Mitigating the Aging Process
So I’ve certainly heard the phrase, “If you don’t use it, you lose it.” Is there any truth to that, especially in regards to ED?
Well, as terrifying as it is, that’s partially true. There’s a combination of factors. There’s a decrease in what’s called “functional penile length.” This is a stretch of tough fascial layer; connective tissue of the penis that tends to retract over time, if it’s not engorged.
Now this loss is fairly minimal, so no need to freak out just yet. But over time, unfortunately for us guys, our waist circumference increases. As our waist circumference increases that extra adipose tissue overlying the root or the base of the penis actually decreases the amount of functional penile length that we have available to penetrate our partners. That can be frustrating as well.
So the best thing that you can do for all of this is keep on using it and keep on being active, maintaining an active lifestyle and trying to reduce that waist circumference, trying to keep that blood flowing to the penis. That activity with the penis keeps that tissue healthy.
It’s a normal cycling. Those nocturnal erections, or “morning wood” help with that. That’s the body’s way of doing it. But you can take matters into your own hands, so to speak.
Why ED symptoms increase with age
As we age we tend to accrue medical comorbidities, those medical problems; things like hypertension, obesity, coronary artery disease, decreased cardiovascular fitness. But also what tends to happen as we age is our serum testosterone level tends to decrease.
Testosterone is vitally important for the function of the penis, not only as I mentioned for that arousal, that libido, that limbic system component of desire and erectile functions, but also that lining of the big vein of the penis, the endothelium of the corpora cavernosa is dependent upon testosterone. Otherwise it tends to atrophy and just not fill with blood as much.
So current guidelines recommend the initial evaluation of patients with ED include a serum testosterone. This is something that I encourage you to discuss with your doctor. He may do penile tumescence testing or serum testosterone measurement. But just have that conversation because that’s something that won’t get better if you just wait it out.
Monitoring health at different ages
In your 20’s your hormones are doing really well. A lot of times your body fat is not as high as it is as someone in their 40s or 50s. Maybe you can get away with eating a lot of junk food and not gain weight or feel bad in the morning. Maybe you can drink a lot of alcohol and not have a bad hangover. Once you get into the age of around late 30s and 40s, going out all night is not really an option where you can’t go out, go to the bar, drink all night, and then perform well at work the next day.
There’s different goals for everybody at different ages, so once you get into the later 30s we start looking at your testosterone levels and we start to discuss what can we do to help optimize your testosterone.
We look at the way people sleep, their diet—are they eating a lot of highly inflammatory foods, high sugar-containing foods, are they drinking sodas, are they smoking, are they drinking too much alcohol?
Their exercise patterns—are they lifting weights, are they getting out to do cardiovascular exercises, are they walking enough?
Measuring ED and health for different age groups
We like to track a lot of things with our clients with different kinds of wearable technologies. So we’ll look at stress scores, looking at their heart rate variability. If you have a low heart rate variability, that means you’re going to have probably less chances of living a long time.
So we try to increase the heart rate variability by doing things like meditation, increasing their sleep and exercise, and just getting outside in nature. Once you get over 40, things start to change. We look at people’s hormones, hormones like DHEA and testosterone, estrogen and progesterone in women.
We also look at bone mass. We get things like DEXA scans where we’re looking at body fat composition and their bone mass. We also really look into their sleep because as we get older we see that people really don’t get adequate amounts of deep sleep and REM sleep. So it’s a whole different way of looking at things.
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