A multifaceted approach to maximize erectile function and vascular health

Meldrum, David R.; Gambone, Joseph C.; Morris, Marge A.; Ignarro, Louis J.

doi:10.1016/j.fertnstert.2010.04.026

Cited by 41 publications

(46 citation statements)

References 57 publications

(65 reference statements)

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“…49 Pycnogenol is a commercial preparation of polyphenolic compounds that has been extensively investigated, is well standardized and improves erectile function at a dose of 80-120 mg per day. 50 Ginseng has also been shown in a randomized trial to improve ED compared with placebo. 50 Vitamin C increases vascular NO; a dose of 500 mg daily was shown to have a pronounced beneficial effect on blood pressure in patients with uncomplicated hypertension compared with placebo.…”

Section: Excessive Alcoholmentioning

confidence: 99%

“…50 Ginseng has also been shown in a randomized trial to improve ED compared with placebo. 50 Vitamin C increases vascular NO; a dose of 500 mg daily was shown to have a pronounced beneficial effect on blood pressure in patients with uncomplicated hypertension compared with placebo. 51 …”

Section: Excessive Alcoholmentioning

confidence: 99%

“…68 Inset: PON-1 activity was significantly decreased in men with ED (Po0.001). 3 Lifestyle, metabolism and erectile function DR Meldrum et al including various combinations of the listed interventions, 50 such as the favorable effects on ED of combining testosterone and sildenafil, 36 or of the Mediterranean diet, which increases intakes of omega-3's, antioxidants and folic acid. 74 …”

Section: Reduction Of Inflammation Improves Endothelial Function and Edmentioning

confidence: 99%

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Lifestyle and metabolic approaches to maximizing erectile and vascular health

et al. 2011

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Oxidative stress and inflammation, which disrupt nitric oxide (NO) production directly or by causing resistance to insulin, are central determinants of vascular diseases including ED. Decreased vascular NO has been linked to abdominal obesity, smoking and high intakes of fat and sugar, which all cause oxidative stress. Men with ED have decreased vascular NO and circulating and cellular antioxidants. Oxidative stress and inflammatory markers are increased in men with ED, and all increase with age. Exercise increases vascular NO, and more frequent erections are correlated with decreased ED, both in part due to stimulation of endothelial NO production by shear stress. Exercise and weight loss increase insulin sensitivity and endothelial NO production. Potent antioxidants or high doses of weaker antioxidants increase vascular NO and improve vascular and erectile function. Antioxidants may be particularly important in men with ED who smoke, are obese or have diabetes. Omega-3 fatty acids reduce inflammatory markers, decrease cardiac death and increase endothelial NO production, and are therefore critical for men with ED who are under age 60 years, and/or have diabetes, hypertension or coronary artery disease, who are at increased risk of serious or even fatal cardiac events. Phosphodiesterase inhibitors have recently been shown to improve antioxidant status and NO production and allow more frequent and sustained penile exercise. Some angiotensin II receptor blockers decrease oxidative stress and improve vascular and erectile function and are therefore preferred choices for lowering blood pressure in men with ED. Lifestyle modifications, including physical and penile-specific exercise, weight loss, omega-3 and folic acid supplements, reduced intakes of fat and sugar, and improved antioxidant status through diet and/or supplements should be integrated into any comprehensive approach to maximizing erectile function, resulting in greater overall success and patient satisfaction, as well as improved vascular health and longevity.

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Section: Excessive Alcoholmentioning

confidence: 99%

Section: Excessive Alcoholmentioning

confidence: 99%

Section: Reduction Of Inflammation Improves Endothelial Function and Edmentioning

confidence: 99%

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Lifestyle and metabolic approaches to maximizing erectile and vascular health

et al. 2011

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“…Exercise among PC survivors is also associated with decreased mortality [76]. For sexual functioning after PC treatment, minimizing tobacco and excessive alcohol use, and communicating with partners about feelings and sex, are self-management strategies for improving sexual relationships and intimacy [77]. Avoiding spicy, greasy foods, coffee and alcohol, and staying well-hydrated may help limit the adverse bowel effects of radiation (i.e.…”

Section: Introductionmentioning

confidence: 99%

Optimizing veteran-centered prostate cancer survivorship care: study protocol for a randomized controlled trial

Skolarus

Metreger

Hwang

et al. 2017

Trials

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BackgroundAlthough prostate cancer is the most common cancer among veterans receiving care in the Veterans Health Administration (VA), more needs to be done to understand and improve survivorship care for this large population. This study, funded by VA Health Services Research & Development (HSR&D), seeks to address the need to improve patient-centered survivorship care for veterans with prostate cancer.Methods/DesignThis is a two-armed randomized controlled trial (RCT) with a target enrollment of up to 325 prostate cancer survivors per study arm (total anticipated n = 600). Patients will be recruited from four VA sites. Patient eligibility criteria include age range of 40–80 years, one to ten years post-treatment, and currently experiencing prostate cancer symptom burden. We will compare the “Building Your New Normal” program, a personally-tailored automated telephone symptom management intervention for improving symptom self-management to usual care enhanced with a non-tailored newsletter about symptom management. Primary outcomes include changes in symptom burden, bother, and health services utilization at five and 12 months after enrollment. Secondary outcomes include long-term psychosocial outcomes (e.g. subjective health, perceived cancer control). We will use multivariable regression analysis to evaluate the impact of the intervention on primary and secondary outcomes. We will conduct a process evaluation to understand the effective intervention components and explore possibilities for broader implementation and dissemination.DiscussionOur central hypothesis is that intervention group participants will have improved and more confident symptom self-management and prostate cancer quality of life following the intervention and that these outcomes will translate to more efficient use of health services. The study results will provide much needed information about how to optimize the quality of care, and life, of veteran prostate cancer survivors.Trial registrationClinicalTrials.gov ID NCT01900561; Registered on 22 July 2013.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1925-4) contains supplementary material, which is available to authorized users.

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“…[1213] It is an important antioxidant for countering oxidative stress-induced injury in the aged population. [1415] Vitamin E has also been reported to improve NO-mediated arterial relaxation as well as maintain cellular membrane integrity and protein stability.…”

Section: Introductionmentioning

confidence: 99%

The effects of combined free radical scavenger and sildenafil therapy on age-associated erectile dysfunction: An animal model

et al. 2014

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Introduction:Aging results in erectile dysfunction that is partially attributed to decreased nitric oxide (NO) and increased free radical generation. Vitamin E enhances endothelial cell function and acts as a free radical scavenger; however, its benefits on erectile function in the elderly are unknown.Aims:The aim of the following study is to determine if Vitamin E alone, or in combination with the phosphodiesterase 5 inhibitor sildenafil, may improve erectile function and the NO signaling in a cohort of aged (13-15 month old) rats.Materials and Methods:Male Sprague-Dawley rats (n = 28) were divided based upon age into young (4-5 months old, n = 7) and aged (13-15 months old, n = 21) cohorts. Aged rats were treated with Vitamin E, sildenafil or a combination of both. Penile cavernosal and dorsal nerve tissues were evaluated for neuronal nitric oxide synthase (nNOS) and caveolin-1 expression. Erectile function was assessed through intra-cavernous pressure (ICP) recordings.Results:nNOS and cavoelin-1 were significantly decreased in aged rats compared with young controls. In aged rats, both Vitamin E and sildenafil partially recovered nNOS expression but when combined, a synergistic elevation in nNOS was observed. The significant decreases in ICP recorded in aged rats were improved with sildenafil; however, Vitamin E did not yield any additional improvements in ICP.Conclusions:Diminished levels of nNOS and caveolin-1 are found in aged rats. When combined with sildenafil, Vitamin E synergistically increased nNOS expression. Since biochemical gains were not realized physiologically, other contributing factors likely exist.

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A multifaceted approach to maximize erectile function and vascular health

Cited by 41 publications

References 57 publications

Lifestyle and metabolic approaches to maximizing erectile and vascular health

Lifestyle and metabolic approaches to maximizing erectile and vascular health

Optimizing veteran-centered prostate cancer survivorship care: study protocol for a randomized controlled trial

The effects of combined free radical scavenger and sildenafil therapy on age-associated erectile dysfunction: An animal model

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