E.D. Education

It used to be called impotence. But thanks to the proliferation of drug industry advertisements that now threaten to overwhelm our television programs, today we know it as erectile dysfunction, or, more discreetly, simply as E.D. Whatever you want to call it, though, it’s the man’s inability to achieve or maintain an erection sufficient to satisfy him or his partner during intercourse.

When it occurs in young men, it’s usually just a matter of momentary anxiety. In middle-aged men, it’s often caused by stress, guilt, or overwork. In fact, most men experience it at some point in their lives by age forty, though usually only briefly, and they are not psychologically affected by it.

But it gets more common with age, and for some men – as many as 30 million of them according to the drug companies – it occurs frequently and causes serious emotional and relationship problems.

In many cases, E.D. is due to the deterioration of the blood vessels that carry blood into the penis. A host of things can cause this deterioration, including nicotine, which narrows the blood vessels, excessive alcohol, and certain prescription drugs, notably antidepressants. Some physical problems can contribute to the deterioration, too, such as diabetes, high blood pressure, and obesity.

If you have difficulty getting an erection, get help. Discuss it with your partner, and consult your doctor, who will help you find the cause of your E.D. Treatment will, of course, depend on the cause. Though there are a number of mechanical devices that can help men get a better erection, including splints, rings, and pumps, it’s the E.D. drugs that have revolutionized the treatment of this problem. They work well for most men, and if one drug doesn’t work for you, try one of the others – but always work with a doctor’s guidance since the drugs can have significant side effects.

Doing It, or Not?

One reason—if not the main reason—we diet and exercise is that we want to look good to the opposite sex (or maybe the same sex).

And, of course, one reason—if not the main reason—we want to do that is to be attractive to our (real or imagined) sexual partner.

Now, what does any of this have to do with health, you wonder? The answer is, plenty. A healthy sex life improves your overall quality of life. It improves your immune system because it significantly relieves stress. Good physical exercise burns calories, and it improves your mood by pumping endorphins into your bloodstream that make you feel good. It also plays a key role in keeping couples together, so the benefits of sex are innumerable.

But once you get on into your forties, you might find your sex drive shifting into a lower gear. This diminished or lack of sex drive is more common in women than it is in men. Even men with erectile dysfunction usually have a normal sex drive. While libido problems can be either physical or psychological, the root causes tend to be the same in both sexes. Alcoholism is the main physical factor responsible for a decreased libido; another is drug abuse, of cocaine, for example.

Obesity and anemia are other potential physical problems. And there are certain tumors of the pituitary gland that increase the hormone prolactin, which lowers the libido. Some prescribed medications, especially antidepressants, lower the level of the hormone testosterone, which is needed by both sexes to maintain an adequate sex drive. Psychological factors influencing libido include depression, stress, and confusions about sexual orientation.

Anyone with a lack of sexual desire should first try to take these factors out of the equation. So if you’re drinking excessively, overweight, depressed, or taking medications, these issues need to be dealt with to resolve a flagging libido. Counseling can help with the psychological problems of sexual hang-ups, depression, or stress.

There is no magic remedy for the loss of sexual libido. Though testosterone has been identified as a key hormone that improves sexual appetite in women, doctors who have been giving women testosterone supplements for the past 30 years have found that it has little effect on their libido, while it sometimes causes facial hair growth, a deepened voice, and an enlargement of the clitoris.

I have no doubt that one day there will be a libido pill for women and men, as I’m sure the drug companies are hard at work on this potentially lucrative solution.

There are a number of other sexual problems that women may experience at any age. One is dyspareunia, or painful sexual intercourse. Any part of the genitals can cause pain during sex, including the skin around the vagina. Vaginal infections, like yeast infections or viral infections, are a common cause, and the pain can be felt when either a tampon or penis is inserted into the vagina. It can also occur from just sitting or wearing pants. To treat dyspareunia, physicians may recommend hormone creams, dilators to help stretch the vagina, Kegel exercises, or, in rare cases, antidepressants.

Another potential cause of dyspareunia is vaginismus, an involuntary contraction of the vaginal muscles that may prevent insertion of the penis during intercourse. The diagnosis of vaginismus is usually problematic because it’s often difficult to separate the physical pain with the emotional anxiety of experiencing that pain; in other words, just the fear of the pain can cause vaginismus.

Any woman complaining of these symptoms should be taken seriously. A doctor must conduct a physical examination to eliminate the possibility of such physical causes as infections, fibroids, or anatomical deformities of the uterus, ovaries, or vagina. Even vaginal dryness can cause painful sex. A decrease in estrogen at menopause can cause the vaginal walls to become dry, creating a discomfort or pain during intercourse.

If there are no treatable physical conditions, it’s important to discuss the woman’s feelings as well as the physical situations that lead to this type of discomfort. Some women have a very positive attitude toward sex; other women have had negative sexual experiences that play a significant role in their fears and negative feelings about sex.

Some women may have a history of sexual abuse, rape, or trauma, for instance; these things need to be identified in a very delicate way. Treatment of vaginismus usually involves practicing relaxation techniques and doing Kegel exercises to relax the vaginal muscles. At home, one exercise that may prove beneficial is to have your partner gradually insert a dilator into your vagina. This must be done at a pace with which you feel comfortable until the pain and discomfort are overcome. Partner, doctor, and patient all have to be in sync for this type of therapy to be successful.

Many women experience discomfort or pain at the time of their period. This pain is caused by contractions of the muscle of the uterus during menstruation that occur due to the release of the prostaglandins, which are hormones that are produced in the lining of the uterus. For most women these menstrual contractions are neither severe nor disabling. But some women experience significant menstrual pains called dysmenorrhea.

Women suffering from dysmenorrhea should exercise, get plenty of sleep, and avoid stress. Over-the-counter painkillers can minimize the amount of prostaglandins released, and they usually help reduce the pain. If the painkillers are not effective, your doctor will have to look for other things that are causing the pain. And ultrasound is sometimes used in such cases to make sure you don’t have any other medical conditions, like pelvic inflammatory disease, endometriosis, or fibroids.

Dr. Manny’s Freedom Diet

One recent survey of Americans on body image found that more than half of all men and women would rather lose their job than gain an extra seventy-five pounds. And nearly 20 percent of the population would give up, or consider giving up, 20 IQ points to have the perfect body.

Obviously, weight and the way we are perceived is an important factor in our daily lives. It’s not surprising then that dieting is on the minds of so many people these days, particularly as people get on in their forties, when the metabolism begins to slow and the pounds begin to add up. So which diet is best? I’ll tell you.

First, let’s look at some of the big blockbuster diets that have appeared over the past decade or so—the South Beach Diet, the Atkins Diet, the Mediterranean Diet, and so on. Each one of these diets has simply incorporated a different method of teaching you about nutrition in order to get you to lose weight. Each one gives you something to focus on, a behavior to motivate you, which is great because, after all, to lose weight you have to change your thinking.

But if you look at the fundamentals, the underlying theme of each diet is calories. Whether you do Atkins, South Beach, or Dr. Phil, it’s really all about calories.

When reviewed carefully, most diets are really nothing more than low-calorie nutrition plans disguised by clever marketing gimmicks. Scientific-sounding “facts” and hocus-pocus “research” are just ornaments on the diet tree. Diet-plan marketers go to great lengths to explain how their diet can work for everyone, or claim that it is carbohydrate intake or fat intake—or whatever the bad intake of the day is—that’s the culprit.

However, the bottom line is that the only way to lose weight is to have a caloric deficit, which occurs only when you burn more calories than you consume.

The average American today consumes 300 more calories per day today than did the average American of 30 years ago. Today’s average American also burns 260 fewer calories each day due to increased automation, technology, and sedentary occupations. Put those numbers together, and it becomes rather obvious why America’s waistline is growing at an alarming rate.

Check Your BMI

The BMI can tell you if you are underweight, normal, overweight, or obese. Adults 20 years old and older can calculate their BMI with this formula:

BMI = your weight/pds divided by height/in x height/in x 703

You are UNDERWEIGHT, if your BMI is below 18.5.

You are of NORMAL WEIGHT, if your BMI is between 18.5 and 24.9.

You are OVERWEIGHT, if your BMI is between 25.0 and 29.9.

You are OBESE, if your BMI is 30.0 or more.

So here is Dr. Manny’s Freedom Diet. If you really want to lose weight, you have to do two things: eat fewer calories and burn more calories. This is not an optional “either/or” plan but an “and” plan. Of course, the calories you eat should be healthy calories. That’s all. Eat less. Exercise more. It really is that simple.

Fight obesity. Spread the word.

Exercise

People spend an enormous amount of time trying to find the perfect exercise, and while they’re doing that, their clock is ticking. Any physical activity is great, though the best kinds of exercise for you are those like walking, swimming, running, hiking, and skiing—all of which have a “global” impact on your body and mind.

Most important, you should stick to the exercise of your choice and do it regularly. If you adhere to those two principles, you’re going to burn calories, feel better, improve your metabolism, and benefit your health.

Any activity you do during the day—from climbing stairs, to housecleaning, to watching TV—will, of course, burn calories. But those activities don’t provide the necessary continuity, and I think the essence of getting into shape and having a good metabolism has to do with a continuity of exercise.

In other words, it’s better to burn 120 calories a day, seven days a week, doing your favorite exercise, for example, than to burn 800 calories doing the housework once a week. It’s the exercise regimen that has an impact on your health, not necessarily the intensity.

Burn, Baby, Burn

Estimated number of calories burned per minute based on an individual weighing about 150 pounds:

Sitting: 1

Talking on phone: 1

Sleeping: 1

Driving: 2

Housework: 3

Cooking: 3

Washing dishes: 3

Stretching: 4

Sex (active): 5

Walking (3 mph): 5

Calisthenics (moderate): 5

Ballroom dancing (fast): 6

Gardening: 6

Swimming (moderate): 7

Aerobics (low impact): 7

Hiking: 7

Jogging: 8

Stair step machine: 8

Bicycling (12 to 14 mph): 10

Basketball (full court): 12

Running (10 mph): 20

To easily calculate how many calories you burn in a day, go to www.healthstatus.com and click on “Calculators” then “Calories Burned.”

It is also very important to drink adequate amounts of fluid when you exercise. You need to drink about a half cup of water for every fifteen minutes of vigorous exercise. People think that muscle cramps during exercise are caused by a shortage of electrolytes, but that’s not true. You get muscle cramps because of water loss and dehydration. Drink that water!