Can you walk off Erectile dysfunction?

Researchers writing in the medical journal Urology examined questionnaires returned by over 15,000 aging men and found that moderate or severe sexual symptoms occurred in 20% of men 40 to 44 years and that significant symptoms increased with age up to 67% in the men 65 to 69 years. 1

Other researchers writing in The Journal of Sexual Medicine examined sexual function in older adults and noted that 41% of the men were sexually active with an average age between 75 and 87 (yes that says 87). The men who were not sexual active reported erectile dysfunction as the main reason why. Regardless the researchers concluded that desire for sexual activity remained high among men, despite substantial problems with erectile dysfunction. 2

Erectile dysfunction

It is important to understand that dysfunction is not an inevitable aspect of getting older. In fact, it’s more of a side effect of lifestyle than aging.

My initial advice to a man wanting to preserve or restore his sexual function is, instead of drugs, tie on your running shoes and start walking or jogging and change your nutrition. The old adage, “You are what you eat” rings true for sexual health and performance. Nutrition and exercise control the entire physiology of your body, and what you eat and do reflects in your ability to perform in bed.

Aging Men, Obesity, Metabolic Syndrome, Decrease in Total Serum Testosterone Levels
Researchers writing in the Journal of Urology say that their study “…demonstrated that aging men with obesity and the metabolic syndrome have a significant decrease in total serum testosterone levels compared to aging, metabolically healthy men.” Read more

Decreased Testosterone and Erectile Dysfunction
Researchers writing in the Journal of Urology say that their study clearly demonstrated a decrease in testosterone level throughout a 4-year follow up in patients with ED. Read more

Diabetes and ED
Researchers writing in the British Journal of Urology say that about 1 in 3 men newly diagnosed with diabetes had ED. Read more

Is Erectile Dysfunction A Marker For Diabetes?
Researchers writing in the Journal of Urology say that male dysfunction was “an observable marker of diabetes mellitus, strongly so for men 45 years old or younger and likely for men 46 to 65 years old, but it is not a marker for men older than 66 years.” Read more

1. Mäkinen JI, Perheentupa A, Raitakari OT, et al. Sexual symptoms in aging men indicate poor life satisfaction and increased health service consumption Urology. 2007 Dec;70(6):1194-9.

2. Smith LJ, Mulhall JP, Deveci S, Monaghan N, Reid MC. Sex after seventy: a pilot study of sexual function in older persons. J Sex Med. 2007 Sep;4(5):1247-53.

Erectile Dysfunction and Diabetes

Researchers writing in the Journal of Urology say that male dysfunction was “an observable marker of diabetes mellitus, strongly so for men 45 years old or younger and likely for men 46 to 65 years old, but it is not a marker for men older than 66 years.”

Sun P, Cameron A, Seftel A, Shabsigh R, Niederberger C, Guay A. Erectile dysfunction–an observable marker of diabetes mellitus? A large national epidemiological study.J Urol. 2006 Sep;176(3):1081-5; discussion 1085
From the study abstract
Read more

Diabetes and ED

Researchers writing in the British journal of urology say that about 1 in 3 men newly diagnosed with diabetes had ED.

The prevalence and predictors of erectile dysfunction in men with newly diagnosed with type 2 diabetes mellitus.Al-Hunayan A, Al-Mutar M, Kehinde EO, Thalib L, Al-Ghorory M. BJU Int. 2006 Oct 9;

From the article abstract
OBJECTIVE To determine the prevalence of and risk factors for erectile dysfunction (ED) in men newly diagnosed with type 2 diabetes mellitus (DM).

PATIENTS AND METHODS All consecutive samples of men newly diagnosed with type 2 DM attending the diabetes centre in the capital of Kuwait were included in the study. Face-to-face interviews with the men were conducted using the International Index of Erectile Function (IIEF)-5 questionnaire. A threshold IIEF-5 score of <21 was used to identify men with ED. Pertinent clinical and laboratory characteristics were collected. RESULTS Of 323 men with newly diagnosed type 2 DM, 31% had ED; comparing potent men and men with ED, there were statistically significant differences for smoking, duration of smoking, hypertension, education level, body mass index and serum glycosylated haemoglobin level. Among these, age was the most important risk factor identified by multivariate logistic regression.

CONCLUSION About a third of men with newly diagnosed type 2 DM had ED; this was associated with many variables, but most notably with age at presentation.

Decreased Testosterone and ED

Researchers writing in the Journal of Urology say that their study clearly demonstrated a decrease in testosterone level throughout a 4-year follow up in patients with ED.

El-Sakka AI, Hassoba HM. Age related testosterone depletion in patients with erectile dysfunction. J Urol. 2006 Dec;176(6):2589-93.

PURPOSE: We assessed the pattern of age related testosterone depletion in patients with erectile dysfunction.

MATERIALS AND METHODS: A total of 305 patients with erectile dysfunction who had a normal testosterone level at baseline visit and who completed the study were candidates for analysis. Erectile function was assessed using the International Index of Erectile Function. Patients underwent routine laboratory investigations plus total testosterone and prolactin assessment at the baseline visit and on a yearly basis for 4 years.

RESULTS: The mean age +/- SD was significantly higher in 210 patients with decreased testosterone (55.3 +/- 7.3 years) than in 95 patients with steady testosterone (remaining within the normal range) (50.8 +/- 10.2 years).

There was a significant decrease in yearly mean testosterone level throughout the study in all the age groups (determined by decades) older than 30 years.

Of the study population 68.9% had decreases in testosterone levels throughout the 4 years of visits.

Hypogonadism (testosterone lower than normal range) developed in 7.6% of the study population.

There was a significant decrease in mean testosterone at any visit in comparison to previous visits.

There were significant associations between decreased levels of testosterone and increased severity of erectile dysfunction at baseline visit, longer duration and poor metabolic control of diabetes, ischemic heart disease, hyperprolactinemia and low desire.

CONCLUSIONS: This study clearly demonstrated a decrease in testosterone level throughout the 4-year followup in patients with erectile dysfunction. Patients with decreasing testosterone were older than patients with a steady testosterone level.

Intimacy, Urinary, and Depressive Problems In Women Who Have Partners With E.D.

Researchers writing in the medical journal World Journal of Urology say that FSD disorders, urinary symptoms and depressive symptoms are common in partners of men with ED.

From the study abstract
Shabsigh R, Anastasiades A, Cooper KL, Rutman MP. Female sexual dysfunction, voiding symptoms and depression: common findings in partners of men with erectile dysfunction. World J Urol. 2006 Nov 3

The researchers sought to “investigate the prevalence of female sexual dysfunction (FSD), urinary symptoms, and depressive symptoms in female partners of men presenting with erectile dysfunction (ED).”

Through a survey 73 women with male patients presenting with ED were surveyed using a questionnaire at their counterpart’s visit. Fifty of the women filled out the questionnaire sufficiently to be studied.

Of the 50 women, the average age was 44.8 years and 38 of the women reported being sexually active

The women reported the following sexual dysfunctions:

• anxiety/inhibition (26%)
• hypoactive desire (20%)
• arousal/lubrication difficulty (30%)
• orgasmic difficulty (24%)
• dyspareunia* (18%)
• incontinence during intercourse (8%)
• sexual dissatisfaction (34%)



In other questions the women reported:
Forty-one women (82%) rated sexual activity as an important part of their lives.
Urinary symptoms of frequency and urgency were reported by 18/50 (36%).
Depressive symptoms were present in 22/50 (44%).

The researchers noted that: “FSD disorders, urinary symptoms and depressive symptoms are common in partners of men with erectile dysfunction.”

*Note added: Painful intercourse

Testosterone For Men

TESTOSTERONE FOR MEN
The medicinal value of testicles have been documented in the Bible, the writings of the ancient Egyptians and from India. Indeed, nearly every ancient culture believed that the testicles held some form of masculine power.

The use of testosterone as a means of restoring vitality can be traced in the modern era to the work of famed medical researcher Charles Edouard Brown-Séquard (1817-1894). Brown-Séquard had been hailed as a medial pioneer for his ability to treat difficult and previously untreatable disorders of the nervous system. At the age of 72, when he noticed his declining vitality, he injected himself with the extracts of crushed testicles from dogs and guinea pigs and increased his physical strength and intellectual abilities and announced his results to his colleagues.

Brown-Séquard’s work sparked an influx of research and medical use of testicles, however, technology could not, at that time, substantiate his claims.

In 1935 Dutch researchers were able to isolate and create a synthetic form of testosterone. Doctors prescribed it in males with hypogonadism—where levels of testosterone are so low it prevents normal sexual development. Older men suffering from impotence were also treated. A few years later, testosterone supplementation for these disorders became “mainstream.”

What are the potential signs of Testosterone deficiency in men?

1. Diminished Libido
2. Erectile Dysfunction
3. Fatigue
4. Muscle Weakness
5. Bone Density Loss, with increased fracture risk
6. Decrease in Endurance, Stamina
7. Loss of Body Hair
8. Depression
9. Mood Disorders
10. Obesity or increase in fat mass
11. Hypertension
Testosterone Supplementation
Testosterone supplementation has received a fair share of “bad press.” Mostly due to health problems (sterility, coronary artery disease, liver damage, and brain tumors), caused in young men and women who should not be taking testosterone supplementation, but do so at super-physiological doses, to enhance athletic performance. Indeed, testosterone is part of the “Steroid Crisis” affecting amateur and professional sports.

There is very little evidence to support that testosterone supplementation to restore levels lost to aging can cause health problems. Numerous research supports the opposite. Study participants and researchers noted gained muscle, a slowdown in bone loss, increased sexual desire, and better cognitive skills.

Drops in testosterone levels begin in men after the age of 30 and its effects are described as “male menopause” or andropause when problematic.

The recognition that men can suffer from sex hormone deficiency just as women do, and be treated for this deficiency in the same manner as women prescribed hormonal supplementation have lead to an explosion in the demand for testosterone supplementation.

Testosterone Supplementation Risks
It is important to understand that not all men will benefit from Testosterone supplementation. The goals, realities, and risks of Testosterone supplementation should be discussed, at length, with your physician prior to onset of treatment.

Testosterone Supplementation and Prostate Cancer
Men taking testosterone supplementation should have twice yearly PSA tests and once yearly manual examination of their prostate gland. No evidence suggests that testosterone supplementation causes prostate cancer. In fact, studies show a higher incidence of prostate cancer in men with a lower baseline level of testosterone. Have you ever heard of a teen age male (with the highest testosterone levels) having prostate cancer? Studies do suggest that in the presence of existing prostate cancer, testosterone supplementation may accelerate tumor growth. It also appears that there is an association of high estrogen levels and prostate cancer.

Warnings:
Any hormone supplementation can adversely effect other hormone levels.

Testosterone supplementation must be monitored by a physician through blood testing. Very high levels of testosterone can lead to severe and dangerous health problems.

Men who take too much Testosterone may can shut down production of DHEA and other sex hormones.

The result is the frequently seen side effects of:
1. Testicular shrinkage
2. Impotence
3. The development through increased estrogen production of breasts (gynecomastia).
4. Male Pattern Baldness
5. Infertility

Other complications may include:
1. Fluid retention (swelling)
2. Heart Problems through increasing hardening of the arteries.
3. Increase in body hair
4. Acne
5. Liver problems
6. Kidney disease
7. High Blood Pressure
8. Gallstones