Erectile Dysfunction Predictor of Heart Attack

Dear Pharmacist,

I have a bedroom problem. I took Viagra for several years, and it stopped working, so I was put on Cialis. Sometimes that helps, sometimes not. I'm too embarrassed to ask my doctor again, she says this is a part of aging because I am 58. Any suggestions?

--T.M., Bethesda, Maryland

Answer: I have many! I'm stunned that she's never mentioned bio-identical hormone replacement for you, as in testosterone or "T." The reason most men develop erectile dysfunction in the first place is because they are low in their natural 'manly' hormone, which starts to decline with age. The declining T causes a relative increase in circulating estrogen, a hormone found in higher concentrations in women. Restoring testosterone or "T" puts balance back, so it's my best recommendation for increasing mojo.

Giving a man one of those super sex pills like Viagra, Levitra or Cialis is the equivalent of jump starting the car every two miles, rather than just fixing the battery. Why do men medicate themselves every weekend, when they can fix the root cause by balancing hormones? It's a good question isn't it? A good physician should evaluate your hormones and neurotransmitters and decipher if it's low testosterone, low dopamine, high cortisol, high estrogen, low progesterone, high insulin, low DHEA or oxytocin. If you're a man or a woman, and you've 'lost that lovin' feelin' that's what you need to evaluate and replenish. Prescribed sex pills, as useful as they are, can't balance hormones.

There's another reason I get hot under the collar about this topic. Men are dying every day from heart attack and stroke that may have been prevented. The clue that you're headed for trouble is erectile dysfunction. Think that out, it's not hard to understand... if the blood isn't effectively flowing down south to your penis, it isn't flowing up north either, to your heart. The blood vessels are clogged and that could cause erectile dysfunction years before a massive heart attack occurs. What does conventional medicine do? Prescribe a quick fixer upper, so you can have a night of fun, instead of helping you clear your arteries, improve vessel flexibility, correct hormonal imbalances and manage cholesterol (they don't even measure it correctly but that's another column).

I think there is an incomplete knowledge or understanding of physiology or hormones because sex pills should not be your go-to drug for erectile dysfunction. You think it's just me saying that to alarm you? Not a chance, I would never scare you, that's not how I roll.

A study published in March 2010 in Circulation concluded, "Erectile dysfunction is a potent predictor of all-cause death and the composite of cardiovascular death, myocardial infarction, stroke, and heart failure in men with cardiovascular disease." There's no doubt, low testosterone is a risk factor for heart attack. Replacement therapy is controversial. Some studies suggest the very use of testosterone increases heart attack risk, but I find flaws with those studies. Balance is key.

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