An international group of researchers did all males—and their doctors—a great service by showing that the combination of erectile dysfunction (ED) and
arterial disease (CVD) is potentially lethal. In short,
the presence of both puts you at higher risk for death from all
causes and also increases the chance of cardiovascular death,
heart attack, stroke and heart failure hospitalization.
The 2010 study was the first to show that ED is a strong
predictor of death and cardiovascular outcomes. It involved
more than 1500 men in 13 countries, and found that men with
CVD and ED (compared to those without ED) were twice as
likely to suffer death from all causes and 1.6 times more likely
to suffer the composite of cardiovascular death, heart attack,
stroke and heart failure hospitalization.
The take-away message is this: if you go to a general
practitioner or a urologist for ED be sure to get a cardiovascular
workup as well.
The study’s lead author, Michael Böhm, MD, head of
the internal medicine department at Germany’s University
of Saarland, had this to say: “Men are being treated for the
ED, but not the underlying cardiovascular disease. A whole
segment of men are being placed at risk. If a man has erectile
dysfunction, then he needs to ask his physician to check for
other risk factors of cardiovascular disease.”
I say amen to that.
In my cardiology practice, I often heard complaints from
men about ED and that’s because the nature of vascular
disease is diffuse. It is not limited to the coronary arteries.
Typically it is also present in the legs, the brain, and even the
penis. ED is closely associated with the same kind of damage
and dysfunction to the delicate lining of blood vessels that
occurs in atherosclerosis and the build-up of plaque that
precedes heart attack and stroke.
Lifestyle Remedies Work for Erectile Dysfunction (ED)
Many men get a prescription from their doctor to cope with
the performance aspect of ED. But there are other options for
the aging male.
A 2012 article in the International Journal of Impotence
Research impressed me because it emphasized weight loss, improved antioxidant status through diet and supplementation, reduced sugar, and physical and penile-specific
Such lifestyle modifications, said David Meldrum, MD,
and colleagues from UCLA and the University of Naples,
can be integrated into any comprehensive approach to
maximizing erectile function because they result in “greater
overall success and patient satisfaction, as well as improved
vascular health and longevity.”
Oxidative stress and inflammation are major causes of
blood vessel damage and cardiovascular diseases, including
ED. They disrupt the production of nitric oxide (NO), the
chemical produced by blood vessels that contribute to
their health and ability to dilate. They also contribute to
insulin resistance. Men with ED have decreased levels of
NO and increased levels of markers of oxidative stress and
inflammation, factors that worsen with age. Lifestyle can
counteract this pattern in the following ways, the researchers
- Exercise and weight loss increase insulin sensitivity and NO production.
- Antioxidants increase NO and improve vascular and erectile function. They are particularly important in men with ED who smoke, are obese, or have diabetes.
- Omega-3 fatty acids reduce inflammation and increase NO, and are particularly important for men with diabetes, hypertension, or coronary artery disease.
In an interview on his research, Dr. Meldrum contended that
exercise is the “single-most important modality to improve
erectile function and cardiac health.” In my own practice, I
repeatedly saw the benefits of exercise for aging men. Exercise
is terrific for the heart, as most everybody knows, and it is also
good for the pelvis as well, something that most men don’t
know. I used to see so many men in their 40s, 50s, and 60s
with big bellies, metabolic syndrome, insulin insensitivity, and
hypertension. Their testosterone and libido were down in the
dumps. The best thing for them was exercise.
I also remember one heart patient who came to see me
and was doing really well. His testosterone had soared. I
asked him if he was taking any testosterone.
“No,” he said, “I’m walking and skipping every morning.”
He would walk along a golf course for maybe a tenth of a mile,
and then skip for a 100 yards or so, and alternate like that.
That’s right; skip like you did when you were a kid. He was a
smart guy, and knew he was not only helping his heart but his
sexuality as well.
Dr. Meldrum and his associates have created a fascinating
educational website dedicated to erectile health (www.erectile-function.com), and features a potpourri of practical
steps for reversing ED, including pelvic floor exercises. The
exercises were originally designed by researchers in England
to stop post-void dribbling among men and were found to
also improve erectile function.
According to the website, the British researchers found
that the exercises work even for severe ED, and claimed
similar effectiveness as Viagra. The website also offers a
book entitled Survival of the Firmest, by Dr. Meldrum’s team,
with an introduction by Louis Ignarro, PhD, professor of
pharmacology at UCLA who was a co-recipient of the 1998
Nobel Prize in physiology for his research on nitric oxide.
Over the years I have recommended “the bridge,” a yoga
pose that helps strengthen the back, gluteus muscles, and the
pelvic floor. It’s quite easy to do. You lie on your back, bend
your knees, and plant both feet together and as close to your
butt as possible. Arms are alongside your body, palms down.
Press your feet, arms, and shoulders against the floor, and lift
your hips upward. Squeeze your buttocks and try to hold for a
few seconds. Slowly build up your holding time. Give it a try,
but don’t do it if it is a strain.
Also a strategy definitely worth pursuing is Earthing, the
subject of a book I co-authored in 2010. Earthing refers to
major health benefits as a result of contact with the natural,
gentle electrical energy on the surface of the Earth. You can
absorb this healing energy, and doing yourself a big favor in
the process, by regularly walking or sitting barefoot outside
(on grass, sand, or any earthy terrain) or indoors sleeping,
working, or relaxing in contact with a special Earthing sheet
or mat that conducts the Earth’s energy. What happens is the
Earthing, also called grounding, reduces inflammation and
pain in the body and also promotes better circulation and
energy. For more information about Earthing, please visit my