Dr Mathabe completed her undergraduate training at the University of Pretoria, and her internship and community service at Johannesburg General Hospital, and ODI Community Hospital, respectively. In 2011 she became the first woman to qualify as a Urologist from the University of the Witwatersrand and the second black woman Urologist in SA. Dr Kgomotso Mathabe recently presented a webinar for Pharmacy Magazine on starting the conversation about ED and the overall impact of sexual quality of life for both the patient and their partner. It was made possible by Eli Lilly. In the videos shared during the webinar, Dr Mathabe was also joined by Dr Prithy Ramlachan. The following is an excerpt based on their talks.
To really help your patient and offer them the best medical care, you need to understand them. This can often be challenging when treating a condition like erectile dysfunction (ED). Addressing her patient’s mindset and how many of her patients are receiving therapy, Dr Mathabe stressed with concern that only 16% of men with ED are receiving therapy. “75% of patients with erectile dysfunction never seek medical help, 82% would like the physician to initiate the conversation, and most patients do not discuss erectile dysfunction with their physician because of embarrassment,” she explained.
WHAT IS MY PATIENT THINKING?
- I wish my physician would ask.
- I am embarrassed by sexual problems.
- I am avoiding physical contact in case my partner wants more.
- I think about it all the time.
- I don’t feel as masculine as I used to.
- I feel like I am letting my partner down.
WHY IT’S IMPORTANT TO ASK ABOUT ED?
Dr Ramlachan discussed several social, physical, and mental reasons why it’s important to address ED with our patients:
- Reduced quality of life
- Social stigma
- Feeling of emasculation reduced self-esteem
- Depression anxiety
- Significant impact on partner
- Predictor of cardiovascular events
- Relation to risk of diabetes
WHAT ARE THE RISK FACTORS?
Age, lifestyle (low physical activity, smoking, BMI ≥25kg/m2), medical conditions (diabetes, heart disease, hyperlipidaemia, hormone imbalances, hypertension, vascular damage, HIV), some medications, and psychological stress
HOW DO I START THE CONVERSATION WITH MY PATIENT?
Dr Mathabe recommends starting the conversation in one of these ways:
- Diabetes and stress are both risk factors for sexual dysfunction. Are you happy with your sexual activity?
- Assessing sexual health may help us identify undetected conditions, such as heart disease or diabetes. Are you able to have satisfying sexual intercourse when you want to?
She explained that this places the emphasis on a medical condition allowing the patient to feel more free in raising the concern about addressing sexual health.
“Another way to start the conversation would be to say: ‘Sexual function is an important part of overall health. Are you satisfied with your sexual function?’ this is a more general question about health.
KEY TAKE AWAY
Let your patient know:
- Symptoms are common.
- Assessing sexual function may help identify underlying medical conditions.
- Sexual function is important for overall health.
- ED can be a starting point for a conversation about the other issues.
You can access replays of the videos shared during the webinar from Lilly’s platform: https://play.lilly.com/landing
Please note that if it is your first time using the Lilly platform you will need to create a profile which can take a few hours to be activated – please be patient.