Barracks - Beyond Viagra: The Hidden Risks of Erectile Dysfunction
DianeHaught - Mar 27, 2008 - 04:57 AM
Post subject: Beyond Viagra: The Hidden Risks of Erectile Dysfunction
Beyond Viagra: The Hidden Roots and Risks of Erectile Dysfunction
By Norine Dworkin-McDaniel, Special to LifeScript Tuesday, July 31, 2007
Itís estimated that about 50% of men over 40 have some form of erectile dysfunction (ED). And while the knee-jerk reaction is to pop Viagra or one of its cousins for a hydraulic lift, the reality is that erection medications donít work for all men. Surprisingly, some experts say thatís a good thing. Why? ED is often an early warning sign of serious health problems aheadÖ
A malfunctioning member shouldnít be treated by casually popping a pill, says Dr. Ridwan Shabsigh, FACS, director of urology at Maimonides Medical Center in Brooklyn and co-author of the new book Sensational Sex in 7 Easy Steps: The Proven Plan for Enhancing Your Sexual Function and Achieving Optimum Health (Rodale Books, 2007). Shabsigh is one of a growing number of health professionals spreading the word that when a man starts to go soft itís a red flag that other parts of his body need medical attention, too.
A healthy penis starts with a healthy body, according to Shabsigh. But because most guys would rather swallow broken glass than admit they have a problem in any part of their bodies (let alone that part),
itís up to you, Read on to learn:
1. Why an Internet prescription for Viagra isnít the best remedy for bedroom breakdowns.
2. How getting off the burgers and trade the couch for some cross-trainers might beat a prescription for a little blue pill.
3. A trick to get you to the doctor that doesnít require hog-tying or chloroform.
4. Why pinpointing the cause of ED could save your life.
LifeScript: Youíve said that every man can improve his sexual health and most can do it without medication. Whatís the first step?
Dr. Ridwan Shabsigh: The first step is to overcome the barriers. We surveyed 32,000 men in waiting rooms of primary care physicians in America and five other countries. We asked those who had ED if they brought it up with their doctor. And we found that more than half of patients with ED did not bring it up with their doctors despite already being in the doctorís office. When we asked them why, the reasons included denial, thinking that ED is a normal part of aging, not knowing that thereís help, and embarrassment. Embarrassment is a big issue. And we found that embarrassment was more common among younger men with ED. The younger the men, the more embarrassed they were.
In my book I talk about a number of techniques to overcome the barriers. Take someone with you to the doctor, such as your wife, who can help explain. Or write a letter to the doctor. Remember that there is nothing to be ashamed or embarrassed about. The penis is an organ like the spleen, the kidney or the liver. It can malfunction. Itís important to remember that ED is not a normal consequence of aging. Itís a progressive condition. And it should be treated.
LifeScript: Youíve called the penis the ďthermometerĒ of a manís health, and when thatís not working well it usually means there are more serious health problems brewing. What can the penis tell us about the state of a manís health?
Dr.Shabsigh: A number of systems are required for the penis to function. These include the vascular system, which includes the blood vessels in the penis. Consequently, anything that damages the vascular system will result in erectile dysfunction. The nervous system is also required to send signals to the blood vessels in the penis telling them to open up and bring blood to the penis to make an erection. And both the nerves and blood vessels need testosterone to function.
So, think about diseases that interfere with any of these body systems. Diabetes causes nerve damage, which affects the nerves of the penis along with other nerves. It also affects the blood vessels and hormones. Testosterone is low in patients with type 2 diabetes. Low testosterone is associated with low desire, erectile dysfunction and weak ejaculation. So testosterone deficiency can warn us of future diabetes (about eight years in advance).
That is very exciting to know because diabetes in its early stages is a silent disease. Many patientsí diabetes gets discovered years after subtle symptoms like frequent urination first appear. So sexual dysfunctions arenít just sexual dysfunctions by themselves. We realize now that theyíre early warning symptoms of major medical problems.
LifeScript: Can ED signal other problems besides diabetes?
Dr.Shabsigh: Erectile dysfunction can be an early warning symptom of heart disease, high blood pressure and high cholesterol. What are the symptoms of high cholesterol? Itís a number on paper for the patient. But erectile dysfunction is a real tangible symptom.
ED is a warning symptom of future coronary artery disease with a lag time of about three years. If you have high blood pressure and erectile dysfunction, youíre more likely to have a heart attack or stroke than if you had high blood pressure and no erectile dysfunction [/color[color=cyan]]Ė itís an indicator of how dangerous your hypertension is. This is important because hypertension is one of those silent diseases.
LifeScript: Does obesity play a role, too?
Dr.Shabsigh: Obesity is related to vascular disease. The more obese a person is, the more hardening of the arteries Ė or atherosclerosis Ė there is, which affects blood flow in the penis and causes difficulty in obtaining and maintaining erections. Thereís another and probably more profound effect of abdominal obesity: Fat in the abdomen is especially harmful because fat cells in the abdomen have an enzyme called aromatase, which converts testosterone into estrogen. Estrogen lowers testosterone. And if you have testosterone deficiency, then you have sexual dysfunction, erectile dysfunction, low sexual desire, poor orgasm, low-volume ejaculation, and lack of pleasure and satisfaction.
LifeScript: So how does losing weight help?
Dr.Shabsigh: If you lose weight, a number of things improve: The arteries become more flexible. Blood pressure improves. If youíre borderline diabetic, or even diabetic, that will improve. In addition, your testosterone goes up. Itís been shown that if you have abdominal obesity and you lose inches and pounds, your testosterone will go up, your sexual desire will go up, your erections will improve, and your orgasm and ejaculation will become more pleasurable. To see a difference in sexual function, you need to lose ten percent of your weight, which can improve things significantly.
LifeScript: Is smoking also an issue?
Dr.Shabsigh: Smoking damages blood vessels and reduces blood circulation in the penis. So the same way that it affects the heart and coronary arteries, it also affects the penile arteries, keeping in mind that the penile arteries are smaller than the coronary arteries. If youíre taking Viagra, Levitra or Cialis and you stop smoking, your response to the medications will improve.
LifeScript: According to the Health Professionals Follow-Up Study (an ongoing survey of menís health administered by the Harvard School of Public Health), watching more than 20 hours of TV a week, along with excessive consumption of alcohol, smoking and being overweight, was associated with higher levels of ED.
Dr.Shabsigh: Watching football, drinking beer and smoking cigars are typical guy things. If you have a sedentary lifestyle and you start exercising, you improve your sexual function. But it has to be aerobic exercise. That improves the function of the arteries and the veins in the body. Remember, the penis is a complex vascular organ, and you need healthy blood vessels for it to function.
LifeScript: Any other lifestyle factors that affect sexual function?
Dr.Shabsigh: Acute stress releases adrenalin, which restricts blood vessels and makes erections less effective. In addition, when people are under chronic stress, they frequently cope poorly. They overeat. Some people also resort to alcohol, which has two effects: If you drink enough, you go to sleep, and some parts of you go to sleep before other parts. If you abuse alcohol for years, you will damage the nerves in the body. Thatís why many men with a history of alcohol abuse report not only erectile dysfunction but also sensory numbness in the penis.
LifeScript: So your prescription for sexual health is to quit smoking, exercise, lose some weight, manage your stress, and drink less. How do we start?
Dr.Shabsigh: The first step is to know where you are. Calculate your BMI [Body Mass Index] to know whether youíre normal, overweight, obese, or extremely obese. If you want to reduce your [weight], you have to Ö eat less and exercise more. How you do that? The general rule is that any diet that is healthy for the vascular system and the prostate is healthy for sex. As for exercise, I recommend thirty minutes a day, four to six days a week. Choose the activity most suitable to you, individually. Exercise also reduces anxiety and improves the ability to deal with stress. So do meditation and yoga.
LifeScript: Perhaps many men would disagree, but youíve said that the day a man is diagnosed with ED can actually be a good day for him. What do you mean by that?
Dr.Shabsigh: It could be a good day because itís a day to review a manís health. Many men havenít been to a doctor in years. Women are used to going to the doctor. Once a year to get a Pap smear, a mammogram. Men arenít like that. They go ten years without going to the doctor.
Taking a pill is the easy part of this. Thatís why I tell my patients that asking for samples of Viagra or Cialis or Levitra is not helpful because what they really need is a review of their health.
I ask my patients,
Do you know your blood pressure?
Do you know your cholesterol?
Do you smoke?
Do you know your weight?
Do you know your BMI?
Do you know your waist circumference?
Do you know your testosterone level?
Do you have any prostate or urinary problems?
Are you depressed?
How is your relationship?
Are you under stress?
Do you have too much anxiety?
Are you overcommitted in life?
Do you exercise regularly?
Do you overeat?
Do you over-drink?
This review makes coming to the doctor about erectile dysfunction more valuable than just taking a pill.
Sure, there is value in pills for ED. Thereís also value in using penile injection therapy for those who donít respond to the pills. Thereís great value in having a penile implant if medications donít work. Thereís value in taking testosterone if your testosterone is low. There is value in all these things. But alone theyíre not enough. Just taking Viagra and maintaining bad lifestyle habits is not good.
It is not the intention of Raptor-Pack to provide specific medical advice but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided, and Raptor-Pack urges you to consult with a qualified physician for diagnosis and for answers to your personal questions and specific medical advice
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