No taboo, really

MALE ISSUES

Though infertility is attributed to women in most cases, instances of male infertility is rapidly increasing. Often confused with impotence, people seldom realise that there is a difference between the two. But be it impotence or infertility, both have a social stigma attached to them. Sexual incompetence is every man’s fear and it has more of a psychological impact than a physical or morphological one. 

Infertility in men is the inability to impregnate his partner. More than 90 per cent of male infertility cases are due to low sperm count, poor sperm quality, and in some cases, both. Other causes of infertility in men can be due to hormonal imbalances, anatomical problems like blockages in the pathway and genetic defects.

Infertility does not have any specific symptoms. The term primary infertility is assigned if the partners are not able to conceive even after one year of unprotected, regular intercourse. There are no home tests for infertility, but absence of or decreased semen volume on ejaculation may indirectly indicate a possible reason for infertility. Decreased libido and erection also can indicate possible infertility, but may not always be so.

Impotence, on the other hand, is the inability to perform. Men who suffer from impotence lack the capability to have sexual intercourse. In the simplest of terms, it is the inability to attain or maintain an erection. Impotence may develop as a result of lifestyle practices like stress, lack of sleep, anxiety, substance abuse etc. In some cases, impotence could also be due to certain medical conditions, be it physical or psychological in nature.

Though both the conditions are treatable, most men shy away from seeking proper medical attention.  This is because of the social stigma attached to both these conditions, especially in India where it is still considered a taboo. Both of these conditions have deep psychological implications, which could eventually lead to feelings of frustration and low self-esteem.

Though no medication can improve the quality of a man’s sperm, various techniques can increase the odds of conception using the existing sperms. The reproductive techniques available for infertile men are surgery, hormone therapy, artificial insemination and in-vitro fertilisation, to name some.

Since the basic problem with impotence is the flow of blood to the penis, most of the treatments are centered on regulating blood flow to achieve a steady erection. The treatments provided can vary from medication taken orally to injections and surgery like penile prosthesis. It is only in the recent times that there has been a rise in the awareness about these conditions. There has been tremendous advance in andrology research over the past few years.  If not today, one can envisage in the conceivable future, a situation where all males with infertility or impotence can be completely cured.

(The author is director, urology, & transplant surgeon, Fortis Hospitals Bengaluru)