Posted February 13, 2009

No need to whisper

Talking and treating erectile dysfunction

The conversation about male sexual dysfunction has grown from a whisper to a roar. With celebrity confessions from Bob Dole to Mike Ditka, erectile dysfunction, or ED, is no longer hush-hush, as more men are talking more openly. Inescapable commercials convey that help in the bedroom is just a prescription away. And while some 35 million men in this country have found a renewed sex life thanks to the “little blue pill,” Temple urologist Jack Mydlo says men can improve their performance without a visit to the doctor or a drugstore.

“The last thing I want them to do is take a pill and jump in bed, because a certain part of the mechanism for erections is psychological. They have to be in the right mood, with the right person and take care of themselves,” said Mydlo, M.D., professor and chair of the Department of Urology at the School of Medicine.

Surprisingly, a good percentage of men who seek medical help aren’t even in a relationship.

“About 30 percent of the men who have a penile prosthesis don’t even have a partner,” said Mydlo. “They’re putting the cart before the horse, so to speak, and

Jack Mydlo
Photo by Joseph V. Labolito/Temple University
Temple urologist Jack Mydlo says men can improve their performance without medication or a prosthesis.

think they’ll get a partner once they have the implant.”

Instead, Mydlo offers simple tips this Valentine’s Day to turn a man’s potency from terrible to terrific.

Stop smoking

Diabetes and high blood pressure restrict blood flow to the penis, leading to erectile dysfunction. But if you can rule those conditions out as causes of ED, the next culprit in line is cigarettes. “The number one thing we can do to stop erectile dysfunction is to stop smoking. It’s the number one environmental cause of ED in our society,” says Mydlo. Again, smoking restricts blood flow. The catch? Don’t expect better erections the minute you stop lighting up. He says it takes 12 to 24 months for better function once you quit the habit.

Control cholesterol

Cholesterol is a trigger of sorts for ED. “Men with a cholesterol level of 240 or higher have almost a twofold increase of ED compared to a man who has lower cholesterol numbers,” says Mydlo. That’s because high levels of cholesterol lead to plaque buildup in tubes (corpa cavernosa) in the penis and arteries, which can greatly reduce blood flow. And no blood flow means no erection. So start exercising and check with your doctor about cholesterol-lowering medications.

Cut back on fat

Obesity is to blame not only for men with self-esteem issues involving their appearance, but also their performance. “Adipose tissue in body fat converts testosterone to estrogen, and lower levels of testosterone can make it difficult for a man to achieve an erection, no matter how many pills they take,” says Mydlo.

Losing weight will improve the testosterone to estrogen ratio, which may improve sex drive, or libido, as well as erections. It also decreases cholesterol, which will help improve blood flow.

For some of the 18 million men who have erectile dysfunction, these three tips may do the trick. For others, Mydlo suggests a visit to a urologist to go over options, ranging from pumps to implants to pills, like Viagra, Cialis and Levitra. There is one factor, though, that Mydlo can’t help with but Cupid probably can: finding the right mate.

“They believe if they don’t have good sexual function, who is going to want them? But the truth is, if you don’t have a mental connection with your partner, everything will be for naught.”