Dave Can’t get It Up
Dave is a lifter. He’s healthier than the average Westerner and he does a lot of things ideal when it pertains to training and diet. Sure, he drinks a little and stresses a lot. but who doesn’t, right?
But over the last year, Dave has been feeling fatigued. He’s also lacking motivation and drive, and he’s slowly been getting weight around the middle. He’s even starting to get soft around the chest. This is fairly common in men in their mid-thirties to forties, but way less common in a lifter. but what’s really bothering Dave are his erections. often they just don’t happen, and when they do they can’t be sustained.
Dave is actually a pal of mine. When he spoke to me about these issues I asked him two questions:
Are you on any type of anabolic steroid or just getting off of them? A well-known symptom of anabolics is when you come off of them the body has difficulty picking back up its own production of testosterone.
When’s the last time you had your testosterone levels checked?
Dave responded to “no” to the first question and “never” to the second question. So what’s going on here, and what must Dave do?
A crash course in Erections
The male erection is a closely orchestrated event between the nervous system and blood flow into and out of the penis. The brain registers a “sexually relevant” cue. This could be any number of things, and the stimulus action depends upon the man. It might be cuddling up with his partner or seeing his partner walking across the room naked. For others, it could require direct stimulation. The point is: the brain is the hub of erections.
Assuming the brain is adequately sensitized to a sexual stimulus, nerve impulses are sent to the penis. This triggers a host of biochemical events that involve chemicals like nitric oxide (NO) being released, which then trigger cellular cyclic GMP, which open the blood vessels allowing a lot more blood to flow in. While blood flow is boosted going in, a spongy layer of the penis, rich with capillaries, becomes engorged causing pressure to build up. This hydrostatic pressure triggers it to inflate.
This is all also contingent on a separate set of blood vessels that drain the penis. These vessels start to constrict under the boosting pressure and other biochemical events. The coordinated action of the incoming blood vessels, and the building pressure, is what allows blood to rush in and stay in, creating an erection.
Where does testosterone contribute to this entire process? We’ll get to that in a minute. first you need to know about the three B’s.
The three B’s
When you think of testosterone, libido, and erections, it’s valuable to have a framework: brain, biochemistry and blood flow.
1 – Brain
The sexual brain can be thought of as consisting of sexual stimulators and sexual repressors. Emily Nakowski, PhD, calls these “accelerators and brakes.” In buy for sexual desire to occur and sexual arousal to engage, the accelerators need to be turned up while the brakes are turned down.
It works like this: You’re sitting on the couch working frantically to get a proposal done for work. You’re stressed. Your girlfriend sits down next to you and starts rubbing on you. You register a “sexually relevant stimuli.” This hits the accelerators, but then the brain checks in on the context. The anxiety you’re under puts the brakes on. The degree to which the stimulus can amplify the accelerators, combined with the degree to which the anxiety is stepping on the brakes, will figure out the quality of the erection and response.
Many people get this all wrong. The brain is at work here and it’s not just an automatic stimulus action apparatus. There’s much a lot more happening. (By the way, women have far a lot more sensitive brakes compared to men. This is why foreplay and context are so much a lot more crucial for their sexual desire, arousal, and function.)
This is the same reason alcohol or a first date may result in a weak or a complete lack of erection, despite a strong desire. Every man, and likely lots of women, have experienced this phenomenon. The brain is critical, and relaxation with appropriate nerve stimulus to the penis is required. Women, it has nothing to do with you. and guys, it’s completely normal.
To understand this brain effect better, think “point and shoot.” The two branches of the nervous system are P, parasympathetic, and S, sympathetic. Parasympathetic is relaxing and sympathetic is stimulating. The balance of P and S is critical. To get a boner you need appropriate P, or parasympathetic outflow. think P for “point” to Camiseta Borussia Monchengladbach remember this. To ejaculate requires appropriate sympathetic outflow. think S for “shoot.”
So, a man who ejaculates too swiftly and/or has weak erections is taking care of poor parasympathetic (relaxing) outflow. Being overworked, overwhelmed, alcohol, stress, mood medications or any condition that disrupts nerve signaling could cause this, the most common being diabetes.
A man who’s unable to ejaculate, or takes forever to ejaculate, may be suffering from the opposite: poor sympathetic outflow. This too can be caused by stress, mood medications, and diabetes. This may also be a sign of the use of Viagra or another PDE5 inhibitor. For younger men who aren’t overweight, this is nearly always a result of some type of anxiety effect or medication.
Another brain worry has to do with the command and control center of the metabolism. The hypothalamus is an area of the brain that receives signals from other hormones and then coordinates other hormone-producing organs in the body.
The hypothalamus registers all the signals from the environment (site, sound, temperature, etc.) and signals from inside the body (exogenous hormones), then adjusts the metabolism as needed, much like a thermostat.
As it refers to the testicles, the hypothalamus releases gonadotropin-releasing hormone (GNRH), which binds in the pituitary and triggers the release of luteninizing hormone. LH then travels to the testicles, aiding sperm production and turning up testosterone production.
If this hypothalamus-pituitary-gonad communication link is compromised, it can drastically impact testicular function and testosterone. Testosterone inhibits feedback at the hypothalamus and can also be converted to estrogen by means of the enzyme aromatase. That estrogen plays a role in feedback to the pituitary, which is why the drug tamoxifen is often used in men.
The estrogen effect may come to be a major player here. We don’t yet have proof, but lots of natural medicine practitioners, like myself, believe the sharp rise of low testosterone in young men may be connected with the estrogen saturation in our environment. Estrogen-like compounds are anywhere now: our water, leaching out of plastics, sprayed on our food as pesticides, and the accumulation in the fat and milk of the animals we eat.
So when we think “brain,” we also want to be thinking hypothalamus. The other interesting thing here is that the hypothalamus and pituitary are also responsible for thyroid and adrenal function. These are vital to metabolic Camiseta Cruz Azul function: we call them the HP-Axi. HPT= hypothalamus-pituitary-thyroid axis (HPT), hypothalamus-pituitary-adrenal axis (HPA) and hypothalamus-pituitary-gonadal axis (HPG, i.e. testicles and ovaries).
This is why some therapies, like HCG, can be effective in multiple ways for men. It’s also why low libido and low testosterone issues, coming from the brain, normally result in fatigue, sleep disruption, mood issues, weight gain, cold intolerance, etc. When the hypothalamus “takes a hit,” it negatively impacts multiple downstream processes in the thyroid, adrenals, and gonads.
2 – Biochemistry
Remember, the nerve signals transfer into biochemical signals, including signaling molecules cGMP and nitric oxide. This is probably how testosterone gets involved in guideline of erection. When the brain sends nerve signals to the penis, nitric oxide is released and signals cGMP. This then dilates blood vessels and sets the erection cascade in motion with boosted blood flow in and decreased blood flow out.
cGMP is broken down by enzyme called phosphodiesterase 5 (PDE5). considering that PDE5 degrades cGMP activity, if it’s overactive, blood flow into the penis is slowed and erection is either absent or incomplete.
This is how Viagra, Cialis, Levitra and other erectile dysfunction drugs work. They each act as inhibitors to PDE5, prolonging action of cGMP activity, as a result allowing harder, longer enduring erections (yay science!).
This may also be where low testosterone comes in. Testosterone treatment increases nitric oxide activity and may stimulate healthy promotion of erectile tissue. Testosterone also may play a role in PDE5 inhibition because appropriate testosterone levels are required for these drugs to work.
Testosterone is also having an impact on the brain. It’s not completely understood how testosterone promotes libido and sexual function, but one of the hallmarks of any hormone is its ability to impact lots of enzymes and other hormone receptors involved in multiple areas. Testosterone is likely functioning as a priming apparatus for the male sexual brain and penile function. Without this primer, the entire cascade is disrupted.
3 – Blood Flow
Erectile dysfunction is really a blood flow problem. If nervous system function is good and testosterone levels are adequate, but blood flow is compromised, this is “no bueno” for erections.
For younger people who are not overweight, blood flow is likely not the primary issue. However, it will always be involved, which is why erection drugs work. Erection issues in older men, overweight men, and those with metabolic syndrome or diabetes, however, are nearly always about blood vessel issues. High blood sugar, high blood pressure, and inflammatory mechanisms are highly damaging to the cells lining the blood vessels. Theseare the same cells that are functioning through nitric oxide and cGMP.
This is why lifestyle corrections are so vital for men. a lot of men jump to testosterone and erection drugs, but studies show complete restoration of erections in men as old as eighty when lifestyle is corrected.
Erection issues are early alerting signs of cardiovascular disease. fixing the issue at this stage requires a complete upgrade of diet and lifestyle, including: weight loss, decreased sugar and carb intake, weight training, and anxiety reduction. In other words, stop living and acting like an imbecile when it pertains to your erections. If you want to sit on the couch crushing Cokes and crunching Doritos, then your penis is going to rebel at some point!
Unless you want to be reliant on enhancement drugs the rest of your life (which become less effective over time if you don’t right the underlying issue), and you don’t want to die of a heart attack or stroke, then get it together: eat ideal and manage stress. Taking testosterone in the context of an unhealthy lifestyle won’t do a thing for you.
Lifestyle, Testosterone, and Erections
For a lot of healthy men under the age of fifty, the issue is likely going to be brain or biochemistry related and NOT blood flow related. one of the first things you’ll see with low testosterone is a lack of morning wood.
Most men will want to jump ideal to testosterone replacement therapy, but not so fast. The thing you need to understand about hormones is that they work in context. You can’t simply throw testosterone into the mix and expect it to fix the issues. Hormones are like people and behave differently depending on the environment they’re in. Make sure the overall biochemistry is the proper configuration to have testosterone work correctly.
The first step is to live a testosterone-supportive lifestyle. The things that raise testosterone are:
Adequate macronutrient intake. get enough but not too much protein, fat, and carbohydrate.
Adequate calorie intake. Not too much and not too little.
Adequate intake of micronutrients. The three a lot of crucial for testosterone may be zinc, magnesium, and vitamin D. Being low in any of these will compromise testosterone levels. adding these in if you already have appropriate amounts will likely do nothing, but correcting deficiencies will.
Weight training and intense exercise. lifting weights reliably stimulates testosterone. intense exercise – high volume and heavy Camiseta Selección de fútbol de Japón loads – is best.
Enough but not too much exercise.
Lots of walking considering that this sensitizes the body to insulin and lowers the anxiety hormone cortisol, both of which indirectly and negatively impact testosterone.
Insulin, Cortisol & Testosterone
Since the hypothalamus is essentially a anxiety barometer, you don’t want to train too hard, too often, or for too long. You also don’t want to go to dietary extremes by cutting calories and/or carbs too low. Do enough, but not too much. otherwise you risk downstream negative effects flowing from a dysfunctional hypothalamus, which is negatively impacted by insulin resistance and excess cortisol.
Blood sugar management and insulin sensitivity are vital to testosterone. There’s a hormone called SHBG (steroid hormone binding globulin) that binds very strongly to testosterone, successfully eliminating it from the usable pool of hormones.
Insulin resistance and excess cortisol both raise SHBG. The end result is a reduction in usable testosterone, even when you’re making enough. Not to mention, excess cortisol and insulin have lots of other negative effects that interrupt metabolic function.
Diet
There are two dietary regimens I find beneficial as “off the shelf” recommendations for testosterone management: the 40-30-30 dietary method for heavy exercisers and athletes, and 30-40-30 for everyone else.
These formulas dictate the carb-protein-fat macronutrient ratios that I start a lot of men out with. If men are overweight, I suggest a calorie intake that can be calculated by multiplying your body
