Always Erected

John Scott asked:


Life is never fair. Even though the majority may avoid some of the worst possibilities, there are always the few who seem to have the worst of luck. Look around the media and it’s impossible to avoid the stories. Sometimes, it’s news of accidents and crimes where we are shown the victims and their suffering. Sometimes it’s the way of collecting charitable donations. Images of young and old are everywhere reminding us that there will always be some who need our help. One of the ways in which we prove we are human is through empathy. By our willingness to put ourselves in the position of others and to imagine what it would feel like to have their problems. For both men and women, there are hormones and biological drives which guide physical growth and give us an interest in reproduction. Because of the physical gender differences, boys and girls are nurtured to have different functional expectations. Being a man means fertilizing the eggs. Being a woman means having the resulting babies. In later life, should something happen to interfere with reproductive abilities, those affected can at least look back on some life where pleasure and function worked together. But it is emotionally difficult when nature or an accident denies you the chance to experience sexual activity. Although those affected never know what they have missed, there is an underlying sadness and frustration. For teenage boys, erectile dysfunction (ED) is not a common problem. As a result, there is little research. Most healthcare providers prefer a simplistic and dismissive diagnosis of psychological dysfunction and, where there is medical insurance to cover it, refer those affected for counseling. Such research as there is actually prefers formal assessment of the vascular system. A recent meta-research study examined research carried out between 1998 and 2003, looking for common factors in diagnosis and treatments for teenagers under the age of 19 years. On average the young men had suffered symptoms of ED for an average of two years with the most common causes being perineal and penile trauma, and surgery. Formal vascular examinations were carried out in 60% of all cases and almost half were found to have serious problems justifying further angiographic study or surgery. In other words, half the teenagers given a formal test were found to have abnormal blood flow as the explanation for their ED. The practice of routine referral for counseling is expensive and ineffective because, in most cases, the usual consequence of recommending viagra will not represent the best treatment. Indeed, because of the expense, most healthcare providers simply write out a prescription for viagra and send the patients away with the reassurance that they will grow out of it, or everything will work out fine when they meet the right woman. At the very least, there should be a detailed survey of medical history to see whether there is evidence of traumatic injury as the trigger for haemodynamic testing. Our young always deserve the best treatment.