By Dr. Mercola
Many men are reluctant to discuss erectile dysfunction (ED), but this isn't only a matter that affects your intimate life. Even slight problems maintaining an erection can be a sign of serious health problems elsewhere in your body, namely in your heart.
The Connection Between Erectile Dysfunction and Heart Problems
You may be aware that the inability of your arteries to dilate fully and to subsequently harden, also known as atherosclerosis, is a major cause of heart disease and can lead to stroke, heart attack and sudden death.
In a nutshell, this occurs because as the inner lining of your blood vessels (endothelium) undergoes damage and dysfunction and plaque accumulates, the subsequent narrowing and hardening of your arteries makes it harder for blood to flow through them and reach your heart and other organs.
As the disease process unfolds the smaller arteries in your body, such as those in your penis, often get blocked first, before the larger arteries leading to your heart.
The lack of blood flow to the penis results in erectile dysfunction, and this is why ED has been called the "canary in the trousers" for future heart problems. If you have any type of erection difficulty, it's a good idea to see a qualified health care practitioner who can give your heart health a thorough check-up and help you develop a plan to fix the underlying causes of both issues...
New Research Shows Erectile Dysfunction Linked to Increased Heart Risks
An Australian study of 95,000 men1 found that with ED had an increased risk of heart-related problems, including:
- Heart failure
- Peripheral vascular disease
- Ischemic heart disease
- "Other" cardiovascular disease
Those with the most severe ED and a history of heart problems had a more than 60 percent greater chance of having been admitted to the hospital, or died, from a heart-related problem. But even those who had no prior heart problems had a 35 percent greater risk of developing one if they had severe ED.
Even among those with mild ED, the risks of certain heart problems, as well as the risk of dying prematurely from any cause, was greater than in those without.
This doesn't necessarily mean that erectile dysfunction causes heart problems, but, more likely, that both share a common pathology of the blood vessels known as endothelial dysfunction. Erectile dysfunction, therefore, is a biomarker for heart disease, which means if you have it you need to get your heart health checked out right away.
If You Get a Heart 'Check-Up' Make Sure You Check This...
If you end up going to see a physician about ED, potential heart disease or both, be sure your physician doesn't simply give you a total cholesterol test and leave it at that. Total cholesterol will tell you virtually nothing about your disease risk, unless it's exceptionally elevated (above 330 or so, which would be suggestive of familial hypercholesterolemia, and is, in my view, about the only time a cholesterol-lowering drug would be appropriate). Two ratios that are far better indicators of heart disease risk are:
- Your HDL/total cholesterol ratio: HDL percentage is a very potent indicator of your heart disease risk. Just divide your HDL level by your total cholesterol. This ratio should ideally be above 24 percent. Below 10 percent, it's a significant indicator of risk for heart disease
- Your triglyceride/HDL ratios: This ratio should ideally be below 2
Four additional risk factors for heart disease are:
- Your fasting insulin level: Any meal or snack high in carbohydrates like fructose and refined grains generates a rapid rise in blood glucose and then insulin to compensate for the rise in blood sugar. The insulin released from eating too many carbs promotes fat and makes it more difficult for your body to shed excess weight, and excess fat, particularly around your belly, is one of the major contributors to heart disease.
Your fasting insulin level can be determined by a simple, inexpensive blood test. A normal fasting blood insulin level is below 5, but ideally you'll want it below 3. If your insulin level is higher than 3 to 5, the most effective way to optimize it is to reduce or eliminate all forms of dietary sugar, particularly fructose, from your diet.
- Your fasting blood sugar level: Studies have shown that people with a fasting blood sugar level of 100-125 mg/dl had a nearly 300 percent higher risk of having coronary heart disease than people with a level below 79 mg/dl.
- Your waist circumference: Visceral fat, the type of fat that collects around your internal organs, is a well-recognized risk factor for heart disease. The simplest way to evaluate your risk here is by simply measuring your waist circumference. For further instructions, please see my previous article, Your Waist Size Can Be a Powerful Predictor of Hypertension and Other Chronic Diseases.
- Your iron level: Iron can be a very potent cause of oxidative stress, so if you have excess iron levels you can damage your blood vessels and increase your risk of heart disease. Ideally, you should monitor your ferritin levels and make sure they are not much above 80 ng/ml. The simplest way to lower them if they are elevated is to donate your blood. If that is not possible you can have a therapeutic phlebotomy and that will effectively eliminate the excess iron from your body.
Not ALL Cases of Erectile Dysfunction are Due to Physical Issues
It should be noted that while many cases of ED may have an underlying physical issue, some are undoubtedly emotionally based. Your brain and nervous system control your sex glands and genitals, and this is why they also control your sexual desire, as well as orgasms. There are many similarities between men and women in regard to desire; contrary to popular belief, for example, visual images trigger sexual desire in both sexes. Likewise, anxiety, defensiveness, fear, and failure of communication are destructive psychological forces that can take a heavy toll on your libido, whether you're a man or a woman, by acting as roadblocks to desire.
For men, every erection begins in the brain.
Your brain stem emits nerve impulses that control erectile function. These nerve impulses navigate through the erection center of your spinal column to the erectile tissue of the penis, where they trigger a chain reaction in the membranes of your vascular muscle cells. This sophisticated chain reaction is dependent on a messenger molecule called cyclic guanosine monophosphate, or cGMP.
However, this works in reverse as well; an erection softens as soon as another enzyme called phosphodiesterase starts to degrade the cGMP molecules.
Drugs like Viagra, Levitra and Cialis work by inhibiting phosphodiesterase and increasing nitric oxide production, which may help maintain erections. But, these pills will not create an erection in and of themselves. Initial erection still has to be triggered psychologically. Without that initial impetus, potency pills will have no effect whatsoever.
Because sexual dysfunction can worsen due to stress, relationship troubles and anxiety, taking control of your emotions by learning the Emotional Freedom Technique (EFT) can really help. EFT is a psychological acupressure technique that can help you effectively address your stress-related thoughts and leave you feeling calmer and more able to face your challenges, whatever they may be.
Why Natural Viagra Alternatives are Important...
There are a number of lifestyle choices that can contribute to restoring healthy sexual function, and as for sexual potency pills, there are alternatives that are far safer than Viagra. In case you were wondering, Viagra does carry a risk of potentially serious side effects, including:
Headache Upset stomach Flushing of the face Blue/green color blindness Blurred vision Vision sensitivity to light Sudden decrease or loss of vision in one or both eyes An abnormally long-lasting erection that may cause permanent damage to your penis Sudden loss or decrease in hearing, sometimes with ringing in the ears or dizziness Heart attack, stroke, irregular heartbeat and death have occurred in men taking Viagra
As far as natural alternatives go, there are many options to consider including L-arginine, an amino acid that is the precursor to nitric oxide, a natural compound that helps relax your blood vessels.
How L-Arginine May Improve Sexual Function Via Nitric Oxide
Nitric oxide signals the smooth muscle cells in your blood vessels to relax, so that your vessels dilate and your blood flows more freely. This helps your arteries to regain their elasticity and stay free of plaque. L-arginine may also lead to increased microcirculation in genital tissues, which results in stronger erections and better sexual responsiveness, via this nitric oxide mechanism.
In fact, this is how a leading ED drug treats erectile problems — it increases nitric oxide production, relaxing your blood vessels, which increases penile blood flow. However, the price you might pay for these ED drugs is a slew of potentially dangerous side effects, including reducing blood pressure too low. L-arginine increases the action of nitric oxide — similar to ED drugs, but WITHOUT the side effects.
Scientific studies have shown that L-arginine can be particularly effective when used in combination with another natural agent, pycnogenol, which resulted in significant improvement in sexual function in men with ED, according to a Bulgarian study.2 Similarly, a pilot study published in the journal European Urology found 6 grams of L-arginine combined with 6 mg of yohimbine, a compound found in the herb yohimbe, was successful in treating men with ED.3
More Natural Solutions for Erectile Dysfunction
Aside from L-arginine, other natural alternatives include:
- Panax ginseng and maca root, which have been used for centuries as libido-boosting tonics
- Choline and vitamin B5. The neurotransmitter that triggers sexual messages in your brain, whether you're male or female, is acetylcholine (ACH). With too little ACH, sexual activity goes down. One way to safely and effectively enhance your ACH levels is to take choline supplements (1,000-3,000 mg) and vitamin B5 (500-1,500 mg).
You will also want to be sure your overall lifestyle is a healthy one, as the habits below will further help to enhance your sexual health. Remember, even mild erectile dysfunction can be a signal of an underlying heart problem, so addressing the issue on a foundational level could very well save your life:
- Reduce, with the plan of eliminating, grains and sugars in your diet. It is vitally important to eliminate sugars, especially fructose.
- Eat a healthy diet, like the one described in my nutrition plan, which will help to normalize your insulin levels. This simple measure has a profound influence on every area of your health, including your sex life.
- Optimize your vitamin D levels, ideally through appropriate sun exposure as this will allow your body to also create vitamin D sulfate — another factor that may play a crucial role in preventing the formation of arterial plaque.
- Exercise regularly. Make sure you incorporate high-intensity interval exercises, which also optimize your human growth hormone (HGH) production.
- Avoid smoking or drinking alcohol excessively.
- Be sure to get plenty of high-quality, restorative sleep.
- Manage your stress