A Heart Attack ... in Your Pants?

A Heart Attack ... in Your Pants?

Written by Dr. Geovanni Espinosa
Posted November 19, 2014

Erectile dysfunction is a common problem — hands down the most common I see. And that’s no surprise, when you consider the fact that more than half of all men over the age of 50 have trouble rising to the occasion.

Maybe you’re one of them. If so, I want to take this opportunity to make something very clear...

Erectile dysfunction is not normal. In fact, it’s a major warning sign.

That’s because your penis is a barometer for your health — and for your heart’s health in particular. Erectile dysfunction has very strong ties to heart disease. So if you can’t get it up (or keep it up), your life could be in imminent danger.

This is not an exaggeration. The association is supported by plenty of research. In fact, just last year, the European Heart Journal published a study showing that, among patients with ED:

  • Cardiovascular events were 44% more common
  • Cardiovascular mortality rose by 19%
  • Heart attack was 62% more likely 

  • Cerebrovascular events (such as stroke) were 39% more likely
  • All-cause mortality (in other words death by any cause, period) was 25% more likely

So we’re not talking about a small association. Erectile dysfunction and cardiovascular mortality are practically conjoined. And poor arterial health is the lethal string that holds them together — not to mention a vitally important compound called nitric oxide (NO).

Nitric oxide (NO) originates in your endothelium — that is, the lining of your blood vessels. It’s responsible for widening and dilating your arteries.

Without enough NO, those arteries don’t expand as they normally would. Your blood pressure soars. Plaque ends up forming. And this contributes to a variety of heart problems including heart attack and stroke.

But this plaque doesn’t just form on the walls of arteries in the heart and around the brain. It collects on all of the arteries in the body — and the penis is no exception.

What’s different about your penis, though, is that you can easily see whether or not it’s working (It’s harder to look inside your aorta). Nitric oxide opens the arteries in your penis so that blood can flow in and create an erection. And since erections depend on healthy arteries, an erect penis is a great marker of a healthy cardiovascular system.

And if you can’t get it up? Well that’s a reliable sign that your heart is in pretty serious danger. And you need to take some action before it’s too late...

So, how many erections should you be getting? What’s a “day in the life” of a healthy penis?

Here’s what I tell my patients: During normal REM sleep each night, the average man has between three and five erections. (Yes, that many.) So if you’re not sexually active, you should experience morning erections at least three to four times a week.

And, of course, it shouldn’t be difficult to gain an erection leading up to sexual activity. Once again, that’s not normal. And it deserves your immediate attention for reasons that go far beyond a happy wife. 

Keep in mind, though, that ED is not necessarily a sign of a heart problem. It can be caused by anxiety as well — so a failure to rise could stem from fear, discomfort, or other psychological problems. And obviously, there are different issues at play for men who have undergone prostate cancer treatment like surgery or radiation.

But if you don’t fall into these categories, then I’d advise taking a good, hard look at your lifestyle.

Because when it comes down to it, the best thing you can do to guarantee reliable erections is to prevent or resolve endothelial dysfunction. And for most guys, this is as simple as changing your lifestyle.

Get out and exercise. Cut out simple carbs and processed foods from your diet. Focus on whole foods — fresh veggies and fruit, lean protein, and healthy fats from nuts, olives, avocado, and cold water fish.

We’re talking basic common sense stuff here. And it can make a big difference.

But there are other ways to “grease the wheels.” Obviously, the main goal here is to get your NO production back up to snuff. And you can do this by boosting your levels of an amino acid called L-arginine.

L-argnine is an essential ingredient in your body’s production of nitric oxide. Animal protein is an essential dietary source of L-arginine — so eating more steak and eggs is a good place to start. But supplementation is usually necessary.

Just don’t be suckered into buying one of the many L-arginine supplements on the market. Not unless you like flushing your hard-earned money down the toilet.

Let me explain...

L-arginine is critical to NO secretion, yes. But your body also metabolizes it really fast — too fast for it to do what it’s supposed to do. So while an L-arginine supplement sounds like a great idea on paper, in practice, it just doesn’t work.

Luckily, the solution to this problem is simple. Take L-citrulline instead.

L-citrulline is a precursor to L-arginine. It’s less vulnerable to rapid intestinal and liver metabolism and your kidneys easily convert it into its more active cousin.

Newer research has investigated whether it’s better to take L-citrulline or L-arginine, and the results here are clear: L-Citrulline increases NO and L-arginine levels in the blood and the tissues better than taking L-arginine alone.

For being a “non-essential” amino acid, L-citrulline has some critical benefits — including an increased ability to get and maintain an erection. But that’s hardly all.

Supplementing with L-citrulline has also been shown to increase nitric oxide levels and heart function in people with cardiovascular diseases associated with endothelial dysfunction. (Which includes conditions like hypertension, heart failure, atherosclerosis, diabetic vascular disease, and ischemia-reperfusion injury.)

At this point, it should be obvious why L-citrulline is one of my top ten supplements recommendations. Generally speaking, I advise my patients to take 300 to 600 mg of L-citrulline, twice per day. And if you’re dealing with ED, I strongly suggest that you do the same.

Stay tuned and stay well,

Dr. Geo

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Vlachopoulos C, Jackson G, Stefanadis C, and Montorsi P. (2013). Erectile Dysfunction in the Cardiovascular Patient. Eur Heart J. 34(27): 2034-2046.

Hotta Y, Shiota A, Kataoka T, Motonari M, Maeda Y, Morita M, Kimura K. Oral L-citrulline supplementation improves erectile function and penile structure in castrated rats. Int J Urol. 2014 Jun; 21(6):608-12.

Romero MJ, Platt DH, Caldwell RB, Caldwell RW.Therapeutic use of citrulline in cardiovascular disease. Cardiovasc Drug Rev. 2006 Fall-Winter; 24(3-4):275-90.

Wijnands KA, Vink H, Briedé JJ, van Faassen EE, Lamers WH, Buurman WA, Poeze M.Citrulline a more suitable substrate than arginine to restore NO production and the microcirculation during endotoxemia. PLoS One. 2012;7(5):e37439.


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