I want to challenge you to think about lifestyle changes rather than medication for erectile dysfunction. There are so many advertisements on television for different drugs for treatment of the problem, but three-fourths of the advertising time is spent telling you the dangers and possible harms involved in taking the medication. You need to have an understanding of how the medication works as well as possible side effects of the drugs.
The medication that widens the inside diameter of the penile artery is similar to medicine that dilates the arteries of the heart. To understand how the medicine works, you need to understand what the word dilate means in relation to your arteries.
Look at it this way. Let’s say that within the wall of an artery there are numerous bands of elastic fibrous tissue similar to multiple rubber bands around the artery. Let’s also say that these elastic fibers stay fairly tight and that with each heartbeat they stretch just a little to keep the artery from bulging out too much. As they relax and stretch, the inside diameter of the artery becomes larger and balloons out, like going from a narrow straw to a wider straw. That relaxation allows the artery to open up to let more blood flow through. For an artery to “dilate” is this relaxation of the walls to let it expand in size from a narrow straw to a wider straw. That is what the medications you see advertised on television do; they allow the artery to dilate to let more blood flow through.
If someone feels chest pain—angina—there is medication that can be taken immediately to dilate the arteries in the heart. Once the medication is taken, the arteries expand and go from a narrow straw to a wider one. There is comparable medication that will similarly dilate the penile artery to allow more blood flow needed for an erection. These are the medicines you see advertised on television. There is a direct correlation to the process when talking about angina, heart attacks, strokes—and erectile dysfunction.
I am going to tell you the best story I know to illustrate how medication works on arteries, whether it is a heart artery or a penile artery. There is a pill specifically for the heart arteries, not the penile artery, but both arteries react similarly. The medication is called nitroglycerine. Many people who have known blockage of the arteries in their heart have been prescribed this pill so if they feel a tightness or a pain in their chest, they can place it under their tongue to be quickly absorbed. That pill gives the effect of causing those elastic fibers in the wall of their arteries to relax and allow a greater blood flow, at least for a while longer. I say a while longer because the medication is only temporary and more has to be given, either under the tongue or through a vein if the chest pain symptoms persist.
A few years ago, I was on the initial leg of a six-week trip and traveling from New York to London to Africa on an overnight flight. About three hours into the trip, I was awakened by an announcement overhead, asking if there was a doctor onboard. I went forward and was informed that a gentleman had grabbed his chest and then passed out. He was wearing a suit, and he still had his coat on. His tie and white dress shirt seemed proper for being in first class. And even his handkerchief was still in the top front pocket as I quickly laid him out across the first five middle seats in coach. I immediately asked for oxygen and also if there was any kind of heart monitor, blood pressure cuff, or emergency medication. No was the answer to all my questions, except for the oxygen.
I requested that the crew ask over the speaker system if anyone onboard had any nitroglycerine tablets. Three passengers had some because of problems with occasional chest pain. We had gotten my new patient’s coat and tie off, and I had unfastened the top button of his shirt. His pulse was erratic and barely palpable. I kept my fingers on his pulse, kept the oxygen flowing full force, and began placing the nitro tablets beneath his tongue. As soon as one was absorbed, I would place another.
The pilot came back and said, “We are ten minutes from the halfway point of the trip,” and asked if it would be better to continue to London or turn the plane around. I said the sooner we got the gentleman on the ground, the greater the chance of saving his life. My reasoning was that if we turned around now, we would get him on the ground twenty minutes sooner because we were still ten minutes before the halfway point, plus getting to the same distance on the other side of the halfway mark would take an additional ten minutes. The pilot didn’t say another word but immediately turned and went back to the cockpit.
I will never forget looking out the window and seeing the full moon slowly pass by the window as we were making a 180-degree turn to get our patient back on the ground. In about thirty minutes, although he looked lifeless, he regained consciousness. His pulse became steady and stronger. His suit coat was lying on his chest as we rolled him on a stretcher toward the ambulance. He had not said one word, but his eyes were searching, trying to comprehend all that was going on. He kept looking up at me, and just before we reached the back of the ambulance, he said, “Reach in my inside coat pocket and get my business card. I want you to have it.” He was the CEO of one of the largest hotels in Las Vegas. He was also a lawyer for a very well-known individual.
It was only after I returned home six weeks later that I received a call from his son, who had learned who I was through the airline. He informed me that my patient survived his heart attack. Even though he had to be operated on, the outcome was successful.
What did the medication do to his heart arteries, and how does that relate to erectile dysfunction? The pills I placed under his tongue allowed the artery that was partially blocked in his heart to dilate and to allow more blood flow for a short period of time. And as long as I kept placing those pills, the artery remained dilated and allowed more blood flow into the heart muscles downstream of the partial blockage.
Similarly, when you take pills for erectile dysfunction, the penile artery dilates as though from a narrow straw to a wider one, allowing more blood to flow into the penile tissue and making an erection happen.
The basic medicines used to treat erectile dysfunction—Viagra, Cialis, Levitra, or similar type drugs—work by letting the artery dilate to allow more blood flow, similar to what happened to the arteries in the heart of the man on the plane.
The real question you should be asking yourself is this: are there lifestyle changes that will do the same thing?
How to Prevent or Reverse Erectile Dysfunction
Many reports show that heart disease can be prevented by changing your lifestyle to protect your arteries. Can changing your lifestyle also help prevent erectile dysfunction? Will alleviating those same risk factors to the arteries of your heart also improve or reverse erectile dysfunction? Let’s see what the medical literature says.
Being overweight or obese affects erectile dysfunction.
Erectile dysfunction can be improved by getting to your ideal weight.
One study dealt with more than fifteen hundred men who had erectile dysfunction. They were divided into three groups according to their weight. They used BMI (body mass index) to determine in which group each man belonged. In this study, almost 40 percent were considered normal weight according to the BMI range.
The study’s findings were twofold. They used a Doppler device and measured blood flow in the penile arteries and found that obese patients had more reduction in their penile blood flow, resulting in more severe erectile dysfunction than those in the normal weight group. In addition, they found that the men of normal weight who also exercised had the least amount of erectile dysfunction. (You may want to read that statement again.)
Another compelling article from the journal Archives of Internal Medicine found that obesity is associated with a 30 percent higher risk of erectile dysfunction.
Another report from the Journal of the American Medical Association found that about one-third of obese men with erectile dysfunction regained their sexual function after two years of adopting a healthy lifestyle. Their main emphasis was on exercising and losing weight, similar to the Prescription for Life plan.
Not only is exercising and losing weight important to address erectile dysfunction, but the food you eat while losing weight and beyond is important too.
The Effect of Food on Erectile Dysfunction
A change in diet can improve erectile dysfunction. A study was set up to evaluate if eating certain foods resulted in improvement of the problem. They discovered that an eating lifestyle high in fruits, vegetables, nuts, whole grains, and fish but low in red and processed meat was followed more by men who did not have erectile dysfunction.
Then they took it one step further by studying diabetic men. It is known that men with diabetes have more erectile dysfunction than nondiabetics. Yet, even in these diabetic men, those who ate the closest to this basic list of good foods, similar to the Prescription for Life plan eating strategy, had the least occurrence of erectile dysfunction and were more likely to be sexually active. The particular foods you eat do make a difference.
They also evaluated obese men to see if changing their diet had any effect on erectile dysfunction. They found that the obese men who began eating the healthy diet just mentioned had more improvement in restoring function than the obese men who didn’t follow the healthy diet. So even for obese men, eating the right foods showed an improvement in the erectile problem.
Because erectile dysfunction is more common in diabetic men, a similar study was done in which diabetic men recorded how much of the healthy diet they ate. The 555 men, who were thirty-five to seventy years of age, had been diagnosed with diabetes at least six months before but less than ten years and were overweight. This is interesting because they broke it down by how well each man adhered to this eating lifestyle. They found that the diabetic men who stuck closest to eating fruits, vegetables, pasta, peas, legumes, beans, nuts, cereal, salads, fibrous whole grains, chicken, and fish were the least likely to have erectile dysfunction, as compared to the men who did not adhere to this eating lifestyle.
Exercise: The Positive Factor
Medical reports show that exercise plays a significant role in the prevention of erectile dysfunction. The Archives of Internal Medicine reports that exercise is associated with a 30 percent lower risk of erectile dysfunction. The same report shows that obesity results in a 30 percent higher rate of the dysfunction.
Get lean and active.
And a last reminder for those who are in midlife and adopt the Prescription for Life plan, an article in the Journal of Urology points out that men who initiated physical activity in midlife had a 70 percent reduced risk of developing erectile dysfunction than the couch potato men.
Get an exercise program.
Even if you get off the sofa and start walking only one mile per hour, get started and go from there.
A change in your lifestyle offers protection against erectile dysfunction. If you already have the dysfunction, the same changes can improve or even reverse the problem. There are studies that evaluate the effect of combining the three lifestyles you have been learning in Prescription for Life. One of the largest studies, and I think the most significant, is from the International Journal of Clinical Practice. It is a conclusive summation study of six separate clinical trials from four countries. What I like about this report is that researchers were strict in scoring whether the dysfunction was mild, moderate, or severe. They also were strict in scoring the improvement of the erectile dysfunction by degrees. They targeted diet, exercise, and weight loss as the three significant factors to evaluate how they collectively affected erectile dysfunction.
First, they found improvement in the dysfunction with the men eating similar foods stressed in Prescription for Life.
They also found that exercise was significantly important in reducing the dysfunction. To document this point, men who ran for nearly 90 minutes a week or did more vigorous activity for 180 minutes per week had a 30 percent reduced risk of developing erectile dysfunction.
They also included a study of obese men who had the dysfunction. That study showed that within two years of lifestyle change, about one-third of them fully regained their sexual function.
Probably the most significant part of the study was that men already on medication for their erectile dysfunction had better improvement results with lifestyle changes than they had with the medication.
Men can prevent or improve erectile dysfunction. The same aging process that may cause erectile dysfunction involves the entire arterial tree throughout your body. Erectile dysfunction can be an alarm and a reminder that your arteries are the cornerstone for the prevention of aging.
Don’t ignore the flashing warning signals of your body. (Review this owner’s manual frequently.)