The other side of infertility coin

After marriage, relatives and neighbours usually begin to count days until a baby arrives. The expectation is that a baby will follow soon after a couple gets married. The reality is that sometimes the baby takes a long to come or does not come at all.

The blame of delayed childbirth or childlessness in a marriage is usually seen as the fault of the woman. The reality is that male infertility is a big factor in childlessness.

What statistics say

Infertility is on the rise in Kenya. According to data from the Kenya Fertility Society, at least one in every five couples suffers from infertility. The data also estimates that at least 4.2 million Kenyans require medical assistance to conceive.

The most common reproductive problems are low sperm count, zero sperm count, and blocked tubes. The World Health Organization attributes 20 percent of infertility cases to men and 27 percent to both men and women. The Kenya Fertility Society attributes up to 30 percent of infertility cases to men, 30 percent to women, and 40 percent to unknown factors. 

Impotence vs infertility

 Impotence also referred to as erectile dysfunction, is the inability of a man to get and maintain an erection. On the other hand, infertility also referred to as sterility, refers to the inability of a man to make and release sperm. With impotence, sexual intercourse is impossible but with infertility, sex is possible but conception is impossible.

Let's look at the causes of impotence

Psychological impotence

Psychological impotence is a condition in which a man is unable to get an erection, struggles to get an erection, or has difficulties maintaining an erection due to psychological triggers. Dr. Gitobu Mburugu, a Consultant Urologist at Kenyatta National Hospital (KNH), and chair of the Kenya Association of Urological Surgeons says that this form of impotence is on the rise among younger men who’d otherwise not have erectile problems or impotence. “We are witnessing an increase in the number of sexually traumatised young men with psychological impotence due to pressure and performance expectations perpetrated by society and contained in pornographic materials,” he says.

Medical impotence

Endocrine diseases such as diabetes can lead to medical impotence. An endocrine disorder affects the endocrine system which produces hormones that regulate among others reproduction, mood, sexual function, and metabolism. Conditions such as high cholesterol and high blood pressure are associated with an increased risk of impotence. According to Dr. Alana Biggers, an internal medicine physician, chronic disease epidemiologist, and author of The Chronicles of Women in White Coats, if you have diabetes, the risk of impotence comes from nerve damage which affects your penile sensations, impaired blood flow, and hormone levels. “There are neurological conditions such as brain tumor, stroke, Alzheimer's and Parkinson’s diseases which may affect your ability to stay fertile. Medications, surgical procedures, and the use of drugs such as cimetidine used for cancer chemotherapy and prostate surgical procedures may induce impotence. ,” she says.

Lifestyle impotence

Lifestyle habits such as excessive drinking, smoking, a poor diet, obesity, and living a sedentary lifestyle can make it difficult for a man to have or maintain an erection. For instance, a research study by the United Kingdom’s Centre for Biotechnology Information found that the intensity of cigarette smoking is directly linked to the degree and severity of impotence in men.

Infertility

Causes of impotence are closely related to causes of infertility. Diabetes and cancer treatment through the use of chemotherapy and radiation are two of the commonly shared causes. Dr. Biggers says that injuries and infections to the testicles and the abuse of certain drugs such as steroids, sexually transmitted diseases such as gonorrhea, and genetic conditions such as cystic fibrosis can result in infertility, “There is also a condition known as retrograde ejaculation in which the sperm flows into the bladder, [translating to infertility],” she says.

Coping

If you and your spouse have been unsuccessfully trying for a baby, you are both advised to go for a checkup. Dr. Mburugu says that you should not make assumptions or go for over-the-counter pills without a prescription. “The best way to treat erectile dysfunction or infertility is to go for medical diagnosis and treatment, not to buy sex-enhancing drugs,” he says. The effectiveness of the treatment will depend on how psychologically and physically healthy one is. This means that you need to eat a healthy diet, exercise, quit smoking, and excessive drinking. “Embrace intimacy. Cuddle and hold hands, communicate your feelings and fears to your partner openly and gently. Stay optimistic that you will get your groove back. Go out on spontaneous dinner dates, and start to explore sensuality in place of sexuality,” says psychologist Ken Munyua.