Erectile dysfunction from non-pyschological issues is one of the first signs of a decrease in endogenous nitrous oxide production. Insufficient nitrous oxide (NO) production sets the stage for the progression of heart and vascular disease in general.
The implications of decreased NO spread father than vascular disease. Decreased vascular flow in the brain leads to dementia and Alzheimer's as well as hypertension and thrombotic events (stroke).
NO declines with age, but this is believed to be largely due to increased insulin resistance.
The increase in circulating glucose, insulin and cytokines that occurs in diabetes type 2 or pre-diabetes have all been independently shown to impair NO activity in experimental models.
Insulin resistance is controlled with dietary and lifestyle changes that can be quite rewarding in their own right let alone the beneficial domino effect in the bedroom.
Under normal healthy conditions, when sexually stimulated, NO is produced in the penis and signals blood vessels to dilate and accommodate more blood flow and volume. Without this pathway functioning, erectile activity is reduced and or non-sustained.
Note, this is the same mechanism for erectile activity in women of the analogous organs and without clitoral enlargement orgasm is difficult or impossible to achieve. And for achievement oriented people, this can be frustrating or in the case of many of my patients, depressing.
Proper NO production is essential for maintaining normal blood pressure, preventing clots, and healthy sexual function. The inability to generate adequate NO is one of the first signs of a number of chronic disease we associate with normal aging but needn't be.
NO levels can be tested easily employing a simple salivary test performed in my Chicago area office. Treatment consists of lifestyle changes and very specific supplements that enhance nitrous oxide production. Levels are then re-tested a few weeks into treatment or can be implicated in patient reporting.