#237 - Erectile dysfunction may mean chronic disease & early death | Dr. Merrill Matschke & Dr. Casey Means - (Replay)
Nov 16, 2023
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Dr. Merrill Matschke and Dr. Casey Means discuss the connection between metabolic dysfunction and erectile dysfunction, how ED develops, oxidative stress, the importance of testosterone levels in insulin sensitivity, and the role of diet, exercise, and sleep. They also talk about the reasons for dropping testosterone levels and the need for improvement in our healthcare system.
Erectile dysfunction can be an early indicator of future cardiovascular disease, endothelial dysfunction, and early death.
Low testosterone levels have a significant impact on metabolic health, particularly in men, leading to endothelial dysfunction and erectile dysfunction.
Obesity and metabolic disorders contribute to low testosterone levels in men, further impairing nitric oxide production and promoting cardiovascular risk.
Testosterone and sperm counts are declining globally, highlighting the importance of lifestyle changes for reproductive health and hormone production.
Deep dives
The Impact of Low Testosterone and Erectile Dysfunction on Metabolic Health
Low testosterone (T) levels have a significant impact on metabolic health, particularly in men. The decrease in T is associated with obesity and metabolic disorders such as type 2 diabetes. Low T can lead to endothelial dysfunction, which affects nitric oxide production and impairs blood flow, resulting in erectile dysfunction (ED). ED is an early warning sign of cardiovascular disease and can be more significant than other risk factors like smoking. Addressing low T through testosterone replacement therapy has shown improvements in insulin resistance, glucose levels, and an increased cure rate of type 2 diabetes.
The Connection between Metabolic Health and Sexual Function
Metabolic health plays a crucial role in sexual function, including erectile function. Endothelial dysfunction, oxidative stress, and inflammation are common factors that impact both metabolic health and sexual function. The health of the penis is a strong indicator of overall endothelial health, as both conditions are influenced by nitric oxide production and oxidative stress. The changes in lifestyle, including nutrition, exercise, and adequate sleep, are key factors in improving metabolic health, supporting healthy nitric oxide production, and promoting healthy sexual function.
The Interplay between Testosterone, Obesity, and Diabetes
Obesity and metabolic disorders like type 2 diabetes contribute to low testosterone levels in men. Visceral adiposity, the hormoneally active fat found in obesity, releases inflammatory cytokines that can affect testosterone production centrally in the hypothalamus and locally in the testes. Low testosterone levels further impair nitric oxide production, promoting endothelial dysfunction and cardiovascular risk. Addressing metabolic issues through diet, exercise, and stress management can help improve testosterone levels and overall metabolic health.
Declining Testosterone and Sperm Counts as a Concern for Reproductive Health
Testosterone and sperm counts are declining globally, leading to concerns about reproductive health. Factors such as obesity, insulin resistance, and oxidative stress negatively impact testosterone levels and sperm production. Studies have shown dramatic declines in sperm counts over the past few decades. Lifestyle changes, including a healthy diet, regular physical activity, stress reduction, and adequate sleep, may help improve testosterone levels and sperm production, promoting better reproductive health.
Obesity and metabolic health
Obesity is believed to be strongly linked to various health issues, including reproductive health problems. Obesity affects hormone production at both the hypothalamic and testicular levels, leading to issues such as low testosterone levels, smaller testes, and erectile dysfunction. The epigenetic impact of parents' health and lifestyle choices can also influence the reproductive health of their offspring. Addressing obesity and improving metabolic health can have significant positive effects on reproductive health.
Declining sperm count and infertility
There is a significant decline in sperm count, particularly in developed countries. Studies have shown that semen parameters are decreasing, leading to a corresponding increase in infertility rates. Factors contributing to this decline include obesity, sleep-related issues, stress, and endocrine-disrupting chemicals found in our food, water, and environment. The decline in sperm count and increase in infertility rates signal the need for preventive measures rather than relying solely on assisted reproductive technologies to overcome fertility issues.
Practical recommendations for improving sexual function and fertility
Implementing dietary and lifestyle changes can have a positive impact on sexual function and fertility. Recommending a diet focused on whole foods and avoiding added sugars and processed carbohydrates is crucial. Introducing fasting concepts, such as time-restricted eating, can also be beneficial. Addressing sleep hygiene, reducing stress levels, and minimizing exposure to endocrine-disrupting chemicals are essential factors in promoting overall metabolic health and optimizing sexual function and fertility.
Erectile dysfunction can be an early indicator of future cardiovascular disease, endothelial dysfunction, and early death. Learn more in this conversation betweenurologist and male reproductive specialist and surgeonDr. Merrill Matschke and Levels Co-Founder and Chief Medical Officer Dr. Casey Means. Look for multiple new shows per week on A Whole New Level, where we have in-depth conversations about metabolic health and how the Levels startup team builds a wellness movement from the ground up in the health and wellness tech industry.
Levels helps you see how food affects your health, empowering you with the tools needed to achieve health goals and improve healthspan. Levels Members gain access to the Levels app and continuous glucose monitors (CGMs), providing real-time feedback on how diet and lifestyle choices impact your metabolic health.
Look for new shows every month on A Whole New Level, where we have in-depth conversations with thought leaders about metabolic health.
🎙 What Dr. Merrill Matschke & Dr. Casey Means discuss:
(00:00) – Intro
(13:24) – The connection between metabolic dysfunction and erectile dysfunction
(21:44) – How ED develops
(33:42) – Let’s talk about oxidative stress
(39:40) – The importance of testosterone levels in insulin sensitivity
(46:21) – The importance of diet, exercise, and sleep
(48:16) – Why is testosterone dropping?
(59:28) – Our healthcare system needs to do better
