A healthy diet and sound exercise regimen may help you battle more than a bulging waistline. If you have trouble having or maintaining an erection, a condition known as erectile dysfunction (ED), these lifestyle modifications may greatly improve your sex life and heart health as well.
For some time, the medical community has recognized that ED and CVD share many of the same risk factors, including obesity, smoking, high blood pressure, high cholesterol levels, and diabetes. Now, revised guidelines published in 2005 be Second Princeton Consensus Conference on sexual activity and cardiac risk reflex the growing body of evidence that two conditions also respond to many of the same behavioral interventions.
Since CVD is a condition that interferes with blood flow, its tie to ED is hardly surprising. Cardiovascular disease changes the lining of blood vessels due to plaque buildup. Blood vessels that are stiff or partially blocked by plaque reduce blood pressure. If this vascular damage disrupts blood flow to the heart, it may cause a person to experience chest pain. If it disrupts blood flow to the penis, it may cause ED. In fact, in the initial stages of CVD, the only clinical symptom may be ED. That's because the arteries supplying the penis are much smaller, than those of the heart.
The health Professionals Follow-up Study used mailed questionnaires to asses the impact of obesity, physical activity, and other lifestyle factors on the erectile factors on the erectile function of more than 22,000 middle-aged and alderfly men. At enrolment in 1986, none of the men had any major chronic disease. Over a 14-year follow-up, nearly 18% of the participants reported at least one incident of ED. Based on weight at study enrolment, men who were obese had nearly twice the risk of ED compared to men who were ideal weight. Exercise also appeared to reduce the risk of ED in this study.
A smaller study, published in the Journal of the American Medical Association in 2004, showed that, even among obese men, lifestyle modification could have a dramatic effect on erectile function and overall health. The study enrolled 110 obese men between the ages of 35 and 55 years. None had diabetes, high blood pressure, or high cholesterol levels, but all had ED as indicated by scores of 21 or lower on the International Index of Erectile Function (IIEF), a 15-item, self-administered questionnaire with a maximum score of 25.
Half the men(the "control" group) were given general health information about food and physical activity. The other half (the "intervention" group) were provided with detailed information and teaching sessions about how to lose weight and reduce fat in their diets. They were offered behavioral and psychological counseling as well as individualized activity coaching. The intervention group met with nutritionists and exercise trainers on a monthly basis during the first year of the study and two-month intervals during the second year.
Within two years, the average body mass index (a measure of weight related to height) in the intervention group dropped markedly from 36.9 to 31.2, compared to a modest drop from 36.4 to 35.7 in the control group. Intervention group members increased average time spent exercising more than fourfold-from 48 to 195 minutes per week. By contrast, the control group did not even double their efforts, with average time increasing only from 51 to 84 minutes per week.
The effect of lifestyle modification on ED was significant. The intervention group raised their average IIEF from 13.9 to 17, and 17 men in this group achieved scores 22 or higher. There was no change in average IIEF score in the control group, though three members achieved scores of at least 22.
It is ironic that cigarette smoking represents sexiness and maturity for some adolescents. In reality, those who smoke have a greater risk of developing ED-and improved erectile function is one of the many benefits of smoking cessation.
Smoking is associated with arterial narrowing due to plague build-up and damage to the arterial lining. It has long been recognized as a major contributor to CVD. In the Health Professionals Follow-up Study, described earlier, smoking increased the risk of ED by 50%. Additionally, the Massachusetts Male Aging Study, a community-based survey of men between the ages of 40 and 70 years that was conducted between 1987 and 1989, found that men with heart disease and hypertension who smoked at enrolment faced almost twice the risk of moderate or total ED compared to those who did not smoke.
Weight control, smoking cessation, and managing other cardiovascular risk factors-including blood pressure, cholesterol levels, and diabetes-also may improve erectile function. While certain blood pressure medications can worsen erectile function, others may have beneficial effects.
Talk to your doctor about the best ways for you to address all cardiovascular and ED risks. Be sure to bring a list of all the medications you are taking so that doctor can determine whether any are contributing to your ED and, if so, whether substitutions can be made.
Sexual Medicine Society of North America and Quadrant Medical Education grant permission to reprint this handout for patient education, not for sale or commercial reproduction.
1. Reprinted from: Men's Sexual Health Consult Collection. (A Supplement to Physicians' Travel & Meeting Guide). Annenberg Center for Health Sciences at Eisenhower. November 2006
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