Associated Conditions

Testosterone Part III: The Key to Prostate Health?

May 19, 2021 by admin

Testosterone. And Prostate Health

The prostate is normally about the size of a walnut. Once men hit their 50s and beyond it’s very common for their prostate to grow. The prostate gland is located between the bladder and the penis. The prostate is just in front of the rectum. The urethra runs through the center of the prostate, from the bladder to the penis, letting urine flow out of the body. The prostate secretes fluid that nourishes and protects sperm.

“The value of testosterone replacement therapy (TRT) for older men is currently a topic of intense debate. While US testosterone prescriptions have tripled in the past decade (9), debate continues over the risks and benefits of TRT.

TRT is currently prescribed for older men with either low serum testosterone (T) or low T plus accompanying symptoms of hypogonadism. The normal range for serum testosterone is 300 to 1,000 ng/dl. Serum (less than) 300 ng/dl is considered to be low, and T (less than) 250 is considered to be… hypogonadism. Most experts support TRT for older men with… hypogonadism and symptoms.

Treatment for men who simply have low T remains somewhat controversial. TRT is most frequently administered by intramuscular (im) injection of long-acting T esters or transdermally via patch or gel preparations and infrequently via oral administration. TRT produces a number of established benefits in hypogonadal men, including increased muscle mass and strength, decreased fat mass, increased bone mineral density, and improved sexual function, and in some cases those benefits are dose dependent. For example, doses of TRT administered by im injection are typically higher than those administered transdermally, which results in greater musculoskeletal benefits. TRT also produces known risks including development of polycythemia (Hct > 50) in 6% of those treated, decrease in HDL, breast tenderness and enlargement, prostate enlargement, increases in serum PSA, and prostate-related events and may cause suppression of the hypothalamic-pituitary-gonadal axis.

“I thought this is just a part of aging. I asked my friends it they felt the same way and some of them said that they had experienced the same issues around the age of 50. One of my friends suggested it might be low testosterone.”

-Boston Medical Group Patient

Importantly, TRT does not increase the risk of prostate cancer. Putative risks include edema and worsening of sleep apnea. Several recent reports have also indicated that TRT may produce cardiovascular (CV) risks, while others report no risk or even benefit…”

* https://pubmed.ncbi.nlm.nih.gov/25898953/

A Preeminent Medical Expert on TRT & Cancer Risks

“Abraham Morgentaler, MD, explains new concepts that could subvert the long-held belief that high levels of testosterone exacerbate prostate cancer growth. He discusses the androgen saturation model, as well as the benefits of testosterone therapy for patients’ quality of life.

General attitudes in the urologic community have long maintained that high testosterone exacerbates prostate cancer (PCa), low testosterone is protective, and raising testosterone levels in men with PCa will enable tumor growth. However, these assumptions may be flawed.

In the 1940s, Huggins and Hodges found that giving men with bony metastases testosterone caused acid phosphatase levels to rise. They concluded that high testosterone was dangerous for PCa patients. However, this study only reported results for 2 men, one of whom was castrated. This means that the prohibition against T therapy in men with prostate cancer originated from observations in one non-castrated patient. Later, many researchers looked for a link between high testosterone and PCa, but found no conclusive results. However, data does show that low testosterone does not protect men from developing PCa.

One concept subverting this long-standing assumption is a saturation model. This concept dictates that PCa growth is sensitive to variations in testosterone levels at the low levels, but this sensitivity lessens at higher testosterone levels. According to this model, depriving PCa of testosterone can cause tumor death. However, testosterone only exerts a prostatic effect by binding to the androgen receptor (AR). Once serum testosterone concentrations reach maximal androgen-AR binding, or a saturation point, increasing testosterone will not cause tumors to grow.”

** https://grandroundsinurology.com/testosterone-therapy-in-men-with-advanced-prostate-cancer

https://player.vimeo.com/video/340896194

An Oncologist on TRT & Cancer Treatments

“Testosterone is usually viewed as a fuel for prostate cancer. Consequently, most researchers are reluctant to explore it as potential therapy. However, Johns Hopkins cancer researcher, Dr. Samuel Denmeade, took a page right out of cancer’s playbook, and figured out what prostate cancer cells were doing to survive hormonal therapy and then beat them their own game. After prolonged treatment with testosterone-blocking drugs, prostate cancer cells adapted to living with low levels of the hormone by ramping up the activity along with the amount of receptors within the cell surface to suck up every bit of testosterone available.

With prostate cancer cells in this state, adapted to an environment with low levels of testosterone, Denmeade wondered what would happen if he flooded the cancer cells with a short burst of high-dose testosterone, using the hormone like a drug. “If we give testosterone acutely through injection to cause a sharp rise in the hormone, prostate cancer cells won’t like that, and some will die,” says Denmeade. “Prostate cancer cells might be killed by the hormone shock, and the cells that survived would make fewer receptors, making prostate cancer cells vulnerable once again to hormone-lowering therapies.” At first glance, it seems paradoxical to give testosterone to a prostate cancer patient, but Denmeade and Isaacs say this approach is very different from the chronic, ongoing supply of testosterone that naturally occurs in men or testosterone replacement therapy. “It’s pharmacologic testosterone, not physiological testosterone,” says Isaacs.

Prostate cancer cells are not expecting an intense dose of testosterone, and they don’t know that it’s a short burst. Cancer cells that survive will adapt again, this time turning down the activity of those cell surface testosterone receptors. “They will downregulate their receptors at a time when the drug is wearing off, so we will see a period of low testosterone, low receptor, and that’s not good for cancer cells,” says Denmeade. As the cells are continually challenged with these short bursts of testosterone, they are constantly adapting levels of cell surface receptors up and down. “We are taking the cancer cells’ options out of play by making the testosterone levels rise and fall rapidly,” says Denmeade. Denmeade turned the idea in a clinical trial of testosterone as a prostate cancer drug therapy.”

*** https://www.hopkinsmedicine.org/news/articles/testosterone-as-a-drug

Boston Medical Group has TRT Programs

“At first I was skeptical about this whole testosterone idea. I was not prepared for what was in store for me…It has taken some time to get the levels adjusted but there is no denying the effects of testosterone has had a huge positive effect on my life.”

-Boston Medical Group Patient

Testosterone is the key hormone produced by the Leydig cells of the testicles and is responsible for the normal growth and development of male organs and for maintenance of other sexual characteristics. Aside from sexuality, it also contributes to some essential body functions such as embryological development, facial hair development, brain function, body muscle mass, bone strength, red blood cells function and even mood and energy levels.

The range for normal testosterone level is 300-1100 ng/dL. It is optimal for a man to get around 800- 1100 ng/dL. When a man reaches his mid 30’s, production of testosterone declines an estimate of 1% each year – 10% in 10 years or even more. Greater decline in testosterone level can happen due to obesity, infectious diseases, excess of blood iron and inflammatory diseases.

Low testosterone level can post significant health risks and physical limitations such as decreased energy, low libido, decreased mental quickness and depression. If left untreated, it may lead to more serious health problems such as osteoporosis, muscle atrophy, alopecia and erectile dysfunction.

*** https://www.bostonmedicalgroup.com/low-testosterone

Click here to read Part I: It’s Not Just About Muscles

Click here to read Part II: A Man’s “Time of the Month?”

This Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Blood Testing For Sexual Health

February 18, 2020 by admin

As human beings, we each are basically a body of cells, composed mostly of bones and blood encased in a large organ, our skin.

Blood, of course, delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away. Cells are mainly red blood cells, white blood cells and platelets.

Boston Medical Group offers blood tests. This testing is a part of an overall methodology to ascertain the best treatment options for each patient.

The most abundant cells in vertebrate blood are red blood cells. These contain hemoglobin, an iron-containing protein, which facilitates oxygen transport by reversibly binding to this respiratory gas and greatly increasing its solubility in blood. In contrast, carbon dioxide is mostly transported extracellular as bicarbonate ion transported in plasma. And the way we discover our overall health is most often tied to what’s in and what’s not in our blood.

While blood tests may be very common for patients getting normal or annual checkups, there are certain, specific tests one’s doctor might want to order to evaluate your overall health. These special tests could be needed to ascertain if symptoms or even just general issues like you age, weight, blood pressure or personal habits could be contributing to risks. Even more importantly, they can signal alerts or warning signs of the need for immediate medical attention.

Usually, blood tests don’t require any unusual preparations. But in some instances, you might need to not eat any food for up to 12 hours before the blood draw. Your doctor or assistant usually advises you how to prepare for certain or general blood tests.

A Laboratory draws the blood in order to analyze it. Either whole blood is used to count blood cells, or the blood cells are separated from the fluid that contains them, called plasma or serum.

The plasma fluid is used to measure different substances in the blood. The results can help detect early stages in health problems. This is when treatments or lifestyle changes can work best.

It should be noted that doctors cannot diagnose all diseases and medical problems just with blood tests. There might be other factors utilized to confirm a diagnosis. Symptoms, medical history, vital signs, such as blood pressure, breathing, pulse, and temperature, and results from other tests and procedures administered come into play.

Blood – Your Body’s Information Highway

Your blood can reveal a lot about your overall health. Lab work is merely a part of a puzzle piece and can be used to determine what’s going on.

“Blood tests help diagnose, treat, and manage heart disease. Your blood provides many hidden clues about your heart health. For example, high levels of “bad” cholesterol in your blood can be a sign that you’re at increased risk of having a heart attack. And other substances in your blood can help your doctor determine if you have heart failure or face a risk of developing plaque in your arteries (atherosclerosis). It’s important to remember that one blood test doesn’t always determine your risk of heart disease. The most important risk factors for heart disease are smoking, high blood pressure, high cholesterol, and diabetes.”*

Testing, Testing, One Two… E.D.

“It’s not easy for men to talk about problems in the bedroom. An inability to have sex with penetration can result in a stigma around being unable to perform. Worse, it might mean having difficulties in fathering a child. But it can also be a sign of a dangerous underlying health condition. A blood test can reveal issues beyond problems attaining or sustaining an erection. Read through this article to learn why blood tests are important. A blood test is a useful diagnostic tool for all sorts of conditions. Erectile dysfunction (ED) can be a sign of heart disease, diabetes mellitus, or low testosterone (low T), among other things. All of these conditions can be serious but are treatable and should be addressed. A blood test can determine whether you have a high sugar (glucose) level, high cholesterol, or low testosterone. In men with heart disease, the vessels that send blood to the penis can get clogged, just as other blood vessels can. Sometimes ED can be a marker of vascular dysfunction and atherosclerosis, which results in reduced blood flow in your arteries. Complications of diabetes can also result in a lack of blood blow to the penis. In fact, ED can be an early sign of diabetes in men under 46 years old. Heart disease and diabetes can cause ED, and this can be associated with low T. Low T also can be a sign of health conditions such as HIV or opioid abuse. Either way, low T can result in reduced sex drive, depression, and weight gain.”**

The Boston Medical Group Centers & Your General Health

Having treated hundreds of thousands of men worldwide, Boston Medical Group physicians understand both the physical and psychological effects of sexual dysfunction. With that in mind, all of Boston Medical Group medical centers are built with individual waiting rooms to create comfortable and private patient experience.

All visits are by appointment only to limit the number of patients in the office at any given time. Further, The Boston Method® is designed so that all testing and treatment is completed right there in the office without the need for any off-site travel.

* https://www.leehealth.org/our-services/cardiology/blood-tests

** https://www.healthline.com/health/erectile-dysfunction/blood-tests

Overcoming Intimacy Issues While Dealing with Prostate Problems

February 5, 2020 by admin

Old-fashioned beliefs suggested erectile dysfunction to be psychological in origin. While anxiety and stress are factors that can cause ED, scientific advances now provide proof that in a majority of cases, it is traced back to physical conditions which interrupt nerve functioning and restrict blood flow.¹ Diabetes, arthrosclerosis, cardiovascular conditions, as well as some types of prostate disease and their treatments are responsible for most cases of ED.³ This article will focus on how prostate diseases have impacted erections and sexual activity.

Erection is a matter of synchronous body function, which fills the penile tissue with blood, allowing it to swell and stand erect. This process requires an orchestrated mechanism, lead by blood vessels, endocrine system, and the nervous system, and obviously, any interference can affect the quality of an erection.² Nitric oxide promotes vasodilatation while neurotransmitters such as norepinephrine and acetylcholine increase the production of chemicals such as guanosine monophosphate, prostaglandins, and polypeptides which initiate the erection process by shifting chemical gradients in the muscles and capillaries of the corpora cavernosa, which runs along the shaft, causing inflation and swelling of the penis.¹

It is important to understand how conditions such as prostate disease can interrupt the above mentioned process, leading to abnormal erections or inconsistency in the erectile functioning. It is also helpful to realize limited erections for one or two nights does not mean you have ED.

Prostate Cancer

Sudden and frequent erectile problems can be a symptom associated with prostate cancer, so a prostate-specific antigen, PSA test, accompanied by a rectal exam is performed to assess the situation.

Prostate surgery to remove tumors is often associated with the high risk of nerve damage or cardiovascular complications due to the site specificity of such surgeries. Many choose radical prostatectomy, which only 25% to 80% of men can regain their abilities to maintain any erection.¹ Patient’s medical background and the surgeon’s experience are often taken into consideration when evaluating the chances to regain sexual abilities after a surgical procedure.⁴Rehabilitation takes up to eighteen months, and that alone takes away from the sexual functioning of men in many cases. Radiation therapy very often harms erectile mechanisms, as both the radiation beam and the radiation-emitting seeds implanted in the prostate can severe the nerve and the muscle cells.²

Hormone therapy is another treatment option which men with prostate cancer opt-in for, but such medication such as goserelin and leuprolide may also translate to ED symptoms, since interference in the endocrine system can greatly impact the erectile mechanism.⁶

Benign Prostate Hyperplasia

BPH is a non-cancerous enlargement of the prostate, which can greatly impact erectile and ejaculatory function. An enlarged prostate, does not lead to ED, rather some of the treatments used for this condition can lead to ED. Finasteride is an example of an anti-testosterone which is used to treat BPH, can cause reduction in libido, and in turn switch off the erectile engine in men. Transurethral resection, a surgical procedure used in the reduction of the prostate gland has also failed to skip ED as one of its side-effects.⁶

Prostatis

Simply known as the inflammation of the prostate gland, prostitis can be acute, or chronic, which is either caused by an infectious agent or not respectively, can trigger ED in many men. Aside from pain, frequent urination, and discharge from the penis, this condition can directly cause ED. It can also be accompanied by painful ejaculation and lack of sexual pleasure for men. The infection can clear in several weeks if treated, but the chronic form can be a permanent problem for some men.⁷

However, there is no need to panic. Every failed attempt to maintain an erection is not ED. When the male genitals don’t get hard enough, or it loses the rigidity and softens soon after an erection, there might be some speculations about ED. It might take longer to get an erection, and in other occasions, the erection might not be as firm or last as long. With such conditions witnessed regularly, it would be time to contact your doctor, and figure out a way to stop this condition in its tracks. With all the new medical discoveries and pharmaceutical advances, a right solution for you might be easier to access than you might imagine.

Diagnosis Methods*

In order to confirm a case of erectile dysfunction, a visit to your primary care physician, urologist or ED specialist would be required. Below is a table from Harvard Health Publishing which summarizes the procedure followed by doctors for each possible cause of erectile dysfunction:

Possible cause of erectile dysfunction	What the doctor does
Vascular (circulatory system)	Takes your blood pressure and listens to your heart. Checks pulse in groin and feet. Checks your abdomen for aortic aneurysm.
Neurological (nervous system)	Tests reflexes of your knees and ankles, as well as anus. Checks for sensation in your legs and feet.
Hormonal (endocrine system)	Assesses testicular size and breast development. Checks your thyroid gland.
Local (reproductive system)	Examines your penis for Peyronie’s disease. Checks your prostate.
Psychological (stress, anxiety, emotional)	Assesses the history of the problem, especially whether it started suddenly and if nocturnal erections are affected.

*Table from Harvard Medical School’s Health Publishing: Sex and Prostate (2009)¹

Doctors who specialize in ED treatments often use advanced diagnostic equipment to measure: blood flow, nerve sensitivity, and hormonal levels.

Treatment Method

Despite the fact that there is no definite cure for ED, we can remain hopeful on not giving up sexual activities due to such conditions that limit our sexual abilities. We live in an era where we are offered multiple treatment options to overcome such limitations and to regain the sexual abilities and cravings. Men with prostate diseases might be at most risk for developing ED, right next to cardiovascular disease patients, inactive individuals, and individuals who do not pay attention to their diet and mental health.⁷ Overcoming erectile dysfunction while dealing with prostate cancer is not an easy job but we can’t sit around and hope for a miracle to happen. The first step for a healthier sex life post-diagnosis of a prostate disease is the will and determination to make it happen. The next step is contacting specialists and evaluating the treatment options available to you. You can also help the recovery and treatment by remaining active, consuming a balanced diet, and taking the treatment seriously. Below is a list of all the modern and most popular treatment options available:

Therapy	Duration of Action Mechanism	Effectiveness Duration	Pros	Cons
IC Injections (ICP, Fx)	10-15 Minutes	30-75 Minutes	Highly Effective (98%), Few side effects	Training required; Injection might be uncomfortable for some men; may cause pain or priapism
Sound Wave Therapy (Rejuvapulse)	While In Use	Long-term	Non-invasive, Effectiveness varies (up to 85%), Non-pharmaceutical	Takes longer to see results.
Sildenafil (Viagra)	30-60 Minutes	3-5 Hours	Oral form, Effective (70%),	Not suitable for men with cardiovascular diseases or on blood pressure medication and nitrates. Side-effects.
Vardenafil (Levitra)	15-30 Minutes	3-5 Hours	Oral form, Effective (70%)	Not suitable for men with cardiovascular diseases or on blood pressure medication and nitrates. Side-effects.
Tadalafil (Cialis)	30-45 Minutes	2-3 Days	Oral form, Effective (70%)	Not suitable for men with cardiovascular diseases or on blood pressure medication and nitrates. Side-effects.
Alprostadil Pellets	Immediate	While In Use	Effective for some (80%)	Requires training; may cause burn; awkward and might cause bruising
Penile Bands	Immediate	While In Use	Needs adjustment. Cheap	Tricky to use
Stem cell Technology	On-going sessions	Long-term	Next-Gen; Permanent results; Personalized	Expensive

There are some misconceptions about this condition which gives an inaccurate image to many individuals dealing with erectile dysfunction.

MYTH: Erectile dysfunction only affects the elderly.

FACT: After the age of 45, almost 1 out of 2 men experience some sort of ED. It is true that ED occurs more prevalently as men age, however, men can retain their erectile functioning well unto their 80s, but it is medication and age-related conditions that exaggerates the occurrence of ED.³

MYTH: Men must accept and live with erectile dysfunction.

FACT: Effective and modern treatment options are readily available. Contact an ED specialist.⁴

MYTH: ED is a psychological disease.

FACT: Studies show only 10%-30% of ED cases are linked with psychogenic factors. Vascular disorders, abnormalities, nerve damage, endocrinologic disorders and prostate problems build up the remaining 70%-90% of ED cases.³

MYTH: Erectile dysfunction is not common.

FACT: A case study found 52% of Americans have some degree of ED between the ages of 40 to 70 years, and approximately 35% had moderate to severe ED.³

Sources:

The Link between Diabetes, Erectile Dysfunction and Intimacy Issues

January 30, 2020 by admin

Did you know that the root causes of Erectile Dysfunction (ED) can be linked to pre-existing health conditions? There are several prevalent conditions that can increase the likelihood of developing Erectile Dysfunction. One such pre-existing condition that increases the likelihood of developing Erectile Dysfunction includes Diabetes. Research studies suggest that the prevalence of developing Erectile dysfunction for “men with diabetes ranges from 35%–75% versus 26% in general population.” ⁽¹⁾This reveals that men with Diabetes have a significantly higher risk for developing Erectile Dysfunction then the general population due to complications resulting from Diabetes.

Overall men who are Diabetic have approximately a “threefold higher probability to develop Erectile Dysfunction compared with non-diabetics.”⁽²⁾ This suggests that the chances of developing impotence are much higher if an individual has a pre-existing condition such as Diabetes. According to the American Diabetes Association “the onset of Erectile Dysfunction occurs 10–15 years earlier in men with diabetes than it does in sex-matched counterparts without diabetes.^{” (1)} Research also conducted by the Boston University Medical Centre, has found that “about half of men who are diagnosed with type 2 diabetes will develop ED within five to 10 years of their diagnosis.”⁽³⁾

Not only is Erectile Dysfunction more common in men who have been diagnosed with Diabetes, research studies suggest that Erectile Dysfunction in Diabetic men “has been shown to be more severe and associated with a poorer quality of life”. ^{(5, 6)} Furthermore, studies have shown that men who have ED are “less responsive to medical treatment compared with ED in non-diabetic men.”^{(5, 6)}

So what’s causing Erectile Dysfunction stemmed from Diabetes?

Erectile Dysfunction can stem from several complications associated with Diabetes. One such complication includes poor long-term blood sugar control which results in damage to “damage small blood vessels and nerves” increasing the likelihood to develop Erectile Dysfunction. ⁽³⁾ Another complication includes “low nitric oxide levels which are commonly found in individuals with Diabetes.” ⁽¹⁾When a man is aroused, a chemical called nitric oxide is released into the bloodstream. This nitric oxide signals the muscles and the arteries in the penis to relax, allowing for more blood to flow into the penis, giving an erection. When a man’s blood sugar levels are too high, there is less nitric oxide produced resulting in less blood flowing into the penis therefore causing the inability to achieve or maintain an erection. Gh levels of nitric oxide act as local neurotransmitters therefore facilitating the maximization of blood flow as well as penile engorgement. “Loss of erection occurs when nitric oxide–induced vasodilation ceases”, or with low nitric oxide synthase levels. ⁽¹⁾ Individuals with Diabetes have a higher chance of developing Erectile Dysfunction due to the interference of nitric oxide synthesis as it prevents “intracavernosal blood pressure from rising to a level sufficient to impede emissary vein outflow, leading to an inability to acquire or sustain rigid erection.” ⁽¹⁾

Another complication of Diabetes which can facilitate impotence includes the reduction of Norepinephrine- and acetylcholine-positive fibers two substances which attach to skeletal muscle fibers in the penile tissue region. These two substances are shown “to be reduced in people with diabetes” resulting in the “loss for muscle relaxation that is essential for achieving an erection.” ⁽¹⁾ The reduction in these two fiber substances arises from damage to the nerves as well as blood vessels caused by long term imbalances in blood sugar level. Additionally, the use of medications frequently assumed to be administered by diabetic patients, such as “antihypertensive drugs (β-blockers, thiazide diuretics, and spironolactone), psychotropic drugs (antidepressants), and certain fibrates, have all been associated with an additive deleterious effect on diabetic Erectile Dysfunction.”⁽⁵⁾ Overall Erectile Dysfunction linked to Diabetes is multi-factorial in nature and there can be several underlying causes attributing to the condition so a global approach in regards to treatment may be required.

Let’s Talk about Prevention, Supplements and Treatment Options

The first step in preventing or resolving Erectile Dysfunction includes addressing the root cause of the problem. Initially, preventive measures or steps towards multi-factorial intervention can help to reduce the risk of developing Erectile Dysfunction. Preventive measure include but are not limited to taking initiatives to managing hypertension, maintaining lipid control, completely omitting cigarette smoking, engaging in adequate physical exercise, as well as reducing alcohol intake.

Treatment and prevention measures can also come in the form of glucose management, and diet changes. Recent clinical studies have shown that better glucose management has “been associated with improvements in sexual function” and reduces the likelihood of developing Erectile Dysfunction. ⁽⁷⁾ According to ISSM and the American Diabetes Association adopting a Mediterranean diet could cut the risk of a man developing erectile dysfunction by 40 percent. ^(12,11) Additionally, the American Association of Diabetes states that the benefits of a Mediterranean diet “on erectile function might be related to an improved lipid and glucose metabolism, increased antioxidant defenses, and increased arginine levels which could raise nitric oxide activity and thus improve erectile function .” ^{(11, 10)}

Supplements can aid in the improvement of Erectile Dysfunction as well. Recent studies also show that “supplementation with amino acids called l-arginine and l-citrulline may help to improve erectile function as these acids are known to increase the body’s production of nitric oxide, which can increase blood flow to the penis.” ⁽⁸⁾ Substituting as well as removing medications that may be linked to Erectile Dysfunction is helpful as well. ^{(2, 9)}

Below are listed lifestyle change measures to consider when treating or preventing Erectile Dysfunction: ⁽⁴⁾

Managing blood sugar levels

A diabetes-friendly well balanced diet assists in controlling blood sugar levels and decreases potential damage which might occur to both blood vessels and nerves.

Limiting the consumption of alcohol

Drinking can often times damage blood vessels which can contribute to erectile dysfunction.

Adopting an active lifestyle

Incorporating regular exercise can assist in controlling the blood sugar levels as well as improve circulation and lower stress.

Quit smoking

Smoking constricts blood vessels and reduces levels of nitric oxide in the blood, which in turn reduces the blood flow towards the penis, therefore contributing to the worsening the condition of erectile dysfunction.

For Diabetic men who have onset Erectile Dysfunction there are several effective therapy options available. Boston Medical Group offers first line pharmacologic therapy options effective for treating Erectile Dysfunction for men who have pre-existing conditions such as Diabetes. The initial steps of Boston Medical Groups consultation includes going over a patient’s background history through a thorough evaluation of their medical conditions, and current health statues in order to distinguish between psychogenic and primary causes. The second step Boston Medical Group initiates includes administering quick, simple non-invasive tests in order to determine severity as well as prognosis. The third step of Boston Medical Group’s comprehensive consultation includes prescribing the best recommended line of therapy for Erectile Dysfunction. Such pharmacologic therapies include oral medications and vasoactive agents in order to thoroughly address the issue at hand.

Sources:

Bigger Isn’t Always Better

December 5, 2019 by admin

When Sex Is a Weighty Matter

It’s widely known being overweight can have serious health consequences. And in many cases, it can have deleterious effects on a guy’s sex life. According to the CDC, one third of all Americans are obese. That is a lot of Americans.

“Many men suffering from obesity also suffer from erectile dysfunction (E.D.).” According to Ira Sharlip, MD, spokesperson for the American Urological Association, “Fifty-three percent of men between the ages of 40-70 have some degree of erectile dysfunction.” There are many risk factors for erectile dysfunction including:

Age
Cardiovascular disease
High blood pressure
Low testosterone
Smoking and diabetes, along with a poor diet and sedentary lifestyle

With many conflicting studies, it is unclear whether a high body mass index (BMI) and obesity cause erectile dysfunction or are just tied to the associated risk factors, however, it is clear that obesity is a contributing factor. With significant health and lifestyle changes, erectile dysfunction can be significantly improved.

Simply with increased age alone, there is an associated natural decline in erectile function. If there are other diseases present, there is a greater risk. E.D. and sexual performance are great sources of anxiety and concern for all men. Poorly perceived performance leads to worsening performance and depression for even the most confident of men! Obesity can bring on these diseases and also magnify these psychological concerns.”*

Obviously, for seriously obese men, action should be taken to gain control and seek remedies to lose weight. Nevertheless, E.D. treatment options abound.

When Sex Becomes A Belly Flop

Belly fat is nothing to joke about. Find out what causes belly fat, the health risks it poses for men and what you can do to lose the extra pounds.

If you’re carrying a few extra pounds, you’re not alone. But this is one case where following the crowd isn’t a good idea. Carrying extra weight — especially belly fat — can be risky.

Belly fat is a more dangerous fat. The trouble with belly fat is that it’s not limited to the extra layer of padding located just below the skin (subcutaneous fat). It also includes visceral fat — which lies deep inside your abdomen, surrounding your internal organs. Regardless of your overall weight, having a large amount of belly fat increases your risk of:

Cardiovascular disease
Insulin resistance and type 2 diabetes
Colorectal cancer
Sleep apnea
Premature death from any cause
High blood pressure

Age and genetics may contribute to gaining belly fat. Your weight is largely determined by three main factors:

How many calories you consume during the day
How many calories you burn off through daily exercise
Your age

A Measured Approach To A Better Sex Life.

“If you eat too much and exercise too little, you’re likely to pack on excess pounds, including belly fat.

Getting older plays a role too. As you age, you lose muscle — especially if you’re not physically active. Loss of muscle mass decreases how quickly your body uses calories, which can make it more challenging to maintain a healthy weight. According to the 2015-2020 Dietary Guidelines for Americans, men in their 50s need about 200 fewer calories daily than they do in their 30s due to this muscle loss.

Your genes also can contribute to your chances of being overweight or obese, as well as play a role in where you store fat. However, balancing the calories you consume with activity can help prevent weight gain, despite your age and genetics.

Alcohol’s calories contribute to beer belly. Drinking excess alcohol can give you a beer belly, but beer alone isn’t to blame. Drinking too much alcohol of any kind can increase belly fat, because alcohol contains calories. If you drink alcohol, do so only in moderation.

For men age 65 and younger, moderation means up to two drinks a day. For men older than age 65, it means up to one drink a day. The less you drink, the fewer calories you’ll consume and the less likely you’ll be to gain belly fat.” **

Love Handles Aren’t Always So Lovable.

3d rendered, medically accurate illustration of an obese man

“Overweight/obesity can cause E.D. by damaging the blood vessels, decreasing testosterone and causing a state of generalized inflammation in the body. Obesity can cause damage to blood vessels due to the associated hypertension, diabetes mellitus, hypercholesterolemia, hypertriglyceridemia and inflammation.

It is proposed that the increased state of inflammation may cause free radicals in the body that cause oxidative damage to tissues. The harmful effects of hypertension, diabetes and hyperlipidemia are well studied, published and accepted.

Men who are affected by obesity may have elevated cholesterol, hypertension and high blood pressure and diabetes, all of which contribute to erectile dysfunction. “If you are affected by obesity, the risk of developing diabetes is two to three times more likely than for someone who is not affected by obesity,” says Elizabeth Selvin, PhD, MPH, assistant professor and epidemiologist at John Hopkins Bloomberg School of Public Health. Additionally, she says, “More than 50 percent of men with diabetes suffer from erectile dysfunction.”

It is well studied and accepted that obesity often leads to diabetes as well as atherosclerosis-related hypertension and cardiovascular disease, which can cause E.D. We do not know exactly why, but obesity appears to damage the inner lining of the vessels (the endothelium) and when this lining is damaged the penis cannot get enough blood flow to produce and sustain an erection.

‘An erection is basically a cardiovascular event, and if blood flow cannot increase because the blood vessels can’t dilate normally, then there is a decrease in erectile function,’ says Robert A Kloner, MD, a cardiologist and professor of medicine at the University of Southern California’s Keck School of Medicine. A fatty diet and lack of exercise that contribute to obesity and cardiovascular disease can cause narrowing and hardening of the arteries (atherosclerosis), which can slow blood flow as well.” *

E.D. has many causes. Some genetic. Some age-related. Those that are self-induced, such as obesity can be solved in numerous ways.

About 90% of cases of ED are caused by physical factors, classified as vascular (related to blood flow) and non-vascular diseases. It is estimated that 70% of all ED cases may be attributable to vascular diseases alone.

ED is more than just a sexual problem. A fulfilling sex life can lead to a greater sense of self-esteem and confidence.

***https://www.obesityaction.org/community/article-library/men-is-obesity-affecting-your-sex-life

**https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/belly-fat/art-20045685

Associated Conditions

This Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Testing, Testing, One Two… E.D.

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