Wentzell Emily, Salmerón Jorge
Department of Anthropology, University of Michigan, 101 West Hall, 1085 S. University Ave., Ann Arbor, MI 48109-1107, USA.
Soc Sci Med. 2009 May;68(10):1759-65. doi: 10.1016/j.socscimed.2009.03.016. Epub 2009 Apr 10.
The pharmaceutically focused clinical and epidemiological literature on erectile dysfunction (ED) treatment has paid little attention to men's non-medical responses to changing erectile function. This study explores the relationship of erectile function change, resulting use of medical or alternative treatments, and Mexican men's understandings of masculinity and aging, through a mixed method approach utilizing both quantitative survey and ethnographic interview data. A survey of 750 men undertaken at the Instituto Méxicano del Seguro Social hospital in Cuernavaca, Mexico in April to June 2008 showed that only about half of those who experienced erectile function changes sought treatment for these changes; treatment users were far more likely to seek alternative treatment than medical treatment, especially preferring lifestyle change and vitamins. Ethnographic data from interviews with 250 male urology patients undertaken from October 2007 to August 2008 at the same site reveal that treatment users' preferences were linked to fears about the safety and situational inappropriateness of medical ED treatment. These findings suggest that by focusing on patients' use of pharmaceuticals, biomedically oriented research has overlooked the most common responses to changing erectile function. Broadening the focus of ED treatment research to include analysis of men's rejection of pharmaceutical treatment - either in favor of alternative treatment, or because they do not see their erectile function changes as requiring medical intervention - would correct this imbalance in the literature. Further, the knowledge that even men who seek treatment may prefer alternatives to pharmaceutical interventions will help physicians to offer treatments, such as lifestyle change, that their patients might find more acceptable. Such measures would simultaneously help to mitigate the chronic illnesses, like diabetes and hypertension, which frequently co-occur with diminished erectile function.
专注于药物治疗的勃起功能障碍（ED）临床与流行病学文献，很少关注男性对勃起功能变化的非医学应对方式。本研究采用定量调查和人种志访谈数据相结合的混合方法，探讨勃起功能变化、由此导致的药物或替代疗法的使用，以及墨西哥男性对男性气质和衰老的理解之间的关系。2008年4月至6月在墨西哥库埃纳瓦卡的墨西哥社会保障局医院对750名男性进行的一项调查显示，在经历勃起功能变化的人群中，只有约一半的人针对这些变化寻求治疗；治疗使用者寻求替代疗法的可能性远远高于药物治疗，尤其倾向于改变生活方式和服用维生素。2007年10月至2008年8月在同一地点对250名男性泌尿外科患者进行访谈所获得的人种志数据表明，治疗使用者的偏好与对ED药物治疗安全性及情境不适当性的担忧有关。这些发现表明，以生物医学为导向的研究通过聚焦于患者的药物使用情况，忽略了对勃起功能变化最常见得应对方式。将ED治疗研究的重点扩大到包括分析男性对药物治疗的排斥——无论是倾向于替代疗法，还是因为他们认为自己的勃起功能变化不需要医学干预——将纠正文献中的这种不平衡。此外，了解到即使是寻求治疗的男性也可能更喜欢药物干预之外的其他疗法，这将有助于医生提供如改变生活方式等患者可能更容易接受的治疗方法。这些措施将同时有助于缓解经常与勃起功能减退同时出现的慢性疾病，如糖尿病和高血压。
