Turning the Big Double Play

Taking care of your heart could keep erectile dysfunction at bay

By Patrick Dougherty

June 2006

Suppose there was a machine that could measure a man’s anxiety level, sort of like a lie-detector test. A man could be attached to sensors that would monitor his response to two phrases and the tester would watch how the graph moves. Which words do you think would generate the highest level of anxiety: “heart disease” or “erectile dysfunction”?

Knowing how men feel about “performance issues,” there’s little doubt that the anxiety response to the latter would be off the charts. The irony is that a number of recent studies show that there may be a direct link between heart disease and erectile dysfunction (ED), and that living a healthier lifestyle can minimize both.

Numbers Don’t Lie

Depending on how one defines ED—from an ability to sustain only brief erections to a total inability to achieve one—15 to 30 million American men suffer from the maddening malady. It is also estimated that more than 600,000 men aged 40 to 69 develop ED annually, and that doesn’t account for the men who won’t or don’t want to admit they have it. But if men knew that ED was a risk factor for heart disease—a virtual double whammy of health woe—perhaps they would be more diligent about diet and exercise.

“Lifestyle changes, especially increasing exercise level, may prevent ED,” says Elizabeth Selvin, PhD, MPH. Selvin is a research fellow at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland and the lead author of a March 2006 study presented at the American Heart Association Annual Conference on Cardiovascular Disease Epidemiology and Prevention in Phoenix, Arizona. “The associations between ED and diabetes and other known cardiovascular risk factors,” adds Selvin, “should serve as powerful motivators for male patients for whom diet and lifestyle changes are needed to improve their profile.”

Selvin’s was just the latest of a number of studies which showed the connection between ED and heart disease. In May 2005, a number of studies presented at the American Urological Association found strong connections between ED and heart problems. One report showed that 20 of 30 patients with ED also had high homocysteine levels, a marker for cardiovascular ills. And researchers from Italy reported that among 162 patients with heart disease, 46% had ED, and among those with chronic angina, 71% experienced ED for more than a year before being diagnosed with heart disease.

Last December, physicians at the University of Texas Health Science Center released the findings of a seven-year study of more than 9,000 men in a Prostate Cancer Prevention Trial. They found that men who had no sexual function problems at the start of the study but later developed ED were 25% more likely to have a heart attack or stroke.

“Erectile dysfunction was an important risk factor for abnormal findings on the stress test,” says lead researcher Dr. R. Parker Ward. “These suggested severe blockages in the coronary arteries, heart weakness and other abnormalities that predict cardiovascular risk.” Ward’s bottom line: “ED may be something that doctors should ask patients about and consider as a risk factor for heart disease.”

Elizabeth Selvin’s study in March evaluated more than 2,200 adult male participants in the 2001-2002 National Health and Nutrition Examination Survey. The findings showed that cardiovascular risk factors, such as diabetes and high blood pressure, also appear to be risk factors for erectile dysfunction. Diabetes in particular raises a red flag; ED affects more than half of all men in the US with diabetes.

The common thread behind all these conditions? Sedentary men content with couch potatohood. “Men who reported spending hours each day in front of TV, video and computers were much more likely to have ED even after accounting for other risk factors,” says Selvin. “The more men exercised, the less likely they were to have ED.”

Go With the Flow

A man’s sexual performance relies on good cardiovascular function because erections depend on a rush of blood to engorge the penile chambers. While sexual dysfunction can be caused by psychological or neurological issues, most ED problems can be attributed to poor blood flow: “In 80% of men with sexual dysfunction, the problem is of vascular origin,” explains Dr. Ernst Schwarz, cardiologist at Cedars-Sinai Medical Center and professor of medicine at UCLA. “It’s a problem with blood supply.”

When blood flow into the penis is low, male potency is diminished. But what causes this lack of blood flow? Dr. Schwarz explains that hardening or clogging of the arteries associated with heart disease affects not just those vessels which feed the heart, but arteries throughout the entire body—including those that deliver blood to the penis during sexual arousal.

“Reduced penile inflow can also be caused by the heart not pumping enough blood through the body,” continues Schwarz. “If the heart pumps weakly, sexual function is not good.”
Which is why some men can’t solve an ED problem by popping a little blue pill. Pharmaceutical drugs like Viagra may be a sexual performance aid for some men, but any underlying cardiovascular problems will continue to worsen.

“Our study suggests that non-pharmacologic interventions such as exercise my help improve erectile function,” says Selvin. Adds Schwarz: “The number one goal in treating ED patients is to optimize the function of the heart.”

Get Movin’, Start Groovin’

So how can men make their hearts pump strong for better penile inflow? “You have to raise the heart rate for a prolonged period of time, thus forcing the heart to learn to work faster and more efficiently,” explains Chris Kelly, a certified fitness trainer, nutritionist and editor of the Spotter fitness e-zine (www.thespotter.net). Kelly suggests interval training, also known as high-intensity training, as the best method for improving cardiovascular fitness. In interval training, strenuous (or anaerobic) exercise which can only be sustained briefly (1 to 3 minutes) is followed by a slower (aerobic) exercise pace that allows recovery. “You do a strenuous exercise like jumping jacks for a period of 30 seconds, then rest for a minute before repeating,” says Kelly. “Do this several times and you have a strenuous cardio workout in half the time it takes to do regular cardio.”

Of course, this is a catch-22 for men whose sedentary lifestyles have caused sexual dysfunction and possible cardiovascular problems. They are hardly in condition to dive into furious fitness training regimens. “For beginners, it is best to start with shorter anaerobic intervals (30 seconds to a minute), followed by longer recovery intervals (3 to 5 minutes) for a period of 15 to 20 minutes,” says Kelly. “Ultimately, this sort of training will also raise the resting heart rate for hours after a workout and help the heart to pump more blood at a faster rate.” The heart will also be better equipped to pump blood into the penis, building a foundation of cardiovascular health that empowers male sexual performance.

Good Health = Good Virility

Selvin’s study also suggests that a shift towards healthy, heart-smart living and eating may be the ideal remedy for men with sexual dysfunction. “All the things that are important for the prevention of cardiovascular disease and diabetes—losing weight, eating a low-fat, high-fiber diet rich in fruits and vegetables, and getting lots of exercise—may also prevent ED,” she says.

There are some nutritional supplements that can help men mitigate the effects of ED and perhaps allow them to achieve peak sexual performance:

• Folic Acid: In combination with vitamins B-6 and B-12, this nutrient found in green leafy vegetables, citrus fruits and salmon can reduce high homocysteine, a protein that is a marker for cardiovascular disease.
• Rhodiola: An adaptogen and reputed sex-enhancer, it has been used by Russian athletes for decades to help supercharge their workout routines.
• Vitamin E: This powerful antioxidant has been associated with reduced risk of heart disease.
• CoQ10: It has an energizing effect on the heart and promotes optimal heart function.
• Ginkgo Biloba: Studies suggest that an extract of this ancient tree’s leaves may help circulation to the extremities, including the penis.

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