Erectile dysfunction as an early warning: blood flow, not hormones
Urologists Michael Eisenberg and Rena Malik say most erectile problems come from blood vessels and the pelvic floor and often appear before heart disease does, and Kelly Starrett and Kyle Gillett add the movement and lifestyle side. Men who treat it as a health signal get a chance to fix the cause early.
What is the usual cause of erectile dysfunction, according to Eisenberg and Malik? Show answer
Blood flow. Hormonal causes are a small share, about 5 percent by Eisenberg's estimate and about 3 percent by Malik's.
Why can erection trouble appear before heart disease does? Show answer
The penile arteries are only about one millimeter across, so they narrow to the point of trouble sooner than the larger arteries of the heart.
What figure does Rena Malik cite linking erectile dysfunction to the heart? Show answer
About 15 percent of men who develop it have a cardiovascular event within seven years.
What does Michael Eisenberg have new patients screened for? Show answer
Blood pressure, lipid levels and fasting blood glucose, through primary care.
How does Malik separate desire from arousal? Show answer
Testosterone is the main hormone for desire, wanting sex. Arousal is the body's response, which is a separate thing and mostly depends on blood flow.
What does Malik often find in men in their 20s and 30s with erection problems? Show answer
Pelvic floor dysfunction, linked to stress and long hours of sitting, often compounded by performance anxiety.
Why can a tight pelvic floor affect erections? Show answer
The pudendal nerve and artery run through the pelvic floor, so chronic tension there can reduce blood flow and inflame nerves.
Why are Kegels not a blanket prescription? Show answer
They strengthen, but many men have a tight pelvic floor that needs to relax. Overdoing them can make urinary and erectile problems worse.
What does getting erections during sleep indicate? Show answer
That the organ itself works, so the cause is more likely situational, anxious or muscular.
How do PDE5 inhibitors work? Show answer
They slow the breakdown of cGMP, the chemical that drives the erection. That is why they can restore erections without fixing the underlying cause.
What does Kyle Gillett mean by the canary in the coal mine? Show answer
Erectile dysfunction can be an early sign, because the plaque that causes it can also build up in the coronary arteries.
When is an erection a medical emergency? Show answer
When it lasts more than four hours without arousal. Malik says to go to an emergency room.