Erectile Dysfunction: A Warning Sign of Systemic Issues?
Beyond Sexual Health
Dear friends,
I think I won’t spend more time for this particular segment to bring you information on erectile dysfunction. I am just collecting information and highlighting parts of the conversation (and perhaps with some errors as there are terms I can not understand), but here is the best I could do to engage your curiosity.
Erectile Dysfunction (ED): A Warning Sign of Systemic Issues?
Beyond Sexual Health: Challenge the Perception of ED Solely as a Sexual Concern
Erectile dysfunction is often viewed solely as a sexual health issue, but Dr Nathan Bryan suggests it may be an early warning sign of broader systemic problems. As he states, "If you have vascular dysfunction in the sex organs, you have vascular dysfunction in the heart, the brain, the liver, the kidneys, it's a systemic disease." I have listen to this podcast many, many times and exploring the connection between ED and nitric oxide deficiency, seems a worthwhile activity as it may help to reframe the understanding of this condition. It certainly did for me.
Nitric Oxide and Erectile Function: The Critical Link
Nitric oxide plays a crucial role in achieving and maintaining erections in both men and women. The Dr Bryan explains: "When you lose the ability to produce nitric oxide, you fail to get vasodilation, you don't get engorgement, and it's the fundamental basis for erectile dysfunction." This was a real eye opener for me. I had never looked into the detail and listening to this podcast has been a learning experience from beginning to end. It underscores the central importance of nitric oxide in sexual function. And he views this as a “Canary in the Coal Mine.” for all sorts of health problems.
Dr Bryan continues with the benefits of nitric oxide for women's sexual health, stating: "They need engorgement and erections as well. It's a clitoral erection instead of a penile erection, but it's the exact same the anatomy is a little bit different, the physiology is exactly the same."
Prevalence and Impact of Erectile Dysfunction
I was shocked to find that ED is a relatively common condition, affecting an estimated 30-50% of men over the age of 40. While it was once primarily associated with older age, the prevalence of ED has been increasing among younger men as well. This is concerning, as it may also signify a broader decline in overall cardiovascular health.
The impact of ED extends beyond the bedroom, as it can have significant psychological and emotional consequences. Men with ED may experience decreased self-esteem, relationship difficulties, and a diminished quality of life. Recognising ED as a potential harbinger of systemic issues is crucial for addressing the root cause and improving overall well-being. As Dr Bryan explains, it can be more complex for women than it is for men as in women it influences hormonal, emotional, psychologic, vascular physiological.
Underlying Causes of Erectile Dysfunction
Numerous factors can contribute to the development of ED, including:
Cardiovascular disease: As discussed, vascular dysfunction and poor blood flow can impair erectile function.
Diabetes: Diabetes-related nerve damage and microvascular complications can lead to ED.
Hormonal imbalances: Conditions like low testosterone or thyroid dysfunction can negatively impact sexual function.
Neurological disorders: Neurological conditions, such as multiple sclerosis or Parkinson's disease, can disrupt the neural pathways involved in erectile function.
Medications: Certain prescription drugs, including antidepressants, blood pressure medications, and chemotherapeutic agents, can have ED as a side effect.
Lifestyle factors: Smoking, excessive alcohol consumption, and obesity can all contribute to ED by impairing vascular and metabolic health. But, erectile disfunction is a symptom that leads to all of these so it is a classic chicken and the egg riddle.
Recognising ED as a Potential Cardiovascular "Canary in the coal mine"
Dr Bryan posits that ED could be an early indicator of underlying vascular dysfunction and potential cardiovascular risks. As Dr. Bryan states, "If you have vascular dysfunction in the sex organs, you have vascular dysfunction in the heart, the brain, the liver, the kidneys, it's a systemic disease." This perspective suggests that ED may serve as a "canary in the coal mine," prompting further investigation into the individual's overall cardiovascular health.
Addressing the Root Cause: The Importance of Investigating Underlying Health Issues
Given the potential link between ED and broader health concerns, Dr Nathan Bryan emphasises the importance of investigating and addressing any underlying issues contributing to nitric oxide deficiency. This may include dietary, lifestyle, or other factors that impact the body's ability to produce and utilise this critical molecule. This is not the complete discussion, but i think I grabbed the most important points he made:
“There are two primary pathways that make nitric oxide. One is an enzyme in the lining of the blood vessels that makes nitric oxide ( …) — some is genetical predisposition, with age that enzyme becomes dysfunctional but a lot of it is due to died and lifestyle. Poor dietary, sedentary lifestyle, render that enzyme dysfunctional . So we know how to correct that we know how to recoup the enzyme and restore the function - nitric oxide synthase - so it's in found the lining of the blood vessels, immune cells and neurones. I's part of the neuro-signalling and the action potentials by neurones and the cells signalling is called a retrograde messenger - that is how neutrons talk to one another.
There is a high concentration of nitric oxide synthase on the endothelial cells in fact it is the e basis for blood pressure lowering effects of deep breathing - that is why mouth breathing is so detrimental for mouth breathers - they fundamentally bypass a fundamental nitric oxide production cascade.
But if you have a dysfunctional enzyme in the endothelial cell that enzyme is dysfunctional the epithelial cells so you can do nasal breathing or deep breathing exercise but if we don't fix that enzyme and function you're not gonna get any nitro oxide produced when you do breathing exercise .
So that's what people failed recognises what's the enzymopathy in that enzyme then how do you fix it ? (…) Because that's literally the holy Grill and cardiovascular medicine and then the other is Ah Ah moment for most people - about 20 years ago we recognised that there's an interior salivate circuit - mechanism of action of certain dietary patterns with plant-based diet diet Mediterranean diet we're consuming a lot of inorganic nitrate and then this molecule is inert in humans - humans cannot process this molecule - we’re 100% dependent upon the bacteria so there's bacteria on the crypt of the metabolism nitrate into nitrate and nitric oxide so if you don't have the right oral Microbiome you can consume these vegetables but you don't get the nitric oxide benefits of it and here's where the problem comes in (…) Fluoride is causal of hypertension. So when you eradicate these essential commensal nitrate producing bacteria causes an increasing blood pressure. Fluoride in antiseptic kills the bacteria (…) most people are using fluoride toothpaste, fluoride municipal water. Fluoride as well as an antiseptic it's a neurotoxin and it kills your thyroid function.
Potential Benefits of Nitric Oxide Supplementation
Given these facts it seems to me important to investigate the potential benefits of nitric oxide supplementation, especially for individuals who may be non-responsive to traditional ED treatments. I found this article: Low-intensity extracorporeal shock wave therapy for erectile dysfunction: Myths and realities that may be helpful for those considering the various approaches, and Dr Bryan mentions another clinical trial where the researchers "took non-responders to PDE5 inhibition therapy... and those that were non-responsive, we actually made them responsive by giving them the nitric oxide."
This suggests that addressing the underlying nitric oxide deficiency could be a valuable approach for improving sexual function and overall cardiovascular health. As Dr. Bryan explains, "If you just improve nitric oxide production, all the downstream signalling aspects of that take care of itself. You generate nitric oxide, you activate cGMP [cyclic guanosine monophosphate], you increase cGMP, you get vasodilation, you get an erection."
Integrative Approach to Managing Erectile Dysfunction
Given the multifactorial nature of ED, a comprehensive, integrative approach is often required to address the condition effectively. This may involve:
Dietary modifications to increase nitrate-rich foods and support nitric oxide production
Regular exercise to improve vascular and metabolic health
Stress management techniques to address psychological factors
Addressing any underlying medical conditions, such as cardiovascular disease or diabetes
Consideration of nitric oxide-boosting supplements, if appropriate, under the guidance of a healthcare provider
By taking a holistic view of ED and its potential systemic implications, individuals can work with their healthcare team to develop a personalised management plan that addresses the root causes and supports overall cardiovascular and sexual health.
There seems to be a lot to nitric oxide than meets the eye and I will continue to delve deeper into this podcast as it is fascinating to me how much I am learning about our biology and functionality. I also found his 2018 book on Nitric Oxide. I am sure it is full of useful information. I will be ordering it myself. I like the cover very much.
As we can see Nitric Oxide may well be the miracle we need to deal with chronic diseases and all manner of conditions which may be an underlying indication we should pay attention to if afflicted by certain symptoms of which, ED may be one of.
I don’t know if you know, but for Viagra to work, it needs Nitric Oxide. If one is Nitric Oxide deficient, it won’t work. I think Dr Bryan mentions that it only works on 50% of men. So there is some food for thought there. Here is the interview in its completion as 10 hours of listening and transcribing is all I can handle for now. But I have no doubt that this will prove to be the single most important podcast I listened to this year.
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Read the next one? The Surprising Link Between Your Mouth and Your Heart
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Until next time,
Bee well,
Xanda
Thanks for an informative piece. I should note that the anti-androgens given to people with prostate cancer may (and often do) cause erectile dysfunction. Fortunately, many foods are rich in nitric oxide (e.g., garlic, nuts, beets, leafy green vegetables, citrus fruits, et al. Anyone battling prostate cancer should do a little dietary research.