Sexual Health

When Mr Happy Does Not Work For Erectile Dysfunction

Someone from my newsletter list unsubscribed and delivered this comment:
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


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


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 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 , 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 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

Blog_smells copy


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!


SnakeViper_s_39543829 copy


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. 🙂



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.

Women’s Sexual Health Overview


Invited Expert AuthorsEvery now and then we’ll invite authors to write on this platform particularly when their expertise is a million times greater than mine. Female Sexual Health is one of those areas where my knowledge is limited. And yes, we have lots of female readers too at Enjoy!

Women’s Sexual Health Overview

By Robert Valenzuela, MD & Seth Cohen, MD

Women have more sexual health complaints than men, and women with sexual health problems have significant impairment of their life quality. Ironically, the study, diagnosis and treatment of women with sexual health concerns is limited.

“Sexual health” refers to a state of physical, emotional, mental and social well-being. Women have the right to a positive and respectful sexual relationship, and to have pleasurable and safe sexual experiences.

Following Masters and Johnson’s groundbreaking work in the early 1970s there was a flurry of scientific inquiry into the etiology and treatment of female sexual dysfunction. With the introduction of an oral treatment for erectile dysfunction, sildenafil (Viagra), a second renewed wave of scientific enthusiasm regarding female sexual dysfunction evolved. Now with the support from various medical and surgical societies like International Society for Sexual Medicine (ISSM) and the International Society for the Study of Women’s Sexual Health (ISSWSH), new treatment models are being studied and utilized in offices to treat female arousal problems.

Low Sexual Desire


Hypoactive sexual desire disorder (HSDD), refers to a persistent or recurring deficiency or absence of sexual fantasies or thoughts and desire for or receptivity to sexual activity that causes personal distress according to DSM-IV.

A woman’s sexual desire naturally fluctuates over the years. Highs and lows commonly coincide with menopausal status. Medications like antidepressants, anti-seizure medications and birth control all can cause low sex drive in women of any age.


Important to the treatment of any patient with HSDD is to start with a comprehensive history, followed by complete physical exam and lastly a full hormonal workup. By utilizing these three techniques the astute physician can come to a diagnosis and treatment approach quickly and efficiently.

Once the diagnosis has been made, hormone supplementation may be required to help achieve success; however, there are many non-hormonal techniques that can be utilized to correct low desire.

Sexual Arousal Disorders


Female sexual arousal disorder (FSAD) is a disorder characterized by a persistent or recurrent inability to attain sexual arousal or to maintain arousal until the completion of a sexual activity. The diagnosis can also refer to an inadequate lubrication-swelling response normally present during arousal and sexual activity.

This condition should be distinguished from a general loss of interest in sexual activity and from other sexual dysfunctions, such as the orgasmic disorder (anorgasmia) and hypoactive sexual desire disorder.


Female sexual arousal disorder is a complex problem with multiple overlapping etiologies. There are many treatment options with the optimal therapy depending on the etiology of the problem.

Available therapeutic options include adjusting medications, counseling, treating depression or anxiety, reducing stress and fatigue, sex therapy, devices and hormone supplementation therapy.

Painful Sex (Dyspareunia)

Biologic patho-physiologies resulting in woman’s sexual health problems associated with sexual pain may occur in the clitoris, urethra, bladder, vulva, vestibule, vagina, and pelvic floor muscles.

Clitoris, Prepuce:

In women with focused clitoral pain, clitoral itching, or clitoral burning, careful inspection of the glans clitoris should be performed. Failure to visualize the whole glans clitoris with the corona is consistent with some degree (mild, moderate, or severe) of prepucial phimosis, based on the elasticity of the prepuce and its ability to retract on examination. Since phimosis may create a closed compartment, phimosis is often the underlying pathology in clitoral glans balanitis associated with recurrent fungal infections.


Genital sexual pain in the vulva/vestibule may be related to varied specific disorders like hormonally mediated vestibulodynia, neuroproliferative vestibulodynia, and dermatologic conditions like lichen sclerosis and lichen planus.

Hormonally Mediated Vestibulodynia:

Hormonally mediated vestibulodynia symptoms are similar to those of neuroproliferative but seen more commonly in young women who have been exposed to birth control pills and menopausal women. Symptoms include vaginal dryness, painful sex (dyspareunia), itching and burning upon palpation of the vestibule.

Neuroproliferative Vestibulodynia:

Neuroproliferative vestibulodynia is a disorder seen less commonly than hormonally mediated vestibulodynia; it is seen in younger women who have either been living with vestibular pain since they “can remember” (congenital) or have developed symptoms over time. 

Hormone Imbalance and Female Sexual Dysfunction:

Androgens play an important role in healthy female sexual function, especially in stimulating sexual interest and in maintaining desire. Androgens are also vital for the health and maintenance of vaginal tissues including the vulva, vestibule and vagina.

There are a multitude of reasons why women can have low androgen levels with the most common reasons being age (pre- and post-menopause), oophorectomy and the use of oral contraceptives.

Symptoms of androgen insufficiency include absent or greatly diminished arousal, sexual motivation and/or desire, and persistent unexplainable fatigue or lack of energy, and a lack of sense of well-being.



APA Summary of Practice-Relevant Changes to the DSM-IV-TR.

Graham, Cynthia A. (2009). “The DSM Diagnostic Criteria for Female Sexual Arousal Disorder”. Archives of Sexual Behavior 39 (2): 240–55.

Bancroft, J. (2005). The endocrinology of sexual arousal. Journal of

Endocrinology, 186, 411–427.

Singer, B. (1984). Conceptualizing sexual arousal and attraction. Journal of Sex Research, 20, 230–240.

Laan, E., & Both, S. (2008). What makes women experience desire? Feminism & Psychology, 18, 505–514.

Arch Sex Behav. 2004 Dec;33(6):527-38.

Turning on and turning off: a focus group study of the factors that affect women’s sexual arousal.

Graham CA1, Sanders SA, Milhausen RR, McBride KR.

Bancroft, J. Central inhibition of sexual response in the male: A theoretical perspective. Neuroscience and biobehavioral reviews. (1999) 23, 763-784

Dennerstein, L., Burrows, G. D., Wood, C., & Hyman, G. (1980). Hormones and sexuality: Effect of estrogen and progestogen. Obstetrics and Gynecology, 56, 316–322.


Fitness Does a Lot for Your Sex Life

Fitness Does a Lot for Your Sex Life


The Takeaway First

High levels of physical activity are linked to better performance in bed, reports a new study published last week in the Journal of Sexual Medicine. And it turns out the daily workout you need to boost your staying power isn’t extreme at all.

Study Details

  • 295 male veterans participated in the study.
  • Participants represented multiple racial groups.
  • Men whose sexual performance benefited from the exercise were logging 18 METs per week, which is the equivalent of 2 hours of strenuous exercise, 3.5 hours of moderate exercise, or 6 hours of light exercise.

My Take on This

I like to tell my patients that the penis is the “barometer” of male health. The cardiovascular system carries blood to every part of the body through arteries, a few of which makes its way down to the penis. These provide the penile tissues with oxygen and nutrients from day to day, and they also engorge the erectile tissues during an erection. Because erections depend on an unobstructed blood flow to the penile arteries, if a man can’t keep it up, I often look into health of his heart.

If one of my patients is having trouble keeping it up, I also remind him that the other most important factor in achieving and maintaining an erection is the state of your brain. If you’ve ever tried to have sex when your mind was somewhere else, you understand this. Stress from work, unresolved relationship conflict, guilt, anxiety—psychological disturbance not only saps the energy and interest from sex, but it also keeps your parasympathetic nervous system (PNS) in a chokehold. The PNS is the part of your nervous system that helps you relax and feel at ease, and it’s also the system that triggers erections. It’s the circuit breaker that can shut down any turn-on.

Now, this relates to exercise in an indirect way. Regular moderate to vigorous exercise decreases your resting heart rate and can help to reduce anxiety by raising your body’s stress tolerance. With a higher stress tolerance, it’s easier for your brain to engage your PNS at the right time.

What Should You Do?

If you’re having problems keeping it up, do two things. First, check your heart. Are you out of shape? Do your daily activities leave you winded? If so, it’s time to make changes in your lifestyle to strengthen your cardiovascular system. You can achieve 18 METs per week just by walking for one hour a day. And this is the very least you can do. But if you’re unsure of yourself or have other complicating health problems, talk to your naturopathic or functional medicine doctor about what kinds of physical activity are best for you.

The second thing you should do is check your mind. What goes through your mind when you’re getting ready for sex? Are you distracted? Worried? Self-conscious? Going through performance anxiety? Sometimes the answers are obvious, and sometimes they’re not, but digging a little deeper for the root cause of your confidence problem could uncover a lasting solution. Keep in mind that there is no relationship closer than the one between your body and your mind.

Related posts:

Does Size Matter

Stress and Testosterone

Nutrients for sexual health



Ross M Simon, Lauren Howard, Daniel Zapata, Jennifer Frank, Stephen J Freedland, Adriana C Vidal. The Association of Exercise with Both Erectile and Sexual Function in Black and White Men. The Journal of Sexual Medicine, 2015;