We all know how the commercials go: 1) a pair of bathtubs face the sunset (which we have so many questions about), 2) a deep voice-over warns us about erectile dysfunction’s ability to ruin the perfect moment, 3) you pray that you won’t end up a slave to the blue pill. But you don’t have to be a silver fox like the ones on TV to suffer from erectile dysfunction (ED). In fact, it’s more common in younger men than you’d expect.
A study from 2013 found that 1-in-4 men seeking treatment for ED were under the age of 40.1 We're guessing you don’t want to be on the wrong side of that statistic, so keep reading – we’ve gathered some valuable information about how to avoid and/or counteract its onset.
What is erectile dysfunction?
Let's start with the basics. ED is defined as persistent difficulty getting and maintaining an erection, sometimes accompanied with reduced sexual desire. While this may seem like just a nuisance on the surface, its implications go far beyond that; over the years, ED has become an important indicator of men’s overall heart health.1 Considering erections are caused by the dilation of blood vessels in the penis, it stands to reason that a strong heart and clear arteries are essential for men’s sexual performance.
Causes of ED, however, aren’t limited to cardiovascular problems. Sources can range from chronic inflammation to hormone imbalance to mineral deficiencies; chances are that if you’re suffering from ED, something under the surface is amiss. Keeping an eye on related biomarkers can therefore help to stop the progression from occasional mishaps to a clinical diagnosis.
Biomarkers related to erectile dysfunction
As blood cholesterol levels rise, cholesterol continuously gets deposited on arterial walls, forming a plaque that causes blood flow to slow down or stop altogether. When this happens in the penis, erection strength and duration suffer.
Despite popular belief, having a normal BMI or trim waistline will not shield you from ED; seemingly perfectly healthy people can have high cholesterol, especially if it runs in the family. Moral of the story: keep an eye on your cholesterol!
HDL is commonly known as "the good cholesterol" because it acts as a street sweeper, picking up bits of deposited cholesterol from arteries and bringing it back to the liver for recycling. High HDL, therefore, helps to reverse the process outlined in the above paragraph; in fact, researchers agree that high HDL lowers your risk for ED.2, 3
If you had a hunch that ED was somehow connected to a testosterone imbalance, you were right: research shows that men with low levels of circulating free T were more likely to have ED than those with normal levels.4 Generally speaking, testosterone is important for proper muscle function in the penis (no, your penis is not a muscle itself), so even if you don’t have ED, low free T can impair your ability to get and maintain erections. If you think you are toeing the ED line, keep an eye on your free T levels and eat a variety of magnesium-rich foods to increase your levels safely.5
hsCRP (high-sensitivity C-Reactive Protein) is released by the liver during periods of systemic (full-body) inflammation, which can be caused by a host of issue, from being overweight to overexertion. And since inflammation can negatively affect blood flow to areas of the body, it’s no surprise that multiple studies have found high CRP levels to be associated with an increased risk of ED.2, 6, 7 So, if your hsCRP levels are above optimal, they may be playing a role in the development of ED.
New research shows that ED is most common in those with low magnesium levels.8 And while the study was specific to elderly men with chronic kidney disease, the implications are much more far-reaching: magnesium plays essential roles in inflammation, endothelial (blood vessel lining) function and testosterone production.9, 5 Sure, the evidence is still fresh, but optimizing your Mg levels can’t hurt.
Don't let erectile dysfunction keep you down
If you’re still having male performance issues despite relatively normal biomarker levels, pivot your focus to your lifestyle. Have you been overly stressed? Do you use tobacco, alcohol, or recreational drugs? It can be easy to overlook habits like these and their relation to seemingly random health issues.
But remember—your blood doesn’t lie! Staying ahead of these biomarkers, rather than reacting to them once they become suboptimal, is important for warding off ED. Using statins to lower cholesterol, for example, can result in lower free T levels—not much help on the ED front.10 If you keep an eye on related biomarkers and adjust your diet and lifestyle proactively, you can get to the root of the problem and keep ED from interfering with your life in the first place.
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References Capogrosso, Paolo, et al. "One patient out of four with newly diagnosed erectile dysfunction is a young man—worrisome picture from the everyday clinical practice." The journal of sexual medicine 10.7 (2013): 1833-1841.
 Eaton, C. B., et al. "A retrospective study of the relationship between biomarkers of atherosclerosis and erectile dysfunction in 988 men." International journal of impotence research 19.2 (2007): 218.
 Wei, Ming, et al. "Total cholesterol and high density lipoprotein cholesterol as important predictors of erectile dysfunction." American journal of epidemiology 140.10 (1994): 930-937.
 Aversa, A., et al. "Androgens and penile erection: evidence for a direct relationship between free testosterone and cavernous vasodilation in men with erectile dysfunction." Clinical endocrinology 53.4 (2000): 517-522.
 Cinar, Vedat, et al. "Effects of magnesium supplementation on testosterone levels of athletes and sedentary subjects at rest and after exhaustion." Biological trace element research 140.1 (2011): 18-23.
 Esposito, Katherine, et al. "High proportions of erectile dysfunction in men with the metabolic syndrome." Diabetes Care 28.5 (2005): 1201-1203.
 Bank, A. J., et al. "Relation of C-reactive protein and other cardiovascular risk factors to penile vascular disease in men with erectile dysfunction." International Journal of Impotence Research 15.4 (2003): 231.
 Toprak, Omer, et al. "The impact of hypomagnesemia on erectile dysfunction in elderly, non-diabetic, stage 3 and 4 chronic kidney disease patients: a prospective cross-sectional study." Clinical Interventions in Aging 12 (2017): 437.
 Fatuzzo, Pasquale, Luca Zanoli, and Viviana Scollo. "Letter regarding the article “the impact of hypomagnesemia on erectile dysfunction in elderly, non-diabetic, stage 3 and 4 chronic kidney disease patients: a prospective cross-sectional study”." Clinical Interventions in Aging 12 (2017): 741.
 de Keyser, Catherine E., et al. "Use of statins is associated with lower serum total and non-sex hormone-binding globulin-bound testosterone levels in male participants of the Rotterdam Study." European Journal of Endocrinology 173.2 (2015): 155-165.