Ask an expert: What you should know about men’s sexual health

July 27, 2017 Providence Health Team

As many of us know, men are often hesitant to seek medical advice for health concerns, let alone discuss them with their partners or friends. This is especially true when it concerns their sexual health.

Erectile dysfunction, or ED, is one of the most common male sexual dysfunctions and it greatly affects the quality of life for men and their partners. Studies show nearly 52 percent of men experience ED in their lifetime. Although 70 percent of men with ED are age 70 or older, more men age 40 and younger are being diagnosed with it, as well.

Why is this happening? To help shine a light on one of the most distressing sexual health issues for men and their partners, we spoke with Mehran Movassaghi, M.D., urologist and director at Providence Saint John’s Men’s Health Center in Santa Monica, Calif.

Why are ED rates on the rise in men under 40?

This is tied to an increase in obesity and diabetes in younger men. Men who have heart disease, diabetes and are taking certain medications have higher risks of experiencing erectile dysfunction.

Can stress related to work or money cause ED?

Yes, your brain is the biggest sex organ. If you’re stressed or worried, then even with no history of ED, getting an erection can be difficult.

What sports or activities can cause or affect ED?

Anything that can cause pelvic injury or spinal cord injury can affect erectile function. Otherwise, I’m not aware of any specific sports leading to ED.

Is there a connection between sleep apnea and ED?

Yes, patients with sleep apnea are more likely to have low testosterone and also ED. They are also more likely to be overweight, which can cause vascular disease.

Do chemicals have an effect?

Environmental toxins, including lead, pesticides and organic solvents, can affect erectile function. Effects on the nervous and hormonal systems (pesticides have hormone-disrupting abilities) have been named as the main ways environmental toxins may impact the ability to achieve and maintain an erection. Ina study of 199 men who had erectile dysfunction, researchers evaluated the possible impact of exposure to pesticides, solvents and heat on sexual function. They determined that all three factors, but especially pesticides and solvents, are risk factors for erectile dysfunction.

But some studies are not as conclusive. At the Cancer Research Institute of Queen’s University, scientists analyzed blood samples from 101 men with erectile dysfunction for the presence of organochlorine pesticides and PCBs (polychlorinated biphenyls). When these blood samples were compared with those gathered from 234 healthy controls, the researchers found no evidence of an association between pesticide levels and erectile dysfunction.

In China, researchers compared the rates of sexual dysfunction among 230 men who worked at factories that produced BPA or a similar chemical with 400 men who were not exposed to BPA at work. Men who worked with BPA had a fourfold greater risk of erectile dysfunction and a sevenfold greater risk of ejaculation difficulties than men who were not exposed to the chemical.

A recent study shows the Mediterranean diet is the healthiest diet for men with ED. How can diet affect ED?

Ultimately, the link is between cholesterol-lowering foods that can help unclog the arteries and eventually result in improved blood flow to the penis. A Mediterranean diet is high in fruits, vegetables, minimally-processed whole grains, beans, nuts and olive oil. It can feature moderate portions of lean animal proteins, such as fish, poultry and low-fat or fat-free dairy.

The benefit of the Mediterranean diet for erectile dysfunction is likely caused by a number of factors – more than just any weight loss that results from the diet. It’s an antioxidant- and omega-3-rich (and therefore anti-inflammatory) way of eating that helps keep blood vessels flexible and healthy. It’s also loaded with potassium-rich veggies and is sparse on high-sodium processed foods, which helps keep blood pressure low. Its staples are foods with a known cholesterol-lowering effect, such as whole grains, nuts, and certain vegetables and fruits.

Is Viagra the solution for most men?

PDE5 inhibitors (the drugs used in the treatment of erectile dysfunction) work by increasing blood flow to the penis to help achieve and maintain an erection. In general, these drugs are safe for men who are not on nitrates and who are healthy enough for sex. Nonetheless, ED may be a warning sign of other underlying disease so it’s important that men experiencing erectile issues see their provider.

How often is ED related to relationship problems?

It can affect relationships in many ways: It can make a man feel embarrassed and lose interest in sex, while his partner may not feel like she’s turning him on. It can be a vicious cycle.

What is the first thing you recommend to your patients suffering from ED?

Depending on their age, ED might be a warning sign for other underlying conditions so they should seek medical attention. Don’t ignore it or find an over-the-counter medication because they can be dangerous.

If you’re struggling with ED, don’t be ashamed to talk to your provider. There are things you can do to help the condition. You can find a Providence provider in your area by tapping into our multistate directory.

About the Author

The Providence Health Team brings together caregivers from diverse backgrounds to bring you clinically-sound, data-driven advice to help you live your happiest and healthiest selves.

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