madman
Super Moderator
Again everyone so caught up on T, DHT and estradiol LMFAO!
Much more involved than just having healthy hormones!
One of the top in the field love this guy!
Mulhall always breaks it down!
Listen closely as he hits the nail on the HEAD!
3:33-7:13
* if you look at men with ORGANIC ED we can talk about psychogenic ED a little later on if we have time but if you take men with ORGANIC ED PROBABLY 70% OF THEM ARE GOING TO HAVE A VASCULAR COMPONENT INFLOW OR OUTFLOW PROBLEMS and that includes men with diabetes, those high profile causes like medication induced or hormonal ED or Arteriogenic ED, radical pelvic surgery for example account for the vast minority of patients with erectile dysfunction and if you focus in on HORMONE PROBLEMS such as TESTOSTERONE that accounts for the VAST MINORITY of MEN with ERECTION PROBLEMS so the BULK of ED that's PHYSICALLY BASED is VASCULOGENIC as its called!
* the whole link between TESTOSTERONE and ERECTILE FUNCTION it's a WEAK LINK, it's not a POTENT ERECTO-GENIC HORMONE, it's CERTAINLY a LIBDO-GENIC HORMONE and an ORGASMO-GENIC HORMONE but if you take men who have got LOW TESTOSTERONE who have ERECTILE DYSFUNCTION and you treat them with T the AVERAGE CHANGE in ERECTILE FUNCTION is MINIMAL if you use the validated scores (the international index of erectile function scores) so the ELEVATION in those scores is MINIMAL so the CONTRIBUTION of T you DON'T NEED A LOT of T you need SOME you DON'T NEED A LOT of T for ERECTION FUNCTION!
Dr. John Mulhall doesn't just treat erectile dysfunction (ED), he's also on a global mission to demystify its causes, highlight its complexities, and offer an alternative to how we currently think about sexual health.
This is for you if you’re wondering: what can I do today to ensure better sexual health tomorrow? Even if it's good today, don't you want to ensure it'll be good in your later years? And if it's not where you want it to be today, perhaps you've not spoken to anyone about it yet - you're not alone here. There are answers out there and support to be given. But you've got to ask for it.
We cover:
* Exercise and erectile health - getting it up (your heart rate)
* Durability and frequency - it matters, but it should only matter to you
* Exogenous testosterone - risk of transference and its impact on fertility
* Premature ejaculation: lifelong vs. acquired - and what to do about each
* Navigating treatment options - pills, patches, and injectables and caution over the the ‘Wild West’ of supplements
* PDE5 inhibitors - how they work, their cardiovascular benefits, and their limitations
* The psychology behind ED - how placebos enter in and integrating psychological and medical approaches for effective treatment
* Emerging therapies - shockwave therapy, platelet-rich plasma, and penile botox injections - do they work?
Understanding the Link Between Exercise, Vascular Health, and Erectile Function: Key Insights from Dr. John Mulhall
For more insights, follow Dr. Mulhall on X (formerly Twitter) at @SaveYourSexLife.
Much more involved than just having healthy hormones!
One of the top in the field love this guy!
Mulhall always breaks it down!
Listen closely as he hits the nail on the HEAD!
3:33-7:13
* if you look at men with ORGANIC ED we can talk about psychogenic ED a little later on if we have time but if you take men with ORGANIC ED PROBABLY 70% OF THEM ARE GOING TO HAVE A VASCULAR COMPONENT INFLOW OR OUTFLOW PROBLEMS and that includes men with diabetes, those high profile causes like medication induced or hormonal ED or Arteriogenic ED, radical pelvic surgery for example account for the vast minority of patients with erectile dysfunction and if you focus in on HORMONE PROBLEMS such as TESTOSTERONE that accounts for the VAST MINORITY of MEN with ERECTION PROBLEMS so the BULK of ED that's PHYSICALLY BASED is VASCULOGENIC as its called!
* the whole link between TESTOSTERONE and ERECTILE FUNCTION it's a WEAK LINK, it's not a POTENT ERECTO-GENIC HORMONE, it's CERTAINLY a LIBDO-GENIC HORMONE and an ORGASMO-GENIC HORMONE but if you take men who have got LOW TESTOSTERONE who have ERECTILE DYSFUNCTION and you treat them with T the AVERAGE CHANGE in ERECTILE FUNCTION is MINIMAL if you use the validated scores (the international index of erectile function scores) so the ELEVATION in those scores is MINIMAL so the CONTRIBUTION of T you DON'T NEED A LOT of T you need SOME you DON'T NEED A LOT of T for ERECTION FUNCTION!
Dr. John Mulhall doesn't just treat erectile dysfunction (ED), he's also on a global mission to demystify its causes, highlight its complexities, and offer an alternative to how we currently think about sexual health.
This is for you if you’re wondering: what can I do today to ensure better sexual health tomorrow? Even if it's good today, don't you want to ensure it'll be good in your later years? And if it's not where you want it to be today, perhaps you've not spoken to anyone about it yet - you're not alone here. There are answers out there and support to be given. But you've got to ask for it.
We cover:
* Exercise and erectile health - getting it up (your heart rate)
* Durability and frequency - it matters, but it should only matter to you
* Exogenous testosterone - risk of transference and its impact on fertility
* Premature ejaculation: lifelong vs. acquired - and what to do about each
* Navigating treatment options - pills, patches, and injectables and caution over the the ‘Wild West’ of supplements
* PDE5 inhibitors - how they work, their cardiovascular benefits, and their limitations
* The psychology behind ED - how placebos enter in and integrating psychological and medical approaches for effective treatment
* Emerging therapies - shockwave therapy, platelet-rich plasma, and penile botox injections - do they work?
Understanding the Link Between Exercise, Vascular Health, and Erectile Function: Key Insights from Dr. John Mulhall
Exercise and Penile Health
Dr. John Mulhall emphasizes the critical role of exercise in maintaining vascular health, which directly supports erectile function. He likens the penis to a "large blood vessel," reliant on proper blood flow for optimal performance. Regular aerobic activity promotes endothelial health (the inner lining of blood vessels) by enhancing blood flow and protecting against vascular damage. This is crucial as the majority (70%) of erectile dysfunction (ED) cases have vascular origins.Key Takeaways: Exercise and ED Prevention
- Aerobic Exercise: Activities that elevate heart rate improve vascular health and support endothelial protection. These include running, cycling, or brisk walking.
- Consistency Matters: Long-term, regular exercise yields sustained endothelial benefits compared to sporadic activity.
- Balance with Medical Conditions: Conditions like high blood pressure, diabetes, and high cholesterol adversely affect endothelial health, highlighting the need for preventive exercise.
Understanding Erectile Dysfunction (ED)
Vascular vs. Hormonal Causes
- Vascular Origins: Most ED cases (approximately 70%) are due to issues with blood flow rather than hormonal imbalances. Conditions like diabetes or cardiovascular disease are common culprits.
- Hormonal Factors: While testosterone plays a role in libido and energy, its impact on erections is minimal. Over-the-counter testosterone boosters and supplements often offer limited benefit and can lead users astray.
Approaches to Address ED
- Cardiovascular Health: Regular aerobic exercise and monitoring conditions like diabetes and hypertension are more effective than relying on unproven supplements.
- Medications (PDE5 Inhibitors):
- Drugs like Viagra and Cialis work by enhancing blood flow to the penis. They inhibit an enzyme (PDE5) that degrades cyclic GMP, a molecule essential for achieving an erection.
- The choice between short-acting (Viagra) and long-acting (Cialis) depends on sexual frequency and predictability.
Testosterone and ED
Dr. Mulhall explains that testosterone is crucial for libido and overall vitality but is not the main driver for erectile function. Only small amounts are needed for erections, and testosterone replacement therapy (TRT) should be carefully considered, particularly in men interested in fertility or exposed to children (to avoid accidental transfer through gels).When to Consider TRT:
- Persistent symptoms like fatigue, low libido, and poor endurance despite normal lifestyle interventions.
- Confirmed low testosterone levels via reliable early-morning blood tests.
Emerging Therapies and Considerations
- Research is ongoing into restorative therapies like shockwave treatment and platelet-rich plasma (PRP) injections for ED.
- Preventive measures, such as regular nocturnal erections (natural or induced), are critical for maintaining penile muscle health.
The Role of Mental Health and Stress
Psychological factors like anxiety or high adrenaline levels contribute significantly to ED. Techniques like mindfulness, counseling, and addressing stressors are often used alongside medical interventions to boost confidence and outcomes.Conclusion
Dr. Mulhall advocates for a comprehensive approach to erectile health that combines regular exercise, management of chronic conditions, and targeted medical treatments. Empowering men to discuss sexual health openly with physicians and debunking misconceptions about testosterone and supplements are critical steps toward better outcomes.For more insights, follow Dr. Mulhall on X (formerly Twitter) at @SaveYourSexLife.
