Erectile Dysfunction (Impotence)-a Dangling Stress Test

Erectile dysfunction (ED) or impotence may more than affect your relationship with your significant other. ED just may be a warning sign of impending heart disease.

Men with even mild erectile dysfunction — but no known heart problems — face a major extra risk of developing heart disease in the future. And as erectile dysfunction becomes more pronounced, signs of hidden heart disease and earlier death risk grow.

Not surprisingly, men already known to have a heart condition along with severe erectile dysfunction fare worst of all. Among men aged 45 and up without diagnosed heart disease, those with moderate or severe erectile dysfunction were up to 50 percent more likely to be hospitalized for heart problems. Erectile dysfunction boosted the risk for hospitalization with a diagnosis of heart disease.

Men with erectile dysfunction should take action by seeing a health professional and asking for a heart check.

An estimated 60 percent of men aged 70 and up suffer from moderate to severe erectile dysfunction. The condition can place major limits on sexual activity and require the use of drugs like Viagra, Levitra, or Cialis that can come with side effects.

A variety of causes can contribute to impotence, but it is widely acknowledged that erectile dysfunction is predominantly the result of underlying cardiovascular disease.

Doctors already believe that erectile dysfunction is an early warning sign of heart problems. The arteries of the penis are smaller than those of other parts of the body including the arteries to the heart and may be more likely to reveal problems when their lining deteriorates before heart symptoms occur.

Bottom Line: Men with severe erectile dysfunction, compared to those with no problem, were eight times more likely to have heart failure, 60 percent more likely to have heart disease and almost twice as likely to die of any cause.
 So before you ignore erectile dysfunction as occurring with age, think of your ED as a dangling stress test and see your doctor and get your heart checked out.

Can Too Much Exercise Be Hazardous To Your Health and Your Heart?

Excessive endurance exercise can do long-term harm to the cardiovascular system

Wait a minute; you have been harangued to get off the sofa, put down the chips and salsa, and get moving. Is that bad advice? Probably not. However, I do want to report on a study from Mayo Clinic that suggests that too much running may hurt you. If you are a runner there is nearly a 20% reduction in death over not running. However running more than 20 miles per week appears to cancel out that benefit. Jogging slowly decreases mortality risk, whereas running at a pace faster than 8-minute miles has been found to put extra stress on the heart. More than an hour of intense aerobic activity per day can cause serious heart problems. Many runners assume that if moderate exercise is good than more is better.

Bottom Line: Probably, like so much else in health, moderation is the watchword. Exercising more than one hour a day may not be good for your health or your heart. My suggestion is to do cross training and that is running mixed with biking, weight lifting, and even an occasional day of rest with no exercise.

Happy New Year to everyone. The Whiz

Spices May Really Be The Spice Of Life

Paul Prudhome’s Magic Seasoning

I know I have focused on male and female pelvic health but I would also like to blog on other aspects of health that I think are worthy of mention. This blog discusses the health benefits of adding spices to meals.

It has been reported in medical journals that spices can increase your metabolism and improve your heart health. A study of two groups: one receiving high fat meals and the other group had the same identical high fat diet but had an added mix of spices-rosemary, oregano, and cinnamon. Each rich foods typically increases blood levels of insulin and triglyceride fats, which heighten the risk of diabetes and heart disease. Volunteers eating the spicy meal saw increase in triglycerides and insulin that were significantly lower than those of the group who ate the diet without the spices.

The investigators believe that antioxidants found in spices are responsible.

Bottom Line: Spices may be helpful for boosting metabolism and may be heart healthy. So add a little spice to your life and you just may increase the length of your life.

For more information on using spices in your cooking check out Chef Paul Prodhomme’s website: http://www.chefpaul.com/seasoning

A Drink A Day Keeps A Heart Attack Away

Moderate alcohol consumption may lower the risk of heart disease.

Alcohol in moderation may help the heart

A recent study from Japan evaluated moderate alcohol consumption in in men , especially those with metabolic syndrome which consists of hypertension, diabetes and high cholesterol levels, found higher levels of HDL bandeaux in men who did not consume any alcohol. Again, there may be a medicinal advantage to moderate alcohol consumption.

Hypertension awareness
More men than women in the United States have hypertension, that men are less likely than women to be aware of their condition and to be taking medication to reduce the high blood pressure. The study appeared from the national health and nutrition examination survey.

The data from the study showed that less than 80% of the men were aware of their condition of high blood pressure compared with 85% of women. In addition, 70% of men were taking medication for hypertension compared with 80% of women with hypertension.

Bottom line: “If it may grow, don’t fix it” may apply to your car but not to your heart and blood vessels. Hypertension is a silent disease and often has no symptoms until complications occur. See your doctor at least once a year to have a blood pressure determination.

Get Your Blood Pressure Taken in BOTH Arms-Could Save Your Life

Patients commonly get their blood pressure taken in only one arm. However, there has been a finding that there is may be a disparity between your right and left arm. People whose systolic blood pressure — the upper number in their reading — is different in their left and right arms may be suffering from a vascular disease that could increase their risk of death.
The arteries under the collarbone supply blood to the arms, legs and brain. Blockage can lead to stroke and other problems. That’s why the blood pressure should be taken in both arms should be routine.
The arteries that run under the collarbone can get blocked, especially in smokers and diabetics. If one artery is more blocked than the other, then there is a difference in blood pressure in the arms.
Doctors should, for adults — especially adult smokers and diabetics — check the blood pressure in both arms. If there is a difference it should be looked into further.
A report in the prestigious British Medical Journal, Lancet, found that a difference of 15 millimeters of mercury (mm Hg) or more between readings was linked with an increased risk of narrowing or hardening of the arteries supplying the lower limbs, called peripheral vascular disease.
The difference in blood pressure was also associated with a 70 percent increased risk of dying from cardiovascular disease and a 60 percent increased risk of death from any cause.
Finding peripheral vascular disease early and treating it by lowering blood pressure and cholesterol as well as giving up smoking can help reduce the risk of death.
Bottom Line: Next time you visit your doctor and have your blood pressure taken, request that the doctor or nurse measure your blood pressure in BOTH arms. It could save your life.

The Life and Death of the Penis-What’s Happening Down There As Men Grow Older

It is a fact that as a man ages, the penis also changes in size, shape, and function. This blog discusses some of those changes to help men better understand what’s happening “down there”.
It’s no secret that a man’s sexual function declines with age. As his testosterone level falls, it takes more to arouse him. Once aroused, he takes longer to get an erection and to achieve orgasm and, following orgasm, to become aroused again. Age brings marked declines in semen volume and sperm quality. Erectile dysfunction (ED), or impotence, is clearly linked to advancing years; between the ages of 40 and 70, the percentage of potent men falls from 60% to roughly 30%, studies show.
Men also experience a gradual decline in urinary function. Studies show that a man’s urine stream weakens over time, the consequence of weakened bladder muscles and, in many cases, prostate enlargement.
And that’s not all. Recent research confirms what men have long suspected and, in some cases, feared: that the penis itself undergoes significant changes as a man moves from his sexual prime — around age 30 for most guys — into middle age and on to his dotage. These changes include:
Appearance. There are two major changes. The head of the penis (the glans) gradually loses its purplish color, the result of reduced blood flow. And there is a slow loss of pubic hair. As testosterone wanes, the penis gradually reverts to its prepubertal, mostly hairless, state.
Penis Size. Weight gain is common as men grow older. As fat accumulates on the lower abdomen, the apparent size of the penis changes. A large prepubic fat pad makes the penile shaft appear shorter. Advice to obese men who are concerned about their shrinking size of their penis, if they would lose some weight especially in their abdominal area, the penis would appear to grow longer.
In addition to this apparent shrinkage (which is reversible) the penis tends to undergo an actual (and irreversible) reduction in size. The reduction — in both length and thickness — typically isn’t dramatic but may be noticeable. If a man’s erect penis is 6 inches long when he is in his 30s, it might be 5 or 5-and-a-half inches when he reaches his 60s or 70s.
What causes the penis to shrink? At least two mechanisms are involved, experts say. One is the slow deposition of fatty substances (plaques) inside tiny arteries in the penis, which impairs blood flow to the organ. This process, known as atherosclerosis, is the same one that contributes to blockages inside the coronary arteries — a leading cause of heart attack. It is common for men with coronary artery disease to have erectile dysfunction several years before they have chest pain or signs of a heart attack. It is this reason that men who have erectile dysfunction seek out medical care and be checked for heart disease.

Another mechanism involves the gradual buildup of relatively inelastic collagen (scar tissue) within the stretchy fibrous sheath that surrounds the erection chambers. Erections occur when these chambers fill with blood. Blockages within the penile arteries — and increasingly inelastic chambers — mean smaller erections.
As penis size changes, so do the testicles. Starting around age 40, the testicles definitely begin to shrink. The testicles of a 30-year-old man might measure 3 centimeters in diameter; those of a 60-year-old, perhaps only 2 centimeters.
Curvature. If penile scar tissue accumulates unevenly, the penis can become curved. This condition, known as Peyronie’s disease, occurs most commonly in middle age. It can cause painful erections and make intercourse difficult. The condition may require surgery.
Sensitivity. Numerous studies have shown that the penis becomes less sensitive over time. This can make it hard to achieve an erection and to have an orgasm. Whether it renders orgasm less pleasurable remains an open question.
Bottom line: The normal changes that occur in nearly all men need not ruin your erotic life. According to a good friend, Dr. Irwin Goldstein, “The most important ingredient for a satisfying sex life is the ability to satisfy your partner, and that doesn’t require peak sexual performance or a big penis.” Remember it isn’t the size of the penis, but how you use it that counts.
This has been modified from an article in WebMD by David Freeman, http://men.webmd.com/features/life-cycle-of-a-penis

Putting the “Good” In Good Cholesterol

How to Boost Your ‘Good’ Cholesterol

At the risk of sounding like a certain 20-something socialite, High-Density Lipoprotein (HDL) is hot! Advances in research have brought more attention to the blood lipid (or fat) we often call “good” cholesterol.

“Good” cholesterol doesn’t refer to the cholesterol we eat in food, but rather to the high-density lipoprotein cholesterol circulating in our blood. It’s one of the fats measured in the lipid panel blood test doctors perform. And it’s the component you want more of, because a higher HDL is associated with a lower risk of heart disease.

Experts from the National Cholesterol Education Program (NCEP) note that although LDL or “bad” cholesterol has gotten most of the attention, there’s growing evidence that HDL plays an important role.

Facts About “Good” Cholesterol

• HDL cholesterol normally makes up 20%-30% of your total blood cholesterol.
• There is evidence that HDL helps protect against the accumulation of plaques (fatty deposits) in the walls of coronary arteries.
• Research suggests that a five-point drop in HDL cholesterol is linked to a 25% increase in heart disease risk.
• In prospective studies — that is, studies that follow participants for a period of time to watch for events like heart attacks or death from heart disease — HDL usually proves to be the lipid risk factor most linked to heart disease risk.
• HDL cholesterol levels are thought to be impacted by genetics.
• Women typically have higher HDL cholesterol levels than men. About a third of men and about a fifth of women have HDL levels below 40 mg/dL. Doctors consider levels of less than 40 mg/dL to be low.

Researchers from the Netherlands who analyzed 60 studies concluded that the ratio of total cholesterol to HDL (in which your total cholesterol number is divided by your HDL number) is a better marker for coronary artery disease than LDL measurement alone.

“Boosting HDL is the next frontier in heart disease prevention,” says P.K. Shah, MD, director of cardiology at Cedars-Sinai Medical Center in Los Angeles. Shah says that if the new drugs designed to increase HDL levels prove effective, they could potentially reduce the number of heart attacks and strokes by 80% to 90% — and save millions of lives. HDL-boosting drugs are now being tested.

How Does HDL Cholesterol Help Your Heart?

Experts aren’t yet sure exactly how HDL cholesterol helps reduce the risk of heart disease. But a few possibilities have emerged.

The NCEP says that high HDL levels appear to protect against the formation of plaques in the artery walls (a process called atherogenesis), according to studies in animals.

Lab studies, meanwhile, suggest that HDL promotes the removal of cholesterol from cells found in plaques, or lesions, in the arteries.

“Recent studies indicate that the antioxidant and anti-inflammatory properties of HDL also inhibit atherogenesis,” says the NCEP report

What many people don’t know is that some diet and lifestyle changes may help to increase HDL cholesterol levels, although to a small extent.

Here are some of the contenders:

1. Orange Juice. Drinking three cups of orange juice a day increased HDL levels by 21% over three weeks, according to a small British study (at 330 calories, that’s quite a nutritional commitment). This study could be highlighting an effect from high-antioxidant fruits and vegetables. Stay tuned in the years to come.

2. Glycemic Load. The glycemic load is basically a ranking of how much a standard serving of a particular food raises your blood sugar. And as the glycemic load in your diet goes up, HDL cholesterol appears to go down, according to a small recent study. Along these lines, the NCEP report recommends that most of our carbohydrate intake come from whole grains, vegetables, fruits, and fat-free and low-fat dairy products. These foods tend to be on the lower end of the glycemic scale.

3. Choosing Better Fats. Replacing saturated fats with monounsaturated fats can not only help reduce levels of “bad” cholesterol, it may also increase levels of “good” cholesterol, according to the Food & Fitness Advisor newsletter from Cornell University’s Center for Women’s Healthcare.

4. Soy. When substituted for animal-based products, soy foods may have heart health benefits. Soy products are low in saturated fats and high in unsaturated fats. Soy products are also high in fiber. An analysis found that soy protein, plus the isoflavones found in soy “raised HDL levels 3%, which could reduce coronary heart disease risk about 5%,” says Mark Messina, PhD, a nationally known soy expert. Messina notes that soy also may lead to a small reduction in LDL cholesterol and triglycerides (another type of blood fat), and a possible enhancement in blood vessel function. Other studies have shown a decrease in LDL cholesterol (about 3%) and triglycerides (about 6%) with about three servings of soy a day. That adds up to 1 pound of tofu, or three soy shakes. Further research should focus on whether a higher soy diet intervention is associated with a reduction in heart disease risk.

5. Alcohol in Moderation. Drinking moderate amounts of alcohol is associated with a higher level of HDL. Alcohol is also associated with a lower risk of cardiovascular disease in men and women.

6. Aerobic exercise. Moderately intense exercise of at least 30 minutes on most days of the week is the exercise prescription that can help raise your HDL, according to many health care professionals.

7. Stopping smoking. Experts agree that kicking the habit can increase your HDL numbers a bit, too.

8. Losing weight. Being overweight or obese contributes to low HDL cholesterol levels, and is listed as one of the causes of low HDL, according to the NCEP.

Bottom Line: Not all cholesterol is bad.  HDL is the good cholesterol and this article from the Wall Street Journal provides suggestions for boosting your HDL

 

Your Chair May Be Hazardous To Your Health-The Sins of Sitting

You’ve seen that advice about smoking hazardous to your health which is posted on every package of cigarettes. Now they may be putting a similar warning on the very chair you sit on. It was just fifty years ago when half of American jobs involved moderate physical activity, often in manufacturing or agriculture. Today less than 20% are physically active at work. The rest spend most of their time sitting in a chair at work and at home. Most Americans now spend more time sitting than they do sleeping. Many spend 10 hours a day in a car, at work or at home in a chair. The problem is worse with older Americans. Nearly 75% of middle age and older Americans are sedentary, and more than 40% get no physical activity at all. Women who sit more than six hours a day outside of work had a 34% higher risk of death than those who sat fewer than three hours a day. Even physically active men were 64% more likely to die of heart disease if they sat more than 23 hours a week in front of the TV.

The Benefits
Going for a daily walk will immediately help you feel better. Regular walking can help protect the aging brain against memory loss and dementia, help cut the risk of heart disease, and reduce the change of developing type 2 diabetes in high-risk adults. You can reduce your risk of developing cancer by merely getting at least 30 minutes a day of moderate-to-vigorous exercise.

How to Get Started
Start by thinking of ways to add physical activity to your workday and leisure time. You might consider parking your car a few blocks away from where you work and walk to and from the office. Walk up a few flights of stairs a few times every day. Reduce TV viewing. There are many who will watch 10-12 hours of football games every weekend. During a commercial or time out, you can drop down and do 10-15 push-ups or sit-ups. The famous Heisman Trophy winner and professional football player, Herschel Walker, said he never lifted weights but did push-up and sit-ups during commercials while he was watching T.V.

Consider working on your computer while standing up.

Deliver message to colleagues in person instead of texting or E-mailing.

Set the clock in your computer to remind you to stand up and stretch every 30 minutes.

Train yourself to standup when the phone rings.

You can place the waste paper basket on the other side of the room, which forces you to stand up and walk a few feet to make a deposit into the waste paper basket.

If you have to use the restroom, walk up a flight or two instead of using one down the hall on your floor.

Take a brisk 20-minute walk at lunch and eschew the desert.

Bottom Line: Americans, we need to get moving and spend less time sitting. There are simple ways to get more exercise even if you have a sedentary job. Remember, your chair may be dangerous to your health.

After a Heart Attack: Nine Important Steps to Follow

Heart disease is one of the most common conditions affecting middle age and older men and women. What you do after you have a heart attack (myocardial infarction) is important to your recovery and to your survival.
If you’ve just had a heart attack, how do you know whether you’re getting the best possible care? A new set of clinical performance measures can tell you whether your in-hospital treatment is on track. The measures, which were developed by the American College of Cardiology and the American Heart Association, are designed to help physicians provide optimal care for heart attack patients by outlining the key therapies that define high-quality hospital care.
• Heart Attack Step 1. You should receive aspirin when you arrive at the hospital. Studies show that aspirin reduces the risk of dying after a heart attack.
• Heart Attack Step 2. The hospital should provide clot-busting medication or angioplasty quickly. Prompt treatment is essential after a heart attack to reduce the risk of death. If you’re a candidate for clot-busting medication, you should receive it within 30 minutes of arrival at the hospital. Angioplasty with or without stenting should be done within 90 minutes of arrival.
• Heart Attack Step 3. While you’re in the hospital, you should receive a test that evaluates your heart’s pumping ability. Doctors will administer an echocardiogram, radionuclide angiogram or left ventriculogram to evaluate your heart’s left ventricular systolic function, or pumping ability.
• Heart Attack Step 4. Within 24 hours of admission, doctors should measure your total, LDL and HDL cholesterol levels as well as your triglyceride level. The results of this test will help determine your risk of a second heart attack and how aggressive your lipid-lowering therapy and dietary modifications need to be.
• Heart Attack Step 5. You should leave the hospital with prescriptions for a beta-blocker and a statin and advice to take a daily aspirin. These drugs reduce the risk of death and a second heart attack. A statin will be prescribed even if your LDL cholesterol is below 100 mg/dL.
• Heart Attack Step 6. If your heart’s pumping ability is reduced, you should also receive on discharge a prescription for an ACE inhibitor or angiotensin II receptor blocker (ARB).
• Heart Attack Step 7. If you received clot-busting medication after your heart attack, you should also receive a prescription for the antiplatelet drug clopidogrel (Plavix) when leaving the hospital. Adding Plavix to a daily aspirin further reduces the risk of heart attack in individuals treated with clot-busting medication after a heart attack.
• Heart Attack Step 8. You should receive a referral to a cardiac rehabilitation program or information about a clinical exercise program. These programs offer supervised exercise in addition to counseling on lifestyle measures, medication use and psychological issues. Make sure to follow through with your referral to cardiac rehab.
• Heart Attack Step 9. If you are a smoker, you should receive advice on smoking cessation while in the hospital. Quitting smoking is an essential part of recovering from a heart attack and has important long-term health benefits, including reducing your risk of a second heart attack.

This was excerpted from Johns Hopkins Medical Report: https://mail.google.com/mail/?hl=en&shva=1#inbox/133da74a2625336a

High Blood Pressure Can Lower Your Sex Life

Robert is a 53 year old man with high blood pressure. He has a job associated with stress. He is 25 pounds overweight. He rarely exercises and admits to being a little heavy handed with the saltshaker. He takes a diuretic, hydrochlorthiazide, and an anti-hypertensive medication and since beginning these two medications, he has noted that his sexual performance has gone into very low gear.

High blood pressure can get worse over time and cause problems with getting an erection. A major study showed that 26% of men with high blood pressure said they had erectile dysfunction (ED). That was twice the rate of ED in men with normal blood pressure. Some medicines for high blood pressure, such as diuretics, can also cause ED. But if you’re able to keep your blood pressure under control — even with medicines — you can help prevent your ED from getting worse. 


An estimated 15 million to 30 million men in the U.S. have ED. Some changes in sexual function are normal as a man ages. Erections may be less firm, or it may take you longer to get erect. ED is sometimes temporary, too. Stress, relationship issues, illness, and drug side effects may cause it. But if your erection difficulty is ongoing and it keeps you from having the sex life you want, it may be time to seek treatment.


Many men have problems getting or maintaining an erection at some point in their lives. If it happens occasionally, it is probably not a medical problem. But if you repeatedly have trouble — if it happens about a quarter of the time or more — you may want to talk to your doctor about treatment. .


Some drugs for high blood pressure may cause ED. These include diuretics (water pills) and beta-blockers. ACE inhibitors and calcium channel blockers are less likely to cause ED. If you started having erection problems after you began taking medicine, talk to your doctor. You may be able to switch to a drug that can lower your blood pressure without increasing your risk for ED.


Even with high blood pressure and ED, you can still have a good sex life. If your blood pressure is under control you may be able to take an ED pill. Cialis, Levitra, and Viagra are safe to take with most blood-pressure medicines. If ED pills aren’t for you, other proven treatments include implants, pumps, and injectable drugs.
 You also need to check your testosterone level if your sexual performance is not what you would like it to be or if your sex drive has gone into the tank.

Heart disease — a common complication of high blood pressure — and ED are commonly seen together. A blockage in a heart artery is a good indication that the same thing may be happening in arteries that supply blood to the penis, making it difficult to get an erection. Many men with heart disease can’t take ED pills due to an interaction with heart disease drugs called nitrates. But new research suggests some men with stable heart disease may be able to slowly stop taking nitrates if their doctor thinks they would benefit from an ED pill. Stopping nitrates can be dangerous, so talk to your doctor first. If ED pills aren’t for you, there are other ED treatments that are safe for men with heart disease.

Robert spoke to his doctor and got the message about the connection of ED and high blood pressure. He began an exercise program, lost the 25 pounds over a six-month period, and cut out salt in his diet. His blood pressure normalized and he was able to stop using the medication and he had a noticeable improvement in his sexual performance.

Bottom Line: High blood pressure can lower your sexual performance. Treating the high blood pressure and healthy life style changes can also significantly improve ED.

This article was excerpted from an article by Brunilda Nazario, MD appearing in WebMD