MEN’S SEXUAL HEALTH

Sexual health is an important part of human development. For many men, the desire for sex typically starts around puberty and continues well into their golden years. Optimal sexual health typically includes the desire to have sex, and the ability to have any enjoy sex with their partners. When any part of the sexual experience is disrupted, this can have last effects, not only on one’s sexual health, but emotional and psychological health and well-being as well.

 

SEXUAL DYSFUNCTION

Sexual dysfunction is any physical or psychological problem that affects your ability to have a sexually satisfying relationship with your partner. There are several types of sexual dysfunction in men, some of which include: Erectile dysfunction, premature ejaculation, and low libido (low desire for sex). Male sexual dysfunction is common and can affect men of any age; however, it is most common as men age. Fortunately, there are treatments available that may help men suffering from sexual dysfunction.

To understand male sexual dysfunction, it is important to review the 4 phases of sexual function to better help identify some of its causes:

 

Phase 1 – Desire Phase: The desire phase can typically last minutes to hours and consists of increased blood flow to the genitals. Other bodily responses are heightened as well, including increase in muscle tension, and physiologically raised heart rate and breathing.

Phase 2 – Arousal Phase: During this phase, the changes occurring from phase 1 are heightened and intensified, including breathing rate, heart rate, and blood pressure. Changes typically occur in the testicles and muscle spasms may begin in the feet, face, and hands. This phase typically takes you to the brink of orgasm and is considered the longest phase of the four.

Phase 3 – Orgasm Phase: This phase includes the peak or climax of the sexual response cycle and is generally the shortest lasting (usually only a few seconds). During the climax (orgasm), involuntary muscle contractions occur, as well as heightened blood pressure, heart rate, and respirations, as there is a release of sexual tension. A flush may appear over the entire body as a result of having an orgasm.

Phase 4 – Resolution Phase: During the resolution phase, the body slowly returns to normal levels of functioning. This phase is usually marked by a general sense of well-being and often fatigue.

ERECTILE DYSFUNCTION

Erectile dysfunction (ED) is the inability to attain or maintain an erection firm enough to have sexual intercourse. ED typically occurs in phase 2 (arousal phase) of the sexual phase experience, where there may be a desire to have sex; however, the arousal to engage in sex is disrupted. Erectile dysfunction is the most common form of sexual dysfunction in men, with estimates of about 1 in 10 men experiencing erectile dysfunction on a long-term basis. Occasional ED that occurs less than 20 percent of the time is not uncommon, and usually is due to stress. However, erectile dysfunction that occurs more than 50 percent of the time and is persistent typically signals an underlying problem that should be treated.

Erectile dysfunction can affect men of any age; however, it is most common in older men. Approximately, 40% of men in their forties and nearly 70% of men in their sixties are affected by ED. Several causes can contribute to ED, including metabolic disorders, mood disorders, chronic illnesses, poor dietary habits, and substance abuse. For many men with ED, it can be a very defeating and debilitating condition. Erectile dysfunction can affect one’s self-esteem, masculinity, and sense of self-worth.

ERECTILE DYSFUCNTION CAUSES

Having an erection is caused by a physiological process that consists of increased blood flow through the penile arteries to the relaxed penis upon arousal. The result of increased blood flow to the penis causes the penis to erect (grow) more firm and rigid. When there is blockage of blood flow to the penis, this usually results in erectile dysfunction. There are many causes of ED, and they can include both physical, behaviorally, or emotional causes. Common causes include:

• Cardiovascular disease (heart disease, atherosclerosis)
• High blood pressure
• High cholesterol
• Obesity
• Low testosterone levels
• Advanced age
• Kidney disease
• Mood disorders (depression, anxiety, stress)
• Relationship problems
• Sleep problems
• Some prescriptions medications (i.e. blood pressure medications, antidepressants)
• Substance use or abuse (including alcohol, cigarettes, street drugs)
• Other chronic health conditions (such as Parkinson’s disease or multiple sclerosis)
• Peyronie’s disease (development of scar tissue in the penis)
• Pelvic injuries or surgeries

 

EMBODIED WELLNESS’S APPROACH

At Embodied Wellness, we can help uncover the root cause of your ED problems and may be able to provide treatments that allow you to experience a fulfilling sex life once again! We understand that although erectile dysfunction is a common problem for many men as they age, the physical, emotional, and psychological symptoms that accompany ED does not need to be. At Embodied Wellness, we work in understanding your goals and preferences regarding treatment. We want to understand from you your vision of improved sexual health and well-being, so that we may partner with you in achieving your goals.

Our process typically starts with a thorough health evaluation on your first visit with us to provide foundational history regarding your sexual health concerns. We order comprehensive bloodwork to look at your hormone levels and other key markers to support your treatments. We also supplement our services when appropriate with holistic medications and other therapeutic treatments that compliment your values and can potentially assist in optimizing treatment outcomes. Some of these services may include hormone replacement therapy, nutritional and lifestyle support, your personal priorities, herbal supplementation, and more!

 

ERECTILE DYSFUNCTION DIAGNOSIS AND TESTS

At Embodied Wellness, we understand that the cause of ED can be multifactorial. Therefore, we conduct a thorough evaluation of your medical history, recommend physical examinations, and order pertinent laboratory tests to target the root cause of sexual dysfunction. Some of the comprehensive examinations and tests conducted include:

Psychosocial History-Taking

As part of obtaining information regarding your medical history in treating your ED, your provider will ask pertinent questions about your sexual, psychiatric, and social history, as well as lifestyle habits. Some of these questions may include:

• How long have you been experiencing erectile dysfunction? Didi this occur suddenly or was it a gradual process?
• What are the specific circumstances around your ED issues?
• Have you had any problems with sexual desire, ejaculation, or achieving an orgasm?
• How often or frequently do you have sex, and has there been any changes recently?
• Have you been experiencing a lot of stress lately, or changes in mood?
• What medications are you currently taking? Are they prescript or nonprescription drugs?

Physical Examination

A physical examination by your primary care provider will be recommended as one of the first steps to rule out any physical causes of sexual dysfunction. The physical exam may consist of a general check, as well as an examination of your testicles and penis to rule out any underlying abnormalities. Based on your age and risk factors, a rectal exam may be needed to check your prostate.

Laboratory Testing

After your medical history is reviewed and data collection s complete, your provider will order comprehensive blood work to further help diagnose ED. Some of these blood work may include:

Complete Blood Count (CBC):

This set of blood count will help your provider determine of anemia is present. Anemia is caused by low red blood cell count, which can manifest into symptoms of fatigue and low energy, which may affect ED.

Kidney and Liver Function Tests:

These laboratory markers may help your provider determine if ED is caused by abnormalities in liver and kidney functioning.

Lipid Profile:

This blood test helps determine the levels of lipids (fats) in your body. Higher levels of lipids are associated with cardiovascular problems, like atherosclerosis (hardening of the arteries), which can restrict blood flow to the penis, causing ED.

Thyroid Function Tests:

Thyroid hormones help regulate the production of sex hormones, among other functions. Deficiencies in thyroid hormones may help explain the cause of ED.

Testosterone and other Hormone Levels:

Some men who have ED have low testosterone levels and other hormonal abnormalities. Testosterone and/or prolactin levels may be measured to determine if any contributing abnormalities may be present which may affect ED.

 

ERECTILE DYSFUNCTION TREATMENT

At Embodied Wellness, we consider your goals and preferences in formulating a treatment plan that is right for you We offer holistic, modern approaches to medically treating erectile dysfunction, including PDE5 inhibitors, bioidentical hormone replacement therapy, peptides, herbal supplements, and more!

 

 

Tadalafil or Sildenafil

Tadalafil (Brand name, Cialis) and Sildenafil (brand name, Viagra) are considered first line treatments for correcting ED when medications are needed. They are in a class of drugs called PDE5 inhibitors. They work by increasing the effects of nitric oxide, allowing for increased blood flow to the penis, and inhibit the PDE5 enzyme, allowing for more sustained erections. These effects translate to increased sexual desire, arousal, and satisfaction. Although Tadalafil and Sildenafil help treat erectile dysfunction, they do not cause an erection alone when taken. They still require for physical or mental stimulation for arousal. Both Tadalafil and Sildenafil have proven efficacy in treating ED. They should be taken 1-2 hours before sexual activity and can last anywhere from 5 – 36 hours depending on the medication.

 

Bioidentical Hormone Replacement therapies (BHRT) for Men

For some men with low sex hormone levels, BHRT hormones may be suitable for treating sexual dysfunction. Bioidentical hormones are plant-based and are closely identical molecularly to the hormones your body naturally produces. BHRT brings hormonal balance back to your body and can treat various forms of sexual dysfunction, including erectile dysfunction and lack of sexual libido.

 

The two main types of bio-hormone therapies include:

 

Testosterone Replacement Therapy: Testosterone replacement therapy (TRT) is the gold-standard and mainstay treatment for men with clinically low testosterone levels for treating sexual dysfunction, such as erectile dysfunction. TRT helps increase testosterone levels back to youthful levels of functioning. Men who begin supplementing with TRT hormones notice immediate improvements in their symptoms, including enhanced sex drive, erectile functioning, improved focus, increased muscle strength and physical performance, as well as improved mood and energy. However, it is important to note that not all men will qualify for testosterone replacement therapy. Consult with your provider to learn if TRT is right for you.

DHEA: DHEA may be a suitable option for men looking for alternative ways to naturally boost testosterone levels, or for men who cannot use TRT hormones for other reasons. DHEA is a prohormone that converts sex hormones, like testosterone, in the body for men. They are naturally produced in the adrenal glands, as well as small amounts in a man’s testicles, and therefore the body naturally recognizes, and thus may respond to this form of treatment. One of the benefits of DHEA is that it can help boosts testosterone levels without slowing the production of testosterone a man’s body naturally produces, making this a more favored choice by some men. DHEA may help improve sexual libido, promote weight loss, increase muscle mass, and aid in immune support.

 

Peptide Therapy for Men

Peptides are naturally found in our own bodies. They are safe and effective, and mimic the molecular structure and function our own bodies use and produce. Peptides may act as hormones or chemical messengers and are used to treat a variety of health ailments, including increasing sexual desire/libido, promoting weight loss, and improving sleep, mood, and mental clarity. They may be used alone or in combination with BHRT for optimal results.

When it comes to sexual health, peptides, such as Bremelanotide, target certain receptors in your body that are responsible for improving sexual function, including increased sexual libido and induced erections. Bremelanotide works on the central nervous system and studies show that about 80% of men who do not respond to PDE5 inhibitors, like Viagra, respond well to Bremelanotide. This peptide hormone comes in either a simple injectable or a nasal spray and is easy to self-administer. It can be used as monotherapy or in conjunction with bioidentical hormone replacement therapies to enhance sexual experiences.

 

Nutritional & Lifestyle Plans

Did you know that certain foods you eat can either improve or worsen erectile functioning? Switching to an anti-inflammatory diet with foods packed with antioxidants help reduce inflammation and oxidative stress, repairing cellular function and optimizing health. Furthermore, a diet that limits saturated fats and cholesterol, prevents hardening of the arteries that can lead to atherosclerosis and reduced blood flow to the penis. At Embodied Wellness, we recommend making nutritional and lifestyle changes to support and improve erectile dysfunction.

Additionally, we may recommend herbal supplements that can serve as a natural and holistic alternative to improving symptoms of sexual dysfunction. Such herbs, like Maca, Ginkgo, or Yohimbe just to name a few, have all been implicated in treating erectile dysfunction and other symptoms of sexual dysfunction.

 

Sex Therapist

Working with a therapist who specializes in treating various forms of sexual dysfunction may be suitable for some men in discovering the root cause to sexual problems when holistic medications and supplements are not enough, or if medical causes are not the cause. We may also recommend general psychotherapy if there are other issues and concerns that impact your sexual function. These services may serve to complement your desire for improving your sexual health with the services we provide at Embodied Wellness. Talk to your provider at Embodied Wellness to determine if seeking therapy is right for you.

 

If you are a man suffering from erectile dysfunction, or other similar symptoms of sexual dysfunction, you are not alone. Learn how Embodied Wellness is revolutionizing the way we address and treat men’s sexual health. Schedule your free consultation today.