Erectile dysfunction. A problem that many men encounter on various levels that could signal that something bigger is going on health wise and not just a problem in the bedroom. If you’re a man, you’ll encounter this problem at some stage of your life and it may not just be when you are older. Just like other health conditions, there is often a bigger picture to the issue than what we’d like to believe. Many just create the excuses of too much stress or maybe they are not in the mood, both of which are important, but if the problem is recurrent, it may be wise to look deeper.
Statistics tell us that as men age, erectile dysfunction (ED) or impotence becomes more of a problem. According to the Cleveland Clinic, upwards of 52% of men experience ED, with it impacting 40% of men around the age of 40 and 70% of men at the age of 70. About 5% of those men at the age of 40 experience complete erectile dysfunction, which increases to 15% of men by the age of 70. What’s the deal?
Well, if you’re a man, we’ve all been there at some stage in our life. Maybe we were in our twenties when it happened, or maybe it just started to happen as we hit the milestone age of 40. Either way, all men will likely encounter the problem, but the ultimate question is….is it a problem? Let’s look at the basics.
The Makings of an Erection in Men
During sexual arousal, nerve impulses from the brain stimulate a region of the penis, called the Corpus Cavernosa to relax and dilate. This region is like a storage vat of sorts, multiple chambers which open and are capable of storing blood. Along with this dilation, blood circulation to the penis is also altered, increasing blood flow to the genital region, which then pools in the Corpus Cavernosa tissue. As this occurs, the blood pressure to the region increases, the penis expands and an erection occurs. This is not much different with other erections that can occur, such as ‘goose bumps’ on the skin (piloerection), nipple erections in response to stimuli and temperature, and clitoral erections in women.
In order for this event to occur, we must have:
- Sufficient sexual arousal and adequate nerve impulses
- Adequate function of the penis and Corpus Cavernosa
- Adequate blood circulation to the penis
- Adequate function of blood vessels and cardiac health
When Things Go Wrong with in the Bedroom
In order to obtain an erection, all 4 of those factors much be in place.
The first factor is the nerve impulses and transmissions that dictate changes to the body and alter blood circulation. This stage can be impacted by inadequate sexual stimulation but could also be created by inadequate nerve transmission or conduction. This second cause could be created by nervous system or brain issues or trauma, but can also be impacted negatively by stress and even diet. A male individual that has a nervous system disorder or brain trauma or other condition could experience erectile dysfunction. The same can be said for a male individual that is highly stressed and not focused on the moment. Those altered stress pathways can directly interfere not just with nerve transmissions, but also blood circulation. One example of altered nerve transmission occurs in men after prostate surgery, which can interfere with normal function of both nerves and blood circulation to the genital region.
Inadequate normal function to the penis and/or Corpus Cavernosa tissue is usually seen after trauma to the penile region or may be secondary to surgery. This is not extremely common, but does happen to some men.
Inadequate blood circulation may also be a problem. This is not just directly related to cardiovascular problems, but could be a sign of reduced blood volume or blood pressure. Some medical conditions that result in anemia or reduced blood pressure could pose a problem for some men. If there is inadequate blood circulation to the rest of the body, or a problem in that region, the body will prioritize where the blood should go. It will put the kidneys, heart, brain, and other organ systems well ahead in the line in front of the penis. Those organs are vital for life, the penis not so much.
Inadequate blood circulation and cardiac health are the main areas of concern in the man that experiences recurrent episodes of erectile dysfunction. Here, the main issue is a reduced or diminished ability to circulate blood to the penile region, which then impairs the ability to obtain an erection. First, you must have adequate blood volume, but second, that blood needs to be delivered to the genital region. In order to do this, the blood vessels to the penis need to be healthy and have the ability to dilate or expand. Third, the heart needs to be healthy enough to increase its stroke volume and heart rate to increase circulation outside of the normal regions of the body. So, in many men that experience erectile dysfunction, the main concern is regarding blood vessel health (endothelial function) and cardiac health. Obviously, if a man is experiencing cardiac problems, such as a prior heart attack, reduced outflow, abnormal rhythms, or valve problems, this could pose an issue in regards to obtaining an erection. The same goes for altered endothelial function or blood vessel health.
Erectile Dysfunction in Men; A Bigger Problem
All men will likely experience erectile dysfunction at some point in their life. It happens and it could be a result of a bad day or just a stressful life. In those cases, the problem is intermittent or maybe just happens once or twice. Correct the stress situation and the problems in the bedroom often repair themselves. However, many men experience the problem more often as they age, sometimes becoming permanent. Although there are many ‘solutions’ offered in today’s medical world, it is always best to see and understand the bigger picture.
Current therapies offered to men with ED include medications which dilate blood vessels to the penile region and other areas of the body. When these efforts fail, and it is still very important to the man to achieve an erection, then there are penile implants that can be implemented surgically. The medication options are likely the most beneficial as they do offer some hope and do address one of the primary problems, endothelial dysfunction. The penile implant route may benefit some men, but is likely best suited for those with primary nerve input problems or penile damage to some degree. This route of therapy does nothing in regards to endothelial function or blood circulation.
Most cases of erectile dysfunction in men is directly related to impaired blood circulation or endothelial dysfunction, which is reflective of cardiac disease and function. This means that the blood vessels are not working properly, cannot dilate or expand, or maybe they are blocked due to accumulation of blood clots or otherwise. In many research projects, erectile dysfunction is seen as a vascular disease and can be used as an indicator of overall poor cardiovascular health. As with many health conditions, there is often always a starting point which then often progresses over time and becomes worse.
A man with chronic episodes of erectile dysfunction may likely have underlying endothelial dysfunction, which is reflective of cardiovascular health. Aside from the difficulties in obtaining an erection, maybe they are fine otherwise or appear so clinically with normal blood pressure, glucose reading, cholesterol, and other factors. This may be true for that instant in time, but keep in mind that everything is always changing in our body and in our lives. Nothing is ever static! If there are erectile dysfunction concerns, then there is likely impaired circulation, not just to the penile region but other areas of the body. This may include the legs, arms, organ systems, brain, and the heart.
The overall point is that in regards to our health, you need to head warning signs. Watch for them, recognize them, and don’t ignore them. To me, they are road signs telling us that a change is needed in what ever we are doing. This does not mean that you rush to the doctor to get a prescription for every ED medication on the market, but more so it means that you should re-evaluate your life, your stress, your habits and lifestyle, and your diet. Even though some medications can improve endothelial dysfunction and blood circulation, you are always best to reduce or change other contributors along with or outside of those medications. That’s when a person yields the best results. Do not just put all of your hopes on one medication solving all of the problems. Even then, if a doctor gives you a prescription and it seems to help, do not just believe that all of your problems are resolved. You have to look at the big picture.
Factors Involved with Endothelial Dysfunction
There are many factors associated with endothelial function of blood circulation, but the prevalence of the condition becomes more common as you age. This is not just in men by the way! The cardiovascular system, including the heart and blood vessels, are subject to your diet, stress, and other factors. As a state of health is challenged in the body, you may find that certain monitoring parameters are likewise altered, which may include cholesterol, resting heart rate, blood pressure, fasting glucose and A1C, among others. All of these parameters are signals that certain systems within the body are not working properly and could impact health.
The bottom line with endothelial dysfunction revolves around the process of inflammation and oxidative stress, both of which contribute immensely to heart and blood vessel function. These processes are extremely damaging in the chronic phase, altering cell health and function. Then you add diet and stress to the mix, which compounds the problem. The aging process in our body, internally and externally, is directly linked to inflammation and oxidative stress. These two processes are inevitable but the level found within your body on a daily basis can really dictate how quickly you age and deteriorate. When you eat a diet high in fat, high in refined sugars or carbohydrates, low in whole-food nutrients, the level of inflammation will rise. Then when you live a stressful lifestyle, physically or emotionally, this too will add to the equation and make matters worse in the world of inflammation. This inflammatory process is responsible for reduced blood circulation not just to the genital region, but to other areas of the body. This may equate to restless leg syndrome or it could manifest as a heart attack or even reduced cognitive function.
Curbing the Process
Inflammation is inevitable, but there are things you can do to improve the situation.
- Alter your lifestyle and gain control of stress
- Exercise, which can be beneficial to the inflammatory response and circulation
- Watch your body weight and body mass index, as a heavier weight equates to higher inflammation
- Eat better, reduce fat intake, increase consumption of fruits and vegetables
- Change your mood and mental outlook on life and your life situation
- Take advantage of specific herbs that can impact the inflammatory process and even circulation
All of these means of intervention can be a life changer and a life saver. Through their implementation, you won’t just regain function in the bedroom, but will also make huge strides in your overall health.
Stress management is huge and a major player in health and disease. Body weight and exercise are also very key players in overall health. Making modifications to your diet can be a challenge for many, but it is something you have to try and commit to, knowing that progress can be made regarding your health in a very short period of time. The hard part there is being 100% on board and resistant to the many temptations that are around us in every isle of the grocery store.
Herbs and foods can provide more than just nutrients for our body. They offer many phytochemicals and antioxidants that can help to curb the inflammatory process that is happening in all of our bodies. The more efforts you put into play to offset these effects, often the bigger the reward. Some of my favorite foods and herbs include green spinach, kale, broccoli, carrots, beets, berries, Curcumin, Boswellia, Schisandra Berry, Hawthorne Berry, Ashwaghanda, and Eleutherococcus. All of these provide nutrient provisions the body and are documented in research to benefit the inflammatory and stress process. Many of those foods can help to improve your body weight and even aid in management of blood sugar. Some of those herbs even have direct research linked back to improved cardiovascular health and circulation. Another herb, known for its rejuvenative properties in men and women, is Cordyceps sinensis, which not only demonstrates the ability to modulate the inflammatory process, but also impacts hormone production in the body, including testosterone.
In the end, if erectile dysfunction impacts you, see it as a problem that is not just localized to the bedroom or the penis. This is a condition that has roots in many other health ailments and should be viewed as a warning signal of sorts. A sign that something needs to change and if you make the proper changes, your whole body will benefit!
Author: Tom Schell, D.V.M, CVCH, CHN