Erectile Dysfunction

In the event you think you are the only man with an erectile dysfunction situation, think again. Bob Dole opened Pandora's Box when he candidly spoke about it on national television.

Viagra (generic name Sildenafil) was approved in March, 1998 and sales reached ONE BILLION in the first year. It would appear we are witnessing the era of pharmaceutical companies entering the "anti-aging" arena. That is good. One often hears the term "a boner" when discussing erections. Please know that there are no bones in your penis!

Viagra was originally a medication for high blood pressure. We learn the most from our mistakes. Viagra turned out to be quite poor for managing high blood pressure. But, something very wonderful happened -- men had an erection.

Viagra works by allowing the muscles of your penis to relax, then allowing the dorsal vein to become engorged with blood. Wala, an erection has been achieved.

The medication also BLOCKS an enzyme that PREVENTS erections from happening. Remember the words Nitric Oxide which was awarded molecule of the year in Science Magazine, 1992. Nitric Oxide is crucial for erections! And there are many ways to increase Nitric Oxide.

Although I do write many prescriptions for erectile dysfunction medications, I am passionately curious about the cause(s). Discovering the causes involves thinking in a multifaceted way. The cause may be neurologic as there may be damage to the vagus nerve which often accompanies Diabetes, decreased blood flow as a result of obesity, clogged arteries, insufficient or deficient hormonal levels, etc. Some medications have a side effect of erectile dysfunction.

Regarding hormones, which is presently being reported in the media in an enormously complex and fear based way, we may consider taking pause. Perhaps we have more to learn. Presently we have astounding lucid confusion regarding hormonal replacement for men and women.

The fourth generation European endocrinologists who further trained me reported that Great Grandpapa extracted bull testicles and implanted them in aging males in the 1910s. He was curious to observe if replacement of a waning hormone secondary to "natural aging" had life enhancing properties!

Did you know that we are learning most men today have one half the amount of viable sperm as their Grandfathers? Did you know that Testosterone is a steroid, and so is Cholesterol and Estrogen? Did you know that there have been reports of Floridian male alligators being born with questionable female genitalia? Did you know that our environment is full of xenoestrogenic (synthetic Estrogens), so you are probably full of Estrogen? Did you know that it is quite common to have difficulty achieving and maintaining an erection with a new partner?

There is much to learn. Learning requires neuronal flexibility and the ability to change, the ability to unlearn and relearn. As the Brown Medical School students were told at graduation, "fifty percent of what we taught you was wrong, we just don't know which fifty percent."

Sex is important. There is a French saying, "many problems are solved on the pillow." Upon climax, there are many hormones and brain chemicals released. One is called Oxytocin which enhances a sense of closeness. That is one reason women often believe you are the one. Oops. Originally, the release of 20 mgs of Oxytocin upon climax confused me. Oxytocin is the hormone that women release to contract their uterus during childbirth. Then the European endocrinologists explained that Oxytocin makes all the other brain chemicals (neurotransmitters) work better. This is good because we have thousands of brain chemicals and can presently manipulate seven with medication.

Endorphins (a feel good upper in the brain) are also released -- which is one reason for the immediately falling asleep thing. Then there is the fact that most humans require twenty two hugs a day for sustenance. So as I already said, sex is important.

I see sixty something year old men pushing their baby in a stroller on the boardwalk. They did not want a baby. They wanted sex. The "new woman" was very willing and thought he was fascinating in every way, including his hard earned acquisitions. My thoughts are that some of this could have been prevented if your previous woman who was menopausal had been tendered differently.

Has a physician tested your Free Testosterone, IGF-1 (Somatocedin C), Sex Hormone Binding Globulin, Insulin, HgbA1C, Triglycerides, Estradiol, Estrone, Dihydrotestosterone, Liver Function, etc.? Are you on a medication that has a side effect of ED?

What physician is measuring this in our elite athletes? There is bad boy Testosterone and Bioidentical Testosterone. And, by the way, taking a few shots of Human Growth Hormone does nothing. This elite athlete situation has me confused and curious regarding what the rules are, and if the those decisions are being made by physicians. If there are physicians involved, do they understand what to order to determine if someone is abusing hormones. I have many questions.

I abide by the law so I am not taking sides here. I am merely passionately curious and confused the way these issues are being presented by the media. I would like to speak with Roger Clemens people. The Mitchell Report was fascinating.

Updated by Roberta Foss-Morgan, D.O. - March 5, 2008