Food help erectile dysfunction. The Surprisingly Important Link Between Food and Erectile Dysfunction

03.04.197507.10.2021 by alexxlab

Does your diet affect your sexual health. Learn how certain foods can reduce the risk of erectile dysfunction and what to avoid for better bedroom performance.

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The Surprising Connection Between Food and Erectile Dysfunction

Erectile dysfunction (ED) is a common issue that many men face, with an estimated 30 million men in the United States affected. While there are various medical and lifestyle factors that can contribute to ED, emerging research suggests that diet may play a significant role as well. In this comprehensive article, we’ll explore the surprising link between food and erectile dysfunction, uncovering the key dietary factors that can impact sexual health.

Flavonoids: The Superheroes of Erectile Function

One of the most exciting discoveries in the field of ED research is the role of flavonoids. Flavonoids are a class of plant-based compounds known for their powerful antioxidant and anti-inflammatory properties. A study published in The American Journal of Clinical Nutrition found that men who regularly consume foods rich in flavonoids, such as anthocyanins, flavones, and flavanones, experienced a significantly reduced risk of erectile dysfunction compared to those who did not.

So, what are the top sources of these beneficial flavonoids? According to the lead researcher, Aedin Cassidy, the primary sources in the American diet include strawberries, blueberries, red wine, apples, pears, and citrus products. Incorporating these flavonoid-rich foods into your diet can be a simple and effective way to support your sexual health.

The Mediterranean Diet: A Recipe for Bedroom Success

In addition to the power of flavonoids, research has also highlighted the benefits of following a Mediterranean-style diet for erectile function. The Mediterranean diet, known for its emphasis on plant-based foods, healthy fats, and limited red meat, has been linked to a reduced risk of erectile dysfunction.

The reason? A Mediterranean diet can help maintain healthy blood flow and reduce the risk of heart disease, which is closely tied to erectile dysfunction. By focusing on fruits, vegetables, nuts, beans, and fish, while limiting saturated fats and processed meats, you can support your cardiovascular health and, in turn, your sexual function.

Alcohol: The Surprising Libido Killer

While it may seem counterintuitive, the beverages you choose to consume can have a significant impact on your ability to perform in the bedroom. Alcohol, in particular, is one of the top culprits when it comes to erectile dysfunction.

According to Dr. James Ulchaker, a urologist, excessive alcohol consumption can lead to both short-term and long-term sexual function problems, including erectile dysfunction, low sexual desire, and premature ejaculation. The effects of alcohol can even diminish the effectiveness of medications used to treat erectile dysfunction, making it even more important to limit your alcohol intake.

Dietary Patterns and Erectile Dysfunction: The Big Picture

When it comes to the link between diet and erectile dysfunction, it’s not just about individual foods or nutrients. The overall pattern of your eating habits plays a crucial role. Research has shown that men who follow a healthier dietary pattern, such as the Mediterranean diet, are less likely to experience erectile dysfunction compared to those who consume a diet high in saturated fats and processed foods.

By focusing on a balanced, nutrient-rich diet that emphasizes plant-based foods, healthy fats, and limited alcohol, you can support your cardiovascular health and, in turn, your sexual function. It’s a holistic approach that can pay dividends in the bedroom and beyond.

Frequently Asked Questions

Can certain foods prevent erectile dysfunction?

Yes, research suggests that foods rich in flavonoids, such as berries, citrus fruits, and red wine, can help reduce the risk of erectile dysfunction. Additionally, following a Mediterranean-style diet, which is high in plant-based foods and healthy fats, can also support sexual function.

How does alcohol affect erectile dysfunction?

Alcohol is one of the top contributors to erectile dysfunction. Excessive alcohol consumption can lead to both short-term and long-term sexual function problems, including erectile dysfunction, low sexual desire, and premature ejaculation. Alcohol can also diminish the effectiveness of medications used to treat erectile dysfunction.

What is the link between diet and erectile dysfunction?

The overall pattern of your eating habits plays a crucial role in erectile dysfunction. A diet high in saturated fats and processed foods has been linked to an increased risk of erectile dysfunction, while a healthier dietary pattern, such as the Mediterranean diet, can help reduce the risk.

Conclusion

The relationship between food and erectile dysfunction is more complex and important than many realize. By incorporating flavonoid-rich foods, following a Mediterranean-style diet, and limiting alcohol, men can take proactive steps to support their sexual health and reduce the risk of erectile dysfunction. Remember, a holistic approach to diet and lifestyle is key to maintaining a healthy and fulfilling sex life.

11 Foods That Reduce Your Risk of Erectile Dysfunction

Out of all the 52 foods that boost penis health, there are 10 major ones that can dramatically cut your risk of erectile dysfunction (ED) according to brand new research.

In the study—published in The American Journal of Clinical Nutrition—researchers collected data from more than 50,000 middle-aged men. Since 1986, the men were asked about their ability to have and maintain an erection during intercourse, their body weight, physical activity, caffeine consumption, and their smoking habits every four years.

Researchers discovered men who regularly consumed flavanoid-rich foods—especially those with anthocyanins, flavones, and flavanones—experienced a significantly reduced risk of the disorder than those who did not. Good news since the foods are already popular in American diets. Lead researcher Aedin Cassidy says, “…the top sources of anthocyanins, flavones and flavanones consumed in the U. S. are strawberries, blueberries, red wine, apples, pears and citrus products.”

Overall, men with a higher total intake of fruit saw a 14 percent reduced risk of ED, whereas men who consumed foods rich in anthocynanin, flavones, and flavanones, had a 10 percent reduced risk of ED. What’s more, consumping several servings of these foods each week is as beneficial for your manhood as briskly walking for five hours each week. But, if you really want to reap the benefits, men who exercised and consumed flavanoid-rich foods experienced a whopping 21 percent reduced risk of erectile dysfunction.

Though this disorder is more common in older men, Cassidy and her team “found that the benefits were strongest among younger men,” according to a press release. And lets’s face it, no man (or woman) wants to encounter a “failure to launch.” So, rather than going the medicinal route, stock up on these 10 powerful eats instead.

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Can Your Diet Cause Erectile Dysfunction? – Cleveland Clinic

It’s a classic date night formula: You have a couple of cocktails and a nice meal, and then, you head home for some bedroom time with your sweetie. But could those drinks and that meal be make harder to get to the “dessert?”

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“Your diet can affect erectile function in a variety of ways. Keep reading to learn how all of that good food and drink could possibly lead to some not-so-good times in the bedroom from urologist James Ulchaker, MD.

Erectile dysfunction and alcohol

What you drink generally matters more than what you eat, says Dr. Ulchaker. “Alcohol is one of the top things we ingest that impacts erections.”

Too many drinks can lead to a disappointing performance between the sheets. And men who have a history of heavy drinking or alcohol dependence are more likely to experience long-term problems with sexual function. That can include erectile dysfunction (ED), low sexual desire and premature ejaculation.

Think you can just counteract a few too many drinks with a little blue pill? Sadly, it doesn’t always work that way. Prescription medications used to treat erectile dysfunction don’t work as well on a full stomach or when you’ve been drinking, Dr. Ulchaker says.

“In our society, we typically have a drink, go out to dinner, and then come home and have intercourse. I advise guys to do the opposite: Take erectile medication at 4:30 p.m., have some fun at 6 p.m., then have a drink and go out to dinner.”

Are there foods that can prevent erectile dysfunction?

There’s no miracle food that will magically prevent ED. But a healthy overall eating pattern can decrease your risk. Diets high in saturated fats are linked to heart disease — and men with heart disease are more likely to experience ED.

“High-fat diets can lead to blockages in the coronary arteries and decrease the size of the arteries supplying blood flow to the penis,” Dr. Ulchaker explains.

On the other hand, research has shown that men who follow a Mediterranean diet are less likely to develop ED. The Mediterranean diet is full of fruits, veggies, nuts, beans and fish, and short on meat and full-fat dairy (if ever there was a reason to eat a salad, this might be it).

Some research also suggests that a diet rich in flavonoids can reduce the odds of penile problems. Flavonoids are antioxidant compounds found in foods like fruits, vegetables, seeds and tea. They’re linked to a whole range of health benefits — including benefits in the bedroom.

Obesity and erectile dysfunction

Poor diets can also contribute to excess weight and obesity. And carrying extra pounds can increase the odds of developing ED. But making better dietary choices can help turn things around. Research shows that when men with obesity lose weight, their erectile function tends to improve.

So you can add “healthy sex life” as another reason to adopt nutritious eating habits. “A heart-healthy diet is also good for prostate and penis health,” Dr. Ulchaker says. And it might just bring some romance back to date night.

High blood pressure and ED

Dr. Ulchaker adds that high blood pressure and medication that is used to manage it can cause ED as well. This is a result of not having a proper flow of blood through the arteries. If your blood pressure isn’t well-managed or you’re noticing performance-related side effects from your medication, talk to your doctor.

Association of Diet With Erectile Dysfunction Among Men in the Health Professionals Follow-up Study | Lifestyle Behaviors | JAMA Network Open

Key Points

Question
Is diet quality associated with risk of erectile dysfunction?

Findings
In this cohort study among 21 469 men in the Health Professionals Follow-up Study, higher diet quality based on adherence to either a Mediterranean or Alternative Healthy Eating Index 2010 diet, which emphasize the consumption of vegetables, fruits, nuts, legumes, and fish or other sources of long-chain (n-3) fats, as well as avoidance of red and processed meats, was found to be associated with a lower risk of developing erectile dysfunction.

Meaning
These findings suggest that a healthy dietary pattern may play a role in maintaining erectile function in men.

Importance
Erectile dysfunction, especially in younger men, is an early sign of cardiovascular disease and may decrease quality of life. Men may be motivated to adopt a healthy dietary pattern if it lowers their risk of erectile dysfunction.

Objective
To assess the association between adherence to a diet quality index based on healthy dietary patterns and erectile dysfunction in men.

Design, Setting, and Participants
This population-based prospective cohort study included men from the Health Professionals Follow-up Study with follow-up from January 1, 1998, through January 1, 2014. Participants included US male health professionals aged 40 to 75 years at enrollment. Men with erectile dysfunction or a diagnosis of myocardial infarction, diabetes, stroke, or genitourinary cancer at baseline were excluded. Analyses were completed in February 2020.

Exposures
A food frequency questionnaire was used to determine nutrient and food intake every 4 years.

Main Outcomes and Measures
Diet quality was assessed by Mediterranean Diet score and the Alternative Healthy Eating Index 2010 score, with higher scores indicating healthier diet. Dietary index scores were cumulatively updated from 1986 until men developed erectile dysfunction, cardiovascular disease, died, or were lost to follow-up. Incident erectile dysfunction was assessed with questionnaires in 2000, 2004, 2008, and 2012. Hazard ratios (HRs) by prespecified categories or quintiles of dietary index scores were estimated using Cox proportional hazards regression analyses stratified by age.

Results
Among 21 469 men included in analysis, mean (SD) age at baseline was 62 (8.4) years. During a mean (SD) follow-up of 10.8 (5.4) years and 232 522 person-years, there were 968 incident erectile dysfunction cases among men younger than 60 years, 3703 cases among men aged 60 to less than 70 years, and 4793 cases among men aged 70 years or older. Men younger than 60 years and in the highest category of the Mediterranean Diet score had the lowest relative risk of incident erectile dysfunction compared with men in the lowest category (HR, 0.78; 95% CI, 0.66-0.92). Higher Mediterranean diet scores were also inversely associated with incident erectile dysfunction among older men (age 60 to <70 years: HR, 0.82; 95% CI, 0.76-0.89; age ≥70 years: HR, 0.93; 95% CI, 0.86-1.00). Men scoring in the highest quintile of the Alternative Healthy Eating Index 2010 also had a lower risk of incident erectile dysfunction, particularly among men age younger than 60 years (quintile 5 vs quintile 1: HR, 0.78; 95% CI, 0.63-0.97).

Conclusions and Relevance
This cohort study found that adherence to healthy dietary patterns was associated with a lower risk for erectile dysfunction, suggesting that a healthy dietary pattern may play a role in maintaining erectile health.

Erectile dysfunction affects an estimated 18 million men in the US,¹ with the disease burden expected to grow as the population ages. Erectile dysfunction is associated with reduced sexual intimacy and health-related quality of life as well as psychological distress for both the affected men and their sexual partners.²^,3 If all affected men sought treatment, treatment costs in the US could reach $15 billion.⁴ Modifiable risk factors for erectile dysfunction, particularly among younger men (ie, age <60 years),⁵ are largely shared with cardiovascular disease (CVD) and include smoking, obesity, sedentary behavior, diabetes, hypertension, hyperlipidemia, and metabolic syndrome.⁶^,7 In fact, erectile dysfunction is associated with future CVD and may represent an opportunity to identify and modify shared risk factors.⁸ Although evidence-based lifestyle interventions,⁹ including healthy dietary patterns,¹⁰^,11 are offered to men interested in lowering their CVD risk, it is unknown whether healthy dietary patterns are associated with lower risk of erectile dysfunction.

Studies evaluating the association between diet and erectile dysfunction are limited, and have focused on men with diabetes or prevalent erectile dysfunction. Several small- to moderate-sized randomized clinical trials report that multimodal lifestyle and weight loss interventions improve erectile dysfunction among men with significant cardiovascular risk factors.¹² However, fewer studies have examined the association between a healthy dietary pattern and erectile dysfunction risk,¹³^,14 and to our knowledge, no prior studies have evaluated the association between adherence to healthy dietary patterns and incident erectile dysfunction in men without diabetes.

We analyzed the association of 2 dietary index scores representative of healthy dietary patterns, the Mediterranean Diet score (MDS) and the Alternative Healthy Eating Index 2010 (AHEI-2010) score, with incident erectile dysfunction in the Health Professionals Follow-up Study, a large prospective cohort study of adult men. We hypothesized that greater adherence to healthy dietary patterns would be associated with lower incident erectile dysfunction, particularly among younger men.

This study was approved by the Human Subjects Committee at the Harvard T.H. Chan School of Public Health. As approved by the Human Subjects Committee, the return of a questionnaire was considered to imply consent. This study is reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.

The Health Professionals Follow-up Study is a prospective study of US male health professionals who enrolled in 1986 by completing a mailed questionnaire. Detailed methods have been published elsewhere.¹⁵ Briefly, enrolled participants complete a food frequency questionnaire (FFQ) every 4 years and questionnaires that included information regarding lifestyle factors, health outcomes, and medications every 2 years (response rate, 96%).

Of 51 529 men enrolled in 1986, 5510 died prior to 1998; we excluded 8505 men who did not complete the FFQ in 1998, 2551 men who reported a diagnosis of prostate, bladder, or testicular cancer prior to 1998, 445 men who reported implausible energy intake (ie, <800 or >4200 kcal/d), 429 men who did not complete the erectile function assessment questionnaire in 2000, and 35 men who were missing age information. We further excluded 5458 men (20.3% of eligible participants) who reported erectile dysfunction prior to the first erectile function assessment in 2000. To avoid unmeasured confounding due to an unhealthy dietary pattern prior to their diagnosis, we also excluded 3796 men with a history of myocardial infarction, 2499 men with diabetes, and 832 men with a history of stroke prior to 1998 (eFigure in the Supplement).

Assessment of Dietary Patterns

Usual dietary intake of approximately 130 food items was estimated over the previous year using a FFQ completed every 4 years starting in 1986. Participants indicated portion size and frequency of consumption, from never or less than 1 serving per month to 6 or more servings per day. This FFQ has been validated against the standard criterion of repeated 1-week diet records. The mean Pearson correlation coefficient for all foods was 0.63, and 73% of food items had correlation coefficients of 0.50 or greater.¹⁶ Calculation of dietary index scores using self-reported intake of specific food items with a FFQ have been previously published.¹⁷^,18

To calculate the MDS index score, participants received 1 point each for consuming above the median intake of vegetables, legumes, fruits and nuts, grains, fish, and the ratio of polyunsaturated to saturated lipids, calculated separately for each dietary questionnaire cycle; 1 point each for consuming less than the median dairy and red or processed meat intake; and 1 point for alcohol intake between 10 and 50 g per day (total score range, 0-9). Monounsaturated fat, used in the traditional MDS,¹⁷ was not used for the lipid ratio because the main dietary contributor of monounsaturated fat in our cohort was beef.¹⁹^,20 To harmonize with prior publications, the MDS was reported categorically as low (0-3), moderate (4-5), and high (6-9) adherence to a Mediterranean dietary pattern.²⁰

To calculate the AHEI-2010 score, participants were scored on 11 items with predefined criteria for complete adherence vs nonadherence based on the Healthy Eating Pyramid (2010 version).¹⁸^,21 Higher intake of fruits, vegetables, whole grains, nuts and legumes, polyunsaturated fats, and ω-3 fatty acids, and lower intake of red and processed meats, sugar-sweetened beverages, trans fatty acids, and sodium contribute to a higher (healthier) dietary index score. Moderate alcohol intake (0.5-2 drinks/d) contributes to a higher index score. Each item is scored from 0 (complete nonadherence) to 10 (complete adherence), with partial scores awarded for proportional intake (total score range: 0-110). The AHEI-2010 score was evaluated by quintile.

To examine associations with individual nutrient and food components, we analyzed each of the dietary index score components categorically using intake servings per week of MDS components and quintiles of AHEI-2010 components.

Starting in 2000, participants were asked to rate their current ability to maintain an erection sufficient for intercourse without treatment as very poor, poor, fair, good, or very good. Each question included a time grid with year and month increments (before 1986, 1986-1989, 1990-1994, 1995 or later, and in the past 3 months) to allow participants to report historically if and when erectile function changed. Participants were asked to report their current function (without treatment) again in 2004, 2008, and 2012. Consistent with prior studies, we defined incident erectile dysfunction as a response of poor or very poor in any periods from 2000 to 2012 among men who reported good or very good erectile function prior to 2000. ²²^,23 Date of diagnosis was defined as the date of return of the questionnaire, and we censored at first report of erectile dysfunction.

Each participant contributed person-time from date of return of the 1998 questionnaire until date of first report of erectile dysfunction, genitourinary cancer (ie, prostate, bladder, or testicular), death, loss to follow-up, or end of follow-up (ie, January 1, 2014). To estimate long-term intake and reduce random within-person variation,²⁴ we calculated the cumulative mean of dietary index scores from all FFQs completed prior to first report of erectile dysfunction, CVD, death, lost to follow-up, or the last FFQ in 2010. We stopped updating dietary index scores after a CVD diagnosis because CVD is a strong potential confounder of the association between MDS or AHEI-2010 and incident erectile dysfunction and dietary changes are more common after a CVD diagnosis.²⁵

Multivariable adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% CIs for associations between categories of dietary index score and risk of incident erectile dysfunction. We used age in months as the time scale and stratified baseline hazard by calendar year. Final multivariable models were adjusted for biennially updated covariates that included smoking (never, past, or current 1-14, 15-24, or ≥25 cigarettes/d), body mass index (BMI, calculated as weight in kilograms divided by height in meters squared; <25, 25-29.9, or ≥30), physical activity (total metabolic equivalent task [MET]–hours/week, categorized in quintiles), incident CVD during follow-up (yes or no), incident diabetes during follow-up (yes or no), hyperlipidemia (yes or no), hypertension (yes or no), depression (yes or no), antidepressant or antipsychotic medication use (yes or no), benzodiazepine use (yes or no), α-blocker or 5α-reductase inhibitor use (yes or no), marital status (married, divorced, separated, widowed, or never married), self-reported race (White, Black, Asian, or other), and total caloric intake (kilocalories/d). If exposure or covariate data were missing for a questionnaire cycle, we carried forward nonmissing exposure and covariate data from the previous cycle. To test for a linear trend across categories of dietary index score, we modeled scores as continuous variables using the median value for each category.

Because age is one of the strongest risk factors for erectile dysfunction¹⁵^,26^,27 and modifies associations of diet²⁸ and lifestyle factors⁵^,29^,30 with erectile dysfunction, we conducted a priori stratified analyses by age and reported primary results within age strata. We conducted a sensitivity analysis without adjustment for incident CVD during follow-up. We also examined whether presence of CVD risk factors modified associations within strata of age by including a cross-product term between the continuous dietary index score variable and the potential effect modifier in our multivariable model. We tested for modification by smoking status (never vs current or past), BMI (<25, 25-29.9, or ≥30), history of hypertension (yes or no) or hyperlipidemia (yes or no), and physical activity (<8. 3 vs ≥8.3 total MET-hours/week, corresponding to Department of Health and Human Services guideline recommendations for ≥150 minutes of moderate or ≥75 minutes of vigorous physical activity per week³¹). P values were 2-sided, and P < .05 was considered statistically significant. For interaction tests, we used a threshold of P < .0017 (.05 / 30) based on Bonferroni correction. All analyses were completed in February 2020 using SAS statistical software version 9.4 (SAS Institute).

Among 21 469 men (mean [SD] age, 62 [8.4] years) included in the analytic sample, compared with men in the lowest categories of either dietary score index, men in the highest categories had older mean (SD) age (MDS: 61 [8] years vs 63 [8] years; AHEI-2010: 60 [8] years vs 64 [9] years), had lower mean (SD) BMI (MDS: 26.4 [4] vs 25.4 [3]; AHEI-2010: 26.4 [4] vs 25.3 [3]), and were more likely to be physically active (mean [SD]: MDS, 32 [39] MET-hr/wk vs 42 [41] MET-hr/wk; AHEI-2010, 27 [36] MET-hr/wk vs 47 [43] MET-hr/wk), nonsmokers (MDS: 4177 men [53%] vs 3700 men [54%]; AHEI-2010: 2219 men [55%] vs 2280 men [54%]), and use cholesterol-lowering medication (MDS: 728 men [9%] vs 1147 men [17%]; AHEI-2010: 421 men [10%] vs 603 men [14%]). Additional baseline demographic and health-related characteristics are reported for the extreme categories of each dietary index score (Table 1). We observed 968 incident erectile dysfunction cases during 53 245 person-years among men younger than 60 years, 3703 cases during 107 048 person-years among men aged 60 to less than 70 years, and 4793 cases during 72 229 person-years among men aged 70 years or older.

Table 2 displays the associations between MDS and incident erectile dysfunction, stratified by age. Compared with men in the lowest category of MDS, men in the highest category were less likely to develop erectile dysfunction regardless of age group (age <60 years: HR, 0.78; 95% CI, 0.66-0.92; P for trend < .002; age 60 to <70 years: HR, 0.82; 95% CI, 0.76-0.89; P for trend < .001; age ≥70 years: HR, 0.93; 95% CI, 0.86-1.00; P for trend = .04) (Figure, A). This inverse association was greatest among men younger than 60 years (P interaction = . 003).

Table 3 displays the associations between AHEI-2010 score and incident erectile dysfunction, stratified by age. Similar to the MDS, men in the highest quintile of AHEI-2010 score were less likely to develop incident erectile dysfunction compared with men in the lowest quintile regardless of age group (age <60 years: HR, 0.78; 95% CI, 0.63-0.97; P for trend = .007; age 60 to <70 years: HR, 0.78; 95% CI, 0.69-0.87; P for trend < .001; age ≥70 years: HR, 0.89; 95% CI, 0.81-.99; P for trend = .03) (Figure, B). Hazard ratios were also lower among men younger than 60 years compared with older men (P for interaction = .0004) and CIs were more likely to exclude 1.0 in lower quintiles of AHEI-2010 index score among younger men.

When dietary index components were examined separately, higher scores (corresponding to higher intakes) for most healthy components, including vegetables, fruit, legumes, and fish, were associated with lower risk of incident erectile dysfunction. Higher scores (corresponding to lower intakes) for most unhealthy components, including red or processed meat and trans fatty acids, were associated with lower risk of incident erectile dysfunction (Table 4; eTable in the Supplement).

Smoking status, history of hypertension or hyperlipidemia, BMI, and physical activity did not modify the observed associations. These associations were robust in sensitivity analyses when incident CVD during follow-up was removed as a covariate.

In this cohort study evaluating the association between a healthy dietary pattern measured by 2 dietary index scores and incident erectile dysfunction among men in various age groups, men with the greatest adherence to a Mediterranean or AHEI-2010 dietary pattern were least likely to develop erectile dysfunction. Inverse associations were strongest among men younger than 60 years using AHEI-2010 score; however, men in the highest categories of either dietary index score had the lowest risk of erectile dysfunction in all age groups. These findings suggest that adherence to healthy dietary patterns is associated with lower risk of erectile dysfunction.

To our knowledge, this is the first prospective study that included men without diabetes to evaluate the association between adherence to heathy dietary patterns and incident erectile dysfunction. Our findings are consistent with evidence from prior cross-sectional studies that suggests that men with higher adherence to a Mediterranean dietary pattern are less likely to have prevalent erectile dysfunction³²^,33 and extends prior work by evaluating longitudinal associations between adherence to a Mediterranean or AHEI-2010 dietary pattern and risk of incident erectile dysfunction. Randomized studies have demonstrated that multimodal lifestyle interventions with caloric restriction are effective at improving erectile function among men with erectile dysfunction and significant cardiovascular risk factors.¹⁴^,34^-39 However, it is difficult to disentangle the independent effect of a healthy dietary pattern from these multimodal intervention studies because obesity and sedentary behavior are associated with increased risk of erectile dysfunction. While we wait for high-quality randomized clinical trials to test whether dietary interventions are effective for preventing or treating erectile dysfunction, our findings support counseling men with low adherence to healthy dietary patterns that they are at higher risk of developing erectile dysfunction compared with men who adhere to healthy dietary patterns.

In a secondary data analysis of men enrolled in randomized clinical trials of dietary interventions, Esposito et al¹³ demonstrated that men with metabolic syndrome and erectile dysfunction randomized to a Mediterranean dietary pattern were more likely to have improvement in erectile function and resolution of erectile dysfunction. The MÈDITA trial¹⁴ was the first randomized clinical trial to examine the independent effect of a Mediterranean dietary pattern on change in erectile function among men with both normal and abnormal erectile function, to our knowledge, although erectile function was not a primary end point. Among 106 men with newly diagnosed type 2 diabetes in the MÈDITA trial,¹⁴ those randomized to an energy-restricted Mediterranean diet experienced slower declines in erectile function, measured via the International Index of Erectile Function, compared with men in the energy-restricted low-fat diet group. Our study provides additional evidence that adherence to a healthy dietary pattern may have a protective association against erectile dysfunction beyond the established beneficial effects of weight loss and physical activity on erectile function, particularly among younger men.

A strength of our study is the use of repeated measures of long-term adherence to dietary patterns, which are more aligned with the whole-diet approach to CVD prevention and may be less susceptible to residual confounding due to strongly correlated intake of individual nutrients or food items.⁴⁰ Both MDS and AHEI-2010 consist of components that have been associated with erectile dysfunction or intermediate CVD risk factors in prior studies, which can also provide insight into age-dependent mechanisms of observed associations with erectile dysfunction. Men who report higher fruit and vegetable intake are less likely to have erectile dysfunction in cross-sectional studies⁴¹^-43 and short-term interventional studies have demonstrated fruits and vegetables, as well as other antioxidant-rich foods, are associated with beneficial postprandial effects on endothelial function and blood pressure.²⁸^,44^-46 Specifically, higher intake of flavonoid-rich foods, a major component of the Mediterranean diet, is associated with lower erectile dysfunction incidence among younger, but not older, men.²⁸ Long chain (n-3) fats, most often from fish sources, are associated with lower plasma levels of soluble adhesion molecules and inflammatory markers, which also improve endothelial function.⁴⁷ While our study is the first to our knowledge to evaluate the association between trans fats and erectile dysfunction, trans fats have long been appreciated as a cause of CVD via adverse effects on lipid profiles, proinflammatory changes, and endothelial dysfunction. ⁴⁸ This evidence eventually led to the Food and Drug Administration ruling in 2015 to ban trans fats from the US food supply.⁴⁹ Associations between alcohol intake and erectile dysfunction been inconsistently observed in prospective cohort studies²²^,41^,50^,51; however, interventional studies have demonstrated improvements in inflammatory and lipid biomarkers, as well as cardiometabolic risk factors, with moderate alcohol intake.⁵²^,53 In addition to the hypothesized associations of individual foods and nutrients, several randomized studies have demonstrated that the Mediterranean dietary pattern as a whole is associated with improved endothelial function, blood pressure, and lipid profiles, as well as decreased inflammatory markers and insulin resistance.⁵⁴^-56 Furthermore, in the MÈDITA trial,¹⁴ the beneficial effects of randomization to a Mediterranean diet were also observed among women with diabetes based on improvements in the Female Sexual Function Index; thus, observed associations could be due to differences in sexual function unrelated to erectile function. Although the exact mechanisms have not been elucidated, many components of a Mediterranean or AHEI-2010 diet have been found to be associated with reduced cardiometabolic risk, which is believed to share important biological pathways with erectile dysfunction.

There are several limitations to our observational study. Men were not randomized to their dietary pattern and residual or unmeasured confounding owing to factors that cause unhealthy dietary pattern and erectile dysfunction is possible. However, we considered many widely recognized confounders and took the additional step of stopping dietary exposure updates after a diagnosis of incident CVD during follow-up. Dietary patterns are measured with known error, which can lead to biased results; however, we used well-validated questionnaires to collect long-term dietary intake, and in general, we expect nondifferential measurement error to bias our results toward the null. Additionally, we used a single item question to evaluate erectile dysfunction which could have reduced sensitivity compared with multiple questions; however, a similar single self-report question demonstrated high accuracy (area under the curve, 0. 89) compared to urologic examination.⁵⁷

This cohort study found an inverse association between healthy dietary patterns, such as Mediterranean and AHEI-2010 diets, and risk of developing erectile dysfunction in men. These dietary patterns emphasize the consumption of vegetables, fruits, nuts, legumes, and fish or other sources of long-chain (n-3) fats, as well as avoidance of red and processed meats. These findings suggest that men who are concerned about erectile dysfunction risk should be counseled regarding the potential contribution of their dietary practices. Future randomized clinical trials of healthy dietary patterns in men should include erectile function assessments to determine whether healthy dietary patterns can prevent or reverse erectile dysfunction.

Accepted for Publication: August 13, 2020.

Published: November 13, 2020. doi:10. 1001/jamanetworkopen.2020.21701

Corresponding Author: Scott R. Bauer, MD, ScM, Division of General Internal Medicine, San Francisco VA Medical Center, 4150 Clement St, Bldg 2, Room 135, San Francisco, CA 94121 ([email protected]).

Author Contributions: Drs Bauer and Kenfield had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Bauer, Giovannucci, Kenfield.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Bauer.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Bauer, Kenfield.

Obtained funding: Bauer, Rimm, Giovannucci.

Administrative, technical, or material support: Stampfer.

Supervision: Breyer, Kenfield.

Conflict of Interest Disclosures: Dr Stampfer reported receiving grants from National Institutes of Health during the conduct of the study. Dr Kenfield reported receiving personal fees from and serving on an advisory board and as a consultant for Fellow Health outside the submitted work. No other disclosures were reported.

Funding/Support: This study was supported by research grant Nos U01 CA167552 and R01 HL35464 from the National Institutes of Health. Dr Bauer is supported by grant No. 1K12DK111028 from the National Institute of Diabetes, Digestive, and Kidney Disorders. Dr Kenfield is supported by the Helen Diller Family Chair in Population Science for Urologic Cancer at the University of California, San Francisco. Publication of this study was made possible in part by support from the UCSF Open Access Publishing Fund.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: Lydia Liu, SM (Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School), and Rebecca Graff, ScD (Department of Epidemiology and Biostatistics, University of California, San Francisco), assisted with programming. They were not compensated for their roles.

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Association of Diet With Erectile Dysfunction Among Men in the Health Professionals Follow-up Study

JAMA Netw Open. 2020 Nov; 3(11): e2021701.

, MD, ScM,^1,^2,³, MD, MAS,^2,⁴, MD, DrPH,^5,⁶, ScD,^5,⁶, MD, ScD,^5,⁶ and , ScD^2,⁴

Scott R. Bauer

¹Department of Medicine, University of California, San Francisco

²Department of Urology, University of California, San Francisco

³Division of General Internal Medicine, San Francisco VA Medical Center, San Francisco, California

Benjamin N. Breyer

²Department of Urology, University of California, San Francisco

⁴Department of Epidemiology and Biostatistics, University of California, San Francisco

Meir J.

Stampfer

⁵Departments of Nutrition & Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

⁶Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts

Eric B. Rimm

⁵Departments of Nutrition & Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

⁶Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts

Edward L. Giovannucci

⁵Departments of Nutrition & Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

⁶Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts

Stacey A. Kenfield

²Department of Urology, University of California, San Francisco

⁴Department of Epidemiology and Biostatistics, University of California, San Francisco

¹Department of Medicine, University of California, San Francisco

²Department of Urology, University of California, San Francisco

³Division of General Internal Medicine, San Francisco VA Medical Center, San Francisco, California

⁴Department of Epidemiology and Biostatistics, University of California, San Francisco

⁵Departments of Nutrition & Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts

⁶Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts

Corresponding author.

Article Information

Accepted for Publication: August 13, 2020.

Published: November 13, 2020. doi:10.1001/jamanetworkopen.2020.21701

Author Contributions: Drs Bauer and Kenfield had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Bauer, Giovannucci, Kenfield.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Bauer.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Bauer, Kenfield.

Obtained funding: Bauer, Rimm, Giovannucci.

Administrative, technical, or material support: Stampfer.

Supervision: Breyer, Kenfield.

Received 2020 May 1; Accepted 2020 Aug 13.

This is an open access article distributed under the terms of the CC-BY License.

Supplementary Materials

Supplement: eTable. Multivariable-Adjusted Association of Alternative Healthy Eating Index 2010 Components With Erectile Dysfunction, by Dietary Index Score Component

eFigure. Study Flowchart

GUID: 73BFCAA7-04F3-48B2-9FA2-BBBB9AF215A1

Key Points

Question

Is diet quality associated with risk of erectile dysfunction?

Findings

In this cohort study among 21 469 men in the Health Professionals Follow-up Study, higher diet quality based on adherence to either a Mediterranean or Alternative Healthy Eating Index 2010 diet, which emphasize the consumption of vegetables, fruits, nuts, legumes, and fish or other sources of long-chain (n-3) fats, as well as avoidance of red and processed meats, was found to be associated with a lower risk of developing erectile dysfunction.

Meaning

These findings suggest that a healthy dietary pattern may play a role in maintaining erectile function in men.

Abstract

Importance

Erectile dysfunction, especially in younger men, is an early sign of cardiovascular disease and may decrease quality of life. Men may be motivated to adopt a healthy dietary pattern if it lowers their risk of erectile dysfunction.

Objective

To assess the association between adherence to a diet quality index based on healthy dietary patterns and erectile dysfunction in men.

Design, Setting, and Participants

This population-based prospective cohort study included men from the Health Professionals Follow-up Study with follow-up from January 1, 1998, through January 1, 2014. Participants included US male health professionals aged 40 to 75 years at enrollment. Men with erectile dysfunction or a diagnosis of myocardial infarction, diabetes, stroke, or genitourinary cancer at baseline were excluded. Analyses were completed in February 2020.

Exposures

A food frequency questionnaire was used to determine nutrient and food intake every 4 years.

Main Outcomes and Measures

Diet quality was assessed by Mediterranean Diet score and the Alternative Healthy Eating Index 2010 score, with higher scores indicating healthier diet. Dietary index scores were cumulatively updated from 1986 until men developed erectile dysfunction, cardiovascular disease, died, or were lost to follow-up. Incident erectile dysfunction was assessed with questionnaires in 2000, 2004, 2008, and 2012. Hazard ratios (HRs) by prespecified categories or quintiles of dietary index scores were estimated using Cox proportional hazards regression analyses stratified by age.

Results

Among 21 469 men included in analysis, mean (SD) age at baseline was 62 (8.4) years. During a mean (SD) follow-up of 10.8 (5.4) years and 232 522 person-years, there were 968 incident erectile dysfunction cases among men younger than 60 years, 3703 cases among men aged 60 to less than 70 years, and 4793 cases among men aged 70 years or older. Men younger than 60 years and in the highest category of the Mediterranean Diet score had the lowest relative risk of incident erectile dysfunction compared with men in the lowest category (HR, 0. 78; 95% CI, 0.66-0.92). Higher Mediterranean diet scores were also inversely associated with incident erectile dysfunction among older men (age 60 to <70 years: HR, 0.82; 95% CI, 0.76-0.89; age ≥70 years: HR, 0.93; 95% CI, 0.86-1.00). Men scoring in the highest quintile of the Alternative Healthy Eating Index 2010 also had a lower risk of incident erectile dysfunction, particularly among men age younger than 60 years (quintile 5 vs quintile 1: HR, 0.78; 95% CI, 0.63-0.97).

Conclusions and Relevance

This cohort study found that adherence to healthy dietary patterns was associated with a lower risk for erectile dysfunction, suggesting that a healthy dietary pattern may play a role in maintaining erectile health.

Introduction

Erectile dysfunction affects an estimated 18 million men in the US,¹ with the disease burden expected to grow as the population ages. Erectile dysfunction is associated with reduced sexual intimacy and health-related quality of life as well as psychological distress for both the affected men and their sexual partners. ^2,3 If all affected men sought treatment, treatment costs in the US could reach $15 billion.⁴ Modifiable risk factors for erectile dysfunction, particularly among younger men (ie, age <60 years),⁵ are largely shared with cardiovascular disease (CVD) and include smoking, obesity, sedentary behavior, diabetes, hypertension, hyperlipidemia, and metabolic syndrome.^6,7 In fact, erectile dysfunction is associated with future CVD and may represent an opportunity to identify and modify shared risk factors.⁸ Although evidence-based lifestyle interventions,⁹ including healthy dietary patterns,^10,11 are offered to men interested in lowering their CVD risk, it is unknown whether healthy dietary patterns are associated with lower risk of erectile dysfunction.

Studies evaluating the association between diet and erectile dysfunction are limited, and have focused on men with diabetes or prevalent erectile dysfunction. Several small- to moderate-sized randomized clinical trials report that multimodal lifestyle and weight loss interventions improve erectile dysfunction among men with significant cardiovascular risk factors.¹² However, fewer studies have examined the association between a healthy dietary pattern and erectile dysfunction risk,^13,14 and to our knowledge, no prior studies have evaluated the association between adherence to healthy dietary patterns and incident erectile dysfunction in men without diabetes.

Methods

Participants

Of 51 529 men enrolled in 1986, 5510 died prior to 1998; we excluded 8505 men who did not complete the FFQ in 1998, 2551 men who reported a diagnosis of prostate, bladder, or testicular cancer prior to 1998, 445 men who reported implausible energy intake (ie, <800 or >4200 kcal/d), 429 men who did not complete the erectile function assessment questionnaire in 2000, and 35 men who were missing age information. We further excluded 5458 men (20.3% of eligible participants) who reported erectile dysfunction prior to the first erectile function assessment in 2000. To avoid unmeasured confounding due to an unhealthy dietary pattern prior to their diagnosis, we also excluded 3796 men with a history of myocardial infarction, 2499 men with diabetes, and 832 men with a history of stroke prior to 1998 (eFigure in the Supplement).

Assessment of Dietary Patterns

To calculate the MDS index score, participants received 1 point each for consuming above the median intake of vegetables, legumes, fruits and nuts, grains, fish, and the ratio of polyunsaturated to saturated lipids, calculated separately for each dietary questionnaire cycle; 1 point each for consuming less than the median dairy and red or processed meat intake; and 1 point for alcohol intake between 10 and 50 g per day (total score range, 0-9). Monounsaturated fat, used in the traditional MDS,¹⁷ was not used for the lipid ratio because the main dietary contributor of monounsaturated fat in our cohort was beef.^19,20 To harmonize with prior publications, the MDS was reported categorically as low (0-3), moderate (4-5), and high (6-9) adherence to a Mediterranean dietary pattern.²⁰

To calculate the AHEI-2010 score, participants were scored on 11 items with predefined criteria for complete adherence vs nonadherence based on the Healthy Eating Pyramid (2010 version). ^18,21 Higher intake of fruits, vegetables, whole grains, nuts and legumes, polyunsaturated fats, and ω-3 fatty acids, and lower intake of red and processed meats, sugar-sweetened beverages, trans fatty acids, and sodium contribute to a higher (healthier) dietary index score. Moderate alcohol intake (0.5-2 drinks/d) contributes to a higher index score. Each item is scored from 0 (complete nonadherence) to 10 (complete adherence), with partial scores awarded for proportional intake (total score range: 0-110). The AHEI-2010 score was evaluated by quintile.

Outcome Assessment

Starting in 2000, participants were asked to rate their current ability to maintain an erection sufficient for intercourse without treatment as very poor, poor, fair, good, or very good. Each question included a time grid with year and month increments (before 1986, 1986-1989, 1990-1994, 1995 or later, and in the past 3 months) to allow participants to report historically if and when erectile function changed. Participants were asked to report their current function (without treatment) again in 2004, 2008, and 2012. Consistent with prior studies, we defined incident erectile dysfunction as a response of poor or very poor in any periods from 2000 to 2012 among men who reported good or very good erectile function prior to 2000.^22,23 Date of diagnosis was defined as the date of return of the questionnaire, and we censored at first report of erectile dysfunction.

Data Analysis

Because age is one of the strongest risk factors for erectile dysfunction^15,26,27 and modifies associations of diet²⁸ and lifestyle factors^5,29,30 with erectile dysfunction, we conducted a priori stratified analyses by age and reported primary results within age strata. We conducted a sensitivity analysis without adjustment for incident CVD during follow-up. We also examined whether presence of CVD risk factors modified associations within strata of age by including a cross-product term between the continuous dietary index score variable and the potential effect modifier in our multivariable model. We tested for modification by smoking status (never vs current or past), BMI (<25, 25-29.9, or ≥30), history of hypertension (yes or no) or hyperlipidemia (yes or no), and physical activity (<8.3 vs ≥8.3 total MET-hours/week, corresponding to Department of Health and Human Services guideline recommendations for ≥150 minutes of moderate or ≥75 minutes of vigorous physical activity per week³¹). P values were 2-sided, and P < .05 was considered statistically significant. For interaction tests, we used a threshold of P < .0017 (.05 / 30) based on Bonferroni correction. All analyses were completed in February 2020 using SAS statistical software version 9.4 (SAS Institute).

Results

Among 21 469 men (mean [SD] age, 62 [8.4] years) included in the analytic sample, compared with men in the lowest categories of either dietary score index, men in the highest categories had older mean (SD) age (MDS: 61 [8] years vs 63 [8] years; AHEI-2010: 60 [8] years vs 64 [9] years), had lower mean (SD) BMI (MDS: 26.4 [4] vs 25.4 [3]; AHEI-2010: 26.4 [4] vs 25.3 [3]), and were more likely to be physically active (mean [SD]: MDS, 32 [39] MET-hr/wk vs 42 [41] MET-hr/wk; AHEI-2010, 27 [36] MET-hr/wk vs 47 [43] MET-hr/wk), nonsmokers (MDS: 4177 men [53%] vs 3700 men [54%]; AHEI-2010: 2219 men [55%] vs 2280 men [54%]), and use cholesterol-lowering medication (MDS: 728 men [9%] vs 1147 men [17%]; AHEI-2010: 421 men [10%] vs 603 men [14%]). Additional baseline demographic and health-related characteristics are reported for the extreme categories of each dietary index score (). We observed 968 incident erectile dysfunction cases during 53 245 person-years among men younger than 60 years, 3703 cases during 107 048 person-years among men aged 60 to less than 70 years, and 4793 cases during 72 229 person-years among men aged 70 years or older.

Table 1.

Baseline Characteristics of 21 469 Men From the Health Professionals Follow-up Study by Extreme Categories of Dietary Index Score

Characteristic	No. (%)
	Mediterranean diet score^a		AHEI-2010^b
	0-3	6-9	Lowest quintile	Highest quintile
Age, mean (SD), y	61 (8)	63 (8)	60 (8)	64 (9)
BMI, mean (SD)	26.4 (4)	25.4 (3)	26.4 (4)	25.3 (3)
Physical activity, mean (SD), MET-h/wk	32 (39)	42 (41)	27 (36)	47 (43)
Race
White	7306 (93)	6255 (91)	3704 (92)	3890 (92)
Black	42 (<1)	49 (<1)	30 (<1)	21 (<1)
Asian	77 (1)	134 (2)	70 (2)	50 (1)
Other	7425 (5)	449 (7)	230 (6)	270 (6)
Currently married	6987 (89)	6248 (91)	3560 (88)	3821 (90)
Smoking status
Never	4177 (53)	3700 (54)	2219 (55)	2280 (54)
Past	3120 (40)	3036 (44)	1469 (36)	1866 (44)
Current	558 (7)	151 (2)	346 (9)	85 (2)
Self-reported disease
Hypertension	1012 (13)	1087 (16)	539 (13)	629 (15)
Hyperlipidemia	3224 (41)	3395 (49)	1720 (43)	1893 (45)
Depression^c	323 (6)	229 (5)	153 (6)	135 (5)
Medication use
Antihypertensive	1640 (21)	1678 (24)	915 (23)	937 (22)
Cholesterol-lowering	728 (9)	1147 (17)	421 (10)	603 (14)
Antidepressant or antipsychotic	479 (6)	306 (4)	258 (6)	196 (5)
Benzodiazepine	189 (2)	168 (2)	111 (3)	97 (2)
α-blocker or 5α-reductase inhibitor	411 (5)	387 (6)	185 (5)	267 (5)
Alcohol, mean (SD), g/d	10 (15)	12 (13)	11 (18)	11 (10)
Calories, mean (SD), kilocalories/d	2084 (627)	1932 (582)	1928 (588)	2081 (612)
AHEI-2010 score, mean (SD)	42 (7)	57 (8)	35 (4)	63 (5)
Mediterranean diet score, mean (SD)	2.1 (1)	6.8 (1)	2.3 (1)	6.5 (1)

displays the associations between MDS and incident erectile dysfunction, stratified by age. Compared with men in the lowest category of MDS, men in the highest category were less likely to develop erectile dysfunction regardless of age group (age <60 years: HR, 0.78; 95% CI, 0.66-0.92; P for trend < .002; age 60 to <70 years: HR, 0.82; 95% CI, 0.76-0.89; P for trend < .001; age ≥70 years: HR, 0.93; 95% CI, 0.86-1.00; P for trend = .04) (, A). This inverse association was greatest among men younger than 60 years (P interaction = .003).

Table 2.

Multivariable-Adjusted Association of Mediterranean Diet Score With Erectile Dysfunction Among Men From the Health Professionals Follow-up Study Stratified by Age

Outcome	Category of Mediterranean diet score^a			P for trend^b
Outcome	0-3 (less healthy)	4-5	6-9 (healthier)	P for trend^b
Age <60 y
Events/person-years, No.	478/22 649	261/16 154	229/14 442	NA
Event rate, per 1000 person-years	21.1	16.2	15.9	NA
Index score, mean (SD)	2.0 (0.9)	4.5 (0.5)	6.8 (0.8)	NA
Age-adjusted model, HR (95% CI)	1 [Reference]	0.76 (0.65-0.88)	0.71 (0.60-0.83)	<.001
Multivariable model, HR (95% CI)^c	1 [Reference]	0.78 (0.67-0.91)	0.78 (0.66-0.92)	.002
Age 60 to <70 y
Events/person-years, No.	1516/40 007	1109/32 350	1078/34 691	NA
Event rate, per 1000 person-years	37.9	34.3	31.1	NA
Index score, mean (SD)	2.1 (0.9)	4.5 (0.5)	6.8 (0.9)	NA
Age-adjusted model, HR (95% CI)	1 [Reference]	0.87 (0.80-0.94)	0.77 (0.71-0.83)	<.001
Multivariable model, HR (95% CI)^c	1 [Reference]	0.89 (0.82-0.97)	0.82 (0.76-0.89)	<.001
Age ≥70 y
Events/person-years, No.	1517/22 253	1547/23 031	1729/26 945	NA
Event rate, per 1000 person-years	68.2	67.2	64.2	NA
Index score, mean (SD)	2.2 (0.9)	4.5 (0.5)	6.9 (0.9)	NA
Age-adjusted model, HR (95% CI)	1 [Reference]	0.97 (0.90-1.04)	0.92 (0.86-0.98)	.02
Multivariable model, HR (95% CI)^c	1 [Reference]	0.98 (0.91-1.05)	0.93 (0.86-1.00)	.04

Multivariable-Adjusted Association of Diet Quality Indices With Incident Erectile Dysfunction Stratified by Age

AHEI indicates Alternative Healthy Eating Index; Q, quintile.

displays the associations between AHEI-2010 score and incident erectile dysfunction, stratified by age. Similar to the MDS, men in the highest quintile of AHEI-2010 score were less likely to develop incident erectile dysfunction compared with men in the lowest quintile regardless of age group (age <60 years: HR, 0.78; 95% CI, 0.63-0.97; P for trend = .007; age 60 to <70 years: HR, 0.78; 95% CI, 0.69-0.87; P for trend < .001; age ≥70 years: HR, 0.89; 95% CI, 0.81-.99; P for trend = .03) (, B). Hazard ratios were also lower among men younger than 60 years compared with older men (P for interaction = .0004) and CIs were more likely to exclude 1.0 in lower quintiles of AHEI-2010 index score among younger men.

Table 3.

Multivariable-Adjusted Association of Alternative Healthy Eating Index 2010 With Erectile Dysfunction Among Men From the Health Professionals Follow-up Study Stratified by Age

Outcome	Quintile of Alternative Healthy Eating Index 2010^a					P for trend^b
Outcome	Q1 (less healthy)	Q2	Q3	Q4	Q5 (healthier)	P for trend^b
Age <60 y
Events/person-years, No.	266/12 299	219/11 754	185/10 959	168/10 281	130/7951	NA
Event rate, per 1000 person-years	21.6	18.4	16.9	16.3	16.4	NA
Index score, mean (SD)	35 (4)	44 (2)	49 (2)	55 (2)	63 (4)	NA
Age-adjusted model, HR (95% CI)	1 [Reference]	0.83 (0.69-0.99)	0.76 (0.63-0.92)	0.71 (0.58-0.86)	0.68 (0.55-0.84)	<.001
Multivariable model, HR (95% CI)^c	1 [Reference]	0.87 (0.72-1.04)	0.80 (0.66-0.97)	0.78 (0.64-0.95)	0.78 (0.63-0.97)	.007
Age 60 to <70 y
Events/person-years, No.	731/19 212	758/21 748	807/21 925	775/22 552	632/21 612	NA
Event rate, per 1000 person-years	38.0	34.9	36.8	34.4	29.2	NA
Index score, mean (SD)	36 (4)	44 (2)	50 (2)	55 (2)	64 (4)	NA
Age-adjusted model, HR (95% CI)	1 [Reference]	0.91 (0.82-1.00)	0.94 (0.85-1.03)	0.86 (0.77-0.95)	0.71 (0.64-0.79)	<.001
Multivariable model, HR (95% CI)^c	1 [Reference]	0.92 (0.83-1.01)	0.96 (0.87-1.06)	0.89 (0.80-0.98)	0.78 (0.69-0.87)	<.001
Age ≥70 y
Events/person-years, No.	635/9626	875/13 236	950/13 841	1165/16 500	1168/19 026	NA
Event rate, per 1000 person-years	66.0	66.1	68.6	70.6	61.4	NA
Index score, mean (SD)	36 (4)	44 (2)	50 (2)	55 (2)	64 (5)	NA
Age-adjusted model, HR (95% CI)	1 [Reference]	0.98 (0.89-1.09)	1.02 (0.92-1.12)	1.03 (0.94-1.14)	0.89 (0.81-0.98)	.02
Multivariable model, HR (95% CI)^c	1 [Reference]	0.99 (0.89-1.09)	1.00 (0.91-1.11)	1.03 (0.93-1.13)	0.89 (0.81-0.99)	.03

Table 4.

Multivariable-Adjusted Association of Mediterranean Diet Score Components With Erectile Dysfunction Among Men From the Health Professionals Follow-up Study^a

Diet	Quintile of Mediterranean Diet Score component intake^b					P for trend^c
Diet	Q1	Q2	Q3	Q4	Q5	P for trend^c
Healthy components^d
Vegetables, servings/d
Mean (SD)	1.6 (0.4)	2.4 (0.2)	3.1 (0.2)	3.9 (0.3)	5.8 (1.4)	NA
HR (95% CI)	1 [Reference]	0.95 (0.89-1.01)	0.91 (0.85-0.97)	0.88 (0.83-0.94)	0.85 (0.80-0.91)	<.001
Fruits and nuts, servings/d
Mean (SD)	1.4 (0.4)	2.2 (0.2)	2.9 (0.2)	3.7 (0.3)	5.1 (1.0)	NA
HR (95% CI)	1 [Reference]	1.00 (0.93-1.06)	0.94 (0.88-1.00)	0.89 (0.83-0.95)	0.84 (0.78-0.90)	<.001
Grains, servings/d
Mean (SD)	1.4 (0.3)	2.0 (0.1)	2.4 (0.1)	3.0 (0.2)	4.2 (0.8)	NA
HR (95% CI)	1 [Reference]	0.93 (0.87-0.99)	0.98 (0.92-1.05)	0.97 (0.91-1.04)	0.93 (0.87-0.99)	.18
Legumes, servings/d
Mean (SD)	0.2 (0.1)	0.3 (0.03)	0.4 (0.04)	0.6 (0.1)	0.9 (0.3)	NA
HR (95% CI)	1 [Reference]	0.98 (0.92-1.04)	0.98 (0.92-1.04)	0.92 (0.86-0.98)	0.87 (0.81-0.93)	<.001
Fish, servings/d
Mean (SD)	0.1 (0.1)	0.2 (0.03)	0.3 (0.03)	0.5 (0.1)	0.8 (0.2)	NA
HR (95% CI)	1 [Reference]	0.97 (0.91-1.03)	0.96 (0.90-1.02)	0.89 (0.84-0.95)	0.86 (0.80-0.92)	<.001
Ratio of polyunsaturated to saturated fat, g/d
Mean (SD)	0.4 (0.5)	0.5 (0.03)	0.6 (0.03)	0.7 (0.04)	0.9 (0.2)	NA
HR (95% CI)	1 [Reference]	1.00 (0.94-1.08)	1.00 (0.94-1.07)	0.98 (0.92-1.05)	0.91 (0.85-0.97)	.001
Unhealthy components^e
Red or processed meat, servings/d
Mean (SD)	0.3 (0.1)	0.6 (0.1)	0.8 (0.07)	1.1 (0.1)	1.6 (0.3)	NA
HR (95% CI)	1 [Reference]	1.11 (1.04-1.19)	1.14 (1.06-1.22)	1.21 (1.13-1.30)	1.17 (1.09-1.25)	<.001
Dairy, servings/d
Mean (SD)	0.8 (0.3)	1.4 (0.2)	1.9 (0.2)	2.5 (0.3)	3.8 (0.9)	NA
HR (95% CI)	1 [Reference]	0.97 (0.91-1.04)	1.02 (0.95-1.09)	1.03 (0.96-1.09)	1.00 (0.94-1.07)	.42
Moderate components^f
Alcohol, g/d
Mean (SD)	0.1 (0.2)	2.2 (1.2)	6.9 (2.5)	14 (4.3)	31 (12)	NA
HR (95% CI)	1 [Reference]	0.97 (0.90-1.03)	0.96 (0.90-1.03)	0.99 (0.92-1.05)	1.09 (1.01-1.16)	<.001

Discussion

To our knowledge, this is the first prospective study that included men without diabetes to evaluate the association between adherence to heathy dietary patterns and incident erectile dysfunction. Our findings are consistent with evidence from prior cross-sectional studies that suggests that men with higher adherence to a Mediterranean dietary pattern are less likely to have prevalent erectile dysfunction^32,33 and extends prior work by evaluating longitudinal associations between adherence to a Mediterranean or AHEI-2010 dietary pattern and risk of incident erectile dysfunction. Randomized studies have demonstrated that multimodal lifestyle interventions with caloric restriction are effective at improving erectile function among men with erectile dysfunction and significant cardiovascular risk factors.^{14,34,35,36,37,38,39} However, it is difficult to disentangle the independent effect of a healthy dietary pattern from these multimodal intervention studies because obesity and sedentary behavior are associated with increased risk of erectile dysfunction. While we wait for high-quality randomized clinical trials to test whether dietary interventions are effective for preventing or treating erectile dysfunction, our findings support counseling men with low adherence to healthy dietary patterns that they are at higher risk of developing erectile dysfunction compared with men who adhere to healthy dietary patterns.

A strength of our study is the use of repeated measures of long-term adherence to dietary patterns, which are more aligned with the whole-diet approach to CVD prevention and may be less susceptible to residual confounding due to strongly correlated intake of individual nutrients or food items.⁴⁰ Both MDS and AHEI-2010 consist of components that have been associated with erectile dysfunction or intermediate CVD risk factors in prior studies, which can also provide insight into age-dependent mechanisms of observed associations with erectile dysfunction. Men who report higher fruit and vegetable intake are less likely to have erectile dysfunction in cross-sectional studies^41,42,43 and short-term interventional studies have demonstrated fruits and vegetables, as well as other antioxidant-rich foods, are associated with beneficial postprandial effects on endothelial function and blood pressure.^28,44,45,46 Specifically, higher intake of flavonoid-rich foods, a major component of the Mediterranean diet, is associated with lower erectile dysfunction incidence among younger, but not older, men.²⁸ Long chain (n-3) fats, most often from fish sources, are associated with lower plasma levels of soluble adhesion molecules and inflammatory markers, which also improve endothelial function.⁴⁷ While our study is the first to our knowledge to evaluate the association between trans fats and erectile dysfunction, trans fats have long been appreciated as a cause of CVD via adverse effects on lipid profiles, proinflammatory changes, and endothelial dysfunction.⁴⁸ This evidence eventually led to the Food and Drug Administration ruling in 2015 to ban trans fats from the US food supply.⁴⁹ Associations between alcohol intake and erectile dysfunction been inconsistently observed in prospective cohort studies^22,41,50,51; however, interventional studies have demonstrated improvements in inflammatory and lipid biomarkers, as well as cardiometabolic risk factors, with moderate alcohol intake.^52,53 In addition to the hypothesized associations of individual foods and nutrients, several randomized studies have demonstrated that the Mediterranean dietary pattern as a whole is associated with improved endothelial function, blood pressure, and lipid profiles, as well as decreased inflammatory markers and insulin resistance.^54,55,56 Furthermore, in the MÈDITA trial,¹⁴ the beneficial effects of randomization to a Mediterranean diet were also observed among women with diabetes based on improvements in the Female Sexual Function Index; thus, observed associations could be due to differences in sexual function unrelated to erectile function. Although the exact mechanisms have not been elucidated, many components of a Mediterranean or AHEI-2010 diet have been found to be associated with reduced cardiometabolic risk, which is believed to share important biological pathways with erectile dysfunction.

Limitations

Conclusions

Notes

Supplement.

eTable. Multivariable-Adjusted Association of Alternative Healthy Eating Index 2010 Components With Erectile Dysfunction, by Dietary Index Score Component

eFigure. Study Flowchart

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7 foods that may help relieve erectile dysfunction

Healthy food decrease your risk of erectile dysfunction.

There are many men who need help with erectile dysfunction (ED). Some only struggle to achieve or maintain an erection on the odd occasion while others have a more permanent problem.

There are a number of radical treatments available, but if you only experience occasional erectile dysfunction and want to treat it without any medical intervention, you could do it at home – with food.

Healthy diet

“A healthy diet and an avoidance of highly processed unhealthy food will go a long way towards relieving symptoms of erectile dysfunction,” said Dr Zakariyya Patel of Pelonomi Hospital Complex in Bloemfontein.

Although certain foods may assist with ED, cases are not well documented and evidence is only anecdotal – based on individual accounts, said Dr Patel. These foods can be labelled as aphrodisiacs, and although some people may swear by their effects, there is no medical evidence that any one specific food can cure ED.

“The reason for this is that ED is a complex condition that may have complicated aetiology (causes). So, certain foods may increase sexual desire to a certain extent but it does not mean that it will change the ED if the underlying cause is not addressed,” added Dr Patel.

Foods that may increase your sexual desire:

Berries (as well as citrus fruits) contain chemicals that are associated with a decreased risk of ED.
Dark chocolate increases levels of dopamine, the “pleasure” hormone, in the body.
Oysters contain more zinc than other foods and assists with sperm mobility.
Cayenne pepper raises the heart rate and releases endorphins.
Red wine relaxes the arteries and increases blood flow to the genitals. (Red wine contains the same biochemicals found in berries and citrus fruits.)
Pistachios contain the protein arginine, which relaxes the blood vessels, increasing blood flow throughout the body.
Coffee. A study suggests that caffeine relaxes certain muscles and arteries in the penis, increasing blood flow and helping to maintain an erection.

Your lifestyle has an impact

Owing to the fact that physiological factors like blood flow and hormone levels may affect erectile dysfunction, a good diet with the right vitamins and minerals will optimise the patient’s sexual health, according to Dr Patel.

It does, however, not mean that there is a “silver bullet” that will “magically” solve the problem.

And as the world population struggles with obesity and cardiovascular disease, there is a significant increase in diseases such as hypertension and diabetes, which have a direct impact on blood flow – consequently increasing the severity of ED, Dr Patel added.

Exercise may help

Studies have shown that men who exercise more have better sexual and erectile function. Better sexual function was reported by men in the study who engaged in either two hours of strenuous exercise, 3.5 hours of moderate exercise, or six hours of light exercise a week.

And although there is no specific exercise men need to do in order to achieve better sexual health, any form of exercise is better than none at all.

Foods For Erectile Dysfunction | LloydsPharmacy Online Doctor UK

Erectile dysfunction (ED), also known as impotence is defined as the persistent inability to attain and maintain an erection enough for satisfactory sexual performance. Mr Baghdadi (Consultant Obstetrician, Gynaecologist and Specialist in Infertility at BMI The Priory Hospital) explains the impact of food and diet on erectile dysfunction.

Why does erectile dysfunction happen?

Erectile dysfunction is a very common condition. It is estimated that 50% of all men between the ages of 40 and 70 will have it at different severities. The causes can be both physical and psychological. The former is caused by narrowing of the blood vessels leading to the penis and is most commonly linked with high blood pressure, high cholesterol, diabetes, hormonal issues and injury or surgery. Psychological causes can include mental illnesses such as, anxiety and depression. Relationship problems can also affect erectile dysfunction.

Can your diet affect erectile dysfunction?

Certain dietary choices can certainly increase the risk of men getting erectile dysfunction. As erectile dysfunction is a blood flow related problem, your blood vessels need to be in good health, therefore by eating healthy foods, it reduces your risk of common vascular problems caused by high cholesterol, high blood sugar, high triglyceride levels and obesity.

Excessive alcohol consumption can also increase a man’s risk of getting erectile dysfunction and can make it worse. If you drink regularly and you’re experiencing erectile dysfunction, you should try and reduce your intake or give it up to see if this helps.

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Foods that help you stay erect

Healthy lifestyle habits such as those recommended to prevent heart disease may help prevent erectile dysfunction. Eating the recommended amount of fruit, vegetables and whole grain products are all foods that can help reduce the risk of erectile dysfunction. Try to limit your intake of red meat, full fat dairy, sugary food or drink and food with excessively unhealthy fats. A Mediterranean diet in particular has been associated with a lower prevalence of erectile dysfunction. Ensuring you’re getting regular exercise can also help prevent it.

After changing your diet, how long does it take to see a change?

Seeing a change after altering your diet depends entirely on the individual. The severity of erectile dysfunction prior to changing your diet and other major health problems will affect this. If you don’t see a change, perhaps consider other lifestyle factors that might also be affecting it such as, smoking, excessive alcohol consumption or drug use. Make an appointment with your GP to discuss investigation and treatment.

It’s important to note that erectile dysfunction could possibly be a sign of an underlying condition or health issue. If you continue to get erectile dysfunction after you’ve made changes to your diet, please make an appointment with your GP to discuss this or do a free ED assessment from LloydsPharmacy Online Doctor.

To find out more from BMI Healthcare read their 10 tips to prevent male impotence,

References

https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/

Eating Fruit Might Help with Erectile Dysfunction

Source: Beverly Buckley/Pixabay

Men may have another reason to eat well.

If a man has had problems with his erections, he may get anxious during the next attempts. No one wants to be disappointed or disappoint his partner.

But it’s important to know that anxiety sometimes isn’t the source of the problem, or at least the original source. Erectile dysfunction (ED) is often a sign of poor blood flow. ED, which increases with age, is a warning sign that you may be at risk of heart disease or a stroke. High-blood pressure, obesity and smoking increase your risk of both ED and cardiovascular disease. ED is considered its own risk factor for cardiovascular problems, even if you don’t have the other issues.

And just as with heart disease, your diet can make a difference. Don’t focus on one “miracle food”;l always aim for a diet with a variety of recommended foods. Each will contain different nutrients you need. One simple rule to follow: Eat food with bright natural colors.

To potentially mitigate the risk of ED, eat at least three servings a week of any of the following foods—strawberries, blueberries, red wine, apples, pears, and citrus products. So you could have strawberries one day, citrus the next, and blueberries on the third day. This could cut a man’s risk of ED by 19 percent, according to a study of more than 25,000 men published in the American Journal of Clinical Nutrition. In this research, the dietary benefits were strongest in younger men who were also overweight.

How the study worked: Over about 10 years, the researchers asked volunteers about their diet and other key questions, including their ability to have and maintain an erection during intercourse. More than 35 percent had a problem at some point. But men who ate food high in flavonoids, also called antioxidants, had fewer erection issues. That’s probably because flavonoids increase blood flow, improving blood pressure and helping to open blood vessels while making your arteries more flexible.

There are six kinds of flavonoids. The ED study found foods rich in three—anthocyanins, flavones, and flavanones—especially helpful, with blueberries and citrus fruit at the top. Men who got at least five hours a week of exercise and consumed flavonoid-rich foods had the lowest ED risk.

So which foods could help you or your man?

Blueberries. These berries contain all six of the flavonoids. Put them in your oatmeal for a fiber-rich breakfast or eat them for dessert. The anthocyanins in blueberries may improve markers of heart disease. Blueberries also may help you burn off fat.

Like red wine, blueberries are a good source of resveratrol, a flavonol, another type among the six flavonoids.

Some research links resveratrol to lower levels of inflammation and blood clotting—although it still isn’t clear that it prevents heart disease.

Other berries. Blackberries, cherries, and raspberries also offer all six flavonoids. Strawberries have some anthocyanins.

Grapes or red wine. Grapes and red wine are a good source of anthocyanins.

Why is red wine considered more beneficial than white? The answer: the nutrients, including resveratrol, in wine are concentrated in grape skin, and vintners remove the skin to make white wine earlier in the process. There is some evidence that having a bit less than one glass of wine a day may help protect you against heart disease. But you may be able to get the same effects from grapes or grape juice. If alcohol has ever been a problem for you, opt for the grapes.

Citrus fruits. Oranges, grapefruit, tangerines, lemons, and limes contain flavanones, one of the six flavonoids the ED study found especially helpful.

Apples and pears. It may very well be true that an apple a day keeps the doctor away. Apples may help you burn fat for the same reasons blueberries do. Like apples, pears are full of flavonoids and other nutrients and high in fiber.

Don’t peel off the skin—it contains the most flavonoids. The darker redder or bluer apples contain more flavonoids than yellow or green ones.

Hot peppers. To get your flavones, eat celery, parsley, various herbs and hot peppers.

Note that a chicken parm hero or double cheeseburger or beef stroganoff with buttered noodles isn’t on this list…

A version of this story also appears on Your Care Everywhere.

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Treatment of impotence and erectile dysfunction – restoration of potency

Briefly about the concept of “impotence”

To begin with, it should be noted that recently the term “impotence” is practically not used.It is outdated, has acquired a derogatory and condemning connotation. Instead, the medical community speaks of “erectile dysfunction.”

Erectile dysfunction is a disease associated with the inability of a man to enlarge his penis and maintain a full erection until the end of intercourse.

Erectile dysfunction is not an independent disease. It arises as a consequence of any physical illness, psychological problem, or a combination of the first and the second.This diagnosis is made when more than 25% of the total number of sexual acts end in fiasco. The most noticeable symptoms are:

weakening or abrupt loss of erection during sex,
prolonged ejaculation,
premature ejaculation,
lack of erection and sexual desire. In the presence of signs and treatment of impotence in this case is necessary.

Many men think that bad erections are rare.But in fact, more than half of men after 40 years of age face such problems. This is a lot. Only a small part of the male population turns to specialists. Despite the fact that the restoration of potency during treatment occurs in more than 90% of cases!

Main causes of impotence in men

It is customary to distinguish three factors leading to erectile dysfunction. It:

Organic. They are characterized by various diseases of organs and systems.So, diseases of the cardiovascular and endocrine systems can lead to the manifestation of male weakness. For example, atherosclerosis, diabetes mellitus or various hormonal disorders. Inflammatory diseases of the genitourinary system, trauma to the pelvic organs, spinal cord, painful intercourse also affect. Weakens the potency of taking certain medications (psychotropic, antihistamines, lowering blood pressure).
Psychological. Psychogenic causes of impotence are stress, constant lack of sleep, problems at work or in the family.It also includes dissatisfaction with a partner or oneself, complexes, etc.
Mixed form is a combination of the first two factors in different proportions.

Also, the decrease in potency is greatly influenced by the wrong lifestyle, bad habits. These are alcohol, drugs, smoking, overeating. Lack of physical activity, a sedentary lifestyle and occupational hazards negatively affect. But to restore potency in men, it is not enough to get rid of bad habits, as many people think.Comprehensive treatment is needed.

Make an appointment with a urologist

Methods of treatment at the “Alan Clinic” Izhevsk

Treatment of impotence is carried out in the following ways:

Shockwave therapy. A painless physiotherapy procedure. Together with other types of treatment, it gives a very quick positive effect and a visible improvement in erection.
Magnetic chair. It is used for any urological problems. Effectively affects the pelvic organs, reduces inflammation and pain.Safe and painless when used.
Drug treatment.
Hirudotherapy (treatment with leeches).
Physiotherapy (including ozone therapy).
Adjustment of lifestyle and nutrition (getting rid of bad habits, joining sports, diet).

Complex therapy helps men effectively treat erectile dysfunction. Before treatment, the doctor will conduct an examination and a complete diagnosis of the disease. He will tell you what impotence is and how to treat it.You may need to get rid of infections or restore hormonal balance.

If no treatment is required, the specialists of “Alan Clinic” will develop an individual program for the prevention of erection dysfunction, consult and answer all the patient’s questions. Frequent questions: premature ejaculation and urinary incontinence.

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PHOTO: personal archive

Chingiz Nugmanov

Heart attack at 30 years

Chingiz Askarovich, recently the Blue Cross Blue Shield Association, which insures the health of nearly half of the US population, released a study that promises dire prospects for the millennial generation (born 1981-1996).According to the findings of the researchers, this generation is losing health faster than the previous generation X (born in 1961-1981), and the death rate among millennials is 40% higher. In your opinion, can the same be said about the reproductive health of this generation?

– I’ll make a reservation right away: reproduction is the ability to have offspring, and it is closely related to sexual function. Together, these functions depend on the general somatic state of the person. If we see that a man’s reproductive function (spermogram) is poor, then, most likely, his health in general is unimportant.Erectile dysfunction for doctors has ceased to be a diagnosis – rather, it is a symptom of more complex diseases – heart disease, kidney disease, metabolic disorders, diabetes. Andrologists do not consider the sexual organ autonomously. Therefore, many of our patients are surprised: they think we will only treat prostatitis, and we send them to a cardiogram.

In the lion’s share of age patients (over 40), erection problems are associated with cardiovascular disorders and blood sugar levels. For example, if a man complains about problems in his intimate life and he has high blood pressure, then we already guess what the real problem is.

And what about those under 40?

– Overall health problems have gotten younger. Heart attacks are no longer uncommon at the age of 30-35. What is curious: if a patient begins to have problems with erection, then often this is a harbinger – a heart attack or stroke may begin soon. In this case, it is not so much about the lack of joy in bed as about the patient’s life. The fact is that the blockage of blood vessels begins – atherosclerosis. And if this process starts from below, in narrower arteries, it can soon rise higher.We even say: problems with an erection in a man is the body’s self-defense from death, so that the patient does not die of a heart attack during sex.

Let’s go back to the study. The main health problems of millennials are named: hypertension, high cholesterol, severe depression, overdoses. Does this remind you of a list of causes of erectile dysfunction?

– These are just a few of the long list of causes of dysfunction. In general, today there is such a tendency: the younger the generation, the less healthy it is.Our grandfathers were healthier than our fathers, and our fathers were healthier than us.

Over the past 70 years, the semen analysis of the average man has dropped from 140 million sperm per 1 ml to 50 million. That is, almost three times! What led to this? In addition to what you have listed, we highlight and highlight the sedentary lifestyle. For two million years the man plowed, got food on the hunt, moved, and for the last 50 years he has been sitting, and today he orders food by phone. Muscle function will soon be completely unnecessary for people, everything will be done by an effort of thought.But evolution has not yet had time to adapt to such a lifestyle, we constantly need movement and blood flow. Plus, any man needs muscle strength and exercise to maintain good testosterone levels. And without this hormone, there will be a bad erection.

Hormone King

It turns out that the problem of erectile dysfunction is also getting younger, like heart attacks and strokes?

– Yes, men, in principle, begin to age at an increasingly younger age. Early aging is an earlier decline in testosterone, the male king of hormones, which is responsible for many processes.With a decrease in testosterone, a man begins not only organic problems (erection), but also psychoemotional ones. He becomes depressed, irritable, unstable to stress, less willing to achieve goals. They are no longer interested in women, money, or a career. Today I see such patients as early as 30-35 years old. And if only they knew how easy it is to fix it! In this regard, the problem has been studied well, endocrinology and andrology have advanced quite well.

Moreover, men with low testosterone become a disaster for the family and the economy – they have lost interest in work, lie on the couch, drink beer or go fishing away from their wives so that they do not ask to have sex.

Physical inactivity, unhealthy diet and bad habits – they add up to excess weight. And the fat apron around the abdomen is considered by modern medicine to be a whole endocrine organ, which converts the “male” hormone testosterone into the “female” one – estrogen. Being on high doses of the female hormone, the man, in fact, turns into a woman.

Further problems arise with the level of sugar and thyroid gland. In the complex, metabolic syndrome occurs.

You say it is easy to treat.But how?

– A man should be given testosterone if he lacks. The hormone will restore his vigor and youth. A man will remember what it is like to be a man. Testosterone, by the way, is also the main fat burning hormone. With him, a man loses weight faster, begins to get in shape, there is a motivation to live actively. Therefore, in many cases, dysfunction is a temporary and reversible process.

At first, we stimulate the patient with medications, and over time, when a man changes his lifestyle, we remove the drug.And if a man is young, then we stimulate the production of his own testosterone.

How harmful are these hormonal drugs?

– There are no risks under the supervision of a doctor. Although even some doctors are afraid of hormones. For such people, a term has even been coined – hormonophobia. All this is from ignorance.

How do problems in intimate life affect everyday life?

– It is enough to imagine how important sex is to you and what would happen if you lost it.Most men are so arranged that until their last breath they will think about a woman. Therefore, failures in intimate life are a disaster.

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Homework from urologist

Do you think a man who is not able to live a sex life is generally inclined to lose interest in life and make a mess of things?

– Depression is one of the symptoms of low testosterone, which is why many go to psychotherapists and psychiatrists.

Okay, hormone treatment works over time.And what about pills that solve the problem instantly, which raise the morale of a man here and now?

– Do you mean sildenafil-based drugs? They will not help raise testosterone levels. But they provide excellent symptomatic treatment: by prescribing sildenafil, we give the patient a good erection on demand, and in parallel we treat the underlying problems.

There are two categories of patients in whom the potency begins to weaken. The first is young people who, during debut sexual intercourse, experience stress, anxiety, and insecurity.These patients may benefit from sildenafil-based drugs.

The second – more severe patients. And even in these cases, drugs based on sildenafil are out of competition, they are prescribed in the first place. Therefore, we, doctors, are very grateful to the inventors of this active substance – it made life so much easier for us, solving the patient’s problems already at the first visit.

Can these pills harm the main treatment?

– No, they will only improve the healing effect.We even prescribe low dosages of them not for an erection, but to improve blood circulation – without stimulation, there will be no erection, and in daily doses sildenafil is fitness for the male organ.

Do many patients take them?

– In general, treatment with erectile dysfunction to doctors is low: all over the world, only 90,035 30% of men come with this problem, we have even less. And the low uptake suggests that others are simply buying the drugs themselves to gain confidence overnight.Although many patients themselves take them incorrectly.

But what if neither testosterone nor sildenafil helps?

– There are no incurable cases, except for the complete amputation of the organ. In extreme cases, you can resort to surgery and prosthetics of the male organ. In this case, a super-technological implant is placed, which 98% satisfies the patient and the partner.

In general, today a visit to a urologist and treatment of moderate erectile dysfunction is blood tests, urine tests and, possibly, an ultrasound scan.Everything! Do not need anything else. Therefore, you should not be afraid of this. Already at the second or third appointment with the doctor, the patient receives an appointment. Everything is simple and inexpensive. Yes, and in between visits to the doctor, the patient gets homework – to have sex.

P.S. SANTO regularly publishes information and holds events in Kazakhstan about erectile dysfunction and the means of its treatment. Related materials can be found on social networks using the hashtag #MaxPlay.

90,000 7 main reasons leading to impotence

Normal potency is ensured by the harmonious work of the whole organism: not only the body, but also the psyche.

The modern rhythm of life is not conducive to ideal health. Rapid urbanization, environmental degradation, an increase in the average age of the population of our planet – all this can become negative factors for men’s health.

But there is always a solution: simple rules of a healthy lifestyle will help maintain normal potency!

Staying in the fresh air, regular physical activity (whether it be team games, bike rides or just walking the dog), a balanced, nutritious diet with sufficient fiber and protein – all this will help maintain men’s health until old age.

1. Depression and stress

Fatigue and negative emotions are also possible causes of impotence in men at the age of 40, when it is necessary to find a reasonable balance between career, children and personal life. And this is not at all easy …

Possible causes of impotence in men at a young age are psychological. Even a single failure in bed can lead to the fear of not being up to par again, pessimistic thoughts. It is worth postponing sex until the moment when the man feels rested and full of energy.

Depression is another reason for the violation of potency ². At the same time, problems with erection occur both against the background of the depressive state itself, and due to the intake of antidepressants.

✓ When prescribing antidepressants, the doctor always warns of a possible symptom – a decrease in libido.

After treatment, potency is fully restored. Treatment with a psychotherapist helps to overcome depression and restore potency. A favorite activity – a job or a hobby – can help you cope with stress.Physical activity, walking in the fresh air also helps to improve well-being.

2. Diseases of the heart and blood vessels

Atherosclerosis – the appearance of atherosclerotic plaques in the vessels, which is associated with age-related changes in the body, smoking, high blood cholesterol levels.

Atherosclerosis can also cause a deterioration in blood flow in the penis and become a reason for a decrease in potency.

✓ The causes of impotence in men over 50 are somehow associated with atherosclerosis in 40% of cases ².

Prevention of atherosclerosis will help prevent future erection problems ³. To do this, you must adhere to a healthy lifestyle, quit smoking and make a choice in favor of a balanced diet, as well as undergo periodic examinations by a doctor.

3. Diabetes mellitus

Potency disorders occur in diabetics 3 times more often than in people who have normal blood glucose levels ².

This is due to the fact that with diabetes mellitus, negative changes in blood vessels develop and blood circulation worsens.Diabetes mellitus is a possible cause of early impotence.

Adequate physical activity and regular visits to the doctor will help to avoid erectile dysfunction in this disease or to identify it in a timely manner. At the same time, the doctor prescribes treatment and diet: these measures help maintain normal blood sugar levels.

4. Arterial hypertension

Increased pressure causes impairment of blood circulation. Slowly but steadily, changes in blood vessels are increasing, which cause violations of potency.

High blood pressure pills can also worsen an erection. However, this problem can be easily eliminated: it is enough to consult a doctor who will help you choose drugs that do not have a negative effect on “male strength”.

5. Smoking

Smoking provokes the development of vascular atherosclerosis ³.

This can lead to poor circulation and poor erection.

✓ A bad habit can cost you self-confidence, so it’s best to give it up as soon as possible!

6.Sedentary lifestyle

Moderate exercise can improve overall well-being:

tune in a positive way,
to maintain a good mood,
to stimulate the work of the cardiovascular system ⁴.

All this, perhaps, has a very positive effect on potency. Therefore, it is so important to avoid physical inactivity to prevent male impotence.

7. Age

The older the man is, the more likely it is to have problems with potency ^1.2.

This is due to a decrease in the level of the male hormone testosterone, the development of vascular atherosclerosis, a decrease in the elasticity of the vascular wall and other factors. However, middle age or even old age is not a reason to stop sexual activity.

✓ People who managed to preserve their health have every chance of not experiencing problems with potency even at 80 years old ²!

A holistic approach to wellness is following the rules of a healthy lifestyle:

regular feasible physical activity,
healthy food,
no serious stress,
positive attitude.

All this can help maintain good potency.

What else can be done to improve potency?

Preparations of PDE inhibitors – can also be an effective way to solve problems with potency ⁵.

In some cases, it is possible to achieve the optimal result when taking the dose recommended by the doctor at least 30 – 60 minutes before intercourse. The drug works on condition of sexual stimulation. It helps to restore masculine strength and regain self-confidence.

In case of problems, in any case it is necessary to consult a doctor!

References

Gorilovsky L.M., Lakhno D.A. Erectile dysfunction // breast cancer. 2005. No. 10. P. 653
The original article was published on the breast cancer website (Russian medical journal):
http://www.rmj.ru/articles/obshchie-stati/Erektilynaya_disfunkciya/#ixzz4bwv2c6qX
A.L. Vertkin, D.Yu. Pushkar, A.V. Topolyansky, A.S. Segal, “Erectile dysfunction”, medical scientific-practical journal “Attending physician”, # 07/03.
https://www.lvrach.ru/2003/07/4530520/
WHO official website. “Prevention of cardiovascular diseases.” Geneva, 2007
http://www.who.int/publications/list/PocketGL_Russian.pdf?ua=1
WHO official website. “10 facts about physical activity”.
http://www.who.int/features/factfiles/physical_activity/facts/ru/index1.html
A.G. Martov, D.V. Ergakov, “Sildenafil in modern urological practice” // EFFECTIVE PHARMACOTHERAPY.Urology and Nephrology. No. 2 (15) / 2014
http://umedp.ru/articles/sildenafil_v_sovremennoy_urologicheskoy_praktike.html

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how to understand, signs and treatment of erectile dysfunction, causes, psychological impotence

Erectile dysfunction – an inability to achieve an erection or maintain it in a stage sufficient for sex, lasting more than three months.

Daniil Davydov

talked to the doctor

Author’s profile

In older people, erectile dysfunction is more common, but the age of a man itself is not considered a risk factor. Erection problems are not part of normal aging. There are no natural reasons that would prevent a person from staying sexually active until age 70 or beyond.

Diseases called impotence do not exist

Yuri Kastrikin

urologist of the Fomina Clinic network

Erectile dysfunction is not a disease, but a symptom that may indicate that a person has other diseases.

For example, there is sufficient evidence that erectile dysfunction may be an early manifestation of problems with coronary arteries and peripheral vessels, therefore it is considered not only from the standpoint of a man’s quality of life, but also as a potential marker of cardiovascular diseases.

In addition, the same risk factors lead to erectile dysfunction as to hypertension and coronary heart disease. They are mainly related to the peculiarities of the lifestyle.These include:

tobacco smoking;
alcoholism;
drug use;
hypodynamia;
obesity.

It turns out that erectile dysfunction is an important indicator of health. Especially when you consider that cardiovascular disease is the leading cause of death for men in the world.

Why does erectile dysfunction occur?

An erection is an involuntary reaction that can happen even during sleep.In an awake person, two types of stimuli can cause an erection: psychological – for example, fantasies, or tactile – such as touching a penis.

How an erection works – MSD

Erection problems – not the norm – Uptodate

Clinical guidelines of the European Association of Urology (EAU), 2019 PDF, 10.7 MB

The process itself is rather complicated. To trigger an erection associated with the play of the imagination, the coordinated work of the brain and spinal cord, nerves and blood vessels of the penis is required.Reflex, that is, associated with touch, erection is a little simpler, because the brain is not involved in it. But for it to take place, the peripheral nerves must activate the nerve center responsible for erection in the roots of the sacral spinal cord. If any of this “breaks”, the erection will not work.

Urologists believe that the causes of erectile dysfunction can be both psychogenic, that is, not associated with disorders of organs and tissues, or organic.In some cases, there are mixed reasons.

Psychogenic factors are either situational, that is, associated with the characteristics of the partner, guilt or anxiety, or can be associated with neuroses. For example, with phobias, anxiety disorders or drug effects.

Organic factors are divided into four large groups:

Disorders in the work of blood vessels. Vascular problems are caused, for example, by cardiovascular diseases, diabetes mellitus, an increase in blood cholesterol levels and even tobacco smoking, which causes a spasm of the vessels of the penis.
Disorders in the work of neurons. Stroke, trauma, multiple sclerosis, diabetes and alcoholism can lead to problems with neurons.
Hormonal regulation disorders. Hormone problems are associated with hypogonadism, when the testes do not produce enough testosterone, or, for example, with an insufficiency of the thyroid gland, that is, hypothyroidism.
Medication disorders. There are many drugs that can lead to problems with erection – these are some diuretics, antidepressants, and psychotropic substances.

The most common cause of erectile dysfunction is psychogenic, accounting for about 40% of cases. For organic reasons – 29% of cases. But sometimes the problem has to do with a combination of mental and organic causes. And in 6% of patients, it is still not possible to find out the cause of dysfunction.

Scientists have not yet come to a consensus about what kind of orientation people have erectile dysfunction most often. According to American and French studies, gay men have this problem more often than heterosexuals.However, judging by the Chinese data, the problem does not depend on orientation, so erectile dysfunction is equally common in gay and heterosexual men. I could not find Russian articles on this topic.

As a rule, erectile dysfunction is associated with psychogenic causes, hormonal, vascular or neural disorders – or caused by several factors at once

How to know when to see a doctor

Before contacting a doctor, it makes sense to monitor your health for three months.If the problem does not go away on its own, you need to contact a specialist who is engaged in restoring an erection – a urologist-andrologist.

There is no need to prepare for the visit. It is enough to come to a face-to-face appointment and tell in detail about the problem.

How is an appointment with an andrologist

Yuri Kastrikin

Urologist of the Fomina Clinic network

Urologists-andrologists often ask patients to come to an appointment with a regular sexual partner – this way you can get more useful information.Therefore, if there is such an opportunity, it is better to plan a visit to the doctor for two at once.

Be prepared for the fact that your doctor will ask you to fill out a questionnaire – the International Index of Erectile Function (ICEF-5). This will help to objectively assess the severity of erectile dysfunction over the past month. The questions in the questionnaire are something like this:

How do you rate your confidence that you can achieve an erection and keep it?
How often is an erection that you get with sexual stimulation sufficient to insert your penis into your vagina?
After inserting the penis into the vagina, how often do you manage to maintain an erection?
Is it difficult for you to maintain an erection until the end of intercourse?
How often do you have an orgasm during sex?

In order not to waste time at the appointment, you can fill out the form at home.

Since there are a lot of reasons that lead to problems with erection, it is not surprising that about half of men aged 20-77 are faced with erectile dysfunction. Moreover, every third – with mild erectile dysfunction, in 7% it is average, and in another 7% – severe. The degree of severity is determined by the number of points that the patient gains according to the ICEF-5 questionnaire. In the United States, the European Union and other countries, statistics are similar to those in Russia.

90,051 7% 90,052 9,0002 men with severe erectile dysfunction 9,0003

The doctor will ask about past illnesses and sexual health, assess the patient’s appearance and his genitals.This allows you to identify hidden diseases – for example, Peyronie’s disease or hypogonadism. The doctor will also measure blood pressure, heart rate, and in overweight patients, determine the body mass index and waist circumference, and give a referral for tests.

Cost of consultation with urologist-andrologist – 700-4000 R.

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How is erectile dysfunction diagnosed?

The set of tests and examinations for erectile dysfunction can differ significantly from patient to patient.

Nevertheless, there is a list of tests that are prescribed to everyone: they help to understand whether a patient has diabetes mellitus, atherosclerosis or hypogonadism – testicular failure. You can try to do these tests for free under the compulsory medical insurance policy or for money in a private laboratory.

The cost of blood tests depends on the laboratory and the city in which it is done. To make it cheaper, take all the prescribed tests at the same time – then you will have to pay for taking blood only once.

Prices for analyzes in laboratories KDL and Helix

For total testosterone

350 R

For glucose

180 R

For triglycerides

168 R

For total cholesterol

168 R

For total cholesterol

158 R

High density lipoprotein (HDL)

130 R

Price for taking blood in Moscow

126 R

For total testosterone

550 R

High density lipoprotein (HDL)

320 R

For total cholesterol

290 R

For triglycerides

290 R

High density lipoprotein (HDL)

280 R

For glucose

255 R

Low density lipoprotein (LDL)

200 R

For the diagnosis of erectile dysfunction, an ultrasound pharmacodopplerography of the vessels of the penis is prescribed.During examination, prostaglandin E1 is injected into the non-erect penis – this is called “intracavernous injections”.

Pharmacodoppler ultrasonography allows you to assess the blood flow in the vessels of the penis at different stages of erection. But not everyone needs to do it, but only patients who have indications for this:

primary erectile dysfunction;
previous trauma or surgery on the pelvic or perineal organs;
penile deformity;
complex endocrine, mental or neurological disorders;
research is needed before penile prosthetics.

In public hospitals, this analysis is rarely done for compulsory medical insurance. Most likely, you will have to take it in a public or private clinic for money.

Cost of ultrasound pharmacodopplerography of the penis

Clinical Center. Sechenov in Moscow

“CM-clinic” in Moscow

Nika Spring Clinic in Nizhny Novgorod

How erectile dysfunction is treated

The treatment of a particular person will depend on what exactly happens to him.There are three approaches.

Normalize your lifestyle. This advice is given to all patients by both Russian and international clinical guidelines. For many people who switch to a balanced diet and begin to move regularly, erectile dysfunction goes away on its own, without treatment.

If the patient is taking medication, the side effect of which is a worsening of erection, a substitution of the drug may help. If a healthy lifestyle and replacement of drugs did not help, patients are prescribed symptomatic therapy.

Eliminate the cause of erectile dysfunction. If it was possible to establish it exactly, the treatment begins with this. For example, with psychogenic erectile dysfunction, patients are prescribed rational psychotherapy, and if the problem is due to testosterone deficiency, the doctor may prescribe hormone therapy. At the same time, problems with testosterone occur much less frequently than psychogenic erectile dysfunction.

2000 R

Average cost of an appointment with a psychotherapist

To resort to symptomatic treatment. Erectile dysfunction is treated with a simple-to-complex approach. They start with prescribing medications. If it does not help, they resort to the following line of therapy: injections of drugs into the penis. Doctors teach patients to do these injections on their own.

Non-drug methods of treatment are also used: low-energy shock wave therapy, vacuum erectors. If this does not help, the patient may be offered a surgical operation, that is, to install a falloprosthesis.The operative method is the final line of treatment for erectile dysfunction. As a rule, both men and their partners are satisfied with the result of the operation.

See a doctor

Our articles are written with a passion for evidence-based medicine. We refer to reputable sources and go for comments from reputable doctors. But remember: the responsibility for your health lies with you and your doctor. We do not write prescriptions, we make recommendations. It is up to you to rely on our point of view or not.

Drugs for the treatment of erectile dysfunction

Phosphodiesterase-5 (PDE-5) inhibitors in tablets. These are medications that allow you to control your erection at will. You need to take the pills about an hour before intercourse: it takes time for the medicine to get into the blood. The time over which the medicine should be taken and the dosage required for a particular person depend on the medicine.

It works like this. When a healthy person sees something exciting or feels a touch on the penis, an electrical signal sweeps through the nerves that collect information from the senses.This signal excites specialized nerves that begin to secrete nitric oxide. The gas enters the walls of the arteries of the penis and triggers the synthesis of cyclic guanosine monophosphate (cGMP), a substance under the influence of which the arteries expand.

As a result, the corpora cavernosa – the two chambers located inside the penis – fill with blood, swell and pinch the veins through which blood could leave the penis. An erection occurs. After intercourse, the PDE-5 enzyme destroys cGMP, and the erection stops.

The picture below shows how the cavernous bodies filled with blood pinch the veins, preventing blood from leaving the penis. PDE-5 inhibitors help maximize this condition

In many smokers, men with diabetes mellitus and testosterone deficiency, the amount of the enzyme responsible for the production of nitric oxide is reduced. As a result, little gas is produced, and it is not possible to produce enough cGMP to be enough for a full erection.

Causes of erectile dysfunction – Uptodate

But if you take a drug that temporarily stops the destruction of cGMP, this substance will have time to accumulate, and the erection will be more stable.But does not cause an erection by itself. – you still need a sexual stimulus and an intact penis with healthy blood vessels.

In our country, four active substances are registered, on the basis of which drugs from the group of PDE-5 inhibitors are produced: sildenafil, tadalafil, vardenafil and udenafil. Medicines work for different times – from 12 to 36 hours – all have contraindications, and the dosage must be selected together with the doctor.

The cost of PDE-5 inhibitors depends on the manufacturer, dosage and number of tablets in the package:

Synthetic analogue of prostaglandin E1 (alprostadil) in injections. Before sex, the drug must be injected directly into the corpora cavernosa: it helps to relax the walls of the blood vessels, and this facilitates the filling of the corpora cavernosa with blood. The medicine has contraindications and side effects, so the dosage must be selected together with the doctor. Alprostadil is a prescription drug.

Alprostadil – GRLS

The cost of alprostadil depends on the manufacturer, the concentration of the active substance and the number of ampoules in the package.Average price – 1,766-15,207 R.

What means should not be used

Biogenic stimulants – food additives and medicinal herbs. Unlike drugs, supplements, and herbs have not been tested for safety and efficacy. The concentration of the active ingredient in them can vary from package to package, so that they either do not work at all, or they work unpredictably. Like drugs, supplements have contraindications and side effects, and they can interact with other drugs, distorting their action.Supplements and herbs can be harmful to your health.

What to do? 07/02/20

The doctor prescribed dietary supplements along with the usual medicine. This is fine?

Ancillary treatments for erectile dysfunction

Vacuum erectors. These devices are recommended for use by the elderly, patients who cannot use medications, or those who are not affected by them.

The essence of the method is that the penis is placed in a flask and a bulb is used to create a vacuum inside the flask.As a result, blood rushes to the cavernous bodies – an erection occurs. To preserve it, a squeezing erection ring is applied to the base of the penis, which prevents the blood from leaving the corpora cavernosa prematurely. It works, but about 30% of people give up on erectors because of pain, bleeding under the skin, problems with ejaculation, and decreased sensitivity of the glans penis.

The vacuum erector consists of a bulb and a pear, with the help of which a vacuum is created inside the device.Source: Axel Bueckert / Shutterstock

If you use the erection incorrectly, you can injure your penis. Patients who want to try the device should ask their doctor to teach them how to use it.

The cost of the vacuum pump depends on the manufacturer. You need to choose a pump that comes with an erection ring, otherwise you won’t be able to achieve a stable erection. The price of such a device starts from 1000 R.

1000 R

minimum price of vacuum erector

Low Energy Shock Wave Therapy (LiSWT). The method may be suitable for patients with mild erectile dysfunction and people who are not helped by PDE-5 inhibitor pills.

The most common treatment plan is procedures twice a week for three weeks, then a break of three weeks and repeating the course. To achieve the effect, different people may require a different number of procedures, therefore, before starting treatment, it is necessary to discuss these nuances with your doctor.

The essence of the method is the effect of acoustic waves on the cavernous tissue of the penis.That is, it is such a “sound massage” that does not work on the surface, but inside the penis. According to some reports, this improves the formation of nitric oxide and promotes the growth of new blood vessels in the corpora cavernosa.

Cost of shock wave therapy

Central Design Bureau “Russian Railways-Medicine”, Moscow

“Polyclinic.Ru”, Moscow

Nearmedic, Obninsk

What methods do not help

Some private clinics offer to treat erectile dysfunction with magnetic laser therapy and ozone therapy.However, these methods are experimental, their effectiveness and safety in humans has not yet been seriously tested, and they are not in the clinical guidelines. Until reliable data is obtained, it is safer not to use it.

The effect of laser treatment, for example, was studied only in diabetic rats

Surgical treatment of erectile dysfunction

It is recommended to resort to surgical interventions only as a last resort: if neither pills, nor a pump, nor injections help.

Denture implantation – phalloprosthetics. There are two types of dentures. Flexible shape memory rods are surgically inserted into the penis so that the patient can shape it by hand. The second type is prostheses filled with sterile fluid. These are two- or three-piece hydraulic systems that work almost like their own corpora cavernosa, mimicking a natural erection. Most patients prefer three-piece prostheses: they allow you to achieve the most natural erection and suit almost everyone.

How hydraulic prostheses work. If you press the “bulb” implanted in the scrotum several times, the hydraulic system will fill with fluid from a special reservoir – and an erection will occur. To deactivate the prosthesis, you need to press on the penis or the pads of the pump in the scrotum, then the fluid will return to the reservoir

The most serious complication associated with installing a prosthesis is an infection of the prosthesis. However, frequently operating surgeons rarely have such a problem, and modern phalloprostheses with antibacterial coating have reduced the risk of this complication from 5% to 2%.Modern implants serve more than 15 years, there are devices with a lifetime warranty. But if the prosthesis still breaks, the operation is repeated.

When choosing an operating urologist, it is important to pay attention to the experience and the number of operations that he performs per year. Success strongly depends on the doctor’s skills and knowledge of all the intricacies of the main stages of the operation. Only an experienced surgeon will be able to perform falloprosthetics so that there are no complications, including infectious ones.

The cost of falloprosthetics consists of the price for the prosthesis – the more complicated, the more expensive – and the price of a surgeon’s consultation, surgery, stay in the ward and dressings.In different clinics, prices differ significantly. In a clinic near Moscow, falloprosthetics with a one-component prosthesis will cost about 215,000 R, and with a three-component – 560,000 R.

How much does it cost to treat erectile dysfunction

Option No. 1 – from 4000 R:

visit to the doctor – from 700 R;
analyzes and examinations – from 1300 R;
cost of an appointment with a psychotherapist – from 2000 R.

Option No. 2 – from 2150 RUB for diagnostics and the first pill, in the future you need to pay only for medicines:

visit to the doctor – from 700 R;
analyzes and examinations – from 1300 R;
PDE-5 inhibitor tablets – from 150 R per tablet.

Option No. 3 – from 3000 R:

visit to the doctor – from 700 R;
analyzes and examinations – from 1300 R;
vacuum pump – from 1000 R.

Option No. 4 – from 16 400 R for a course of treatment:

visit to the doctor – from 700 R;
analyzes and examinations – from 1300 R;
low-energy shock wave therapy – from 1200 R per procedure, 14 400 R per course.

Option No. 5 – from 3800 R for diagnostics and the first injection, in the future you only need to pay for medicines:

visit to the doctor – from 700 R;
analyzes and examinations – from 1300 R;
alprostadil injection – from 1800 R.

Option No. 6 – from 217,000 R:

visit to the doctor – from 700 R;
analyzes and examinations – from 1300 R;
penile prosthetics – from 215,000 R.