Erectile Dysfunction (Impotence) is the inability to get or maintain the erection, firm enough for the sexual act. It is no more a disease of only the old age, which itself may not be necessarily so, in good health. It is often encountered by the middle-aged men and even in the younger men in their 30’s nowadays. Males with ED may feel the penis to return to a flaccid state before the ejaculation or complete intercourse with the partner. It has become a nightmare for most of the middle-aged sexually active men. It can be isolating, emasculating and distressing. Psychologically it can make a person to feel ashamed, embarrassed and frustrated. It may lead to anxiety, depression and self-esteem problems if it goes untreated. It strains relationships and Impotence stays as strong grounds for legal divorce than the other reasons for male infertility. In India, it is still considered a taboo to talk about erectile dysfunction, a discussion with the right person and the healthcare professionals to seek out for their advice. Most often than not, the common advice given by their peers is just to pop up a pill, before a sexual act to stimulate and maintain erection for a considerable amount of time.
More than 95% of men can be treated for ED, according to the CDC. Sometimes, ED could be due to the underlying disorders like type 2 diabetes, chronic kidney disease, multiple sclerosis, Peyronie's disease, injury to penis, bladder, prostate, pelvis or spinal cord. Smoking, Drinking and medications (propranolol, methyl dopa, SSRIs) could also lead to erectile dysfunction. There are a variety of treatments available. These include medications that increase the blood flow to the penis, testosterone to help erections in those with low testosterone, a vacuum device that fits over the penis and creates an erection firm enough for sex, injections or suppositories to stimulate an erection before sex and penile implants. Many of us may not even aware of the underlying problem behind erectile dysfunction and the ways to cure it. The only way to know the best treatment is to speak with a doctor and discover whether the source of ED is due to physical or psychological. Early morning erections rule out physical cause of ED.
Although Psychology & Stress play an important role in erectile dysfunction, the most important reason which is often ignored is our failure to understand is that it's not about a problem confined to the sexual organs. Perhaps, it is a symptom of Insulin resistance affecting the entire vascular system. A man is as old as his arteries; so, if the vitality of cardiovascular system is preserved, he can stay younger and agile lifelong. The secret to "Youngevity-Healthspan" is to stay insulin sensitive with diet rich in micronutrients to keep all of your organs in harmony.
The discovery of Nitric oxide (NO) as a signaling molecule in cardiovascular system for which Nobel prize was awarded, led to the billion-dollar business of the little blue pills and eventually the Blue Pill became a Pop Culture Phenomenon. Erection happens only when there is pooling of blood in the penis, mediated by Nitric oxide. What happens in Insulin resistance? The endothelial cells are not producing nitric oxide good enough to maintain erection. Taking pills for ED is just like taking pills for diabetes and hypertension lifelong. Although symptomatically you may feel better momentarily, the disease stays lifelong. Unless the roots of the disease are addressed, the cure for any disease is always remote; ED is not an exception to that.
Nitric oxide in the form of nitrates is used for vasodilation in patients suffering from angina pectoris (ischemic heart disease), which is a disease of inadequate blood supply. Even many vacuum assisted devices are used as effective measures for ED. Aren’t we really ignoring the basic problem which needs to be addressed in the first place?
ED could be a canary in the coalmine. It could be the first symptom of the impending heart attack. In more than 80% of the heart attacks, there is a prior history of erectile dysfunction in the last 5 years. The blood vessels supplying the arteries are affected first considering the caliber of the arteries, smaller being affected first followed by the larger ones. So, if someone suffer from ED, it should be treated as a serious condition after ruling out other causes, because the vascular system is universally affected by endothelial insulin resistance and the atherosclerotic plaques formation.The inability to maintain erection can possibly be the first symptom of vascular insulin resistance. The symptom of heart disease may appear a little late because of the difference in the caliber of the vessels involved.
Erectile Dysfunction should be considered as a comorbidity. Healthcare professional should have a detailed discussion with the patients with ED about the risk of Cardiovascular diseases and possibly evaluate if needed. Hence the focus should be not only to treat the ED but also in the prevention of Cardiovascular diseases.
How can we improve nitric oxide production naturally? There are two sources of nitric oxide namely (i) endogenous – produced by the endothelial cells of the vascular system throughout the body thereby relaxing the smooth muscles, causing vasodilation. (ii) exogenous – from the food supply. The nitrates are enriched in beetroot and green leafy vegetables. The oral nitrates in the food supply are converted into nitrites by the action of facultative anaerobic bacteria in the oral cavity and hence it is essential to chew the food adequately (ideally 25-32 times) with lips closed for facilitating this action. The nitrites are converted into nitric oxide, by the action of hydrochloric acid in the stomach.
The endogenous production of nitric oxide is severely compromised when the body suffers from insulin resistance. It is absolutely essential to reverse insulin resistance completely to cure erectile dysfunction. The exogenous supply of nitrates from natural sources are better choices without any side-effects unlike other prescriptions or procedures.
The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health conditions. For example
1. Seek healthcare professionals who follow evidence-based clinical practice for the reversal of diabetes, heart disease or other chronic conditions.
2. Regular checkups and medical screening tests to look for insulin resistance periodically for prevention.
3. Switch over to organic foods because endothelial nitric oxide synthase is vulnerable to glyphosate (pesticides) and other environmental toxins like aluminium and mercury.
4. Stay away from ultra-processed foods that cause insulin resistance (a trifecta of excess sugars, refined carbs and refined oils).
5. Stop smoking, limit or avoid alcohol and don't use illegal drugs. “Stop Smoking & Keep Walking” is the mantra for your Vascular Wellness.
6. Exercise regularly as it potentiates nitric oxide production by several folds. Nitric Oxide Dump is a new version of high-intensity interval training (HIIT) that is designed to stimulate the release of nitric oxide, which can catalyse and promote health. This training uses simple movements done in quick succession, providing benefits similar to longer workouts, but accomplished in just a very small fraction of time.
7.Kegel exercises, or pelvic exercises, have proven to be effective in addressing erectile dysfunction, and it should be used as the first-line of treatment. The ischiocavernosus and bulbocavernosus muscles in the pelvic area surround the penis and are active during an erection.
8. Take steps to reduce stress that help in performance anxiety.
9. Get help for anxiety, depression or other mental health concerns.
10. Yoga
11. Herbs and supplements like Shatavari, Ginseng, L-arginine, L-carnitine etc.,
12. Fasting improves insulin sensitivity so as regular physical activities. Fasting induces autophagy which could help in the reversal of the atherosclerotic plaques.
Finally, it's not all about the potency of one organ, but the preservation of functionality of the entire vital organ systems which reflect the state of sexual health.
