains strike.
Reaching a milestone birthday is another trigger that encourages people to take better care of themselves.
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That’s according to a recent survey of 2,000 people by OnePoll, which confirms sometimes we need a “wake-up call” to address our lifestyles.
However, the research also found that 39 per cent of respondents regret not taking better care of their health before their mid-20s.
I’d advise not waiting for a health crisis or things to turn bad to start looking after yourself.
You might think: “What is the point if I might still get sick later in life?”
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People get struck with horrible health events, regardless of what their lifestyle choices are.
But you might be more resilient to anything that comes along if you take care of yourself beforehand.
Here’s a selection of what readers have been asking me this week . . .
Q) MY husband, who has type 2 diabetes, has problems getting an erection.
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He takes sildenafil about an hour before sex, but it doesn’t last long. Before he was diagnosed, our sex life was brilliant and we would get intimate at least twice a day. Now I’m lucky if it’s once a month.
His diabetes is under control and he has gone from taking metformin three times daily to just once.
Will he ever be able to get a good erection again, and last when we are having sex?
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Half of men with erectile dysfunction could benefit from wand that delivers shockwaves
A) Sildenafil needs to be taken at the right time before having sex, which your husband appears to be doing.
Erectile dysfunction can be caused by several medical conditions, including diabetes, and it can also be due to psychological reasons.
For many men who have an underlying physical cause, it often becomes a combination of the two.
Your question does make me wonder if he’s developed a psychological component, and something like receiving a diagnosis of diabetes can certainly contribute towards this.
It could be a stage-fright type of event, which is something to consider.
The best way to approach this is to be supportive and aim to have a very open, honest conversation, and for him to share this with his GP too.
One way in which doctors try to differentiate between physical and psychological causes is to ask their patients if they are still getting normal, full-strength early morning erections. If the answer is yes, this suggests it’s less of a circulatory problem and more of a psychological one.
It sounds like your husband is doing brilliantly with his blood glucose management if he’s down to one metformin dose a day.
If he is willing to make some significant changes to his lifestyle he might be able to get his blood glucose levels back into the normal range and not need medication at all.
Usually, this requires changes to diet, weight loss and getting much fitter.
Would he consider something like a low-carbohydrate diet which is beneficial and helps people improve their diabetes? He could look at , which has really useful resources.
WHAT IS BEST WAY TO COPE WITH COLITIS?
Q) I AM 36 and have been living with ulcerative colitis for more than a year.
Since changing my diet, removing chocolate, caffeine, milk and fizzy drinks, I have been in remission for four months.
How can I best support my health? I am worried about the health risks and want to avoid surgery.
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A) Firstly, give yourself a pat on the back.
It sounds as though you have made some positive changes to your lifestyle to help manage your condition. This isn’t easy to stick with, so well done and keep it up.
More lifestyle changes can help to keep you well, alongside your recommended medical support and treatment.
Getting some individualised advice from a dietician would be the best way to figure out what other dietary changes would benefit you, and keeping a detailed food, drink and symptom diary before that would help you get the most out of the appointment.
Your specialist team might have a dietician working alongside them who specialises in inflammatory bowel disease.
Other than this, maintaining a healthy lifestyle in other areas as much as you can will also benefit your general health and help to maintain lower levels of inflammation in the body.
So regular exercise, a good sleep regime, hydrating well and taking measures to manage stress are all worth considering and discussing with your GP or specialist team if you need support in these areas.
For further information and support, have a look at .
Q) MY wife was diagnosed with mononeuritis multiplex.
Her neurologist told her he couldn’t do any more for her as she hadn’t got any worse or any better, but it’s driving her nuts.
She has the right medication to help with the pain but doesn’t want to live the rest of her life like that.
What could she do?
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A) Mononeuritis multiplex (MNM) is a disorder of the peripheral nervous system. By definition, it must affect two or more different locations of nerves, but it doesn’t affect nerves throughout the entire body.
Symptoms vary depending on the underlying cause and which nerves are damaged.
They may include weakness in one or more limbs, loss of feeling, tingling, discomfort, incontinence, or paralysis in one or more areas of the body.
Sometimes it gets better if a treatable cause is found early enough, but in many cases, it becomes a chronic condition where the focus is on treating symptoms and adapting lifestyles to best manage it.
I do not know if an underlying cause was found in your wife’s case. If it was, then treating this is crucial.
MNM can be caused by diabetes, rheumatoid arthritis, lupus and other diseases that affect the blood vessels. Several medications can be prescribed for nerve symptoms including amitriptyline, duloxetine, pregabalin and gabapentin.
Capsaicin cream can help topically for some people. Made from chillies, it works by stopping the nerves sending pain messages to the brain.
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If your neurologist cannot help further then a referral to a pain- management team might be the next step as they can advise on other ways to deal with symptoms.
Occupational therapists and physiotherapists can sometimes support patients with this condition too.
Tip of the week
MUSCULAR strength and bone strength both decrease with age, which is a problem because it can put you at greater risk of falls and fractures.
My best tip to preserve muscles is to use them.
Simply do some resistance exercise every day, such as squats when the adverts come on TV or push-ups on the kitchen bench when you are waiting for the kettle to boil.
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