Almost 400 years ago, English physician Thomas Sydenham wrote that “a man is as old as his arteries.” I can relate. As a cardiologist, my practice is dedicated to helping arteries stay young. In this effort, I ask every one of my male patients about his ability to develop and maintain an erection. Although the usual response is “strong like bull,” many men do have serious problems.
Recent data indicate that identifying a man with diabetes who is unable to have a satisfactory erection predicts the presence of diseased arteries and future heart events several years before a heart attack or heart death — more than asking about smoking, blood pressure, or even a family history of early heart disease.
This allows time to identify, treat, and reverse arterial damage. So do yourself or your man a favor, share this information in a supportive way, teach more people about “survival of the firmest” as it's been called by Dr. Michael Greger, and enjoy a lifestyle that promotes arterial health, head-to-toe but emphasizing the joy of the groin.
1. Why the connection between healthy arteries and satisfactory erections?
The inner lining of every artery, including the penile arteries, is a single layer of cells called the endothelium. An appreciation of the endothelium won three researchers the Nobel Prize in Medicine in 1999. They figured out that when this wallpaper-like lining was healthy, it produced the gas nitric oxide (NO), which resists plaque, clotting, or constriction of arteries.
A good endothelium leads to good sustained erections, just as it leads to good heart artery flow. Endothelial dysfunction (ED) leads to a poor blood flow response throughout the body and poor maintenance of the swollen penis needed to create and sustain an erection.
2. What harms the endothelium?
I know I sound like a broken record about eating properly, but lifestyle factors are known to harm the endothelium and its production of nitric oxide. Lifestyles leading to hypertension, diabetes, elevated lipids and obesity produce erectile and endothelial dysfunction.
The standard American diet (high in processed foods packed with chemicals, fat, sugar and salt), combined with a sedentary lifestyle, poorly managed stress, environmental toxins like BPA, and poor sleep are among the factors that produce ED. Diets emphasizing plant-powered rainbow diets, low in trans- and saturated fats and rich in minerals, vitamins, phytonutrients promote arterial health and erectile success.
3. How powerful a heart predictor is erectile dysfunction?
ED is an amazing predictor of future coronary artery disease events. For example, if you live in Olmsted County, Minnesota, near the Mayo clinic, and are a man between the ages of 40 and 49 without known heart disease but with ED, you have up to a 50-fold higher incidence of eventually having new heart events compared to men the same age without ED. Rarely in medicine is there ever a risk factor this powerful. (To compare: smoking, for example, may raise the risk of similar events 3-fold.)
4. What do you do if you have erectile dysfunction?
My advice is to see a physician, perhaps a cardiologist, interested in advanced detection and prevention of arteries. In my office, patients with ED and no known heart issues are going to receive instructions to address their diet, exercise, and stress management, guiding them to an artery healthy lifestyle that promotes a strong heart and a strong erection. The “numbers” that matter will be measured like blood pressure, weight, waist circumference, blood sugar, cholesterol and LDL particle number, hs-CRP, homocysteine and lpA. An EKG will be performed.
Generally, I recommend patients have a coronary artery calcium CT scan at a local hospital that generally costs under $200. There is now a way to directly measure the health of the endothelium and in my office I perform this non-invasive examination on men with ED.
A trick used by miners to avoid being exposed to and dying from elevated levels of toxic gases was to bring a caged canary into the coal mine. If the canary acted strange or died, the miners knew to exit the mine immediately before they were at risk for death. Erectile dysfunction is often referred to as the canary in the coal mine. The erection that doesn’t happen or cannot be sustained can give clues to poor lifestyles and sick arteries 3 to 4 years before the chest pain strikes. If you're a man with erectile dysfunction, get a complete check-up.
If you know a man with this problem, share this article and gently but firmly (remember: survival of the firmest) guide him to getting checked. You might save a life and restore sexual performance and joy.