Men’s Health Blog
Douglas E Sutherland, MD

February 27, 2018


    Without a doubt, the most common men’s health concern I hear about in clinic is the loss of erectile function (ED). It often ties in directly with the second most common men’s health question I receive, testosterone management, which you can read more on here. In fact, most men assume that the reason they have ED in the first place is because of a low testosterone level, so logically, they ask me about getting their testosterone level checked. While most men ask about their ED with a wry smile, a short conversation often reveals how distressing their ED can actually be. Often the man is more concerned about his partner than the actual loss of his own sexuality. For example, many men fear their ED will be interpreted by their wives as a sign the marriage is failing. ED is not just a loss of a physical function, but damaging to emotional and psychological health as well. 
    The worst part about ED is that I rarely have an satisfactory and economical solution. By the time ED has developed, it is expensive to reverse and requires taking medications or even undergoing surgery. And remember, few insurance companies feel that ED is a condition that merits medical management! So be prepared to pay cash for my services.
    The best treatment of ED is prevention of ED in the first place. Which is why I say I can see the future - that 28 year old obese man I see ordering a massive super mocha coffee/milkshake at the coffee shop; the 34 year old with a smoking addiction; the 41 year old drinking 4-5 beers several nights a week - these are my future ED patients. Though not always the case, ED is most frequently caused by injury to the microscopic blood vessels and nerves that control penile function. This damage is caused by years of obesity, high blood pressure, and diabetes. It is best to understand the onset of ED as a warning sign that a man's cardiovascular health is beginning to seriously decline - when a man asks me about fixing his ED, my first concern is his overall health since the same physiological conditions that lead to ED also result in heart attacks and stroke. 
    Other causes of ED include prescription medications (often drugs to treat conditions caused by obesity, blood pressure and depression, as well as narcotic pain medication), stress/anxiety, and low testosterone. It is important to note that most men suffering from ED often have all or several of these problems, making successful ED management quite challenging. history.
    Can ED caused by obesity-related metabolic syndrome be reversed without needing to take a viagra? Sometimes it can, or at the very least, the man’s natural erectile function can be improved such that medical therapy can become more effective. But even if successfully reversing the root causes of ED does not improve erectile function, there is tremendous value to doing so for overall men’s health. There simply is no down side to losing weight, managing diabetes, quitting smoking, and managing stressors (that you can control). 
    Prevention of ED requires a commitment to consistently “living clean”. No easy task. If you have normal erectile function now but worry that your medical condition may put you at risk for ED in the future, my advice is to make a plan. Your plan should make your life easier, not harder. You may want a fast and radical change, but such a plan is not likely to survive in the real world. Simple is usually better. And stop chasing perfection - your goal is to follow your plan as long as you can, every day. 

Correct obesity - Aim for a normal BMI and a waist circumference of 35 inches or less.
Quit smoking.
Take a careful look at the mediations you take. Even allergy medication can be detrimental to your erectile function.
Prioritize sleep - 7 to 8 hours/day. If this is a struggle, identify the factors preventing you from getting a good night’s sleep and address them.
Drink minimal alcohol. 
Exercise intensely. A long walk or easy jog will not help your erectile function. At least 2 days a week add a high intensity work out that includes heavy weight lifting. 

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