Luc - Position-dependent Erectile Dysfunction
Name, picture and some elements in the case are fictional to protect the anonymity of the patient.
Luc is a successful entrepreneur in his mid-forties. He runs a business strategy consulting company. Over his entire thirties, Luc poured his heart and soul into his business. Working late hours, ordering food in because he was too busy, and declining invitations to play golf on Sundays because he had business matters to take care of, was not foreign to Luc. Like many entrepreneurs working long hours, Luc didn’t have much time to take care of himself and his health took a toll. But overall, Luc was in relatively good health. Sure, he’d put on a few pounds since his varsity years in the rowing team at the University but really nothing major.
One thing was for sure though, Luc's business was booming and was growing by the day and he was quite happy seeing all his hard work paying off. But then there was this one thing that started becoming more and more evident. And it really put everything back into perspective. It made Luc reconsider his priorities. The fact was Luc’s sexual life was drastically declining. He started having difficulty maintaining his erection in standing and sitting positions, then gradually even in lying. When he was aroused, Luc could quickly get hard but would soon lose it while moving his pelvis. The only posture he could maintain his erection in was when he was starting on side-lying. There wasn’t much liberty for Luc in terms of positions he could be in. And Luc started to lose his confidence. His marriage was now at stake. That’s when Luc’s alarm really went off. He had to do something about it.
He tried many things; you've probably heard of them all: Viagra, Cialis, Ginseng, Maca powder, Kegel exercise, Sex therapy, and spent thousands on shockwave therapy. All of that led to nothing. His doctor then referred him to me. Because Luc had tried so many things before, he was quite skeptical but still decided to give it a shot.
When I first started working with Luc, he displayed a hyperkyphotic posture with his lumbar spine shifted to the left side. His lumbar pelvic mobility was significantly diminished from all the years sitting in front of his computer. By looking at the problem through the IPC framework, it was clear what needed to be worked on first to help Luc as effectively as possible. Starting with some education, I explained to Luc that the lumbar spine mobility is critical for men during sexual intercourse and affects pelvic floor muscle activation which are crucial to maintain peak sexual activities. Based on that, we started an exercise program which included some postural correction and mobility exercises. We also modified some of his sexual positions to maximize his recovery. In just two weeks, Luc started to see some positive changes: he could now keep his erection longer without the help of Viagra. In the third week, he was able to maintain a good erection when sitting and even after switching postures. Two months later, he had sex lasting for 30 minutes, which was his longest session over the last two years. During his last visit, with the most hear-warming smile on his face, he told me: "my wife is super happy".
