Sexual health

This episode, we’re talking about men’s sexual health, function and fertility. Our featured expert is urologist and Professor of Surgery, Dr Eric Chung, who shares his deep knowledge of what affects men’s sexual and reproductive health.

You'll also hear from Queensland men, Phoenix and Greg, who asks what happens to your sexual health as you age.

For anyone who is sexually active, struggling with sexual performance, trying to conceive or avoid unwanted pregnancy, this episode is for you. We will explain the science and physiological factors behind libido and erectile dysfunction, sperm health, sexually transmissible infections (STIs) and more.

How can men optimise sexual function? What long-term effects do STIs have on our health? Is the fact that you’ve never had a pregnancy scare actually a sign of infertility? What can we do to bio hack our sperm? Listen to find out.

If you'd like to learn more about men's health, tune in to our brand-new season. Keep your ears open for our next episode, where we explore alcohol and substance use.

Feel free to leave us a review too—we'd love to hear your thoughts.

Featured in this episode:

Dr Eric Chung

Dr Eric is a consultant urologist at the Princess Alexandra Hospital and Professor of Surgery at the University of Queensland.

As the President-elect of the International Society of Sexual Medicine, and Past Chair of the men’s health section for the Urological Society of Australia and New Zealand, Dr Eric knows his stuff when it comes to men’s sexual and reproductive health.

Beau

Podcast host, Beau, is a health-conscious marketing and communications worker in his early 30s.

He loves music, movies, food, drink, and sport (well, watching it) and hates misinformation. He's definitely a dog guy but thinks cats are pretty cool, though he believes neither are as cool as our native animals.

Greg

Greg is a 56-year-old married man with four daughters. He enjoys his work in communications but has had really great roles in education and sport.

He is passionate about health and wellbeing and enjoys everything from outrigger canoeing to yoga. He believes that finding a good GP that you trust is an important key to staying healthy as you age.

Phoenix

Phoenix is an active and healthy 22-year-old. He recently competed in his first Hyrox event and has a passion for music.

Phoenix works as a camera operator and loves to travel, meet new people and push himself outside of his comfort zone. He finds that staying active and making time for music helps him to stay grounded and on top of his mental wellbeing.

Episode resources:

Stop the Rise

STIs are on the rise, often because of unprotected sexual activity and many infections go undetected. Stop the Rise provides free resources and information about how to prevent catching STIs (did someone say free condoms?) and what to do when you need an STI check.

Some STIs can go unnoticed, but they can impact your overall and long-term health. If you’re sexually active, using a condom with water-based lube and getting regular sexual health check-ups are the best way to protect yourself and your partner/s from STIs.

Struggling with erectile dysfunction or infertility?

If you're having a hard time with erectile dysfunction, it's important to check in with your GP. Many things can affect impotence, so seeking professional advice can help to identify and address the root cause.

When it comes to fertility challenges, both partners can be affected. It's important that both parties see the GP to determine whether specialist help is needed. Infertility can be an emotionally and mentally challenging experience. Depending on your situation, you may consider seeking support from a fertility counsellor.

Emergency care in Queensland

If you’re not sure if your medical condition requires emergency care, call 13 HEALTH (13 43 25 84). Registered nurses are available 24 hours a day. They will advise you on what to do and if you need to go to a GP, pharmacy or emergency department.

In an emergency call Triple Zero (000) and ask for an ambulance.

Virtual emergency care is also available in Queensland. Visit our Virtual Emergency Care Service between 8am - 10pm for free specialist emergency care services, by telephone or video conferencing. You can also access the Health Direct symptom checker.

Transcript

Eric: Behind the penis there's a human being.

Phoenix: In the fitness realm. What temperatures like saunas, and cold plunges have an impact on sexual health.

Greg: Men over 40 would be aware of many of the implications and symptoms of sexually transmitted diseases. I don't know if they necessarily would pay attention to 'em.

Beau: Welcome to another episode of season three of It Can't Hurt To Ask, a podcast by Queensland Health, where we look at all your health and wellbeing, questions and concerns.

I'm Beau, and I'm your host this season, all about men's health.

We'd like to acknowledge the traditional custodians of the land on which we record for us in Meanjin, it's the land of the Yuggera and Turrbal people.

Today we're talking all about men's sexual and reproductive health with Dr. Eric Chung. We'll talk about what affects your libido, erectile function and dysfunction, sperm and sperm quality, sexually transmissible infections, and more.

Eric is a consultant urologist at the Princess Alexandra Hospital and Professor of Surgery at the University of Queensland.

He is also the president-elect of the International Society of Sexual Medicine, the peak authority body on all sexual matters, and was the past chair of the andrology - which is men's health - section of the Urological Society of Australia and New Zealand. Needless to say, Eric knows his stuff. He'll help provide advice and meaningful actions you can take and where to get more info or help.

Thanks so much for joining us, Eric.

Eric: Thank you Beau for inviting me. Love to, hear what question you have.

Beau: That's quite a list of accomplishments you've got there. I think it's safe to say I've never met anyone that knows as much about penises as you. I think a lot of guys think they know some things, but it often ends up being urban myths and stuff like that.

So hopefully that's what we're here to help with and tackle today. I'd love to know though, 'cause I'm curious, and I'm sure everyone listening is what led you into this area of specialty?

Eric: Well, thank you Beau for the question. it is a question that always, perplexes a lot of, university students and also young doctors as they come into urology.

So urology is a specialty that deal with, urinary and reproductive function, especially in men. So what draw me to this subspecialty of andrology, which is about male sexual and urinary function, is the fact that this is the area that is undertreated and certainly under-diagnosed and under represented, especially among the, uh, urological community.

So from a sexual function point of view, as we know that prostate cancer is number one condition affecting Australian men, and many Australian men have treatment for prostate cancer. So erectile dysfunction is becoming more common.

Similarly, we see diabetes erectile dysfunction also becoming common.

So there are many men who require treatment from a sexual function point of view. we know that there are many treatment for sexual function because it is a condition that is becoming more prevalent. There's a lot of taboos, but people are getting more open-minded from that point of view. From a reproductive point of view, we know that many times when a couple that have fertility presented to see a doctor, the female usually get all the treatment, whereas male get relegated to nothing apart from being told that they have bad sperm and they need to use sperm donor. So having a person that specialize in this field on both urinary and sexual dysfunction and also reproductive dysfunction really improve the overall quality of, healthcare delivery in this group of men.

And also importantly, me being the expert in this field hopefully I can inspire and empower the younger generation to also pick up this subspecialty and hopefully we get better quality of care for everyone.

Sounds great. Essentially your job is to help people have more fun That is correct. Well help people have more fun and help to improve the uh, population of Australia.

Beau: So it seems like libido struggles and erectile dysfunction, it's a bit of a silent epidemic. I don't know if that's the right words, but can you shed some light on why that might be and what causes it? A quick note for our listeners. Libido refers to our sexual appetite or drive erectile dysfunction is sometimes called impotence, and that is an ongoing issue with getting or keeping an erection.

Eric: Sure. So there's this cycle of, uh, sexual, response in men. So you start with having the libido and then you get erection, and then when you engage in, uh, sexual activity, you end up with ejaculation, orgasm.

And then overall sexual satisfaction from that point of view. Many people confuse libido and erectile dysfunction, so they think they are together, but some men can have normal erection, but have low libido and therefore they're not engaged in sexual activity.

And some men have erectile dysfunction and as a result of erectile dysfunction become embarrassed and shy about the condition, so therefore they become less sexually active, so therefore they have low libido. So these conditions are usually tied most of the time to what we tend to call the, hormone status. testosterone, as we know, is the main hormone that drive male sexual function.

Interestingly, testosterone improve your sexual libido, but testosterone doesn't improve your erection. But testosterone indirect can improve your erection because it help you wake up with morning erection and also help you getting better erection when you are stimulated. So this is a condition that is affected by hormone, as I mentioned before, but there are other factors that also affect this, libido and erectile dysfunction.

For example, as we know in the current environment, stress can play a big role, right? and also we do know that with all this social media and all this, different forum, men get a different view of what is sexual function. Mm-hmm. that can indirectly turn them to having a libido issue because they're not sure whether should they be more hypersexually active.

So I think there's a lot of, myth around this area in terms of libido and sexual function. I'm sure we're gonna delve into that more today.

Beau: with that in mind then, can you give us some real advice on improving those issues?

I think the first thing is to acknowledge that you have a problem. So a lot of time people feel embarrassed, they're shy, they're not sure, are they appearing too hypersexual by turning to GP, to talk about their sexual, difficulties. Mm-hmm. So I think the first thing is try to acknowledge to say that you have a bit of problem, right?

So don't say that you have a dysfunction. Just say that, look, I'm having a bit of difficulty with my sex drive, or I'm having a bit of difficulty with my erection. So that's the first step. Now we published a paper that combined both the, Urological Society and also the, College of GP statement about management of erectile dysfunction.

we go by a step-by-step manner. So number one is to address some of the reversible courses. So reversible courses, things like lifestyle modification, your health status. For example, if you've got diabetes, hypertension, dyslipidemia. Then manage those accordingly, because that's gonna help you. And also in the long term, potentially reverse the underlying dysfunction that result in sexual dysfunction.

The second thing after that is to initiate medication for other conditions. For example, if you got erectile dysfunction, there are medications they are being proven with long-term track record. For example, Viagra, we know the magic blue pill these days, right? So Viagra was introduced in 1998 in Australia, or 1999

you're looking at about 25 year history of consistency in terms of efficacy, durability, and also safety from that point of view. So there are a lot of treatment options that we can offer men to try to improve the erection. And also from a libido point of view, there are a lot of other things that we can also dealt with.

One of the thing that I think we probably don't talk a lot more is about the psychological component of erectile dysfunction. Mm. And also low libido. So I think this is something that we really need to address in terms of the mental anxiety. The, stress level, and also importantly about how they talk to their partner, right?

Mm-hmm. Because this day we are in the environment and the climate where we talk about Me Too movement. So we need to be able to get consent. We need to be able to be more open in terms of engaging in sexual activity these days.

Yeah. That makes sense. there's a lot of physical and mental health tied to libido and erectile dysfunction.

Is the penis a good representation of your overall health then?

Eric: That's a very good question, right? Because behind the penis there's a human being. Mm. So when we talk about erectile dysfunction, we do not, we have to remember there's a human behind it. So we need to address the mental health, right?

'cause the mind is the key to drive all the hormonal and also the neural pathways, For you to have the arterial function to provide the erection and subsequently the satisfaction from that point of view. So when we talk about sexual health, we need to talk about it from a generic health point of view, the general health.

And we also know from clinical study that if you have erectile dysfunction, it is potentially a early telltale sign of underlying cardiovascular disease. Right? They're very good epidemiological study to show that when you have erectile dysfunction. Three to five years onwards. If you don't change your risk factor, you're more likely to develop cardiovascular disease, such as heart disease, wow, stroke, and major other vascular event.

So I think at the end of the day, while erectile dysfunction is a sexual condition, it is a window into general health. So having a good erection means that you are healthy and also importantly, you feel good about yourself, and also you potentially could live longer in a happier way as well.

Beau: That's great. Uh, great news or, uh, great advice for people that need to get it checked out.

Here's a quick trivia question that we'll answer later in the episode. In cases of infertility, what percentage do you think are caused by male factors as opposed to being caused by female factors? Welcome back. switching gears a little bit, I'm keen to find out more about male infertility. Are there similar causes there?

Eric: So male infertility is slightly different, but at the same time, it is also coexisting with erectile dysfunction in the sense that if a man have erectile dysfunction, he's not gonna be able to engage and have natural conception.

Similarly, if you've got low libido, you're less likely to engage in sexual activity with your partner to have natural conception from that point of view. But what we do know about male infertility, is that over the years, in the last four decades, there has been a 60% diminish in sperm. function.

Wow. So this is a big news, right? Mm-hmm. Because traditionally we thought that women has a finite number of eggs. So one they hit forties, fifties, the eggs dry up, they're going into menopause. And we think that men can still father children, right? 'cause we see a lot of those, um, old age celebrities.

Yeah. Their eighties still fathering children, right? Yeah. But we do now realize that over the years, either because of genetic, environmental, maybe metabolic or hormonal factor, there seems to be a decline in sperm function. So this is very important issue, not just from a fertility point of view, but in terms of global issue from economic and also from a productivity point of view, right?

So Australia, the birth rate has diminished, perhaps maybe related to female factors, but some of it could be related to male factors. So there are a lot of factors that can interfere with sperm function, for example, toxin, right? So we have a lot of different toxins, condition like chronic illnesses, diabetes, for example, that certainly can, im- impact on sperm function as well.

Beau: Yeah, that makes sense. I guess that's a bit of an important topic for a lot of people, particularly if they're trying to start a family or continue a family. Have you got any advice in terms of things that you should avoid if you're trying to improve that sperm quality or sperm count? I'm not even sure about what's what, actually, maybe a better start question is what are the things to look for in healthy sperm? Are you looking for quality?

Eric: Sure, definitely. So when we look at semen analysis, semen analysis is a test of your sperm, right? Right. So there are certain criteria that we look at. So there are three criteria that's important. One is the number of sperm. Two is the motility of the sperm, how quick the sperm is swimming.

And three is the morphology of the sperm, whether the sperm has a normal shape. So normal shape of a sperm has a head, a body, and a tail. the tail are the one that propagate the sperm up the, cervical canal into the, fallopian tube. Mm-hmm.

And the, the body carried the genetics and also the, energy supply, right? So the head is where the genetic, so in IVF for example, when you inject the sperm into the egg, you actually remove the tail because there's no need for the motility component. Good count is more important than motility which is more important than morphology, but obviously at the end of the day, you want good count.

so normal man for fertility, you need at least 14 million per mil of ejaculation, Motility, you need to be at least 40% motile. And, from a morphology point of view, the good news is that you only need 4%, normal morphology because at the end of the day, all you need is one perfect sperm, and that will fertilize the uh, egg

Beau: Right, so out of 14 million, that's a lot. Um, I had no idea that they required energy sources too.

Eric: Oh, definitely. Because, if you. believe it or not, the cervical and the uterus environment is actually quite hostile, right? so for those sperm to make all the way up to the egg, it is require a lot of energy, a lot of challenges and stuff like that.

It's a bit like, uh, you have a army trying to storm a castle, right? So you need a lot of army. You needed an all army moving in a smart manner and you know, army that looks quite normal in the sense that they can actually have a helmet and ah fight properly.

Beau: I've never thought about it like that.

And you wanna make sure that they've been working out and eating right so they can get up there.

Eric: That's correct. So that's this that come down to the human being behind where the sperm come from. So for men to want to have a good fertility and good sperm function. It's important for the man to be in tiptop condition, right?

that means that you have good management of your mental health. You eat well, you exercise well, you have healthy living. You optimize your medical condition if you have medical history that will help to improve your sperm function in terms of the count, the motility, and also the morphology.

Beau: I'm sure e everyone listening that's going through something like this is probably interested. Are there particular things you should do or avoid?

Eric:

Beau: beyond the general?

Eric: Yeah. There's a lot of things that we should do. There's a lot of myth that probably people don't know about it.

Yes. So we know that number one, the testes produce sperm. Right? Yep. So as you know, the testes are developed inside the body as you mature in utero, and when you become a baby, the testes come out into your scrotum. So the temperature in the scrotum is a lot colder than the temperature in the body.

So when people want to start a family, it's important to ensure that they don't wear tight underwear, they don't have hot bath. in the era where we play a lot of laptop, computer, mm, don't put your laptop next to your testes. there's also some, myth and also controversy whether you should put your mobile phone in your, in your pants,

Because the mobile phone have, different, energy sort of wave and that potentially could impact, that certainly is a myth, so I can disprove that right now. So it's safe for you to put your, mobile phone so you don't really have the alternate between your right and left pocket every now and then.

Eat healthy, that's very important. So we know antioxidant is very big this days, right? So antioxidant is key to preventing inflammation and oxidative stress to the sperm. So sperm carry DNA and that DNA will match with the egg DNA as well. So if you eat a lot of antioxidants and you exercise a lot, you decrease inflammation. decrease the oxidative stress. That will improve the quality of sperm,

Beau: right? So what's good for you is good for your balls, and

Eric: that is correct.

Beau: It's good to know.

Now let's hear from young Queenslander Phoenix.

Phoenix: I'm Phoenix and I'm 22 years old. In the fitness realm, what temperatures like saunas, and cold plunges have an impact on sexual health?

Beau: I know very popular at the moment. In terms of temperature, both cold plunging and saunas like too extreme, are they problematic in any way?

Eric: Definitely. So, certainly from a extreme temperature point of view is not good, So heat is bad for your testes and too much cold is also bad for your testes because if you have too much cold, it decrease the blood flow to your testes, So when you have low blood flow to your testes, therefore you have less nutrients to the testes and the testes can, develop less and therefore the sperm quality is less as well.

it's important to avoid extreme temperature, but in general, you tend to veer towards the colder environment. So your outside body temperature is about 27, 28 degrees Celsius. So if you can keep it between 25 to 28, it'll be fantastic.

Beau: I think there's must be a market out there for someone to invent climate-controlled underwear or something.

Eric: Well, definitely, but again, I, I'm not advocating every man to go commando these days. Uh, so it's important that you always adhere to some, uh, simple but sane advice.

Beau: something too I'm curious about, 'cause yeah, we've talked about how diet and exercise affects, your sperm quality and all that, for yourself and fertility, I'm curious, does it have any effect on the child or the partner at all?

Yeah. So there are a lot of, myth about certain food you should eat so that you can get different sex and stuff like that.

This is all myth, right? At the end of the day, it come down to the DNA of the father and also the mother. Mm-hmm. But importantly, the Y chromosome in men is the key determining factors, whether you are more likely to get. a male offspring or a female offspring. So unfortunately, at the end of the day, you still have to blame the, the male partner, if you don't end up with the sex that you want.

Eric: talking about, you know, healthy eating and exercise and all that, um, what's good for your balls is good for you and vice versa. What about extreme exercise, is it good to just keep exercising? I think in life, in general, we try to adopt a moderation stance. So if you have extreme, then it's bad.

So inactivity is bad because inactivity means you're putting on weight, you become obese. So obesity is bad because the fat is translated to estrogen, and that is the counter to testosterone, right? And also the fat increases your, uh, oxidative stress and inflammation from that point of view. on the other hand, we, extreme exercise is bad as well, right?

So because you went into a completely sort of like overexertion of your cell body because you exercise too much, and that itself can lead to fatigue. and also create a lot more inflammation and also oxidative stress. Now, one of the very important things to know about in the current environment is that we seems to have, people going to gym a lot, which is good in one hand, but on the other hand, people try to achieve the imaginary sort of six packs body. Yeah. And some of these men resort to taking anabolic steroid. And then the anabolic steroid is actually bad for, fertility because steroid, is testosterone derivative. So if indirectly when you have anabolic steroid, your body testosterone diminish, because you get forced into thinking that you're producing a lot testosterone.

So when your body testosterone diminished, that mean that your testes are not producing sperm. So that is counterproductive for fertility.

Beau: Right? So does that mean it is true that. If you take steroids, you, your testicles will shrink.

Eric: That is correct. That's why you see all this, bodybuilder wearing skimpy underwear, right?

Beau: Yeah. Right. I always thought, I was always assumed that was the truth, but I'd never, it's great to have it proven.

Eric: That is correct. We're doing a myth buster station today. Yeah. So testosterone strengthen your testes.

Beau: Eric, we heard earlier about the resurgence of STIs. I'm sure everyone's keen to know why that's happening.

Eric: Yeah, this is something interesting, isn't it? It's almost like we are going back to the swinging sixties.

So I think there are many reason for, uh, increasing STIs. Number one, because of advances in medicine, with, introduction of, uh, vaccination like Guardasil, and also, pREP, people become less conscious and also less, willing to, uh, adopt safe sex.

So people are a bit more promiscuous, a bit more dangerous in terms of sexual, partner and also, sexual activities number two is probably to do with some of these, online platform that we know. since we shut down during COVID, we can see proliferation on pornography.

sort of, um, encouraging people that increase the risk of STI. And I think the other third important factors is that younger teenagers are having sex

So I think that also contributes to increased sexual activities and indirectly to increased STI because we know that most of the time the young people are usually the people that do not adopt safe sex practice.

Beau: Yeah. Right. Interesting.

Eric: So STI prophylaxis has been around for many decades, we know that there's certain STI conditions can, can be treated with, uh, antibiotic and also antiviral.

For example, you can take, uh, penicillin against, uh, chlamydia, uh, gonorrhea or, um, doxycycline. And also, uh, you can have acyclovir against, herpes. And, uh, lately we also have Gardasil vaccine, which is for HPV virus. and also you have the PrEP, which is, uh, uh, retroviral for, HIV prevention, at least minimize HIV risk mm-hmm.

of being, contracted. So all this vaccine and all this sort of, um, prophylaxis indirectly lower the guard for you to, uh, be more sort of careful in terms of your sexual. practice. So I think in one way it helped because vaccines and also, uh, PrEP, helped to decrease the risk of, malignant transformation or serious condition like cervical cancer in women, and also the development of AIDS complex, which is very prevalent in the eighties and nineties, and certainly very uncommon these days.

so that is good, but at the same time, it also lower the, guard for people to become more. in terms of sexual activities, more safe. so I think that is bad in that sense. So I think we really need to, reach a balance between, using the vaccine for the good, but at the same time, still keep in mind that safe sex is again, very important.

Beau: so knowing that STI are up, I guess going back to what we were talking about before, fertility, is there a correlation there?

Eric: Oh, definitely there's correlation both in terms of the male and also the female. From a man point of view, right, so imagine that you have STI I you've gotta ulcer in your penis, right?

No women in the right mind would want sexual activities with you and also the ulcers and also the STI can create scarring, stricture as the, disease go into your urinary tract. And sometime it can also affect the sperm function because, the sperm cannot come to the ejaculatory tract.

And also some of the STI can have secondary damage to the nerve function, which is important again in terms of sperm function. 'cause you need to have good nerve for stimulation and also, release of, uh, neuro humoral factors for sperm production.

From a female function point of view, it's very important because we know that STI can increase female infertility by pelvic inflammatory disease, and also importantly in terms of, uh, birth damage to the, uh, subsequent offspring.

Right? So I think this is something that, again, very important in terms of STI. So when you wanna start a family, we always ask about STI history. And also when you go through IVF or any of the assisted reproduction you get screened for STI, we screen you for, things like syphilis, gonorrhoea, HIV, hepatitis, and so on and so forth.

Beau: Are you enjoying this episode? Please subscribe and review. Let's find out the answer to our trivia question about the percentage of infertility cases caused by male factors.

First, we need to define infertility. Commonly, it's the inability to conceive after at least one year of regular unprotected sex. This actually affects almost one in five couples. A male factor like sperm quality is estimated to be present in about 50% of those cases with sole responsibility in 30%. And a co-contributing female factor in 20% factors.

I mean, it's makes a lot of sense to be worried about that if you're trying to start a family, but it, it's something that you can't go back and change the past. So we obviously need to be on top of, preventing STIs the whole way through. Uh, for whatever age, young guys, old guys, are there particular things we should or could do to stop STIs?

Eric: So if you are aware that any unprotected sex can increase your risk of STI, that's the first thing. The second thing is to then to try to adopt the safe sex component of it. Certainly condom is not a hundred percent effective, but condom certainly can minimize STI.

But when you talk about fertility, obviously you can't wear a condom, right? 'cause you wear a condom, you're not gonna be able to ejaculate sperm. So I guess from a fertility point of view, from a STI point of view is about if you do for some reason develop STI. Do go to see your GP, your family doctors, to get it treated, because that's very important.

And also contact tracing as well, right? Because you could be affecting other people as well. Right. So I think importantly is that to be more proactive, there's nothing to be shy about, because we do know that having STI has a negative connotation to it. It's almost like you've done something bad and that's why you've been punished with some kind of lesion or some kind of, uh, problem.

But again, you have to be very open-minded. The STI can occur, right? Be proactive. See your GP, get it treated. that's the most important take home message.

Beau: Good to know. Good to know. Because I think everyone sort of knows that, you need to wear a condom, but it's more important I think, to know that there are detrimental effects and it could affect you having kids, it could affect your quality of life, all those sorts of things, which is interesting and slightly scary as well.

STI testing is very important. if a man is engaging in sexual activity with multiple partner it's important for this man to then turn to GP to get some kind of, uh, testing done. this day testing can be done by either a swab of the genital, also by serology with blood tests So if you think you are at high risk. Or if you develop unusual lesion around your penis or genital area, definitely do get it tested.

So the frequency and duration of testing would depends upon your sexual activities or whether you develop any symptoms.

All right. Let's hear a question from Greg who's 57.

Greg: As older Queenslanders, what kind of things should we be looking out for, in terms of, sexual health as we get older?

Eric: Well, that's a very broad question, Greg. So in general, I would say that when you talk about sexual health, most of us equate sexual health to erectile dysfunction.

Now, I'll stick to erectile dysfunction because as I mentioned before, erectile dysfunction is a window to your general health. So when a man have erectile dysfunction, their potentially sign of underlying end dysfunction. Which mean that you are at increased risk of developing risk factor for cardiovascular disease like hypertension, high lipids, cholesterol, diabetes, obesity, smoking, heart disease, and also low testosterone

So from a sexual health point of view, it's about optimizing your health, optimizing your risk factors, get your risk factors checked, get it treated properly so that at least you improve your erection and also at the same time you improve your overall risk of, getting cardiovascular event

Beau: So talking about the importance of mental health to your sexual health, how do STIs factor into that and testing, you know, testing positive,

Eric: Yeah. So we know that, um, STI I has a negative connotation to it, so it's almost like you've done something bad. So a lot of

time people that have STI are embarrassed.

the worst thing you can do is to try to delay active treatment. if you don't seek active treatment, then you get progression of the disease. the other thing is that most of the STI can be treated as well, even though you cannot prevent a remission down the track. for example, if you got, things like a HSV simplex with a cold sore, you can end up with a secondary cold sore, uh, or infection elsewhere, but at least you can minimize the, uh, trajectory of the disease process. 'cause the last thing you want to do is to feel shy about a condition and not seek active treatment.

And the other thing that we mentioned previously is the fact about contact tracing. STI is a communicable disease, so you really need to make sure that other partners are screened and also notified accordingly so that you don't have this, uh, pandemic of STI in the community. As well. From a sexual function point of view, there's a bidirectional relationship between mental health and erectile dysfunction. So people that have, mental health issue can have erectile dysfunction. Some of the medication for depression, anxiety, other affective disorders, can have impact on sexual and also erectile function. And similarly, when the men have erectile dysfunction, even though they don't exhibit the typical symptom of major depression to a certain degree, they're anxious, they're also depressed as well.

So it's important to understand that this is a bidirectional effect.

Beau: I never knew how much it was all interlinked. You know, sexual health, physical health, mental health. It's all a big, I guess it's all us.

Eric: Well, that's correct, isn't it? Like, at the end of the day, you gotta remember that the, we are talking about a human being.

So we what we talk about a condition or a symptom of a condition, we have to acknowledge that there is a man, behind it where it's connected with the brain, the heart. The, uh, other part of the body as well as the penis as well. So you can't just focus on the penis a lot.

Beau: it's a strange thing to say, 'cause guys, we're used to focusing on our penises, but I think a lot of us don't focus on it from a health point of view.

Eric: That is so true because uh, when we go to see the GP, as we know the GP, these days are inundated with a lot of things. So they don't have time to focus on a lot of aspect as we traditionally previously GP a lot of time so they can focus on other aspect as well.

So when you see a man that come to see you with erectile dysfunction, depends on the age group. You also address other conditions. So if they are older men, they're more likely to have cardiovascular disease. So therefore you also engage the cardiologist to look into the cardiac health.

If they have diabetes, you write to the endocrinologist to look into the diabetes. Better optimization of the sugar, urinary symptom. We do know that erectile dysfunction and urinary symptom go hand in hand. so therefore the urologist will just take upper hand in this way where we manage the urinary symptom and also the erectile dysfunction.

From a mental health point of view, we always engage the, psychologist or psychiatrist or sexual therapist because this is something, again, you need to look into it from a more holistic point of view. So I think this day we are looking into how can we fine tune everything, because that's very important.

Beau: I've learned so much already. It's been very eye-opening in a, an area that I thought I knew about, but I guess I didn't I'd love to know, and I'm sure everyone listening is having the same question. Is there one key thing we should be doing for our sexual health?

Eric: It's very hard, isn't it, because there's so many, important information that we cover today. But if there's one take-home message, about today on sexual health is to be proactive, proactive in the sense that you should be proactive to ask for advice.

Do not be embarrassed, because this is something that is common and certainly is gonna affect you in the long term. So be proactive about your sexual health because you potentially, not only are you going to have a better sexual health, but importantly, a better overall general health as well.

Beau: Well, Eric, it's been very enlightening. Like I said, I've learned some things and I'm sure everyone listening has too. thanks so much for coming in and sharing your expertise and taking the time to come in and chat with us. Very much appreciate it.

Eric: Well, thank you Beau for having me. I hope the, uh, audience and the, uh, listener, learn something new today.

Beau:

Male infertility can understandably be associated with significant psychosocial and relationship stress. If you're experiencing any of the issues raised in this podcast or just want more information, listen on.

Regarding impotence. You should talk to your GP to start with.

With fertility issues, as both partners can be affected, it's often best for both of you to see the GP. From there, you may be referred to a fertility specialist or clinic. Infertility can be emotionally and mentally challenging, so you should consider getting support from a fertility counselor. Some fertility clinics will offer fertility counseling.

Want more information on STIs including prevention, testing, and treatment? The Stop the Rise of STIs website has you covered. Search 'Stop the Rise.'

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Many thanks to Dr. Eric Chung and the team at Metro South Hospital and Health Service.

This podcast was produced by Queensland Health.