Sex Life and Long Life

Men, take note: Your penis might be telling you something.

Two studies published last week reveal such a correlation between erectile dysfunction and chronic diseases that doctors think the diagnosis of poor sexual health should warrant screening for a serious, underlying or emerging illness.

The studies might very well raise the profile of erectile dysfunction, or ED, from a trivial disease of inconvenience treatable with a little blue pill to a warning sign from below that can save your life.

Researchers also confirmed that ED is less about old age and more about poor health, with men as young as age 20 reporting erection problems attributed to obesity or inactivity.

Get up, exercise

One study, led by Elizabeth Selvin of Johns Hopkins School of Public Health, published in the American Journal of Medicine, found that nearly 20 percent of the 2,100 men participating in a health and nutrition survey had ED, often as a result of poor physical health or inactivity. That would translate to 18 million American men nationwide.

In this study, over 50 percent of subjects with diabetes and 44 percent of those with high blood pressure had trouble achieving an erection either "sometimes" or "always." Ditto for 22 percent of obese men and 26 percent of subjects who reported such sedentary behavior as watching three or more hours of television per day. It didn't matter if they were ogling The Golden Girls or Desperate Housewives.

Conversely, only 10 percent of physically active men ages 20 and up reported sexual problems. One take-home message from this study is that you have to get off the couch if you want to move into the bedroom. Selvin said that her group's research strongly suggests that lifestyle changes can prevent the onset of ED.

Cause and effect and cause

A second paper, led by Rosemary Basson of the University of British Columbia, published in The Lancet, details how sexual dysfunction can herald a chronic disease. The authors reviewed scores of health studies from the past six years and found cases in which ED predated the diagnosis of coronary heart disease more than half the time.

Similarly, one case they reviewed revealed that otherwise healthy men with erectile dysfunction were twice as likely to develop heart problems at the end of the one-year study.

The take-home message in this study is that any man with ED should be screened regularly for heart disease and diabetes. The authors said that sexual health needed to be part of the doctor-patient dialogue. Men are often too embarrassed to mention the topic with their doctor; or they might associate ED with total impotence and not feel they have a problem if they can occasionally achieve an erection; or they might view ED as a natural part of getting older and thus not see it as a health issue. Doctors need to initiate the discussion if the patient does not.

The Viagra revolution

Viagra and similar prescription medications have revolutionized the treatment of ED. They work, despite a few pesky side effects such as blurred vision and, in rare cases, temporary blindness. Guys don't see to care.

As the Viagra website notes, however, this pill is only one of many treatments for ED. The treatment depends on the cause. Sometimes the cause is mental and can be treated with psychotherapy. Other times the cause is chronic fatigue or from certain medications. This is why a doctor's diagnosis is needed to determine the appropriate remedy.

Treating ED with a pill, however, does nothing prevent or ameliorate a chronic disease. Yes, you're having sex, and that's nice for now; but you have to stay healthy to continue to have sex, even with Viagra. That part only comes with improvements in diet and exercise.

The Hopkins study found that 30 percent of men over age 70 did not have ED. That could be you or your partner someday.

Christopher Wanjek is the author of the books “Bad Medicine” and “Food At Work.” Got a question about Bad Medicine? Email Wanjek. If it’s really bad, he just might answer it in a future column. Bad Medicine appears each Tuesday on LIveScience.

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