“Do you have any sexual problems?”

It’s a line straight out of a television sitcom, but a visiting sexual health expert believes it’s a serious question that doctors should be asking their male patients on a regular basis.

Dr Kevin L Billups, director of the Men’s Health and Vitality Programme at James Buchanan Brady Urological Institute in Baltimore, Maryland, said certain male sexual problems such as erectile dysfunction (ED) can be the first sign of chronic diseases such as heart disease and diabetes. ED is the inability to achieve and sustain an erection suitable for sexual intercourse.

Dr Billups was in Bermuda for a private health seminar.

He said: “ED is a very good barometer of other things that are going on with a patient’s health. It can be an early symptom of cardiovascular disease, diabetes, or neurological problems. The blood vessels in the penis are smaller so they block off easier.”

In fact, men between the ages of 40 and 50-years-old with ED are 50 times more likely to develop coronary artery disease over a ten-year period compared to men who do not have ED. This study shows the importance of asking about ED in younger men because there is a window of opportunity for preventive intervention in this group of men.

Dr Billups received fellowship training in sexual medicine, male infertility, and vascular biology at the University of Virginia in Charlottesville. He was initially interested in male infertility but when, early on in his career, he was assigned to treat ED he was surprised at the connection he was seeing between ED and other serious health issues.

“I was seeing guys in their 40s and 50s post heart attack coming in with ED,” he said.

When he asked his post cardiac patients about when they started to experience ED symptoms it was often two to six years before they ever had a heart attack.

He believes that targeting men’s sexual health may be a way of closing a gap he sees in the medical system everywhere.

“I believe that men’s health, women’s health, geriatric health and paediatric health should be major focuses of any healthcare system,” he said, “but often it is the men’s health component that is overlooked.”

He thought this was partly because women had more types of medical practitioners looking out for them during their lives including paediatricians, general practitioners, gynecologists and obstetricians. Other than a GP, the only other doctor a man might see might be a sports doctor.

“Too many men are dying prematurely in the prime of life in their prime reproductive age,” he said. “They are dying from chronic diseases like obesity, hypertension, high cholesterol, heart disease and diabetes.”

Part of the problem rests with men themselves. Compared to women, men are 24 percent less to have visited a doctor within the last year.

“Men often present back to the medical system when they are in crisis,” Dr Billups said. “A lot of the lessons we learn in sports are about being tough. ‘Don’t cry’. Unfortunately, when a man has chest pain this can translate into ‘tough it out’, ‘suffer through it’.”

He thought targeting men’s sexual health and vitality might be a way to close the gap. Men might be reluctant to visit a doctor to have their blood pressure checked regularly, but they might be more willing to go when they experience sexual issues.

“I tell men, the good news is I can fix your sexual health problems over 90 percent of the time, but let’s look at what else is going on with your health,” said Dr Billups. “The better you control your blood sugar the better the erection.”

He said it was also important to educate women about male health issues such as ED, as it is often the female in the family who reads up on health issues and schedules medical appointments.

His advice to men struggling with ED or other problems, is to first see their GP for an evaluation.

“You also have a urologist in Bermuda,” he said.

For more information see menshealth.jhu.edu.