While I am a fully licensed physician in Kansas, this communication does not constitute personal medical advice or establish a physician-patient relationship. See your own physician to discuss your particular diagnosis and treatment
ERECTILE DYSFUNCTION
Many men are embarrassed and don't want to admit they have erectile dysfunction. As a doctor, I am "a safe place" for this conversation for those that want to be honest. Most patients immediately jump to the next topic which is "the blue pill," of course meaning Viagra or its many cousin medications. Erectile dysfunction is very common and is markedly increasing in incidence. Of course, this increasing prevalence runs in parallel with the increase in metabolic health disorders such as, diabetes, obesity, hypertension, etc. These metabolic health conditions are mostly caused by our diet. If you fix the root cause (poor diet), then you might correct or even prevent erectile dysfunction. Doctors and the medical establishment have "programmed" patients to think in terms of, "we have a medicine for that." In this case, we have many medications that could bring on or worsen erectile dysfunction. Consider causative agents, including: medications that increase aromatase activity. Aromatase results in the excess conversion of testosterone back to estrogen, not so helpful in men.
Here is a list of some possible medications: antihistamines, nonsteroidal anti-inflammatory drugs, anti-Parkinson's medications, antiarrhythmics, anti-hypertensives, anxiolytics, antidepressants, muscle relaxants, statins, prostate cancer medications, and chemotherapy drugs.
Other medical conditions that can contribute to erectile dysfunction include: psychiatric illness, smoking, alcohol abuse, illicit drug abuse, and vascular disease.
Treatment:
Arteriosil supplement. Made from seaweed. In research studies, arteriosil stabilizes the endothelial glycocalyx (see my post about the endothelial gylcocalyx). Arteriosil has anti-inflammatory, anticoagulant, anti-adhesive, and antioxidant properties. Arteriosil improves nitric oxide release. Nitric oxide is important in developing an erection.
As a patient, you don't need to know this, but FYI, phosphodiesterase type 5 (PDE 5) inhibitors work by preventing the breakdown of cGMP. Nerves and endothelial cells release nitric oxide in the penis that stimulates guanylyl cyclase to produce cGMP and decrease calcium levels. This decreased calcium level mediates smooth muscle relaxation that results in arterial dilatation, venous constriction, and erection. I do prescribe these medications for those that need them.
PDE5 inhibitor medications include: Cialis(Tadalafil), Viagra(Sildenafil), Levitra(Vardenafil), Stendra(Avanafil).
Special instructions:
Cialis can last as long as 36 hours.
Viagra and Levitra cannot be taken with food.
Side effects of PDE5 inhibitors: flushing, headache, indigestion, vision changes, nasal congestion, back pain, hearing loss, priapism (painful prolonged erection-medical emergency that requires draining the blood from the penis with a needle).
Contraindications: Nitrate medications, hypotension, uncontrolled hypertension, severe liver disease, end stage kidney disease.
Some other treatments for erectile dysfunction:
Testosterone supplementation
Smoking cessation
Alcohol avoidance
Supplement low Vitamin D levels
Low-carb, high-fat diet/lifestyle intervention
Implantable pump devices
Intracavernosal injections (injections into the penis), cream, or intraurethral suppository-alprostadil
If you are blessed with the opportunity, my recommendation is to try to prevent erectile dysfunction by making the right choices early on in your life.
EAT A LOW-CARB, HIGH-FAT DIET AND EXERCISE REGULARLY.
These 2 strategies are paramount in your longevity and quality of life. Simple, but effective!
I hope this information helps you and your loved ones!
Jason Williams, D.O.