Sexual Health

L-Citrulline: The Heart and Penis Connection

The penis is a barometer of male health. Since erectile dysfunction (ED) is closely linked to various forms of heart disease, failure to keep an erection may be a sign of an incoming cardiac event.

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According to the Massachusetts Male Aging Study, conducted in 1994, erectile dysfunction is a common problem for aging men. More than half of men over 50 and more than two-thirds of men over 70 have ED.

A recent review article in the European Heart Journal showed that ED has a strong connection to heart disease.

In patients who had ED;

• Cardiovascular events were 44% more common
• Cardiovascular mortality rose by 19%
• Heart attack was 62% more likely in patients
• Cerebrovascular events (such as stroke) were 39% more likely
• All-cause mortality (death, period) was 25% more likely.

What connects the Heart to the Penis?

Poor arterial health, and an important compound called Nitric Oxide.

Nitric Oxide (NO) links Erectile Dysfunction with Cardiovascular Disease

NO is mainly responsible for widening the arteries during physical activity, but it also plays a role in sexual activity. It opens the arteries in the penis so that blood can flow in and cause an erection. Without NO, the arteries don’t expand as they usually would.

Plaque ends up forming in the walls of the arteries, and this leads to a variety of heart problems including heart attack and stroke.

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.

Plaque formation in the pelvic area blocks blood flow and is one contributing factor to ED

What’s different about the penis, though, is that you can easily see whether or not the organ working (It’s harder to look inside the arteries of your heart). And since erections depend on healthy arteries, an erect penis a significant marker of a robust cardiovascular system.

 

In Chinese Medicine, the Heart and Penis are Connected

In Chinese medicine, the Heart channel is related to the Kidney channel within the Shao Yin channels. It is also indirectly related to the Kidneys through the Du Mai and Ren Mai, both of which flow through the Heart and originate from the space between the Kidneys. Both the Du and Ren Mai have a profound influence on sexuality and the sexual function including sexual desire, sexual arousal, erection, maintenance of erection and ejaculation. Furthermore, the Chong Mai also starts from the space between the Kidneys and goes to the Heart and, also, it controls the zong muscles in the abdomen which many interpret as being the penis. (Giovanni Maciocia, February 2013)

I know, now I am talking Chinese (haha)

My Take on Erectile Dysfunction Connection to the Heart

Erectile Dysfunction (ED), or impotence, is a common problem, but, for reasons I will explain, I would not say it’s normal. Because of the strong links between erectile dysfunction and cardiovascular issues, and then perhaps stronger links between cardiovascular health, diet, and exercise, I see the penis as a kind of barometer of male health. When the fluid transport systems in the body are working correctly, erections are a natural result. When arteries are clogged and hardened by an unhealthy lifestyle, the arteries in the penis take a hit just as much as the arteries in the heart and erections are blocked.

So, how many erections should you be getting? What’s a “day in the life” of a healthy penis? If you’re not sexually active, you should experience morning erections at least 3 to 4 times a week. During regular REM sleep each night, the average man has between three and five erections. (Yes, that many.)

And, of course, it should not be difficult to gain an erection leading up to sexual activity.

 

L-Citrulline for Erections and Heart Health

What do we learn from this? First, frequent and regular erections are a sign of good cardiovascular health.

Of course, this link does not apply to men who have undergone prostate cancer treatment like surgery or radiation as they would experience less to no erections normally.

Keep in mind, though, that ED is not necessarily a sign of a heart problem; it can be caused by anxiety as well, and a failure to rise could stem from fear, discomfort, or other stressors. But if these are not your problems, then I’d advise taking a look at your lifestyle.

The best thing you can do is to prevent or resolve metabolic syndrome by changing your lifestyle. Get out and exercise. Cut out processed foods from your diet. To make sure your body produces enough NO, get some extra L-Arginine from animal protein and nuts.

Better yet, consider L-Citrulline which is a nutrient that makes more L-Arginine in the body than L-Arginine itself and has shown to help with sexual function. Eating pomegranate and taking Resveratrol can help with endothelial dysfunction.

How L-Citrulline Works?

L-Citrulline is an amino acid not found in proteins but found mainly in watermelon. The health-related applications of l-citrulline supplementation due to the ability of l-citrulline to increase l-arginine availability for NO production.

l-citrulline increases NO biosynthesis indirectly by increasing l-arginine synthesis, which in turn may lead to improved endothelial vasodilator function. In other words, it helps open up arteries.

One small study showed L-Citrulline improved penile hardness.

When Not to Use L-Citrulline

I prescribe L-citrulline in the formula of XYVGGR to help men with sexual function.

However, after using XYVGGR successfully for over seven years, I have had to take about three patients off of it because of a lowering blood pressure effect. Due to the dilating arteries effect of L-Citrulline, a desirable response when needing a pelvic lift, it opens up the arteries of the whole body reducing blood pressure.

When a patient has normal low blood pressure, say 90/60 mmHg or less, they DO NOT get XYVGGR or anything with L-Citrulline. The typical complaint of unwanted lower blood pressure is dizziness. On the other hand, if there is a sexual problem in a man and he also has high blood pressure, using L-Citrulline in a formula like XYVGGR may have a duo effect.

 

Three Recent Blog Post

The Real Cause of Prostatitis and How to Treat it Naturally

Prostate Cancer: Late night eating increases the risk.

How to Prevent a Heart Attack: Part one

 

CaPLESS EVENTS

The CaPLESS Retreat is coming in September to help prostate cancer (CaP) thrivers live their best life by implementing science-based lifestyle practices. Prostate cancer is an opportunity to live healthier than before your diagnosis. Learn how. There is limited space.

Treating Erectile Dysfunction with Traditional Chinese Medicine (TCM)

 

There are many methods for treating erectile dysfunction and improving vitality in men with natural medicine. Traditional Chinese Medicine, Ayurveda, Exercise is all part of it.

I had the privilege of co-editing what is likely the number one resource in treating sexual dysfunction with integrative modalities. The Integrative Sexual Health book is part of the Weil library of Integrative medicine books published by Oxford University Press.

Today, I will focus on how Traditional Chinese Medicine works in treating erectile dysfunction. Some of the information below is excerpted from the Integrative Sexual Health book written by my colleague, Jillian Capodice.

Traditional Chinese Medicine (TCM) which can be traced back 3000 years, employs a philosophical and holistic approach to treating humans, based on the yin-yang, the five elements (wood, fire, earth, metal, and water), and employing massage, acupuncture, clinical diagnosis, and herbology.

Acupuncture has been the most studied since about 1971 when a New York Times reporter, James Reston, traveled to China to cover President Nixon’s trip to the country. Reston developed appendicitis and needed immediate surgery. Pain from the procedure was successfully treated with acupuncture and Reston was so impressed he wrote this 1971 article on the NYT.

A Brief on How TCM Works

According to TCM theory, kidney and liver are the two primary organs related to ED in the TCM understanding. The kidney stores the essence (jing), while liver stores blood (xue).

In addition to storing blood, liver can modulate blood volume and maintain the flow of blood. Sexual and reproductive functions are also under the control of liver. Thereby, kidney and liver are two important organs with a wide range of functions, particularly male sexual dysfunction in TCM.

The diagnosis of disease in TCM, unlike medical diagnosis, lies in identifying patterns of disharmony. Some practitioners like myself look use the best of both worlds to figure out the diagnosis of problems, especially as it relates to erectile dysfunction (ED).

Starting with the pillars of TCM, the key introductory concepts that must be understood are the basics of yin and yang theory and the nature of qi (energy), xue (blood) and jing (fluid essence).

This helps us to understand the importance of the nature of jing as in TCM jing corresponds to the essence of a person. It has also been characterized to be related to the reproductive system has been thought to characterize sperm in traditional texts. Jing is also closely related to shen or spirit, and it is a traditional concept that the spirit of a person and its seminal essence are closely related (regardless of their sex or gender). Jing and shen also represent spirit, vitality, growth, and renewal and are fundamental concepts of sexuality in TCM.

TCM in Male Sexuality

In TCM, the penis is the root of the liver and most TCM patterns for complaints of male sexual function disorders do have liver and kidney disharmony.

When the TCM liver is out of balance about male sexual function it not surprisingly leads to liver qi stagnation and interrupted the free flow of qi that can lead to ED. Liver qi stagnation is often combined with pathologies of the evils such as dampness, heat or cold. Lifestyle factors are common culprits that contribute to these pathologies. For example, in TCM the overconsumption of greasy and spicy foods and excessive alcohol consumption is a common cause of excess heat and dampness. On the other hand, excessive exposure to cold will exacerbate cold and or cold/damp pathologies. The kidney organ and meridian is almost always a factor in a TCM pattern differentiation of ED.

The kidney is deeply related to the jing and this coupled with kidney yin or yang deficiency is a common cause of erectile dysfunction. Lifestyle factors that contribute to kidney yang deficiencies include overwork (both physical and mental taxation), excessive consumption of cold and raw foods, excessive exposure to cold and overindulgence in sexual activity. Lifestyle factors related to kidney yin deficiency also include overwork, night shift work, and insomnia. These factors also deplete the jing.

The three most common main TCM patterns seen in male sexual dysfunction are:

  1. liver qi stagnation
  2. damp heat in the lower jiao
  3. kidney yang deficiency.

In patients with liver qi stagnation common symptoms may include low libido with difficulty maintaining an erection with or without painful urination, lower abdominal or groin pain, and mental/emotional stress. In those with damp heat predominant pathologies, symptoms include difficulty obtaining an erection, premature ejaculation due to blocked qi, low sperm count and poor lifestyle factors. In men with kidney yang deficiency, patients often present with an inability to obtain an erection, low or no libido, fatigue and poor lifestyle factors.

Studies on Acupuncture and Male Sexual Dysfunction

In one randomized controlled trial performed in 22 subjects with psychogenic erectile dysfunction (ED) and were randomized to acupuncture versus a sham control ( “fake acupuncture”, the control group, not exactly placebo). At the end of the study, there was a 68.4% improvement in the acupuncture group vs. the 9% improvement in the sham group.

For premature ejaculation  ninety heterosexual, and sexually active men between the ages of 28 and 50 were randomized to one of three arms. The treatment groups were paroxetine (Selected Serotonin Reuptake Inhibitor), 20mg/day, acupuncture or sham acupuncture twice weekly for four weeks. Acupuncture points were ST36, LI4, KI3, LIV3, EX-HN3 (yin tang) and CV3 (These points will make sense for acupuncture practitioners only). Acupuncture had a significantly stronger ejaculation-delaying effect than placebo, but it is unclear of the lasting effects in longer follow-up when acupuncture treatment ended.

Commonly Used Chinese Herbs for Erectile Dysfunction

Common Cnidium Fruit

Common Cnidium Fruit is the fruit of Cnidium monnieri. It has been used basically for treating ringworm, swelling of women’s genitals and male impotence. Osthole is one major component of Common Cnidium Fruit, which has been shown to have vasodilating effect and relaxant effect on strips of rabbit corpus cavernosum, which might involve the release of nitric oxide (NO) from endothelium and inhibition of phosphodiesterase. (Liao et al. 2012)

Some other extracts of Common Cnidium Fruit such as imperatorin and xanthotoxin also exhibited relaxing effect on rabbit corpus cavernosum with intact endothelium. (Chiou et al. 2001)

Semen Cuscuta

Semen cuscutae is the dried ripe seeds of Cuscuta chinensis Lam. It has been used to treat impotence and seminal emission for thousands of years in China. The flavones from Semen cuscutae could reverse kidney-yang deficiency symptoms by restoring the testosterone level and androgen receptor expression in the kidney and testicle. (Yang et al.2008)

Ginseng

Ginseng is the root of some Araliaceae plants, which grow mainly in the northeast of China. Ginseng is an expensive and famous Chinese herb which is widely used in many Asian countries. It has been used to maintain homeostasis and enhance vital energy in human bodies for thousands of years. It was confirmed by a multicenter, placebo-controlled and double-blinded clinical study that the long-term administration of Korean red ginseng extracts could enhance erectile function in patients. (Choi et al. 2013)

Ginsenosides are the main active components in ginseng and have effects of anti-inflammation, anti-tumor, antioxidant, as well as apoptosis inhibition. Among various kinds of ginsenosides, ginsenoside Rg3 has received the most attention. Oral gavage with Rg3 could protect the erectile capacity in diabetic rats by preventing the degeneration of neurons in dorsal penile nerves and reducing the oxidative stress in the corpus cavernosum. (Liu et al. 2015)

Lycium barbarum L

Lycium barbarum L is the fruits of Lycium barbarum and has a large variety of biological activities. It plays an important role in treating some chronic diseases, such as hyperlipidemia, hepatitis, diabetes and male infertility. Polysaccharides extracted from Lycium barbarum exhibit antioxidant properties, which could shorten the penis erection latency and mount latency of hemicastrated rats (Zhao et al. 2016). Moreover, the administration of Lycium barbarum polysaccharides could promote nerve regeneration and erectile function recovery in rats suffering from cavernous nerve injury.

Tetrandrine

Tetrandrine is isolated from the root of Stephania tetrandra S Moore, a traditional Chinese herb with anti-inflammatory, antipyretic and analgesic effects. It was reported that tetrandrine could inhibit the Ca2+ influx from extracellular matrix and Ca2+ release from intracellular calcium pool in corpus cavernous smooth muscle cells (Liu et al. 2006)

Panax notoginseng

Panax notoginseng is planted mainly in Guangxi province and Yunnan province of China. Panax notoginseng saponins are the effective ingredients of Panax Notoginseng and are often used to treat cardiovascular or cerebrovascular diseases. It was reported that intraperitoneal Panax notoginseng saponins injection for four weeks improved erectile function in rats with diabetic ED by increasing Akt expression and suppressing oxidative stress in the penis. (Li et al. 2014)

Also, Panax notoginseng saponins could restore the endothelial function in corpus cavernosum through the endothelial nitric oxide synthase (eNOS)/cGMP pathway (Lin et al. 2013)

Epimedium (Icariin)

Icariin is one of the major active components in Epimedium, which is a traditional Chinese herb used to treat impotence. Icariin can improve erectile function through various mechanisms. Icariin could inhibit PDE5 activity and preserve the expression of NOS, thereby increasing the cGMP levels in spontaneously hypertensive rats (Liu et al. 2011).

NOTE: Epimedium is my main go to Chinese botanical for treating ED  along with adaptogenic herbs like Rhodiola and the amino acid L-Citrulline. Rhodiola is my favorite adaptogen because it has shown to help with physical and mental fatigue which is a major source of lack of performance in men. This combination works well to accomplish the end goal – provide blood flow to the pelvic area. L-Citrulline improves the availability of L-arginine in the body which helps with NO production, thus more blood to the pelvic organ. One study showed that L-Citrulline helps with erections.

Chinese Herbal Combinations for Erectile Dysfunction

Chinese herbs are used in the form of compound formulas, not in stand-alone. A variety of compound formulas have been created to treat ED, such as Shuganyiyang capsule and Yidiyin.

Shuganyiyang capsule

Shuganyiyang capsule is a formula composed of 15 Chinese herbs, which could increase blood circulation, activate Yang and replenish vital essence of human bodies. It was reported that Shuganyiyang capsule improved the intracavernous pressure in arteriogenic ED in rats by activating the NOS-cGMP pathway and reducing the expression of PDE5. (Wang et al. 2012)

Yidiyin

Yidiyin, a Chinese herbal decoction used to treat diabetic ED, was shown to improve the erectile function in diabetic patients and rats. The combined use of Yidiyin and hypoglycemic drugs could increase patients’ scores on an international index of erectile function-5 (IIEF-5) more than the hypoglycemic drug alone. Animal experiments indicated that administration of Yidiyin increased rats’ erectile function through activating NOS-cGMP pathway (Feng et al. 2012)

Final Thoughts on treating Erectile Dysfunction with Traditional Chinese Medicine.

As a patient, you want to know if TCM works for ED. And it does. Like any treatment, TCM doesn’t work for everyone. It is even more of challenge (not impossible) treating ED successfully with TCM after prostate cancer treatment since prostatectomy or radiation (two main methods of treating prostate cancer) often, not always, damage the tissues associated with erections.

The perfect combination of treatments, including exercise, stress management, acupuncture, targeted nutrients and botanicals and judicious use of pharmaceuticals. The cause of lack of penile luster needs to be addressed. While pharmaceuticals can work, they are more like “band-aids” than a cure. In other words, drugs like Viagra, Cialis, and Levitra treat the symptom (ED) not the root of the problem, but they serve a purpose – there’s nothing wrong with a “band-aid” when you have a cut, but there’s a problem if you’re constantly getting cuts.

Common causes of ED like metabolic syndrome, diabetes, heart disease need to be addressed. Additionally, more than fifty percent of sexuality is mental. If your mind is right, your organ will likely be too.

Lastly, while scientifically proving all aspects of natural medicine, particularly TCM can be a challenge, there needs to be a scientific foundation in most recommendations. Such scientific standards were behind the formulation of XYVGGR and Mr. Happy. These are not a panacea but it attempts to rebuild sexual health while improving pelvic circulation. (See When Mr. Happy Does NOT work for ED)

Make it a Great Day!

 

Reference:

Bartlik, Espinosa, Mindes; Integrative Sexual Health, Oxford University Press, 2018

Xiao HJ, Wang T, Chen J, et al. Chuanxiongzine relaxes isolated corpus cavernosum strips and raises intracavernous pressure in rabbits. Int J Impot Res 2010;22:120-6.

Liao H, Jacob R. Chinese herbal drugs for erectile dysfunction through NO-cGMP-PDE5 signaling pathway. Zhonghua Nan Ke Xue 2012;18:260-5.

Liu JH, Chen J, Wang T, et al. Effects of tetrandrine on cytosolic free calcium concentration in corpus cavernosum smooth muscle cells of rabbits. Asian J Androl 2006;8:405-9.

Chiou WF, Huang YL, Chen CF, et al. Vasorelaxing effect of coumarins from cnidium monnieri on rabbit corpus cavernosum. Planta Med 2001;67:282-4.

Choi YD, Park CW, Jang J, et al. Effects of Korean ginseng berry extract on sexual function in men with erectile dysfunction: a multicenter, placebo-controlled, double-blind clinical study. Int J Impot Res2013;25:45-50.

Liu T, Peng YF, Jia C, et al. Ginsenoside Rg3 improves erectile function in streptozotocin-induced diabetic rats. J Sex Med 2015;12:611-20.

Yang J, Wang Y, Bao Y, et al. The total flavones from Semen cuscutae reverse the reduction of testosterone level and the expression of androgen receptor gene in kidney-yang deficient mice. J Ethnopharmacol 2008;119:166-71.

Zhao ZK, Yu HL, Liu B, et al. Antioxidative mechanism of Lycium barbarum polysaccharides promotes repair and regeneration following cavernous nerve injury. Neural Regen Res 2016;11:1312-21.

Li H, He WY, Lin F, et al. Panax notoginseng saponins improve erectile function through attenuation of oxidative stress, restoration of Akt activity and protection of endothelial and smooth muscle cells in diabetic rats with erectile dysfunction. Urol Int 2014;93:92-9.

Liu T, Xin H, Li WR, et al. Effects of icariin on improving erectile function in streptozotocin-induced diabetic rats. J Sex Med 2011;8:2761-72.

Feng XT, Qin CB, Leng J, et al. Yidiyin, a Chinese herbal decoction, improves erectile dysfunction in diabetic patients and rats through the NO-cGMP pathway. Biosci Biotechnol Biochem 2012;76:257-63.

Wang J, Wang Q, Liu B, et al. A Chinese herbal formula, Shuganyiyang capsule, improves erectile function in male rats by modulating Nos-CGMP mediators. Urology 2012;79:241.e1-6.

When Mr Happy Does Not Work For Erectile Dysfunction

Someone from my newsletter list unsubscribed and delivered this comment:
Comments:
don’t want to buy any of your products. I tried the very expensive ED stuff and it didn’t work.
I assume he is talking about Mr.Happy, a dietary supplement I tested on 15 men with ED before making available to the rest of the world.  As expected, the formula DID NOT help everyone. It’s not supposed to. It did help 9 out of the 15 participants or 60% of the guys who tried it.
Every ED case is different.
Some men have a mild case, and others have moderate or severe dysfunction.
The level of ED depends on:
1. The general health of the person. For example, diabetes can be an erection killer.
2. Amount of stress the individual is experiencing. When you stress you produce adrenaline, an essential chemical for you to “fight or flight.”
3. Prostate cancer treatment, mostly prostatectomy or radiation. Not all guys who undergo one or both of these procedures experience ED, but many do.
The bottom line is that for the male organ to work, there needs to be adequate flow of nerve impulses and blood to the pelvic area. 
If there is any obstruction or interference on these pathways, all bets are off, no elevation.
Still, there are numerous levels of ED, and we measure the severity of it from a questionnaire patients fill out called the Sexual Health Inventory for Men (SHIM).
I had a case where a 62-year-old man told me that dietary supplement I formulated did not work for him. I got on the phone with him to learn details. It turns out he was significantly overweight, on three medications for blood pressure (beta blockers can cause ED), diabetic type 2 and a history of leukemia, managed well with Gleevec.
This gentleman, who found the product on the internet,  was not a good candidate for XYVGGR. I am not sure anything would have worked for him other than a penile implant.
On the other hand, most guys, not all, with mild to moderate cases of ED can experience excellent results from the a carefully formulated dietary supplement.  Even, some men after prostatectomy can benefit when taken at the appropriate dose.
The Takeaway ED supplementation;
1. Dietary supplements do not (or should not) compete with PDE-5 inhibitors (Viagra, Cialis or Levitra). In other words, it is not event-driven. A good formula builds sexual health by restoring pelvic arteries and produce nitric oxide (NO).
2. Those succeeding with Mr.Happy have a mild to moderate case of ED, not severe. And this formula builds sexual health, not cure ED.
3. For the severe case of ED, some guys have reported excellent success with a small dose of a PDE-5, say 5mg of Cialis and two Mr.Happy.
4. Men after prostatectomy may always need at least a PDE-5 or more.
If you like to geek out, here is the science behind Mr. Happy.
Why not just take Cialis, Viagra or Levitra?
As a naturopathic and functional medicine doctor, I don’t have a problem with PDE’5 inhibitors. These drugs often work. But they are also super $$$. It can cost up to $20 for ONE pill. That is why I was caught off guard when the unsubscriber of “DrGeo” said Mr. Happy was expensive. Maybe if it would have worked for him, he’d thought different. I don’t know.
Also, many people cannot tolerate the side effects of PDE-5 inhibitors which include, flushing of the face, temporary blindness, headache, and lower back pain (mostly with Cialis). Still, I think these drugs work well, mainly when used appropriately. Other’s do just fine.
Everyone’s make up is different biochemically.
“The poison is in the dose” as an ancient physician once said. I find it is best to use PDE-5s at the lowest dose possible and see how that works. You may have to cut the pills in half.
Make it a great Day.

Testicular Fortitude by practicing Iron Crotch

Today’s blog post is for informational, and perhaps comical purposes.

There is a trend in some Asian countries in improving male potency by smashing the pelvic area with kicks, logs or any device. It is called Iron Crotch. I am not kidding.

Initially, this martial art technique was developed by kung fu practitioners to withstand a blow to the groin and be able to continue fighting. Within the last twenty-five years or so, it is thought that this practice promotes penile strength and improve sexual prowess.

I posted a video on Yin Diao Gong several years ago, a form of testicular weight lifting if you will which purportedly also helps with improving potency.

I could not find a randomized clinical trial for this approach (LOL) or any credible source to cite but make no mistake; this is practice is a trend working its way to Western countries.

While I can always go for extreme challenges (subjective concept) and look forward to reasonable discomfort ( cold showers daily, Krav Maga lately) in hopes for long-term wellness and survival preparation, crushing my genitals is not something I’m signing for anytime soon. But, you never know. 🙂

Enjoy this video on the Practice of Iron Crotch. Guys, this may be painful to watch. Fair warning.

*Literally, do not try this on your own. I truly have no idea if this approach is beneficial.*

Related Blog Post:

Size Matters

Nutrition

Nutrients for Male Sexual Health

 

What Causes Penis Pain (the Chronic and Annoying Type)?

 

Of all the places to have pain, the penis is one of the most inconvenient. One, it’s super sensitive—depending on where the pain is. And two, it’s not a part of your body you can just “go easy on” for a day, like an arm or a leg. Sooner or later, you’re going to have to pee. And likely make other uses of it ( wink, wink).

Besides the inconvenience, there’s some fear that comes with any penile dysfunction—whether it’s pain or difficulty getting an erection. For us men, the penis is important; no matter how tough and manly we might seem on the outside, we’d run screaming if there were any tangible threat to our penises. For better or worse, we’re emotionally attached to the thing. And that makes penile pain scarier than other types of pain.

Before I list the causes of penis pain, I want to make sure you realize that this list is not an exhaustive list of all things causing “your penis pain.” It’s just a list of possible scenarios that explains why some people feel penis pain. Before you keep reading, I’d recommend you take a deep breath (or two), relax, and trust that your penis pain probably isn’t that serious or life-threatning. (It usually isn’t.)

Penis pain can come in the form of an itching, burning , dull achy sensation , painful urination, discharge, or blood in the urine. It can be caused by a number of different factors, some of which are serious and some of which will probably go away in a day or two. These are the main causes of penis pain:

  • Infection
  • Trauma
  • Priapism
  • Cancer
  • Peyronie’s Disease

OK, I know you saw the word “cancer” in there, but let’s not jump to any conclusions. Penile cancer is very rare. Let’s just go down the list.

Causes of penis pain

Infection

Balanitis is a scary term for a very common problem that affects males of all ages: infection and inflammation of the head or foreskin of the penis. It’s most common in uncircumcised males, probably because that extra flap of skin provides bacteria and molds with their dream-home: dark, warm, and moist. Treatment usually involves antibiotics or creams, sometimes circumcision (for convenience’s sake), but balanitis can usually be prevented by regular washing of the penis and foreskin.

Another type of infection is a sexually transmitted infection, and it’s very easy to schedule a screening at a clinic to see if you have one. However, monogamous men who are married with one partner are unlikely to “suddenly” get an STI. If that’s you, no need to worry.

Trauma

Trauma can range from the horrific (in which case you wouldn’t even be reading this article) to the ordinary, like that one pair of underwear that chafes the tip of your penis when you run. If your penis has experienced trauma, you probably already know what the cause of your pain is.

Priapism

Priapism , a problem most men think they want to have, is an erection that lasts way longer than it’s supposed to. It’s a serious medical condition that requires medical treatment. (Now’s the time either to go to the ER or be extremely grateful you don’t have this problem.) It’s not always painful, but it is sometimes.

Priapism is essentially a cardiovascular problem. Either blood is not returning to the body from the penis (called ischemic or “low flow”), or too much blood is flowing into the penis (called non-ischemic or “high flow”). ED drugs ( Viagara, Cialis, Levitra) or penile injection can cause it too.

One sure way to reduce your risk of priapism is to keep your cardiovascular system in good working order through exercise, reducing simple carb intake, and taking time to take one deep breaths every forty-five minutes or so. 

Cancer

Cancer of the penis is incredibly rare. (And thank goodness for that!) One in 6,000 men will be diagnosed with penile cancer each year. Not to say it’s impossible, but it’s extremely unlikely that the cause of your penis pain is carcinoma of the penis.

Penile cancer usually starts as a blister, and it develops into a tumor that discharges blood or bad-smelling liquid. Human papilloma virus can increase the risk of penile cancer.

Peyronie’s Disease

Peyronie’s disease not an uncommon condition (affect 1 out of every 11 men)  where scar tissue forms on the inside of the penis causing the penis to curve like a banana during an erection. It is either caused by repeated trauma (e.g., abuse) or an autoimmune disorder. Clinically, I have noticed there is no direct cause of Peyronie’s disease. In other words, most patients do not recall penile trauma occurring or have no history of autoimmune disease. 

The Bottom Line on Penis Pain

Penis pain is inconvenient, but the good news is you’re probably going to be fine. Although there are some causes of penis pain that are serious, they’re relatively uncommon. Just schedule a check-up with your doctor, relax, and trust that this too shall pass. Remember, while the discomfort is constant and annoying, it is often not life threatening. 

Be well.

 

3 Previous Blog Posts

Why GNC got axed from the Superbowl 

Prostate Cancer: More distress = More treatment

My Thoughts on the Male Silly Mind

Conventional vs. Naturopathic or Functional Medicine Doctors

 

Most conventional doctors, namely medical doctors (MD) have a “conventional mindset.”

What does that mean?

It means that they treat the symptoms of the problem, not the cause of the problem. They put on a “Band-Aid” without fixing the main problem.

Now, let me be clear; if you are looking for MD bashing, this is the wrong website. I have worked closely with MD’s (mostly urologists) for over 12-years, and I see, first hand, the health problems they solve.

Also, if you are in a car accident, get to the emergency room and be treated by an MD.

But, you would likely agree, that for acute conditions; chronic pain, urinary problems, even many types of cancer’s, our conventional mindset falls short.

In the case of men’s health issue like erectile dysfunction (ED), a conventional doctor will probably prescribe Viagra or another similar drug to create a medically induced erection.

(Doesn’t sound very sexy, does it?)

Maybe the man can “get it up” in bed now, and that’s ok, but his problem isn’t solved. ED is not a Viagra deficiency, is it?

What a naturopathic doctor (ND) or functional medicine doctor (FMD) does is look for the cause of the symptoms. They are holistic practitioners who treat the “whole person” and inspect how all organ systems work together.

In my clinical world, I appreciate how the lower half of the body is connected to the upper half. 

In the case of erectile dysfunction, the ND and FMD will ask about various lifestyle factors such as diet and exercise that may be contributing to cardiovascular problems.

After all, the penis is the barometer of heart health.

The ND and FMD will also ask about anxiety, relationship stress, and nutritional deficiencies that may be causing erectile dysfunction.

Repeat after me: For ED find an ND or FMD. Say that ten times after a couple of drinks 🙂

(I had to do it.)

Once the cause of the problem is identified, the patient and their holistic health practitioner can work together to create a treatment plan, which will probably be heavy on lifestyle changes—not drugs. This way the cause of the problem can be eliminated, and the patient can live a better life.

What a concept!

What you should do when choosing the right doctor

Again, I have nothing against conventional doctors or PDE5 inhibitors (Viagra, Cialis, Levitra) but again, “conventional” doctors have a “conventional” mindset and may prescribe “Band-Aid” drugs, and may forget to ask you important questions like:

  • Are you moving enough?
  • How’s your sleep?
  • Are you eating optimally?
  • Do you and your partner have a good relationship?
  • What nutrients can build your sexual health?
  • Why do you even want an erection? (Insertion is typically not the main answer, I tell you)

An ND or FMD looks at the whole picture. I recommend you see one today for your health issue, whether it’s a bladder problem, problems urinating, ED, prostate issues, BPH, or something else.

Lastly, here are four legitimate organization that can help you find the right holistic doctor:

American Association of Naturopathic Physicians (AANP) – LINK

Institute of Functional Medicine (IFM) – LINK

American College for Advancement in Medicine (ACAM) – LINK

Academy of Integrative Health and Medicine (AIHM) – LINK

Be well.

 

 

The Frontline News Report on Supplements Stinks – Part 1

The Frontline News Report on Supplements Stinks: Part 1

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Well, here we go again.

In case you missed it, Frontline teamed up with the New York Times to deliver a scathing one-hour news segment called “Supplements and Safety.” The spot aired on PBS on January 19th. And since then, I’ve been bombarded with concerned questions from patients and readers who, understandably, want some answers.

Do I have answers? You better believe it. I have a whole lot to say about this latest propaganda piece. But I’m already chiming in a little late on this, so let’s get one thing straight first.

This “investigative report” is really no more than a transparent and biased attack on the supplement industry. One that leans on the same stale talking points I’ve been shooting down for the better part of a decade now.

Frontline… or firing squad?

Before I get to the meat and potatoes, let’s begin with a look at a couple of the main sources behind this report—starting with Dr. Paul Offit.

Does the name sound familiar? It should. Dr. Offit is one of the loudest voices in the modern crusade against natural medicine. In fact, he devoted an entire book to debunking the field—“Do You Believe In Magic?”—which was published in 2013.

That title should tell you all you really need to know about Offit’s contributions to this national conversation. But here are a few more tidbits…

He’s an attending physician at Children’s Hospital of Philadelphia—which, as this report notes in great detail, instituted a hard line policy against the use of outside supplements several years ago. He’s also a fierce vaccination proponent who openly dismisses opposing views as “quackery.”

Dr. Offit has a right to his own interpretation of the facts, of course. And the New York Times has a right to publish it as often as they wish. (Which, it’s worth noting, is a lot. NYT has featured Offit as an op-ed contributor quite a few times.)

After all, he makes some fair points. I’ll be the first to admit that not all supplements are safe or effective. And yes, some of them can be downright dangerous. (Don’t worry—I’ll be coming back to that.)

Nevertheless, this is a doctor who has “picked a side” and is committed to defending it. Offit came to this table with an antagonistic agenda. To suggest that he’s ever given the supplement industry a fair shake is at best patently misleading.

At worst, it’s a straight up lie. And the deep bias decorating Frontline’s soapbox doesn’t stop at Offit, either.

Attorney General of consumer anxiety

We also hear from New York’s Attorney General Eric Schneiderman. You might remember him as the guy who orchestrated the expose that rocked the supplement industry this time last year. You know, the one that suggested that a whopping 80 percent of supplements are mislabeled.

You might also remember my take on that story, in which I called this “scandal” out for what it is: TOTAL BS.

But in case you missed it, here’s the takeaway: The whole thing was fishy as all get-out. Schneiderman’s office delivered a snap judgment without a fair trial. And his results would have been hard to swallow even if they weren’t based on the questionable testing methods of an unqualified lead scientist. (Which they were.)

And yet, Frontline decided he was the perfect guy to chime in on the state of the supplement industry. No mention of the widespread skepticism toward his conclusions—even though one of these skeptics, Dr. Pieter Cohen, made an appearance in the segment.

This isn’t balanced reporting. It’s textbook fear-mongering.

So is it any surprise that the average viewer would walk away with a deep distrust of what really is a fundamentally safe industry? No, it’s not. In fact, it’s obvious that inciting this reaction was the whole point of the segment.

That would be reason enough to brush off the whole hour as a bunch of hot air. But as it so happens, there’s more to pick apart here. And I mean a lot more.

So stay tuned. Because I’ll have a few counterpoints of my own to offer. And then you can decide for yourself whether a thoughtfully chosen arsenal of dietary supplements is worth keeping in your medicine cabinet.

 

 

A Man’s Penis bitten by a Snake – OUCH!

A Man’s Penis bitten by a Snake – OUCH!

 

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OK, the reality is that this may never happen to you. But it happens.

An Indian farmer in his mid 40’s had his penis bitten by a snake while urinating in the fields – then went to the emergency room (ER).

If you are into snakes – the type was a “gunas,” which is the local name of the Levantine viper (Macrovipera lebetina).

In the ER all vital signs were stable, with a grossly swollen penis and formation of bubble like lesions filled with fluid at the bitten areas.

(If your curious, GRAPHIC PICTURE here)

Initially, the patient was not clotting (very low clotting factors) and his blood was thinning. This is a potentially deadly situation caused from hemorrhaging.

The patient received anti–snake venom (a snake antivenom serum that neutralizes the venom of the cobra, common krait, and viper) with no adverse effects.

After a day in a half after treatment began, his clotting problem resolved and he was sent home and the swelling reduced 4 days after.

I wonder if this poor guy will ever pee again in the fields.

 

Just thought you’d find this interesting. 🙂

 

Reference:

Tajamul Hussain, M.D., and Rafi A. Jan, M.D. A Viper Bite

N Engl J Med 2015; 373:1059September 10, 2015

On Lamar Odom’s Tragedy and on ‘Herbal Viagra’

Lamar Odom

On Lamar Odom’s Tragedy and on ‘Herbal Viagra’

Basketball is my favorite sport. I like all levels of basketball: college, professional, Olympic, even high school. Here in New York City, high school basketball is big, and as a result, we praise any high school kid who is really good at the sport and follow their career.

One such player is Lamar Odom, who was a high school phenomenon at Christ the King high school in Queens, New York during the late 90s. He went on to have respectable a 10-year career on the NBA, although he may be better known to the masses as Khloe Kardashian’s ex-husband. Three days ago, he was found unconscious with white material oozing out of his mouth at a brothel near Las Vegas, Nevada.

Today, October 16, 2015 he is on life support at a hospital in Nevada.

Lamar Odom’s story is perplexing, tragic and simply sad. He has had a long history of addiction and substance abuse. What happened on October 13, 2015 that sent him to (what might possibly be) his death bed?

What we know:

Odom was snorting cocaine before a near fatal fall. He also took 10 tablets of “natural” sexual energy pills called Reload.

What’s scary about Reload is that the FDA issued a warning that this unnatural supplement contains sildenafil (Viagra) hidden in the ingredients list on the label.

Cocaine is a stimulant, causes the heart to beat faster and increases blood pressure. That level of stress to cardiovascular system can lead to a heart attack. Combining Viagra with cocaine can tear the body’s main artery, the aorta, which reduces blood to the brain. The overall outcome is often a stroke.

How big of a problem is the sexual supplement industry?

A very big problem. Virtually 25% or about 300 supplement formulas of sexual enhancement supplements are tainted with either Viagra, Cialis or Levitra.

This is a very big problem for two main reasons:

1. Taking ED pharmaceuticals unknowingly can be deadly as they cause widening of the arteries. This can be harmless and even beneficial in moderation, but too much can lead to low blood pressure. Excessively low blood pressure stresses the heart.

2. The bad publicity also stains the good players in the supplement industry, those who make legitimate and safe sexual health supplements.

Effective (truly natural) dietary supplements are not event driven; instead, their benefits accrue over time. Clinically, I notice that it takes about a week or so of daily use before experiencing satisfactory blood flow to sexual organs. A responsible sexual health formula gradually builds stamina, nourishes blood vessels, and improves your production of nitric oxide, which improves blood flow.

How to spot drugtainted sexual performance supplements:

  • If it sounds too good to be true, it is too good to be true.
  • Avoid supplements that claim to make your penis bigger. No dietary supplement does that.
  • Avoid anything sold in small packets of 2 to 10 pills.
  • Avoid anything with an FDA warning similar to those found on ED drugs. For example, “do not use with nitrates or do not use if you have heart disease or high blood pressure.”
  • Avoid supplements that promise fast results. No natural agent or combination of agents work that fast.

What should you do?

Buy supplements from trustworthy manufacturers, and do not expect immediate “home runs” when consuming them. Be suspicious of “magic in a bottle” claims. Understand that there is no short cut for improving your sexual health and vitality.  

Only by eating nourishing foods, exercising vigorously, making smart lifestyle choices, and consuming highquality dietary supplements will you earn your results, defy your age, and reclaim the sexual vigor that you once enjoyed. 

Here is an FDA list of sexual supplements shown to contain ED drugs.

Lamar Odom’s grim condition will require a miracle to overcome, I suspect. I wish our hometown basketball star, his two teenage kids and the rest of his family strength during this difficult period.

Sex Education video… a must watch.

I just came across to this video. I’d thought you’d enjoy it and learn from it.

I know and understand that your time is valuable to you,  so I warn you, this video is 21 minute video long. You will pee in your pants. (excuse the urologic pun here).  But believe me, it’s well, well worth it if you appreciate a fine blend of humor with education.

Enjoy!  Tell what you think below.