Inflammation Leads to Hypertension, Nitric Oxide Inadequacy and ImpotenceDrugs for erectile dysfunction (ED), e.g. sidenafil (Viagra), compensate for inadequate nitric oxide (NO) production from arginine by inhibiting the enzyme, phosphodiesterase (PDE5), that hydrolyzes the cyclic GMP that mediates the NO-triggered process of vascular dilation.
Inflammation Is the Core of ED
Drug treatment to compensate for inadequate NO production is a multibillion dollar industry that avoids curing the underlying cause of the ED. All of the physiological predispositions to ED result in or derive from chronic inflammation. The major cause of ED, hypertension, frequently as a result of kidney disease, diabetes or metabolic syndrome, can be treated with diet and exercise. Of course the typically recommended diet is essentially the Anti-Inflammatory Diet, compromised by the unenlightened persistence in the counterproductive use of grain starches, high fructose corn syrup, omega-6 polyunsaturated fatty acids and low saturated fat.
Decreasing Testosterone Results from Declining Health -- not Age
Recent studies also indicate that testosterone levels do not normally decline with age, but rather with declining health. Healthy men have higher testosterone levels. I would suggest that reduction in serum testosterone could be used as a measure of chronic inflammation in men. This also suggests that many of the symptoms associated with aging in men actually reflect increasing chronic inflammation and reduced testosterone.
ED Diets Are Just the Anti-Inflammatory Diet Plus Veggies
A chronic high starch/sugar/HFCS diet with omega-6 oils in place of saturated fats, leads to chronic inflammation, high triglycerides, risk of metabolic syndrome and obesity. Of course, diabetics have an even lower tolerance for this type of diet. This diet, which is rather typical in many modern cultures, also provides a high risk of damage to endothelial cells lining the circulatory system and to ED. The opposite of the inflammatory diet is the low carb, high omega-3 fish oil, no vegetable oil, meat/fish/dairy, Anti-Inflammatory Diet. This is supplemented with exercise and high vitamin D. Foods labeled as beneficial to ED also include specific herbs, spices and leafy vegetables, because these contain organic chemicals that inhibit components of the inflammation system or are anti-oxidants.
ED and Biofilms
I would suspect that men with ED suffer from chronic dietary inflammation and one of the consequences of this type of diet is the accumulation of pathogenic biofilms. Hypertension, which is a contributor to ED and a consequence of chronic inflammation, is also associated with periodontal biofilms and kidney disease (aggravated by renal biofilms.) I suspect that endothelial cells of capillaries are compromised by biofilm-derived endotoxins that ultimately contribute to apoptosis, decrease in capillary beds and elevation of blood pressure. All of these assaults on endothelial cells undermine penile vasculature and contribute to ED.
Viagra Can Lead to Rosacea
Men taking Viagra or other PDE5 inhibitors typically have compromised vascular systems that are the basis for ED. Increasing the response to NO in men with ED produces an increased risk of rosacea. Withdrawal from PDE5 inhibitors stops the rosacea, which returns if the PDE5 inhibitor use is reinitiated. Thus, the flush that is the goal of Viagra therapy, leaves some redfaced.
ref:
Ioannides, D. et al. (2009) Phosphodiesterase-5 inhibitors and rosacea: report of 10 cases. Br. J. Dermatol. 160: 719-20.
