The Blue Pill vs. the Orange Pill--
Why two bathtubs? As the two lovers, each in a separate bathtub, stare lovingly out at the sunset, the viewer wonders why they are separated and not entwined in one tub. But this is the age of ED, erectile dysfunction, something that was not spoken of in polite conversation, until the last ten years.
The man in the bathtub, previously characterized as impotent or unable to perform sexually, is one of 18 million Americans suffering from ED, a condition that can be alleviated with a small pill, in this case Cialis (tadalafil). With a daily 5-milligram dose he can be ready for sex at any time. What an improvement over Viagra and Levitra, two competing ED drugs that only work for four hours! Drug producer Eli Lilly & Company says sales of the drug exceeded $1 billion in 2007.
The little pill comes with its ample list of not-so-serious side effects: headache, facial flushing, indigestion, back pain, nasal congestion, muscle pain, pain in arms and legs, angina, high blood pressure, dry mouth, insomnia, vertigo, unexplained rash, blurred vision, seeing a blue tinge to objects or not recognizing the difference between blue and green, decrease or loss of hearing, migraines, prolonged erection lasting more than four hours, or painful erection lasting more than six hours.
Consider some serious side effects
Like so many pharmaceuticals, Cialis, the orange pill and its cousins Viagra (sildenafil citrate), the blue pill, and Levitra (vardenafil hcl), also an orange pill, belong to a class of drugs called phosphodiesterase (PDE) inhibitors. Taken before a sexual episode, these drugs enhance the effects of nitric oxide that relaxes smooth muscles in the penis during sexual stimulation and induces increased blood flow. These PDE inhibitors alleviate the symptoms of ED instead of attacking its cause and developing a cure.
According to the American Urological Association, common conditions that cause ED are vascular disease, diabetes, and neurological disease. Lifestyle choices and side effects of medications are other causes.
Vascular diseases, particularly arteriosclerosis or hardening or narrowing of arteries, account for up to 70% of ED cases due to physical causes. High cholesterol and high blood pressure are other factors in vascular disease and can result in ED.
Diabetes linked to ED
Lifestyle choices like smoking, abusing alcohol and drugs, and not exercising will also have their effect on blood vessels in the penis.
More than 200 drugs, both over-the-counter and prescription medications, can cause ED problems.
Psychological problems like anxiety, stress, and depression are estimated as the culprits in 10% to 20% of ED cases.
According to two studies reported on May 19, 2008 on washingtonpost.com, ED problems may be a warning signal for serious heart problems. A Hong Kong study of 2,306 diabetic men who had ED but no signs of heart disease were 58% more likely to have a heart attack or coronary problem in the next four years than those with adequate sexual function.
An Italian study followed 291 men with diabetes and early heart disease for four years. Those with ED were twice as likely as men without the problem to have major coronary events as well as strokes.
"These reports add two things to what we already know," said Dr. R. Parker Ward, associate professor of medicine at the University of Chicago. " One is that they indicate the importance of erectile dysfunction in diabetic patients in terms of predicting future cardiovascular events. These studies suggest that the additional presence of erectile dysfunction places them at incrementally higher risk. Secondly, they show that even when considered in combination with traditional risk factors, erectile dysfunction offers incremental information about the risk of future cardiovascular events."
Impotence signals blocked arteries
Barnard emphasizes that artery blockage can be prevented with diet and lifestyle changes and points to Dr. Dean Ornish's work as proof that a low-fat vegetarian diet "is the key to beginning the cleanup of your arteries.
"I'm suggesting that people get to know vegetarian foods," says Barnard. "Simple foods. Beans, vegetables, fruits and legumes. The good thing is, we're seeing athletes saying, 'That helps my performance.' We're having people who've had erectile dysfunction saying, 'I didn't realize that was reversible by changing your diet and getting circulation back again.'"
Eat yourself impotent
Dr. McDougall makes an interesting comparison between the diameter of the penile artery and the left anterior coronary artery. "The penile artery has a diameter of 1 to 2 mm, whereas the proximal left anterior descending coronary artery is 3 to 4 mm in diameter, " he explains. "An equally sized atherosclerotic plaque burden in the smaller penile arteries would more likely first compromise flow compared with the same amount of plaque in the large coronary artery causing angina."
Dietary and lifestyle changes are at the top of Dr. McDougall's list to alleviate ED problems. "Fortunately, with a change in diet and a little exercise most of our patients are able to lower their blood pressure and get off of their 'erection deflating' medications, and they are able to reduce their 'plaque burden' by reversing the underlying atherosclerosis," says McDougall. "My male patients, and sometimes their mates, often share with me tales of renewed vigor and vitality. Now there's a valid reason to eat vegetables."
To those plagued by ED the message is quite clear. The colored pill may provide a few moments of pleasure, but it offers no solution to the problem. Instead of sitting in that bathtub gazing at the sunset and waiting for the pill to take effect, consider a lifestyle change that includes a low fat vegan diet and an exercise program. It might not only help you in the ED department, but it could also improve your overall health.
Barnard, Neal. "Doctor in the House." PeTA's Animal Times, Fall 2007: 23.
Barnard, Neal. Interview with Tavis Smiley. Tavis Smiley Show. KCET, Los Angeles, January 29, 2007 http://www.pbs.org/kcet/tavissmiley/archive/200701/20070129_barnard.html
Edelson, Ed. "Erectile Dysfunction a Strong Harbinger of Heart Trouble." Washingtonpost.com, May 19, 2008
"Five Tips for Staying Sexually Active." Urology Times, October 1, 2007: pSS10
McDougall, John. "Eat Yourself Impotent." http://www.drmcdougall.com/misc/2008nl/mauy/fav5.htm
Reinberg, Steven. "Erectile Dysfunction Affects 18 Million U.S. Men, HealthDay News, February 1, 2008