Okay men, here’s the deal. You’ve reached a certain age, you’ve put on some weight, your cholesterol levels are elevated, your doctor said you’re pre-diabetic, and you are experiencing erectile dysfunction. Which problem do you want to work on first? Uh-huh, that’s what I thought – erectile dysfunction. For men, having erectile dysfunction, is an assault on their manhood and can deflate their libido at the same time.
“Erectile dysfunction is a very real problem,” said Dr. David Samadi, chairman of urology and chief of robotic surgery at Lenox Hill Hospital, in New York City. “I see hundreds of men in my practice who face this, and it can have a massive impact on their quality of life and their relationships.”
Erectile dysfunction (ED) is defined by the Cleveland Clinic as “the inability to achieve and sustain an erection suitable for sexual intercourse.”
There are several treatments being used to treat ED – we’re all familiar with the medications Cialis and Viagra, then there are mechanical devices that physically pump blood into the penis and psychological counseling if it is stress related.
“The key is not to resort to Viagra, Cialis or Levitra right away, as a knee-jerk reaction for treatment,” said Dr. Samadi.
The National Institutes of Health estimates that ED affects as many as 30 million men in the United States. As a man ages, this number rises. Men who experience a total inability to achieve an erection is about 4 percent for men in their 50s, around 17 percent for men in their 60s, and increases to 47 percent for men 75 and older.
But don’t let those numbers scare you. There are lifestyle factors that you can do today that may help improve your chances of correcting or avoiding ED and preserve your confidence and ego.
“There are many risks factors for ED, but one of the most prominent is chronic disease such as diabetes, high cholesterol or cardiovascular disease,” Dr. Samadi said. “But even more importantly, lifestyle habits play a huge role.”
Whittle your weight or waist circumference
Men, if you want to improve your chances of avoiding ED, keep the weight off. Extra weight and having a waist circumference greater than 40 inches are known to increase chronic diseases and chronic inflammation. This leads to reduction of a substance produced by many cells in the body called nitric oxide. Nitric oxide is produced by vascular endothelium and is important in the regulation of blood flow. In order for a man to achieve and maintain an erection, there needs to be strong blood flow to the penis.
Men who are obese (defined as having a Body Mass Index of 30 or greater) are more likely to experience ED. Studies have shown the following:
ED is strongly correlated with a high waist circumference and waist-to-hip ratio. When men lost weight, ED was significantly improved.
Weight loss led to improved sexual desire, erectile function, mood and self-esteem.
Weight loss decreased inflammation and increased testosterone, which improved ED.
Men should strive for a weight loss of at least 10 percent within 6 months of following a weight loss regimen. Those who had specific weight-loss interventions, such as weight loss counseling from a registered dietitian, had the greatest improvements in ED.
One of the complications of uncontrolled diabetes for men is ED – a man with diabetes is three times as likely to have ED. If a man with diabetes has increased circulating glucose, elevating blood glucose in the bloodstream due to insulin resistance, they will also have reduction of nitric oxide production. Insulin is necessary for the release of nitric oxide, whereas insulin resistance leads to insufficient nitric oxide release and ED.
Control diabetes by checking blood glucose levels daily, following your prescribed meal pattern, and exercising. Doing so will increase insulin sensitivity and improve nitric oxide production, thus lessening the likelihood of ED.
Follow a Mediterranean or heart healthy diet
There’s a saying that goes, “what’s good for the heart, is good for other body parts.” This is very true when it comes to men and avoiding ED. Good blood flow is needed for the penis to become erect. Men who are eating a diet that contributes to heart disease – unhealthy fats, too much sugar, highly processed foods – will have restricted blood flow in the arteries and to the penis. In fact, for men experiencing ED, this could be a predictor of coronary artery disease.
The Mediterranean diet is an example of a way of eating that not only is good for the heart but also has been shown to reduce the incidence of ED. Here are some foods the Mediterranean diet is composed of:
Lots of fruits and vegetables
Whole grains – quinoa, oatmeal, whole wheat bread, brown rice, amaranth, buckwheat
Limited intake of refined sugars and processed foods
Legumes, nuts and seeds
Healthy fats – olive oil, canola oil, sunflower oil, walnuts, almonds, olives, avocados
Limited sodium – use more herbs and spices
Limited processed meat such as bacon, sausage, hot dogs, salami, deli and/or luncheon meats – increase fish, poultry and choose lean red meat.
Why is the Mediterranean diet good for ED? It’s high in antioxidants which reduce inflammation, helping to reduce cardiovascular disease and improves vascular function which improves blood flow to the penis.
Don’t smoke, and consume alcohol responsibly
Men who smoke are twice as likely to experience ED, including any second-hand smoke you’re exposed to. Quitting smoking is difficult, but your overall health depends on it. Seek your doctor’s advice on the best way to accomplish this feat.
When it comes to alcohol, if it’s kept in moderation (no more than two drinks a day for a man) it has been associated with decreased ED. Part of this is probably due to the improvement on high-density lipoprotein (HDL) cholesterol, the good cholesterol. Drinking heavily however, often leads to a greater incidence of ED.
The name of the game here is to get up and move. Whether it’s walking, running, swimming, or other forms of aerobic exercise, much research has demonstrated exercise to be a strong proponent of reducing ED.
One study had older men do interval training for 45 to 60 minutes a day for eight weeks. They had significant improvement of ED which was speculated to be due to increased production of nitric oxide that led to smooth muscle relaxation and blood flow.
It is recommended that men obtain at least 30 minutes of daily exercise, when they burn at least 300 to 500 calories to see improvement of ED.
Consume adequate zinc
Low levels of zinc can lead to a variety of health issues, including ED. Men with a zinc deficiency tend to have low testosterone levels along with a reduced sense of smell which can reduce libido.
Even though zinc deficiencies are uncommon in North America, they can be brought about by low dietary intake, alcoholism, gastrointestinal disorders, vegetarianism, sickle cell disease and some medications such as ACE inhibitors, thiazide diuretics and stomach acid reducers.
Men need 11 mg of zinc daily. Oysters, often considered an aphrodisiac, have more zinc than any other food. The majority of zinc in the American diet comes from lean red meat and poultry. Other good sources are beans, nuts, crab, lobster, yogurt, whole grains and fortified breakfast cereals. Animal sources of zinc are better absorbed than plant sources.
Zinc can be toxic in large amounts. Toxicity from food sources is rare, but chronic supplementation of too much zinc can lead to vomiting, nausea, headaches and other symptoms. The Tolerable Upper Intake Level (UL) for zinc is set at 40 mg per day. It’s best to get your zinc from food sources.
Lifestyle modifications can be a practical option for men experiencing ED.
“If a man smokes, is overweight or consumes a high amount of alcohol, he is much more at risk for developing ED,” summarized Dr. Samadi. “By losing weight and halting some of these vices, he may see a dramatic improvement.”
“There are many things men can do to improve erectile dysfunction, even on their own, without resorting to medication right away,” added Dr. Samadi. “Did you know vitamin D helps keep testosterone at healthy levels? Testosterone plays a key role in the stimulation of a man’s libido. It is also key in helping men achieve an erection. It’s important for him to have his levels checked. Even further, low testosterone decreases libido. Kegel and aerobic exercises that help strengthen the pelvic floor can help improve ED. Some natural remedies have been shown to improve ED such as Yohimbe, L’Arginine and DHEA. If a man is interested in learning more about these options, he should consult his urologist.”
The more of these modifications you put into practice, the greater the likelihood you’ll increase your chances of avoiding ED. At the very least, you’ll improve your health along with raised expectations and high hopes of finding that loving feeling once again.
Sources: Meldrum, D.R., Gambone, J.C., Morris, M.A., Ignarro, L.J. A multifaceted approach to maximize erectile function and vascular health. Fertility and Sterility, Vol. 94, No. 7, December 2010; Leff, J. Can lifestyle changes improve erectile dysfunction? Today’s Dietitian, Vol. 17, No. 4, P. 44, April 2015; Sanjay, S., Bharti, G. S., Manish, G., Rajeev, P., Pankaj, A., Puspalata, A., Keshavkumar, G. Metabolic syndrome: An independent risk factor for erectile dysfunction. J Endocrinol Metab. 2015 Mar-Apr; 19(2):277-282; Insel, P., Ross, D., McMahon, K., Bernstein, M. (2014) Nutrition. Burlington, MA: Jones & Bartlett Learning; National Institutes of Health