No personal information this time, some things are private. However, as a physician we are often faced with questions about sexual function, or more commonly, lack of sexual function- either desire or performance. Many things can result in loss of Libido or performance; stress, not enough sleep, depression, being worn out at the end of a busy and hectic day, and poor nutrition. We all know the double-edged sword of alcohol consumption- increased desire, but decreased ability. Men are bombarded with advertisements about low testosterone and/or advertisements for Erectile Dysfunction (ED) drugs such as Viagra. Most of the ED prescription drugs work by increasing nitric oxide, a vasodilator, thus resulting in an erection. Of course, the vasodilation, if profound (such as if someone is on nitrates), can result in low blood pressure which combined with the increased physical activity involved can result in a heart attack. In the case of someone who has known coronary artery or peripheral vascular disease, or is a smoker, a workup for anatomic causes may be warranted prior to other treatments.
There are natural supplements such as Arginine, the precursor of nitric oxide, that can accomplish a similar result in terms of improved blood flow to the ‘vital’ organ and are safe. While it is true that a man’s testosterone level may decrease with age, the actual number of otherwise healthy men with clinically low testosterone is relatively uncommon. Taking exogenous testosterone if levels are already in a normal range is questionable and potentially risky, even increasing the risk of a heart attack.
However, there are natural ways to support testosterone production, metabolism and response that can be beneficial:
- Whole grains
- Brown rice
- Sweet potatoes
- Vitamin D
Seriously, oysters (like eggs) have cholesterol which is actually necessary for production of all sex hormones including testosterone. Yes I said it. Eating some cholesterol from a good source is necessary.
These foods and supplements are safe, available without a prescription and a lot less expensive than ED drugs. In addition to proper nutrition and use of supplements, exercise is a great way to improve both desire and sexual performance. However, after extreme exercise you may be so tired and loaded with endogenous endorphins you are happy to just sleep. In addition to feeling better about yourself and your physical appearance, exercise promotes a sense of well-being through release of various hormones and leads to increased sexual desire and activity. Equally as important, getting adequate sleep, reducing stress and distractions are all beneficial ways to improve your sex life.
Here is to a healthy sex life!