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Tag: erectile dysfunction causes

  • Porn Can Contribute to Erectile Dysfunction

    Porn Can Contribute to Erectile Dysfunction

    Porn and Erectile Dysfunction

    It’s the conclusion that many articles, websites, and recent conversations have come to: When young men deal with ED, pornography is sometimes the culprit.

    As a medical clinic, the question we ask is always the same: What do the facts say? Does science have the answer to the question “Can porn really cause erectile dysfunction?”

    Let’s find out.

    How Much Do We Really Know About Erectile Dysfunction in Young Men?

    It’s true that erectile dysfunction is an issue for younger men. A 2013 study found that about 1 in 4 men experiencing ED are under the age of 40.

    Is this number an increase? Unfortunately, little data from previous generations exists to make a true comparison.

    Some earlier takes on this subject (such as a Kinsey study in 1948) suggest that ED used to be less common in young men, but these studies are rare and use methods which differ greatly from those we use today, making it hard to conclude one way or the other.

    While we do not know the extent of an “increase” in instances of ED, recent data shows that it is a prevalent issue for young men today. But could porn be the reason? Can porn really cause erectile dysfunction?

    How Does Pornography Affect the Brain?

    Studies have found that the reward centres of the brain respond actively to pornography. Individuals whose reward centres are particularly triggered by these images respond to pornography the same way a drug addict’s brain would respond to a substance.

    Some believe that frequent exposure to pornography trains the reward centres in the brain to respond only to increasingly graphic images which do not mimic real-life sexuality, making it difficult to become excited during intimate encounters.

    Not so fast, neurologist Dr. Simone Kühn notes in a 2013 Telegraph article about her study on the subject. At this point in the research “It’s not clear whether watching porn leads to brain changes or whether people born with certain brain types watch more porn.”

    More recent studies show that healthy young men with a porn addiction experience less ED while using porn than during sex with a partner. See this 2021 study  A web-based survey of men with “problematic” pornography consumption concluded that “prevalence of ED in young men is alarmingly high, and the results of this study suggest a significant association with problematic pornography consumption.”

    What Are Some Reasons For Erectile Dysfunction in Young Men?

    While the consumption of pornography has increased since the advent of the internet, other changes have also taken place in the last quarter century which could also affect male sexual health.

    Young people have seen a rise in instances of high blood pressure, diabetes, obesity, and other health problems associated with ED. Stress has also increased among young people, and attention spans are growing shorter. For young men experiencing erectile difficulties, these risk factors should all be considered by a doctor.

    What Can Young Men Do To Treat ED?

    Yes, the brain can be impacted by pornography. And yes, the brain is one of many factors considered when treating erectile dysfunction. But there is no conclusive evidence linking the two. While it may be worth considering for some individuals with certain brain types, every man is different. Potential causes for erectile dysfunction in young men vary greatly.

    Before running to a doctor for a quick-fix prescription or trying to self-diagnose the reasons for your ED, see a men’s health specialist for an evaluation. Doctors who specifically treat erectile dysfunction are experts in physiological and psychological risk factors and will take your whole health into consideration when creating a treatment plan.

    If you live close to Toronto and the GTA, FullMast Clinics are a great resource for any man dealing with ED. To get started, contact us online or call 1-844-500-1177.

  • Are Erectile Dysfunction Pills Right For Me?

    Are Erectile Dysfunction Pills Right For Me?

    Erectile Dysfunction Pills

    Prescription pills, such as Cialis and Viagra, are among the most commonly used treatments for erectile dysfunction.

    How do pills like Viagra and Cialis work? Are these pills an effective long-term solution? Which pill, if any, is right for me?

    As a Men’s Health Clinic, we hear questions like these all the time. It is important to understand how erectile dysfunction pills work before deciding to take them. Here are are some of our answers to the most common queries.

    How do Erectile Dysfunction Pills Work?

    To understand how these pills work, we have to first understand how erections work.

    The brain, upon becoming sexually aroused, will send signals to a man’s penis to fill with blood and become erect. Seems easy enough, right?

    Here’s the catch: the muscle of the penis must relax to allow for that inflow of blood. Drugs like Cialis and Viagra, also known as “PDE5 inhibitors,” help with that relaxation. They do this by temporarily “inhibiting” an enzyme that can get in the way of this process. This allows blood to flow into the penis, which can make it easier to get and maintain an erection.

    Although they may seem quite similar, the differences between PDE5 inhibitors can be vast. For example, the half-life of Viagra is 4 hours, while Cialis has a 17.5 hour half-life. That means the effects of Cialis can last up to 36 hours! This is something which should definitely be considered when choosing which medication to use. It’s important to discuss any potential prescription with a doctor who has in-depth knowledge of all the differences between available pills. ED specialists at clinics like FullMast are informed about the different molecular structures of pills like Cialis and Viagra, and can advise whether any of these are a good choice for you.

    Positive Effects of Sex

    In January 2023 the results of a large scale study were published in the Journal of Sexual Medicine.

    The study showed that men with ED who used PDE-5i pills had fewer heart problems and live longer than non-users. And, the study found, the more of these pills men take the longer they live.

    The study, which looked at men over a fourteen year period in the United States, is known as “retrospective” which does not untangle the reasons for the benefits. Are the improved health outcomes a direct result of the medication on the cardiovascular system or because the men who are using the pills are having sex which has proven health benefits?

    Our strong hunch is that the benefits of the pills are because the men that use them are having sex more often than those who do not, and it is well proven that intimate relations relieve stress and give the heart a workout.

    Having sex creates a positive feedback loop. Sex makes one feel good and encourages one to undertake other exercise. Exercise and healthy living make a man more appealing to their partner, which in turn strengthens their relationship.

    At FullMast we are strong advocates for having supportive intimate relations and it is necessary to attain erections hard enough for satisfying intercourse. Pills can play their part so too can Dual-Action SONICWAVE.

    Men who take ED pills live longer – likely because they enjoy the health benefits of loving sexual relationships.

    What are the Side-Effects of ED Pills?

    Erectile dysfunction is a health issue, so you should approach treatment in a health-centered way. That means understanding everything you can about the drugs you’re taking, speaking with a specialist, and making sure any treatments are compatible with your medical history.

    In the case of PDE5 inhibitors, that medical history is a critical factor. Some of the same issues which can cause erectile dysfunction, such as heart issues and blood pressure, could interact badly with these medications. Mixing these drugs with nitrates (nitroglycerin tablets or patches) can also make these drugs a dangerous choice for men.

    Side effects of PDE5 inhibitors include vision loss, headaches, body pains (especially in the lower back), stuffy nose, gastrointestinal issues (such a diarrhea and indigestion), and a flushing of the face. If you take these drugs, any side effects should be reported to a doctor immediately.

    By looking at the root cause of your ED, examining your medical history, and paying attention to any potential side effects, a specialist can decide whether they a PDE5 inhibitor should be considered as a part of your treatment plan.

    Are Pills Like Cialis and Viagra Good Treatments for ED?

    Many men have reservations about leaving their love life to a prescription. They’re right to be cautious. Taking a pill like Viagra or Cialis will not address the critical underlying causes of ED, many of which are central to a patient’s overall health.

    Beyond that, it can be a stressful solution: Having to schedule sex around a pill can take some of the spark and spontaneity out of a relationship, and depending on pills like Viagara and Cialis can be expensive and inconvenient over time.

    Many men prefer to pursue long-term treatments which improve performance for the rest of their lives, rather than just a night or two. That’s why we take a multimodal and health-centered approach at FullMast by prescribing these drugs not necessarily as a long-term solution, but as a tool to improve the efficacy of more permanent treatments, such as SONICWAVE™ therapy.

    A consultation with a trained ED specialist is the best way to decide which treatment is best for you. There are many different solutions which can work together to help you reclaim your sex life.

    If you’re in the Toronto or Vancouver area and want to know what treatment option is right for you, call 1-844-500-1177 or contact us online today!

    Note that in the context of this article “specialist” is used to denote a clinical focus, not a medical specialist such as an urologist.

  • Yes, bike riding may cause erectile dysfunction and how to avoid it

    Yes, bike riding may cause erectile dysfunction and how to avoid it

    Bike riding can cause erectile dysfunction

    After 12 years riding the same bike seat, on average of 20 kms a day, George began to notice gradual erectile dysfunction issues in the past five years. “My first thought was that it was related to cycling.” He didn’t experience numbness, as a precursor, but instead, it just wasn’t working in the bedroom.

    His story is common. In fact, hardly a day goes by that Duke’s Cycle in Toronto doesn’t have a customer come in asking for a new seat. “Numbness is a common problem, but they don’t often go into more detail than that,” says Lisa Stockus, a sales representative.

    In 1997 a study from the Massachusetts Male Aging study, which looked at over 1,700 recreational riders between the ages of 40 and 70, blamed cycling for erectile dysfunction. One of the authors, Dr. Irwin Goldstein, proclaimed: “there are only two kinds of male cyclists – those who are impotent and those who will be impotent.”

    Since that study, the following research is saying that instead of ditching the bike, find a new saddle instead. There is hope for riders who want to have healthy and active sex lives.

    What is happening down there?

    Your penis doesn’t have to be directly on the saddle to feel the effects of numbness. In fact, the soft tissue area between the anus and the penis, the perineum, is loaded with blood vessels and nerves. The erectile tissue extends from the tip of the penis back towards the anus. If riders are resting their body weight on this area, and not your sit bones located in your glutes, then the blood flow is not only restricted, the vessels can collapse, or worse, build up scar tissue that can block blood flow needed for an erection.

    The sit bones, or ischial tuberosities, have no organs, and the nerves and arteries are surrounded by the fat and muscle of your bum, therefore we can sit for hours without pain.

    But, the research is revealing that yes, cycling will cause numbness, and yes this can lead to erectile dysfunction. The MMAS study revealed that spending three hours or more a week on the saddle carries a risk ratio of 1.72 (anything over 1.5 is defined as a health risk) of long term arterial damage.

    And while the research since the studies in the early 2000s haven’t produced any new findings, more research has been done on saddles and ways to mitigate the numbness and pressure on the perineum.

    Not everyone who rides will experience numbness or ED. But as the creator of Spongy, a dual seat saddle that removes the pressure from the perineum, Jeff Dixon says, “It’s like a smoker—you might not get cancer, but it’s a risk. With cycling, it’s the same thing, unless you remove the risk: the traditional saddle.”

    Saddles that are designed to spread the pressure to the buttocks without a hard, narrow nose have been shown to alleviate the problem. After complaints and the health concerns of bicycling police officers who spend most of the day on a bike saddle, the National Institute for Occupational Safety and Health (NIOSH) conducted a study that looked at 91 police riders before using an alternative nose-less saddle.

    “There were reports of genital numbness, but the sensitivity was removed and they found the erectile dysfunction was diminished,” says Steven Schrader, a reproductive health expert, and one of the study’s leading authors.

    “We determined that about 20 to 25% of their body weight was being put on the nose of the saddle. With the nose-less saddle you remove that weight on the soft tissue.” After the study, only three officers returned to the regular saddles.

    This was the thinking behind one of the most unconventional, but popular bike seats available. The Spongy Wonder (made in New Brunswick) uses two platforms – one for each sit bone, without a nose.

    Within the athletic cycling community, one brand of saddle stands out. The Power series of saddles from Specialized that shift body weight onto the sit bones avoiding putting pressure on the perineum.

    As far as gel seats or cut outs, Schrader says to avoid both. Both alternatives only transfer the weight and put more pressure on the perineum.

    The type of biking makes a difference

    A 2004 study of 33 bikers revealed that a traditional sport race bike saddles, put twice the pressure on your perineum than other styles of bike saddles.
    “Road cycling and cycle touring are big culprits, but it’s less about body position and more about the fact that it is a long time on the bike and in a position that is static and you don’t move around on the saddle,” says Andrew McGregor, the sports marketing sales rep for Specialized Bicycle Components.

    “Triathletes are poster childs for this as they are in a fixed position while roadies (road cyclists) move around a bit; mountain bike (is the best scenario) because it is a dynamic sport where you’re up and down out of the saddle often.”

    Measure your sit bones

    Your weight has no bearing on the width of your sit bones, meaning, you can be heavier and have a smaller distance between your sit bones. Before finding a perfect fitting bike saddle, experts suggest getting a fitting and that begins with this all-important measurement.
    A profile photo of a rider with a saddle too small for his sit bones reveals a curved spine and his body weight shifted forward. With a correctly fitting saddle, his back straightens and his weight shifts back onto his sit bones.

    “If the saddle isn’t the right width, the body will always adapt to find a way – you might shift body by lifting one leg and shifting your bodyweight to adapt. It might cause back pain or travel up your arm. But this is all fixed with the right bike saddle,” says McGregor.

    And when all else fails, McGregor says just lift your bum for some relief. “As soon as you get up problem resolved—even on a bad saddle.”

     

  • Not in the mood? Do it anyway. It’s good for you.

    Not in the mood? Do it anyway. It’s good for you.

    Sextual Mood

    How many times have these words “I’m not in the mood” stopped you and your partner from getting intimate? There are many reasons Canadian couples start having less sex, especially as relationships mature. This not only takes a toll on a relationship but can affect mood, sleep cycles, heart health and more. That’s why many experts say you should think twice before turning down intimacy, even if you aren’t “feeling it” in the beginning.

    At FullMast Men’s Health Clinic, we often describe sex as being akin to going to the gym. We all know we should do it. When we’re there, we feel good. When we’re done working out, we feel great. We wonder why it had been so difficult to motivate ourselves to hit the gym in the first place. This can be the same with sex – it can seem like a chore in the beginning, but the intimacy and release can make it very worth your while. Here are a few reasons it could be worth pushing past the lack of “mood” to revitalize your sex life.

    Responsive desire means people can get “in the mood” after some fooling around.

    Many people think that the desire to have sex should be a spontaneous craving. However, much like going to the gym, this isn’t always the case. Sometimes you don’t feel like having sex, but if you start kissing and caressing each other, you suddenly find yourself ready for intimacy. This is called responsive desire and is the primary desire style for 30% of men and 80%-90% of women.

    For many people, particularly women, arousal typically comes before the desire for sex. Engaging in foreplay can often set that arousal into motion. In other words, the act of touching and teasing motivates couples to have sex, instead of the other way around.

    “Responsive desire happens when you’re not really looking for it but something sexy like your partner comes along and starts kissing your neck,” says Emily Nagoski, a women’s sexuality lecturer. “You’re in a good state of mind, your body lights up and you go, ‘Oh right, sex! That’s a good idea! We should do that.’”

    Why science says regular sex is good for your health.

    We know that sex on a regular basis is good for our health. It lowers our blood pressure, reduces our risk of heart disease, and boosts our immune system. Here are just a few of the recent findings from researchers exploring this topic:

    How to promote a healthy sex life at home.

    An active sex life may come naturally early on in a relationship, but as time wears on it may take a bit more effort to stay active and engaged in the bedroom. While science says it is well worth the work, there are some realities that can make this difficult. Here is some of our top advice for navigating these common challenges.

    “We’re just too busy!” 

    Couples need to make good, regular sex a priority. It might not seem very sexy or spontaneous, but the best way to do this can be clearly scheduling the time. Remember, research into responsive desire clearly shows that sex doesn’t have to be spontaneous for it to be satisfying. So go ahead – mark “Touchy Tuesdays” on the calendar. Your body and relationship will thank you.

    “I’m tired.”

    Sex should be part of a healthy lifestyle. If you are sleep deprived, overworked, or spend too much time watching TV, chances are fatigue will catch up with you. It’s important to find and address the root cause of your tiredness in order to regain your sex life. And remember, if trouble falling or staying asleep is the culprit, an orgasm can actually help you get a better night’s rest.

    “I can’t perform like I used to.”

    From erectile dysfunction to vaginal pain, there are many medical reasons couples could put sex on hold. But there is no reason to let medical issues stop you from having sex. There are plenty of safe, effective treatments for ED now available – you can check out our list of erectile dysfunction treatments for Canadian men to learn more. Difficulty performing sexually is often a sign of more serious medical issues, so this is one checkup that could save your relationship and your life.

    If you need medical support to understand and treat ED, we are here to help. Schedule your free, confidential consultation with the FullMast Clinic in Toronto or Vancouver, or call 1-844-500-1177 for more information.

  • How are Type 2 Diabetes, Testosterone Deficiency and Erectile Dysfunction Connected?

    How are Type 2 Diabetes, Testosterone Deficiency and Erectile Dysfunction Connected?

    Type 2 Diabetes and Testosterone Deficiency

    Erectile dysfunction (ED) is a very common complication in men with diabetes mellitus (DM).  Diabetes causes changes to the endothelium and penile vascular system.

    What is less often acknowledged is that men with type 2 diabetes also have higher prevalence of testosterone deficiency. In fact, testosterone deficiency in men precedes the development of insulin resistance and diabetes. Low levels of testosterone in men can lead to lower libido and poor erectile function.

    testosterone with diabetes and ED graph

    A six-year study conducted in the UK on 518 men demonstrated a bidirectional relationship between obesity, metabolic syndrome, diabetes, insulin resistance, and testosterone deficiency. The study also found that testosterone replacement therapy could delay or prevent many of these conditions.

    There is other data supporting a direct role of testosterone in insulin sensitivity. In one study, men who had lower than average testosterone levels were taken off testosterone replacement therapy. After two weeks, these men showed an increase in insulin sensitivity without apparent changes in body composition. This suggests that sex steroids have a direct effect in modulating insulin sensitivity, which also affects erectile function. Other studies have demonstrated the interplay between insulin sensitivity, triglycerides, and sex steroids. The effects of testosterone is immediate and not due to weight gain or increased obesity.

    If you have type 2 diabetes, the next time you see your physician ask about your testosterone levels to find out if testosterone replacement therapy is right for you.

    Good News About Treating Erectile Dysfunction

    The good news about treating erectile dysfunction that is connected with type 2 diabetes is that studies show that it responds to treatment with SONICWAVE.

    A 2022 study published in the journal of the American Society of Andrology and European Academy of Andrology concluded that “results of the clinical studies suggest that Li-ESWT is a safe and effective treatment in men with well-controlled DM and moderate or better ED.”  See details here.

  • The One Surprising Question Your Doctor Never Asks But Should

    The One Surprising Question Your Doctor Never Asks But Should

    sexual health

    Men should talk to their doctors about their sexual health.

    It’s easy enough to say, but following this advice is often a challenge. Both men and their doctors can take steps to make it easier to connect on issues of sexual health.  For patients, this involves seeing a family doctor for regular checkups and being honest about personal issues. Meanwhile, your doctor should ask specific questions related to sexual health when conducting checkups. They should also be prepared to offer resources beyond just a prescription for PDE5 inhibitors like Viagra.

    We know this is a challenge, but the stakes are high. By having the right conversations early on, men can often resolve issues like erectile dysfunction. They can also identify other health problems like diabetes and heart disease. In this article, I’m breaking down why people don’t talk to doctors about sexual health – and why that needs to change.

    Why men don’t go to the doctor – and why they should start.

    Going to the doctor is something we know we should do, but we often don’t get around to it. Like going to the gym. Or eating walnuts and avocados. Or going for that walk after dinner.

    Men avoiding the doctor’s office is not just a stereotype. A recent Cleveland Clinic survey showed that only three in five men get a yearly physical. Meanwhile, 40 percent of men still don’t get a health issue checked out until it becomes unbearable. On top of that, the majority won’t talk about their health with others.

    Look, we’re not saying that men should share personal health issues with everyone. Erectile dysfunction doesn’t make for good water cooler conversation. But your doctor does need to be in the loop about any body part that isn’t working properly. For many men, regular check-ups are a great opportunity to raise these concerns.

    What sexual health issues should I discuss with my doctor?

    Men are often unsure of what sexual health issues would be relevant in a check-up.

    Is doing it a bit less than normal a health issue? Possibly not. Is a significant dip in sexual activity worth noting? Probably. Is being physically unable to have sex worth discussing? Absolutely!

    Here are some of the common sexual health issues men should raise with a medical professional

    • Inability to get or maintain an erection
    • Extreme change in libido or stamina
    • Decrease in amount of sex or interest in sex
    • Unusual discharge from the penis
    • Pain, lumps, or other unusual growths on the testicles or penis
    • Need for STI protection and testing

    While talking about these things with a family doctor can be worthwhile, note that you do not need a doctor’s referral to get support from a specialty clinic dealing with sexual health. For example, a local STI testing center may be worth consulting for infection concerns and an ED-focused clinic like FullMast is the best resource for sexual performance.  If you live in the Greater Toronto Area, you can reference our Directory of Toronto Sexual Health Resources to find the best options near you.

    Why your doctor should ask about sexual function

    The question your doctor should ask is a simple one: Are you having sex on a regular basis in an intimate relationship? There are three reasons to ask this question:

    • Sex has many health benefits. Studies show that an active sex life lowers blood pressure, strengthens the immune system, and reduces the risk of heart disease and prostate cancer. While no one should feel forced to have sex by a doctor’s orders, having a bit more could help alleviate some of the psychological and physiological challenges that come with age.
    • Erectile dysfunction can signify other health challenges. Erectile dysfunction is often a blood flow issue. Since blood pumps from the heart, this is no small matter. Many people have discovered serious underlying conditions when undergoing testing for ED. In general, if a body part isn’t working like it used to, your doctor should know.
    • Intimacy can affect treatment and recovery from illnesses. Studies have shown that people with a healthy sex life with an intimate partner mange and recover from serious illnesses at higher rates. An Italian study, for example, found that men with type 2 diabetes who had a healthy sex life were significantly less likely to suffer from illness-related distress. According to renowned doctor and professor of Sexology Christian Graudaard,  “a fulfilling sexual life might reduce morbidity and perhaps even mortality of patients. Sadly, nearly two-thirds of the aforementioned diabetes patients reported that sexuality had not been addressed by any doctor within the past year.”

    It’s undeniable: sex makes a big difference in a man’s overall health. That’s why a doctor should ask specific questions on this subject when performing a check-up on an adult man.

    Can sexual health issues be resolved by my family doctor?

    If talking to a doctor about erectile dysfunction or other sexual health issues makes you nervous, it’s important to remember that it is worth the conversation. The earlier you begin treating something like erectile dysfunction, the more likely you are to completely resolve the issue.

    Recent research has made multiple exciting erectile dysfunction treatments available to men. Some of these, such as SONICWAVE, allow for permanent ED treatment without drugs or surgery. There’s just one catch – it works best with early diagnosis. The health issues that often come with ED, like high blood pressure and diabetes, also benefit from early intervention.

    Regular sex and healthy relationships are critical to the health of most men, but we rarely speak about this sensitive subject with our family doctor. A conversation about sexual health may not be one we’re comfortable initiating or participating in, but an honest dialogue with a qualified health professional can improve our relationships and sexual wellbeing. A doctor should ask about sexual health not only because it is relevant, but because they can truly improve patients’ lives by understanding how things are going in the bedroom.

    “How often are you having sex?” might be the question that leads to big improvements in one’s health.

    If you have questions, please call to set up an appointment at FullMast Men’s Health Clinics.

  • 8 Questions With FullMast’s Chief Medical Officer Dr. Ron Mayer

    8 Questions With FullMast’s Chief Medical Officer Dr. Ron Mayer

    FullMast's Chief Medical Officer Dr. Ron Mayer

    1-Hello, Dr. Mayer. Thank you for sitting down with me today. Would you mind discussing the main issues that come up most often in your clinic?

    Well, primarily, men come into the FullMast clinic for erectile issues and questions about testosterone therapy. When a man comes into our office, and he’s around 45 years old and he presents with erectile issues, the first thing I have to think about is cardiovascular illness. Men who present with early-onset erectile dysfunction will most often have cardiovascular issues such as hypertension and high cholesterol.

    2. As FullMast’s Chief Medical Officer, what are some concerns you’ve noticed when patients come into your office? How have you been able to address these?

    I’ve noticed that some patients are reticent to come into a clinic where there are other men who are sitting around in the waiting room. They’re not necessarily ashamed, but there is still stigma around sexual health and erectile issues. In order to combat this, we manage our consultations according to a specific protocol. The consultations are an hour long. When a patient comes in for his consultation, the previous patient has already left. We have one treatment room. Our main concern is the comfort of the patient. We want to ensure privacy and confidentiality as much as possible.

    3. What are some questions men should ask their doctors during their annual physical?

    Annual physicals are not recommended for men until they’re 50 years old. Before 50 years of age it should be once every two years. During these annual checkups, they should ask for a colonoscopy, a rectal (prostate) exam, which involves the detection of PSA, the prostate-specific antigen. Certainly as a man gets older, he should ask about exercise and weight loss, especially if he is overweight or obese. Most physicians don’t talk to men about those issues. Even a slightly overweight man who doesn’t get that much exercise will present with signs of erectile dysfunction. The most common manifestations of ED are cardiovascular issues, hypertension, high cholesterol, and high blood sugar.

    4. Do issues of mental health ever arise during these consultations?

    Yes, these issues come up quite often. Men who are low on testosterone often come in slightly blue and with less energy. Sometimes, we have a conversation about the use of antidepressants. As part of the assessment, we also evaluate psychogenic causes of erectile dysfunction especially if the man is in his early thirties. Often times the causes are not organic but psychogenic. But keep in mind, psychogenic causes may also occur in men in their fifties as well.

    5. Does fitness or nutrition ever come up during a consultation?

    One of the first things we talk about is exercise. I usually ask them, ‘Do you walk?’ Walking is a good way to start becoming active. I recommend they measure the steps they take every day. There are many phone apps out there to help them keep track of the number of steps they take. I would recommend 1,000 steps per day, or 100 steps per minute to get their heart rate up.

    Vitamin D is also important especially in the wintertime: 5,000 units per day along with magnesium. A trick I tell them is when to start and when to stop: if they go outside at noontime, and their shadow is longer than their height, take the vitamin D, but if at noontime, their shadow is shorter than height, don’t take it that day. I would also recommend lots of unsaturated fats, which can be found in olive oil, avocado, and walnuts (which contain arginine, a precursor for nitric oxide, which assists in producing a fully erect penis).

    6. Do most men who come into your office have some type of support network?

    They do, but it’s mostly support from their partner, especially because their partner is equally affected by these erectile challenges. They often come into the clinic with their partners. Men usually don’t like to talk about these issues with other people like friends or family members. Hopefully over time people will see sexual health as being another facet of overall health, but today, many men are still worried about how people perceive their masculinity. They don’t want to be questioned by their buddies or their friends. I’ve noticed men don’t joke about these issues until they’re in their seventies. In the1990s when Viagra come out, men became more open to discussing sexual health. It opened up the lines of communication; the commercials were humorous, and men felt more comfortable talking about it.

    7. What age group do you see most often at the clinic?

    The range is anywhere between 20-80 years old. Usually, younger patients have erectile issues that stem from psychogenic issues rather than men in their fifties and beyond. Younger men also have concerns with premature ejaculation.

    8. Dr. Mayer, thank you for your time today. Before we say goodbye, is there anything else you would like to add?

    Oh, that’s not a problem at all. Thank you. Yes, so I have noticed that many therapies nowadays focus on medications such as Viagra and Cialis, but there are many non-medicinal therapies and procedures out there. In fact, medications tend to wear off over time. FullMast has pioneered the first new and Health Canada approved treatment for erectile dysfunction called SONICWAVE, which is a non-surgical, non-medicinal therapy that uses high-frequency vibrations to stimulate nerve function, cell regeneration, and increase blood flow to the penis.

    If a man has diabetes or has had prostate surgery or who presents with neurogenic issues, we’re going to recommend both SONICWAVE and Viberect. Viberect is another vibration technology that helps the secretion of nitric oxide. We believe in multimodal therapies so we also recommend pelvic floor exercises to strengthen the muscles that are responsible for maintaining blood flow and rigidity in the penis.

    Overall, we’re here to help men handle the sensitive issue of erectile challenges by providing the best care possible at our clinic. We also want to open up the conversation about men’s sexual health and about maintaining sexual activity as men age. Myself and sexologist Dr. Stephen de Wit will be presenting at an upcoming talk on August 2nd to discuss these key topics in men’s sexual health.

  • What is the Main Cause of Erectile Dysfunction?

    What is the Main Cause of Erectile Dysfunction?

    Main Cause of Erectile Dysfunction

    What does it take for a man to have a good erection? This is a question that plagues many men who are trying to overcome sexual challenges. When I say a “good” erection, I mean an erection that is satisfying for both yourself and your partner. For many of our patients in Toronto, Vancouver, and other parts of Canada, achieving a “good” erection is a daily challenge

    When seeking to resolve this issue, it is a good idea for men to understand the main cause of erectile dysfunction as well as being aware of risk factors and other contributing causes. A thorough diagnosis that recognizes the underlying reason for sexual difficulties will help you find the best treatments for your erectile issues.

    What is the most common cause of erectile dysfunction?

    The best way to understand erectile dysfunction is to take a look at what’s happening inside your body, especially where blood flow is concerned. This is because an erection involves blood flowing to the penis. This process allows the penis to become hard. For this reason, the main cause of erectile dysfunction is something called endothelial dysfunction.

    The endothelium is the lining on the inside of your blood vessels. They are important in regulating four things:

    1. Vascular tone: the extent to which your blood vessels constrict or dilate
    2. Cellular adhesion: the process whereby cells interact and attach to a surface
    3. Thromboresistance: the resistance of a blood vessel to thrombus formation, a thrombus being a stationary blood clot along the wall of a blood vessel
    4. Vessel wall inflammation: blood vessels become swollen in response to injury, infection, or illness

    The endothelium is what causes vasodilation of the vessels in the penis, resulting in a full erection. So, in essence, the main cause for erectile dysfunction from a biological perspective is damage to the endothelium. Any form of chronic inflammation caused by hypertension, diabetes, high cholesterol, obesity, gout, and other inflammatory conditions can harm this function.

    Here’s how it works: When we get excited, either through touch or visual stimulation, messages are sent to the endothelium of the penis to release a substance known as nitric oxide (NO). This chemical is responsible for vasodilation by accumulating something called cGMP. This nucleotide relaxes the blood vessels and allows blood to flow into the penis. When there is damage to the endothelium, there is less nitric oxide, which results in a non-fully erect penis. This is how drugs like Cialis or Viagra work. They prevent the breakdown of cGMP, which allows nitric oxide to be continually be released over a longer duration of time.

    How can I prevent erectile dysfunction?

    Now that we’ve identified the main cause of erectile dysfunction, it’s time to work backwards to determine a resolution.

    To prevent or minimize erectile dysfunction, you must first start caring for your cardiovascular health. Believe it or not, common advice for reducing the risk of heart attacks and strokes is the very same guidance that can help you prevent ED. This is because same conditions that cause heart disease can cause erectile dysfunction. Consistent exercise, managing your weight by watching what you eat, and keeping your blood pressure in check are all important parts of many successful erectile dysfunction treatment plans. These simple changes may go a long way in helping you combat and overcome erectile dysfunction.

    Identifying your personal risk factors for erectile dysfunction

    Whether you have just started experiencing erectile dysfunction or have been working to manage it for a long time, chances are endothelial dysfunction is at the root of the issue. But what is causing it and how can you resolve it? This main cause of erectile dysfunction shows many warning signs and has many associated risk factors. Take a look at the list below to see how many apply to you.

    Behaviours and Conditions that Put Men at a Higher Risk for Erectile Dysfunction Include:

    • A family or personal history of heart disease
    • Type two diabetes and prediabetes (read more about this risk factor )
    • Inflammatory conditions
    • Obesity
    • High blood pressure
    • High cholesterol
    • An inactive lifestyle (for example, working a desk job and not regularly getting exercise)
    • An unhealthy diet
    • Smoking
    • Taking medications related to blood flow (these may be required for your health, but considering current prescriptions is a good idea when trying to understand the causes of your ED)

    There are many benefits to addressing these issues. Along with helping treat ED, these lifestyle changes can prevent a man’s likelihood of developing heart disease. Since heart disease is one of the leading causes of death in Canadian men, this is good news. I often include lifestyle change recommendations into the erectile dysfunction treatment plans I develop for patients in Toronto and Vancouver.

    Is my cardiovascular health the only thing that can cause ED?

    Blood flow and heart health are the main cause of erectile dysfunction, but there are other causes of erectile dysfunction which may be at play in a man’s individual situation. While these factors may restrict blood flow, they do not necessarily relate back to a person’s heart health or lifestyle. These can include:

    • A history of prostate issues, particularly if a man has undergone a prostatectomy
    • Penile injuries and damage to the tissue within the penis (this can be sustained through sexual injury, car accidents, and more)
    • Numbness or a lack of sensation in the penis (research shows that excessive bike riding  can have this result for some men over time)
    • Neurological issues that affect the brain’s ability to communicate with the reproductive system. This can include Alzheimer’s disease, Parkinson’s disease, tumours, epilepsy, and multiple sclerosis.
    • Use of drugs that affect the central nervous system, including depressants (Xanax, Valium, alcohol etc), or stimulants (cocaine, amphetamines)
    • Use of various other drugs that may influence reproductive processes, such as cancer chemotherapy medications or synthetic hormones
    • Psychological, emotional or relationship issues

    At Men’s Health Clinics like FullMast, a doctor will ask questions about all these risk factors in order to determine the causes of your individual ED issues. While the main cause of erectile dysfunction is always considered, these factors may also play a role.

    Why does erectile dysfunction become more common as we age?

    While ED can strike at any age, statistics demonstrate a considerable increase in erectile dysfunction (ED) with increasing age: up to 75% of men who are 75 years of age or older suffer from erectile dysfunction. So what happens to men as they age? Why does it become more difficult to have an erection and why are erections not as hard or long-lasting as they once were?  Perhaps most importantly, can erectile dysfunction be prevented as we age and can the downward progression be altered? The answer to both these questions is a resounding “yes.”

    Many people I meet in my Vancouver and Toronto erectile dysfunction clinics ask me about the relationship between age and ED, stating that it was “so much simpler” when they were young. The truth is that the process of getting an erection was never simple for your body, even if it once occurred without much visible effort. A complex chain of biological processes must occur to produce an erection. This includes psychogenic, neurogenic, vascular, hormonal, and muscular events. An interruption to these processes can get in the way of getting an erection. As we age, there is an increased likelihood of us experiencing health issues related to erectile dysfunction, particularly heart health which is the main cause of erectile dysfunction. By keeping an eye on a man’s overall health, we can often prevent, minimize, or treat his erectile issues.

    Why does erectile dysfunction matter for Canadian men?

    Sexual health can play into a person’s personal health, self-esteem, and well-being. It can also have an influence on the health of romantic relationships. Evidence shows that many couples prefer sexual intercourse where the male partner has a fully erect penis. Also, many couples report missing the feelings of excitement and pleasure that come from this particular form of intercourse. They also report a happier sense of “coupling” when sexual intercourse is enjoyable for both partners. A man with a non-erect penis may still have an orgasm and ejaculate during sexual intercourse, but for many men and for many couples, this may not be enough.

    If you are a Canadian man seeking more information about the possible causes and treatments for your erectile dysfunction, contact us today for a free and fully confidential consultation.

  • Physical reasons for erectile dysfunction

    Physical reasons for erectile dysfunction

    Physical reasons

     

    Here is a calculator that is based on data from the European Journal of Urology.

    Learn about other causes of erectile dysfunction.

  • Could It Be Erectile Dysfunction My Guy No Longer Wants to Have Sex

    Could It Be Erectile Dysfunction My Guy No Longer Wants to Have Sex

    Erectile DysfunctionJulia, a 57-year-old woman presented to my clinic because her husband John of 20 years had lost interest in having sex with her which resulted in them living in a sexless marriage for the previous two years. Julie was experiencing a roller coaster of emotions thinking she was no longer desirable or that he was having an affair.

    She and her husband John never discussed the fact that their sex life had all but disappeared. She was very anxious and the situation was having a negative impact on their relationship and she worried about their future together. She loved him dearly and was still very much attracted to him.

    For many years, they enjoyed a happy and healthy relationship and sex life. They had the building blocks of a very successful marriage; good jobs, a lovely home wonderful children and a great sex life. Sex had always been the grout of their relationship and without it, she felt they were crumbling.

    Julia then recalled that toward the end of their sex life, John was having difficulty attaining an erection and began to lose his erection in the middle of their lovemaking. She remembers attributing this to her having gained a bit of weight during the menopausal time.

    Given the fact that he was losing his erections and his age of 60 it was likely that he was suffering from Erectile Dysfunction (ED) defined by the DSM-V (the bible of sexual disorders) as the inability to attain and maintain an erection adequate for penetrative sex.

    Erectile dysfunction is common and treatable

    ED is very common and may affect men at any age although it is more common in the later years. It is not uncommon for men to be embarrassed and stressed by ED as this strikes directly at their manhood. It may affect a man’s sexual self-esteem and is a common contributor to relationship issues. For these reasons, it is often difficult for men to discuss ED with their partners and/or their doctors.

    Good hard erections are about blood flow. Extra weight especially abdominal weight may increase the risk of ED as will alcohol and certain health conditions like diabetes and medications. It is vital that men speak to their doctors about ED as it may be a risk factor for heart disease and is called the “canary in the coal mine. “ I encouraged Julia to have a conversation with her husband about ED as a health condition.

    It would be important for him to speak to his doctor about it because many times, treating an underlying condition may reverse erectile dysfunction and if that did not do the trick then medications such as PDE5 inhibitors (Viagra, Cialis, Levitra, Staxyn), vacuum pumps, injections, pellets and/or SONICWAVE™ an innovative new therapy might.

    Julia felt equipped to have a dialogue with her husband and she realized this was important for them to address together. “Silent no more!” she proclaimed as she left my office armed with new health information.

    Written by Maureen McGrath