Erectile Dysfunction (ED), sometimes called impotence in layman’s terms, is a common medical problem. Erectile Dysfunction is defined as trouble getting an erection, and/or sustain it for a satisfactory sexual intercourse. Premature ejaculation and lack of libido (desire to have sex) can be associated with ED, depending on the cause of ED.
Relevant psychosexual stimuli, adequate blood flow to the penis and intact nervous supply are all necessary for a good erection and anything that affects these adversely can lead to ED. Smoking, diabetes, high blood pressure, obesity, and normal aging can affect the blood flow to the penis, thus leading to ED. ED can be a sign of undetected heart disease as blood supply issues can be common to both the penis and the heart. Hence, ED may warrant investigation for underlying heart disease.ED can be a sign of undetected heart disease.

Neurological problems due to brain stroke, diabetes, parkinson’s disease, spinal cord injury or prostate surgery can lead to ED. Many medications such as beta blockers commonly used for hypertension, opioids used to treat pain, anti depressants can lead to ED. Alcohol, contrary to popular beliefs does not help ED, but worsens it!

It is not uncommon for a man to go through performance anxiety and this inability to meet one’s own expectations and that of his partner can lead to a vicious cycle of anxiety, depression, lack of performance and misery. The stigma surrounding ED and the lack of awareness about sexual health have confined ED as a matter shared within close friends at the best.

Medical experts who can deal with ED are specialists in hormonal problems, i.e., Endocrinologists, although Urologists and Psychiatrists can also deal with it, depending on the nature of the cause. Usual information that a doctor would want to know is whether ED is sudden, whether the person is getting early morning erections, any social issues with partner and history of underlying diseases, medication usage as detailed above.

Many who suffer from ED do not seek appropriate medical advice and suffer silently. Quacks, self-proclaimed sexologists without qualifications, so-called herbal remedies, misleading information in the internet, myths and superstitions add to the problem.

A general examination of the pulses, and for any unusual enlargement of breasts called Gynaecomastia, size of penis, examination of testes, presence of facial and body hair and examination of prostate if relevant, is usually done by the clinician when a person visits with a complaint of ED. Tests that may be recommended include cholesterol, blood sugar thyroid hormones, testosterone, prolactin and an ECG.

Treatment requires addressing the underlying cause of ED, such as uncontrolled diabetes, hypertension or anxiety, general lifestyle changes such as shedding excess weight, quitting smoking, illicit drugs, and alcohol. Stopping the culprit medication helps. Counseling of the person with ED and /or the couple, tackling stress and sleep disorders is very important.

Medications such as Sildenafil, Tadalafil can be tried strictly after medical advice only. Testosterone hormone replacement may be considered, after appropriate tests and advice of the experts only if appropriate. Intraurethral prostadil injection, Vacuum –assisted erection devices (vaccum pumps), Penile prostheses may be considered in selected cases.

If ED is not tackled in a scientific manner under the supervision of the right expert, apart from an unsatisfactory sex life, ED can lead to anxiety and stress, low self-esteem, relationship problems and even infertility. All these can be avoided with the right lifestyle changes and appropriate methodical management by the right specialist without undue delay.

Hi, I’m Dr. Shree Rao, an ENT surgeon specializing in pediatric ENT and cochlear implant surgeries. Throughout my career, I have learned the importance of embracing challenges and turning them into opportunities for growth.

Navigating Hurdles in Career and Family
Significant insights have come from facing hurdles such as managing family responsibilities, questions from professors about my capabilities, and even doubts from colleagues. Challenges like standing for extended hours during surgeries were opportunities to break barriers and prove my capabilities. Each successful surgery and restored hearing for a patient marked personal and professional growth.

Inspirational Mentor: Dr. Manjula Anagani
Drawing inspiration from exceptional mentors has been crucial in my journey. One such mentor is Padma Shri awardee Dr. Manjula Anagani. Her achievements and the challenges she overcame resonated deeply with me. Despite facing denial and skepticism from other surgeons, Dr. Manjula Anagani persisted and became a role model for me. I owe my first live cochlear implant surgery to her mentorship and guidance.

Empowering Female Surgeons
For aspiring female surgeons, it’s essential to recognize that being a female surgeon is not a hurdle; it’s a strength. The unique ability to empathize and communicate profoundly with patients sets us apart. Embrace challenges as opportunities for learning, invest in knowledge and surgical skills, and build confidence through experience.

The Surgeon’s Strength:Hands of a Woman
In the words of the books, a surgeon should have the eye of an eagle, the heart of a lion, and the hands of a woman. Our unique ability to connect with patients on a profound level is a strength that should be celebrated. Platforms like Hi9 and HealthBUZZ play a significant role in connecting and inspiring doctors, fostering social networking among medical professionals.

Expressing Gratitude and Contributing
I express my gratitude to Mr. Shiva Chenna for providing the opportunity to contribute to the “Surging She- Surgeons” column. These platforms are instrumental in sharing experiences, knowledge, and inspiring the medical community. Thank you for the chance to be part of this network and contribute to the collective growth of surgeons. Thank you.

In India, the two killer cancers amongst women are breast and cervix cancer. But there is no need to panic, as most breast cancers are curable if caught early, possible when a woman regularly and religiously performs the quick and easy self breast examination once every month from the age of 20. Also women between the ages of 45 and 75 should have a mammogram once every two years. The second killer cancer, cervix (lower part of the uterus) is totally preventable if a women has simple “Pap’ test in the clinic once every 3 years between the ages of 25 and 65. Just these two easy, inexpensive tests can cure or prevent the two most common cancers and protect lakhs of Indian women from cancer.

Also, from the age of 40, once a year giving blood, urine, motion samples and undergoing scan of the abdomen will pick up any early cancer of blood, kidney, bladder, stomach, intestines, liver, gall bladder, pancreas. Cancer if caught early is curable. Eating fresh food, cutting down meat, spices, fat and regularly exercise will boost immunity, which is vital to fight any illness.