ED and Good Health

Many men are unaware of the relationship between ED (impotence) and their overall health.  ED not only include ability to engage in sexual intimacy but also includes problems with libido, and abnormal ejaculation.

ED is defined as the consistent inability to attain or maintain a penile erection of sufficient quality to permit satisfactory sexual intercourse.

The process of diagnosis and treatment begins with a careful sexual history.  Men with a sexual problem will probably be asked:

• Are you currently having sexual relations?
• With whom do you have these relations (men, women, or both, and how many partners)?
• When was the last time you had intercourse?
• Are you satisfied with the quality and frequency of your sexual experiences?

The answers will clarify what aspects of sexual dysfunction are occurring and inform the rest of the evaluation. If libido is intact but ED is a complaint, then what underlying medical conditions or medications may be contributing to the problem? If libido is affected, are there significant psychologic or emotional contributing factors that need to be addressed as well as measuring the serum testosterone level.

Although sexual problems are not necessarily caused by aging; it is true that aging is associated with an increase in sexual issues. As early as 40 years of age, up to 40% of men report some impaired sexual function.  Inability to attain or maintain an erection consistently for satisfactory intercourse was reported in 67% of males over 69 years of age in another study.  Testosterone decline is common with age. While this may play a hormonal role in sexual dysfunction, it is important to thoroughly evaluate all possible causes before initiating testosterone replacement therapy for sexual dysfunction alone.

Similarly as men age, interest in sex may decline due to lack of novelty as well as an increase in stress that often occurs in older men. Fatigue, lack of privacy in the family setting, and unresolved anger with a partner may all be determinants of sexual problems in the older male. More critically, loss of interest in sexual activity and loss of libido may be manifestations of depression.  Depression can cause sexual problems, but the reverse may also be true.

In addition to these factors, diabetes, blockage of the blood vessels, and adverse effects from medications, both prescribed and recreational (marijuana and cocaine) may all play roles in sexual functioning. Disease states such as hypertension, diabetes, heart disease, and obesity can affect the blood flow into the penis. Blockage in any of the major arteries feeding the blood supply to the penis can lead to inability to obtain and maintain an erection. Diabetes, for example, this can also affect the mechanism of erection and cause ejaculatory disorders such as backward ejaculation of the fluid to the bladder instead of out of the tip of the penis at the time of orgasm.

Medications that are often identified as causes of erectile disorder which include medications used to treat depression, blood pressure lowering medications, cholesterol medications, and drugs used to treat prostate cancer.  Excessive alcohol use is the most common substance that can lead to ED, though cocaine, heroin, and marijuana have all been linked as well.

Bottom Line:  ED is a common problem affecting millions of middle age and older American men.  The diagnosis can often be attributed to underlying disease states.  A careful history and physical examination will help to elucidate the problem and start you on the road to successful treatment.

Smoking Is Also Hazardous to Your Urologic Health.

It is given that smoking is deleterious to your lungs and heart causing lung cancer, chronic obstructive pulmonary disease and heart disease, just to name a few of the common medical conditions causes by smoking.  There are also urologic conditions that are affected by smoking.

Bladder cancer is 4^th most common cancer in men with nearly 80,000 new cases each year in the united States.  Smoking causes harmful chemicals and drugs to collect in the urine.  These toxic chemical affect the lining of the bladder and increase your risk of bladder cancer.

Nearly 30 million American men have erectile dysfunction or impotence  This is usually due to a reduction of poor blood flow to the penis.  Smoking can harm blood vessels, when decrease the blood flow to the penis.  As a result, men will have difficulty obtaining and keeping an erection adequate for sexual intimacy.

Kidney cancer is in the top ten most common cancers in both men and women with nearly 60,000 new cases every year.  Smoking puts noxious chemicals from the lungs into the blood stream where it is filtered into the kidneys and can cause kidney cancer.

Kidney stones affect 1 million Americans and smoking is a known cause of having kidney stones and also for having recurrent kidney stones.

Painful bladder syndrome affects 12% of women.  The condition is irritated by smoking and produces more symptoms of pain and discomfort in the pelvis.

Overactive bladder (OAB) affects more than 30 million American men and women.  Smoking irritates the bladder and increase the frequency of urination.  Smoking also is associated with coughing that can increase urinary leakage.

Infertility caused by male factors affects 50% of all problems related to difficulty with achieving a pregnancy.  Smoking can harm the genetic make-up in eggs and sperm.  The infertility rate for smokers in nearly twice that for those men who do not smoke cigarettes.

Bottom Line:  Most people are looking for reasons to stop smoking.  There are so many medical conditions that are caused by or are made worse by smoking.  Talk to your doctor about some of the effective ways to achieve smoking cessation.

Erectile Dysfunction and the Other “Bones” That Are Important

I would like men to think of erectile dysfunction as a harbinger of other chronic diseases like heart disease, diabetes, kidney failure, high blood pressure, elevated cholesterol levels and also bone disease or osteoporosis.

A recent study from Taiwan 4,460 men aged 40 years and older diagnosed with erectile dysfunction from 1996 to 2010 with 17,480 randomly selected age-matched patients without ED.  The research found that osteoporosis developed in nearly 6% with ED and 3.65% in men without ED.  Men who had ED had a 3 times more likelihood of developing osteoporosis when compared with men who did not have ED.

Osteoporosis is a metabolic bone disease in which the bones become brittle and porous escalating the rate of bone loss and increasing the chance of a fracture of the hips and spine.

The researchers think that the men with ED had a lower level of testosterone which is necessary for bone strength and development.  Another explanation offered by the authors is that chronic, low grade inflammation can damage the lining of the blood vessels and perhaps lead to a decrease in the blood supply to the penis which is necessary for an erection to occur.  The same inflammation can also cause the bones to fail in calcium rebuilding of bone and thus lead to osteoporosis.

Finally, there is the theory that there is alternation of the vitamin D with decreased levels in men with ED.  With less vitamin D there is a risk of alternations in the lining of the blood vessels especially those that supply the penis and lead to ED.  Decrease in vitamin D also alters bone metabolism and may result in osteoporosis.

Bottom Line: Men with ED should be check for the co-morbid conditions such as heart disease, diabetes, high blood pressure, hormone deficiency and also have tests to be certain that men do not have osteoporosis.

Statins, Cholesterol and Erectile Dysfunction

Statins are a group of medicines that can help lower the level of cholesterol in the blood.  Having a high level of cholesterol is potentially dangerous, as it can lead to a hardening and narrowing of the arteries (atherosclerosis) and cardiovascular disease (CVD) such as coronary heart disease, chest pain, heart attacks,  strokes, and even erectile dysfunction\impotence.  Cholesterol that narrows the blood vessels can decrease the blood flow to the penis thus making it difficult to achieve and maintain an erection adequate for sexual intimacy.

Before taking statins, every man or woman should give strong consideration to lifestyle changes such as losing weight, exercising regularly, limiting alcohol consumption, and consider smoking cessation.  All of these actions can decrease the cholesterol levels.  All of these lifestyle changes can also improve sexual function.

Bottom Line:  Elevated cholesterol levels are deleterious to your health.  Consider lifestyle changes before starting statins.  Your erections and your partner will thank you!

Good News About Red Wine and Prevention of Erectile Dysfunction (ED)

 

ED affects millions of American men.  Most of the men have ED from vascular causes such as heart disease, high blood pressure, diabetes, or side effects of medications.

Men who consume red wine and blueberries and take regular exercise can cut their risk of developing erectile dysfunction by over a fifth.  My cardiologist, Dr. Frank Wilkow, informed me that two glasses of red wine a day was good for my heart and my erections.  (He also told my wife that one glass of red wine was good for her heart as well!)

Scientists have identified that foods rich in certain flavonoids cut the risk of men experiencing the sexual problem which affects up to half of all middle-aged and older men.

The foods with the greatest benefits include blueberries, cherries, blackberries, radishes and blackcurrant, which contain anthocyanins; as well as citrus fruits, which are packed with flavanones and flavones.

The study from The American Journal of Clinical Nutrition showed that men who regularly consumed food high in flavonoids were 10% less likely to suffer from ED.

Bottom Line: Men who consume a diet rich in flavonoids plus participate in regular exercise and maintain their body weight are the best way to preserve sexual health as well as a reduction in cardiovascular risk factors.  And another benefit is that men who consume the healthy diet also have a reduction in risk of diabetes.

Update on ED-When It Is Dead Down There

ED is the inability to achieve and maintain a normal erection adequate for penetration that impacts the intimate relationship between partners.  There are nearly 30 million American men suffering from ED.

ED may occur under various circumstances ranging from diabetes, hypertension, prostate gland surgery, spinal injuries, neurological and emotional problems.  There are times when there is no identifiable cause. However, it’s far more frequently seen in diabetics and to some extent in those with cardio vascular diseases, hypertension and peripheral vascular disease. The effect on the blood vessels leading to poor blood flow seems to be the primary reason.

People suffering from ED should carry out assessment of blood sugar, cardio vascular evaluation, measurement of hormones like testosterone and prolactin. A psychological evaluation will often benefit those who suffer from performance anxiety. Depression is often seen as an accompanying factor of erectile dysfunction in many people especially when there is no other identifiable cause. A detailed evaluation of a man’s medication is also important. Smoking and excessive drinking are both known to have significant adverse impact on erectile dysfunction.

Alcohol is a depressant, and using it heavily can dampen mood, decrease sexual desire, and make it difficult for a man to achieve erections or reach orgasm while under the influence.

According to the U.S. Centers for Disease Control and Prevention, CDC, moderate drinking is no more than two drinks a day for men (and one drink a day for women). The liver can only break down the amount of alcohol in about one standard-size drink an hour, so regularly drinking more than that means that toxins from alcohol can build up in your body and affect the blood vessels supplying the penis.

Heavy drinking can lead to temporary erectile dysfunction. This is because pre-sex drinking decreases blood flow to the penis, reduces the intensity of your orgasm, and can dampen your level of excitement.  Also, Long-term erectile dysfunction has been linked to chronic heavy use of alcohol. In fact, studies show that men who are dependent on alcohol have a 60 to 70 percent chance of suffering from sexual problems. The most common of these are erectile dysfunction, premature ejaculation and loss of sexual desire.

Bottom Line:  ED is a common problem affecting millions of American men.  Help is available.  If you or one you love is suffering from ED, speak to your doctor.

Sex and the Senior or Senior Sex

It is not a myth that seniors engage in sexual intimacy or wish to enjoy intimacy perhaps just as much as younger men and women. However, intimacy like many other physical and social interactions that occur as men and women get older. This blog will discuss simple suggestions for seniors to have enjoyable and more fulfilling sex life.

Start your intimacy by engaging your mouth or your communication skills before engaging in sex. You should be able to communicate your thoughts, fears, and desires with your partner. Be frank with your partner and encourage them too to be open with you. Holding back or hiding certain things will only dampen your spirits and diminish your performance.

Be open to new ideas and experiment

Just because you are growing old, doesn’t mean you can’t expand your horizons. Be open to new ideas and discuss them freely with your partner. Don’t hesitate and put your creative mind to use. If erectile dysfunction is an issue for you, try sex with the woman on top, as hardness is less important. If you are used to having sex in the evening, try the morning and visa versa.

Eat right and exercise

High blood pressure and cholesterol can cause the vascular problems that lead to trouble with your erections. It is important to maintain a healthy lifestyle by exercising and keeping your weight and cholesterol in check.

Avoid large quantities of alcohol and smoking

It’s no news that both alcohol and smoking can hinder a man’s ability to achieve an erection. If you are having sexual difficulties, consider abstaining from smoking and alcohol.

Sex does not always mean intercourse

You need to broaden your definition of sex. Holding each other, gentle touching, cuddling, kissing, and sensual massage are also ways which will fulfill you. Try oral sex or masturbation as substitutes to intercourse.

Know when to visit a doctor

Your doctor can help you manage chronic conditions and medications that affect your sex life. If you have trouble maintaining an erection, ask your doctor about treatments. If you have vaginal dryness, see your doctor as help is available.

Be optimistic

You need to maintain a positive approach when it comes to these sensitive issues. Having said that, you need to be realistic too to accept the changes that your body is going through. But nevertheless, accept these natural changes with confidence.

Bottom Line: Sex is enjoyable at any age. Seniors enjoy sexual intimacy just as younger men and women do. You need to know that you can be successful as a senior both in and out of the bedroom.

ED SOLUTION AU NATRIEL

Erectile dysfunction affects over 30 million American men.  Most of the men are looking for a solution, perhaps a pill to solve their problem.  Viagra, Levitra, and Cialis do work.  However, they are very expensive and not available in the generic format at this time.  So let’s look at other options, even natural supplements that may be effective.

 Ginseng

While a study published in the Journal of Urology found that men taking Korean red ginseng saw significantly improved erections compared to their placebo-popping counterparts, the American Urological Association Clinical Guidelines Panel feels this trial group of 45 men is too small to validate its clinical efficacy. In addition, Korean red ginseng can cause added health issues for men who have heart disease, mood disorders, or immune system disorders.

L-arginine

Taking a supplement of this amino acid can help increase blood flow both to the penis and the heart, While there’s no medical guarantee it will work like Viagra, Levitra, or Cialis, L-arginine is known to increase levels of nitric oxide, a gas that relaxes muscles and increases blood flow, and is involved in maintaining an erection.

Zinc Supplements

Zinc supplements are not shown to help, but a healthy lifestyle with an excellent diet — anything good for the heart — will be good for the penis. Perhaps the best advice is to lose weight, to exercise, and to stop smoking.

Acupuncture, Hypnosis, and Yoga

Anything that helps reduce stress and improves awareness of your body or calms you down is worth trying.  For some people, acupuncture can help in situations where stress, anxiety, or injury is the cause of ED.

Horny Goat Weed

Pills, powders, and teas are made from an extract of this plant, also called Epimedium, which has long been used in traditional Chinese medicine. Some animal-based studies show that it may increase nitric oxide, which is involved in maintaining an erection, but there is no conclusive scientific evidence that it has benefits in humans.

Pomegranate juice

Antioxidants in berries help nitric oxide last longer in the bloodstream, which is where the pomegranate myth began. However, there is no scientific proof that drinking this antioxidant-rich juice can actually help with erections.

Bottom Line:  I wish I could report that these supplements are the Holy Grail and can help men restore their erections so that they will be able to successfully engage in in sexual intimacy with their partners.  However, the jury is out; and although these options are not likely to be harmful they probably won’t solve most men’s erectile dysfunction.

FAQs on Erectile Dysfunction

It often is a mystery about men are able to achieve and hold an erection.  Even more mysterious is what are the causes of failure of erections and to fix the problem.  It is not uncommon for me to feel uncomfortable broaching the topic with their physician.  Fortunately, after the introduction of oral medication to treat impotence or erectile dysfunction in 1999, men are talking about their problems in the bedroom with their physicians.

In this blog I will discuss some of the most frequently asked questions about ED and the treatment for this common condition that impacts over 14 million American men.

1. Why does Viagra fix the problem?

An erection requires an increase in the blood supply to the penis and more blood has to rush into the chambers of the penis than comes out of the penis.  When this happens, an erection will occur. Viagra helps blood vessels relax and increases the blood supply to the penis.

2. Does the male hormone, testosterone, have a role in the erection process?

Testosterone acts on a series of different areas of the body to enhance bone development, muscle growth, sexual interest and function. Testosterone is primarily responsible for the libido or sex drive.  The testosterone level slowly decreases at a rate of about 1% a year starting around 25.  By middle age, most men start experiencing signs and symptoms of testosterone deficiency and men often need hormone replacement therapy.  This can be accomplished with injections, topical gels, or pellets of testosterone inserted under the skin.

3. Why does sex feel good?

There is a high concentration of nerve endings in the penis and vagina, which triggers stimulation and orgasm. Dopamine is triggered and there is a pleasant feeling in the brain during ejaculation. It could also be an evolutionary thing. When we were cavemen with only animal instincts, the fact that sex feels good encouraged us to reproduce to keep the species going.

4. Do sexually transmitted disease cause erectile dysfunction?

Gonorrhea and chlamydia are both sexually transmitted diseases that are caused by direct and unprotected sexual contact. Both STDs live in reproductive genital tracts of men and women and can be cured with antibiotics. If both STDs go untreated, it can lead to infection that will lead to infertility in men but usually does not cause erectile dysfunction.

5 Why does sex hurt?

The obvious reason is if the man’s penis is much larger than a woman’s vagina opening. The other possibility is that women have a decrease in lubrication of the vagina and the friction is a source of pain and discomfort usually for the men but also for the male partner as well.

Bottom Line:  Impotence is a common condition especially in middle age or older men.  Treatment is available and most men can be helped.  Talk to your doctor.

What’s Causing Your Erectile Dysfunction? (ED)

Erectile dysfunction or impotence affects nearly 14 million American men.  The condition is often associated with diabetes, heart disease, high blood pressure and literally hundreds of medications that side effects of ED.  There are a number of conditions that can be treated that can significantly improve your erection that doesn’t require medication or surgery.

1. Vitamin D deficiency: vitamin D is a necessary vitamin and when the vitamin D level is decreased, which can be identified by a simple blood test, a man’s erection can be affected. A study has shown that men with severe erectile dysfunction had lower Vitamin D. The solution is as simple as getting outside in the fresh air and getting some sunshine as the sun helps convert inactive vitamin do to the active vitamin that is vital to good health. Many factors affect the skin’s ability to produce vitamin D, including season, time of day, latitude or how far you live from the equator, air pollution, cloud cover, sunscreen, body parts exposed, color, and age. Dermatologists recommend using sunscreen and getting vitamin D from food and supplements rather than risk the harmful rays of the sun.
2. Diabetes: Erectile dysfunction could be caused by undiagnosed or diagnosed diabetes. If your ED is sudden, consider getting screened and if you know you already have diabetes, expect this to be a risk factor. By getting the glucose level under control and lowering the HbgA1C to normal levels, you can improve your erections.
3. Your drinking: Alcohol has a reputation of increasing the desire for sexual intimacy but decreasing the performance or make getting and holding an erection difficult. If you have issues getting it up and you have also started increasing the amount of drinks you have, including the frequency, then consider cutting back. Heavy drinking increases your risk of ED.  One to two drinks per day is acceptable will not impact your erections.  More alcohol will certainly impact your performance in the bedroom.
4. Stress: If you are stressed at work, home or in your relationship, it will affect your sex life. You need to be a relaxed to get in the mood for sex. This problem can also be a catch-22, because if you cannot get it up, you start to stress about that too, making it even more unlikely you will have an erection. So, basically, just relax and take a deep breath and practice mindfulness.
5. Coffee to the rescue: Studied have found that 42 percent of men who drink between two to three cups of coffee a day are less likely to have erectile dysfunction. Caffeine helps relax the arteries and the smooth muscle within the penis which, in turn, helps increase blood flow.
6. Not enough sex: The more sex you have, the less likely you are to suffer from ED. What is considered regular? Experts say you can shoot for two – three sexual engagements including orgasms per week.
7. Smoking: The more you smoke, the more you risk have a flat, flaccid penis. 23 percent of erectile dysfunction occur among men who smoked.
8. Lack of exercise: Exercises, especially weight resistance ones, do a lot to increase a man’s testosterone which helps reduce the likely of ED. Your levels or testosterone normally drop about 1%a year after age 25.
9. Bicycle riding: Studies have shown that the longer you ride your bicycle, the higher your chance of developing ED. You do not have to stop riding though, just make some modifications. You can ride shorter distances, get off of the seat every 10-15 minutes for 30 seconds, find comfortable seat and get a bike that is sized appropriately.
10. Your medications: Some medications like antihypertensive drugs and antidepressants (SSRIs) can cause erectile dysfunction.

 

Bottom Line:  ED is a common problem affecting millions of American men.  Often times the problem can be related to diet, lack of exercise, and poor lifestyle choices. Take a look at these 10 factors that can significantly affect a man’ erection.  Make some adjustments and you will soon be “back in the saddle”!