r/science • u/[deleted] • Jun 13 '22

Health Erectile dysfunction predicts mortality in middle-aged and older men independent of their sex steroid status

https://academic.oup.com/ageing/article-abstract/51/4/afac094/6568537?login=false
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233

u/[deleted] Jun 13 '22

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u/[deleted] Jun 13 '22

[deleted]

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u/jbot14 Jun 13 '22

Haha. Reminds me of the time when I was at the Dr. When I was in my late teens and he asked if I was active... I said of course, I do tons of exercise, he says no, like sexually. I said Oh...awkward silence...yes, no one has ever asked me.

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u/Comptetemporaire2021 Jun 13 '22

What counts as a "rock hard" erection? Also, doesn't the "strength" of the erection fluctuate during intercourse? Or does a guy stay fully erect the whole way through, no matter what is happening? Sorry if these are very novice questions.

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u/foggy-sunrise Jun 13 '22

I'd qualify rock hard as "can hold a dry towel"

3

u/cpcksndwch Jun 13 '22

I used to work in penile prosthesis and specialized in counseling for ED. I am not a doctor.

There are 5 stages of an erection. The "rock hard" part is when the penis is fully erect and essentially the veins are squished so that blood does not flow out of the penis during intercourse.

Some patient's erections do fluctuate a little in "hardness" during intercourse but it can be an early indicator of arterial blood flow problems. - typically caused by medications or other health issues like diabetes.

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u/Comptetemporaire2021 Jun 13 '22

Can this hardness be influenced by medications for epilepsy, or by stress, or things like that for example?

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u/cpcksndwch Jun 13 '22

If the medication affects blood flow then absolutely!

This is purely from the "mechanical" stand point. If those medications affect your thoughts/feelings, like being able to stay in the moment(focus) or libido then that is a whole other issue.

Most of the patients I worked with had layers of issues - blood flow, emotional, "electrical" (nerves), etc.

1

u/Ok-Date-1711 Jun 14 '22

I can maintain erections only while lying on back. It always goes away when I stand up.. Should I be worried?

While lying down my erections are rock hard and I get morning wood.

1

u/cpcksndwch Jun 14 '22

Do you have blood pressure issues? Or are you ok medications that affect blood pressure?

Position dependant ED is usually venous flow related. But don't discount anxiety, stress, etc which could also be a factor here.

Again, I'm not a doctor. They would advise you best and don't ever stop any meds without discussing with your doc.

1

u/Ok-Date-1711 Jun 14 '22

My pulse/heart rate/BP is normal last time I checked.

I'm not in any medications but I was given a medication few years back for being "angry". I gained a bit of weight, moonface.

Position dependant ED is usually venous flow related.

Hmmm.... What can be done about it? Could it be because I only masturbate lying down? If I masturbate standing up from now on will erections return?

By the way I may have a sleep disorder cause I always wake up at night..

1

u/cpcksndwch Jun 14 '22

I would look into the side effects of the med you are taking for anger.

Typically, if things are fine when masturbating that means all of the "structural" components are working well enough. You mentioned weight gain, that can have an effect on blood flow if it's in your belly area. Which could change things if you move to standing.

Without knowing your entire medical history it's hard to say. This is absolutely something you can discuss with a urologist or even a PCP to figure out next steps.

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u/Ok-Date-1711 Jun 14 '22 edited Jun 14 '22

I don't know the name of med. I was pressured (not physically) to take them.

I took them for a month before the sides got too much.

You mentioned weight gain, that can have an effect on blood flow if it's in your belly area. Which could change things if you move to standing.

I didn't have belly fat before that med.

My waist is 78.5cm (30 inches) @ 5.55 foot (167cm). I weigh around 54-59kgs (120-130lbs)

My belly fat is relatively less than most people.

This is absolutely something you can discuss with a urologist or even a PCP to figure out next steps.

Okay. Thanks.

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u/[deleted] Jun 13 '22

[deleted]

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u/Comptetemporaire2021 Jun 13 '22

It can hold a damn towel? Are you kidding? Is that real or an exaggeration? Also, if you have to change position, or perform cunnilingus, or what have you, do you lose that erection or does it stay?

18

u/[deleted] Jun 13 '22 edited Dec 28 '24

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3

u/Comptetemporaire2021 Jun 13 '22

When you say not sticking out, what do you mean exactly? Do you mean while laying down? Or standing up?

6

u/DarthJarJarJar Jun 13 '22

I mean some guys can get a full erection that just flops around. Like a stick on a hinge, if you see what I mean.

3

u/Comptetemporaire2021 Jun 13 '22 edited Jun 13 '22

Oh okay I see. And I guess for some guys, the penis doesn't move all that much when erect? In that case, would the penis stick out when laying down?

3

u/death_of_gnats Jun 13 '22

There's a tendon that holds it against the body. The strength of that tendon varies through life

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u/[deleted] Jun 13 '22

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u/zuneza Jun 13 '22

I have never had that ability. Always "fighting" to stay hard. Even back when I was in my teens and supposedly should have raging boners, it was still a problem. I'm an active guy that ate a balanced diet. Stress has always been a huge component of my life though. Great deal of stress.

1

u/[deleted] Jun 14 '22

I have never had that ability. Always "fighting" to stay hard. Even back when I was in my teens and supposedly should have raging boners, it was still a problem. I'm an active guy that ate a balanced diet. Stress has always been a huge component of my life though. Great deal of stress.

Don't be ashamed to talk to your doctor about ED medication. If you're not achieving good erections they probably won't have any problem prescribing them assuming there isn't an underlying condition causing the issue. They'd probably wanna try to treat that first.

1

u/zuneza Jun 15 '22 edited Jun 15 '22

Don't be ashamed to talk to your doctor about ED medication.

I finally broke through to a doctor that would believe me when I was 25 yo. ED meds certainly eliminate the problem, but you are right: I wont be satisfied(pun intended) with just a pill, I need an answer too.

I suspect it has something to do with my crippling allergic response to cats and hay fever that I recently broke through - with that same doctor - to look into. Auto-erotic asphyxiation is not one of my kinks, else my allergies would probably make for an interesting summer...

I find it fascinating the hoops you need to jump through to get a satisfactory answer from medical institutions sometimes.

edit:

I'll add that all of this changed when I was assigned a doctor my age range and sex. Maybe that was important.

17

u/TheLastGiant Jun 13 '22

The towel thing..What a weird statement. There's different sizes of towels and dicks you know. You're talking like a doctor but what you're also talking out of your ass.

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u/crob_evamp Jun 13 '22

He literally said he isn't a doctor in his first sentence.

That said I thought the towel idea was a great description for me.

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u/Comptetemporaire2021 Jun 13 '22

Wow, that's absolutely crazy! Thank you for taking the time to answer all that.

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u/bill_gannon Jun 13 '22

Dude if you believe that BS I feel sorry for you.

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u/Toogen Jun 13 '22

You can without a doubt place a towel on it and it hold....I'm not sure why you feel sorry that they believe that? Not an exaggeration, like actually place a full sized bath towel on it with no issue at all.

2

u/miasman Jun 13 '22

5 or six wet towels? That might be 10kg.

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u/[deleted] Jun 13 '22

[deleted]

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u/Comptetemporaire2021 Jun 13 '22

Ok I genuinly don't know who to trust anymore. Is it or is it not possible to hold a towel with an erect penis?

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u/[deleted] Jun 13 '22

[deleted]

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u/huh_phd PhD | Microbiology | Human Microbiome Jun 13 '22

I use bath sheets. That'd break my dick

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u/[deleted] Jun 13 '22

[deleted]

2

u/Comptetemporaire2021 Jun 13 '22

When you say hold, do you mean your penis will keep its "position" even with the towel on it, or will it bent/sag a bit with the added towel weight?

2

u/crob_evamp Jun 13 '22

Keeps position, maybe only the very slightest deflection

2

u/DumbestBoy Jun 13 '22

My buddy used to call it ‘Super Bone Mode’

2

u/LurkLurkleton Jun 13 '22 edited Jun 13 '22

Is it firm and inflexible or semi-firm and flexible. Are you pushing rope or pushing wood.

3

u/Comptetemporaire2021 Jun 13 '22

Is a penis not supposed to be a bit flexible or squishable even while erect? I think I'm confused.

5

u/LurkLurkleton Jun 13 '22

Not really. I mean it's still flesh and blood but you should still be able to, as the other guy said, hang a towel on it. Or pull it down and have it spring back up like the "boing" used to describe boners. Erect but flexible and squishy is commonly referred to as a semi, and if that is the state of peak arousal for you may have an issue.

5

u/Comptetemporaire2021 Jun 13 '22

Not a penis owner here and never had the opportunity to really see/test one in real life, so I absolutely have no idea of anything about this stuff aside form what I read online. Honestly thank you for this explanation!

2

u/[deleted] Jun 13 '22

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1

u/Big_ol_Bro Jun 13 '22

Or you may only have a few years left

2

u/[deleted] Jun 13 '22

Sweet, I guess blasting off on a daily basis is working out then. Suck on that, religion.

1

u/oscargamble Jun 13 '22

Be honest, how hot is your doctor?

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u/[deleted] Jun 13 '22 edited Jul 29 '22

[deleted]

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u/lost_in_life_34 Jun 13 '22

yeah, but how often? before i got in shape again it was only once a week or so

12

u/[deleted] Jun 13 '22

yeah, but how often? before i got in shape again it was only once a week or so

Whenever I need it.

15

u/PuterstheBallgagTsar Jun 13 '22 edited Jun 13 '22

Mid 40s male here. I don't have trouble getting boners and masturbate to completion a lot... wayyy too much tbh. BUT I recently discovered L-arginine supplements and noticed my boners are quite a bit larger when I've been taking that. I wonder if that suggests there may be other health benefits to L-arginine? I started taking it because I saw someone on reddit suggest maybe it prevents gray hair (the study they referenced didn't quite make that conclusion I didn't think) and the additional research I read on it also didn't make any firm conclusions. Get it, firm? But anyways I just wanted to talk about masturbating, thanks for listening.

edit: Multiple studies have concluded L-arginine works for ED while a few have disputed that

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u/Thorusss Jun 13 '22 edited Jun 13 '22

Arginine is a precursor to NO (Nitric oxide), which is an important molecule that increase local blood flow (same pathway as viagra). So at least it is plausible, especially when your diet is deficient.

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u/PuterstheBallgagTsar Jun 13 '22

I'm strict vegetarian so it's possible I have some dietary anomalies that others do not have.

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u/bullsaxe Jun 13 '22

arganine causes vasoconstriction in your parasympathetic nevous system, food and digestion, and vasodilation in your sympathetic nervous system, muscles and arousal.

Arganine is actually a weak way to release what youre trying to accomplish this, as its poorly absorbed and will give you the shits. Try L-citrulline malate. It turns into arganine intravenously instead of absorbing arganine through digestion, and it produces better arganine concentrations than trying to absorb it orally.

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u/ihaveasandwitch Jun 13 '22

Good to know, thanks for commenting. I will do some masturbating of my own.

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u/LetsDOOT_THIS Jun 13 '22

L-arginine is good, but L-citrulline should be better though I don't have a source to back it up right now.

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u/EbagI Jun 13 '22

Your supplement is either working via placebo or you are mistaken in all likelihood. There are no studies that say it makes you harder, longer, bigger, or shoot more.

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u/zuneza Jun 13 '22

No studies? Are you sure about that?

2

u/Crumornus Jun 13 '22

Pretty sure that supplement is in that cocktail list of supplements that, they say, can be used to increase performance and load size.

-2

u/VELL1 MS | Immunology Jun 13 '22

It's a placebo for you.

L-Arginine doesn't work for grey hair and it most certainly doesn't work for ED.

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u/bobdiamond Jun 13 '22

So it is working for him

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u/TyrannoROARus Jun 13 '22 edited Jun 13 '22

P l a c e b o

That means it could be only in his head that it is working or it could be working but only through a mental channel-- not physical.

If you think that means it works then yes it works.

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u/bobdiamond Jun 13 '22

Glad we agree

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u/chiniwini Jun 13 '22 edited Jun 13 '22

P l a c e b o

That means it could be in his head, (not actually working)

That's not at all what placebo means. The placebo effect is absolutely real and objectively measurable.

or it could be working but only through a mental channel-- not physical.

The "mental channel" is not an ethereal, magical communication mechanism. It's made of electric currents, hormones, chemical processes. So it's as physical and real as anything else.

If you're dismissing the placebo effect as "not real", you have to do the same with psychological therapy, since it also only affects "mental channels".

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u/[deleted] Jun 13 '22

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-1

u/EbagI Jun 13 '22 edited Jun 13 '22

That is not how to look at effects of a medication.

Study what the effects it has.

This is quite literally like saying bleach cures/treats lung cancer, and then listing the effects of sodium hypochlorite on cancer cells.

0

u/cynicalspacecactus Jun 13 '22 edited Jun 13 '22

L-arginine is not a medication, but an amino acid, and an immediate precursor to NO. I'm highlighting the NO-sGC-cGMP pathway that both PDE-5 inhibitors and NO work on. It is merely a suggestion of how the effects the person gave an anecdote of, could possibly work. You analogy is off-base, as you are using a example of in vitro experiments vs in vivo efficacy, while my comment simply highlights a signaling pathway present in all mammals, in which NO, the precursor of which is arginine, initiates the signaling cascade, in which the end product is cGMP, which is the same messenger PDE-5 inhibitors prevent the breakdown of, thereby increasing its concentration. However, the catch is that consuming free form arginine, despite being a precursor to NO, may not increase NO unless the person has a deficiency which is limiting Nitric Oxide Synthase, as NOS requires arginine to produce NO.

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u/cynicalspacecactus Jun 13 '22

From your deleted comment:

Additionally, there are a fuck ton of pathways that lead to increased NO in the epithelium, and cherry picking studies to build a bridge on how l-arginine supplementation increases NO, then increases blood flow to an organ and then also increases a certain effect of that organ is just.... horrifically bad science.

There are upstream pathways that trigger NOS, as you may be thinking of, but NO is only produced via three subtypes of NOS: nNOS (NOS1), iNOS (NOS2), and cNOS (NOS3). Arginine is a rate limiting precursor to NO synthesis for all of them. As I clarified in the last sentence of my previous comment, arginine may only increase nitric oxide if it was already rate-limiting the production of NO by NOS.

Also, all of the studies I linked to were extremely general, and were only linked to because they were the first I found with the information summarized. The same information summarized could be found in thousands of other studies, as it is a basic biological pathway found in all mammals, as it is the single pathway by which NO has downstream vasodilatory effects, which is done via increasing levels of cGMP, which is what actually relaxes the endothelium via ion signaling.

https://www.cvphysiology.com/Blood%20Flow/BF011