Conditions We Treat

It is estimated that up to 30 million American men suffer from Erectile Dysfunction(ED). Therefore, if you are experiencing ED, you are not alone. Achieving an erection is a multifaceted process that can be largely affected by hormonal imbalances, nervous system imbalances, and various forms of stress. The most important step in overcoming ED is figuring out what’s causing your dysfunction in the first place. Only by resolving the cause of your ED can you hope to achieve a healthy, long lasting solution to this very common and frustrating problem.

Lately, you can’t turn on a TV without seeing various commercials promoting prescription and herbal remedies that are being hyped to help solve your ED issue. While these remedies may actually work to help you achieve an erection, none of these quick-fixes are addressing the root cause of your problem. This is concerning because erectile dysfunction is a symptom of some sort of imbalance in your body. If your symptoms are merely covered up by some sort of remedy (whether prescribed by your doctor or some “all natural boosters”) your original problem will remain and may eventually lead you to developing a serious health problem.

What Are the Root Causes of Erectile Dysfunction?

A common underlying contributor in men with erectile dysfunction is low testosterone. Low testosterone is a very common problem in men and has been associated with a myriad of other problems like high blood pressure, heart disease, diabetes, depression, and many other symptoms. Unfortunately, low testosterone is extraordinarily common as are the television advertisements promoting products to help treat what has become popularly known as “low T”.

The truth is that none of these products treat the cause of your low T; they only provide a drug and/or herb that are promoted to elevate your testosterone. Whether or not these products work to increase your testosterone is subject to debate. Nonetheless, the more important issue (if you do have low T) is…

WHY is your testosterone low in the first place?

Men, like yourself, normally have both estrogen (a mostly female hormone) and testosterone (a predominantly male hormone) in your body. Unfortunately, many men have elevated levels of estrogen while simultaneously low levels of testosterone. Why does this happen? There is an enzyme named Aromatase in your body that coverts testosterone into estrogen and vice versa. If your Aromatase enzyme activity is elevated, your testosterone will be converted into estrogen. What causes your Aromatase enzyme activity to be elevated? High insulin levels will upregulate the activity of aromatase enzyme, turning your muscle building, libido enhancing, and health protecting hormone, testosterone, into the feminizing hormone, estrogen! There are also many other substances that you may be frequently exposed to that can raise your estrogen and contribute to low T. For example, soy is touted as a “heart-healthy” food because it contains no cholesterol or saturated fat. However, soy has phytoestrogenic properties (plant derived estrogen) which can put a serious hurt on your testosterone levels and your ability to rise to the occasion. In fact, ancient monks in the orient purposefully consumed soy products in order to reduce their libido and make their celibate lifestyles easier. Therefore, if you want to keep your testosterone at a healthy level, you want to make sure to avoid consuming excess sugars and starches and all soy products. In fact, the so called “heart–healthy” foods being hyped will contribute to low T, because your testosterone is made from cholesterol which is found in foods that contain saturated fat. The truth is, the best diet for improving testosterone is a diet filled with meats, eggs, fish and cheese.

Erectile Dysfunction and the “Fight or Flight” Response

Another manifestation of a high carb, low fat (so-called “heart-healthy”) diet is that this diet results in unstable blood sugar levels which can be a disaster if you are attempting to achieve an erection. Your physiology works like this: if you eat a high sugar, high carbohydrate, low fat meal, your blood sugar levels will go sky high, then your insulin levels will shoot up to lower your blood sugar. Often times your sugar will actually drop too low (this is called reactive hypoglycemia) and low sugar will stimulate your adrenal glands to secrete adrenaline into your system. Adrenaline will then initiate what is known as the “fight or flight” response. It is nearly impossible to have an erection when your nervous system is undergoing the “fight or flight response. In fact, any factor that causes anxiety (whether related to your blood sugar or situational stress) will activate your “fight or flight” response and contribute to ED. This “fight or flight” response is also known as “performance anxiety” and can not only lead to ED, but also premature ejaculation.

Stress and Low T

Another major factor causing Low T is stress. Any type of stress (whether caused by your diet, working too hard, immune system problems, lack of sleep, situational stress, and many other factors) will cause your adrenal glands to secrete the stress hormone named cortisol. High cortisol levels can severely impair your ability to make testosterone (and can simultaneously raise your estrogen levels) via its effects on your thyroid gland, your liver, and even parts of your brain (like your pituitary gland and your hypothalamus). Therefore, although low T is associated with heart disease and diabetes, this does not mean that taking some sort of “testosterone booster” will reduce your risk of these diseases. The hard truth (or in this case the not so hard truth) is that the factors that cause low T also cause these diseases and merely taking some “testosterone booster” will not (in general) benefit your health.

Other Causes of ED and Low T

Other contributors to ED and Low T are excessive exercise (which is a form of stress). Believe it or not, exercise programs that are based on mundane repetitive workouts such as running on a treadmill, jogging, long distance cycling, and other “plodding” type exercises can actually raise your estrogen and lower your testosterone. A better exercise approach would be high intensity, low volume training like sprint interval training and weight lifting. Short bursts of vigorous exercise will actually increase your testosterone levels and is much better for your heart and your joints.

Sunlight deficiency can lead to ED and Low T because real natural, full spectrum sunlight is vital to your hormonal balance and overall health. Have you ever noticed you have a better libido after spending the day at the beach? Adequate sunlight should be considered an essential nutrient. Unfortunately, you may be spending too much time indoors, exposed to artificial lights. These man-made (junk) lights may illuminate your environment allowing you to see, but over exposure to them can be devastating to your health (and your sex life).

What About Viagra?

Viagra and similar prescriptions alike work by enhancing blood flow to your penis by increasing your nitrous oxide levels. Nitrous oxide is a chemical found in every cell of your body which can dilate the blood vessels of your penis. These ED drugs were actually originally created to treat symptoms of angina (lack of blood flow to your heart). However, researchers found that the men being studied with these heart drugs often times had an erection as a “side effect” of the medications. You can surmise that the potential danger of these ED drugs is that that they may cause excess blood flow any place in your body that is under the influence of nitrous oxide. Consequently, taking these drugs can lead to a lot of cardiovascular manifestations including low pressure, headaches, visual problems and other “side effects”. Given the fact that these ED medications are potentially dangerous, it would be in your best interest to figure out the root cause of your erectile dysfunction rather than just treating your symptoms. By taking Viagra or other ED medications, you’re ignoring the underlying cause of your problem which can range anywhere from hormonal imbalance, stress, anxiety, or even a bad relationship with your partner.

ED and Low T – A Consequence of “Modern” Lifestyles

This epidemic of sexual dysfunction and hormonal imbalance is yet another symptom of our unnatural and often unhealthy modern lifestyles that may be contributing to your ED and Low T. The combination of low fat, “heart-healthy” foods, excessive stress, “plodding” exercise routines, and lack of natural sunlight are undoubtedly causative to the metabolic disturbances leading to much suffering (and poor sexual functioning).

Unfortunately, if you suffer from “low T” and ED, these symptoms may represent the “tip of the iceberg” when it comes to your health. Bear in mind that ED and “low T” are associated with heart disease, high blood pressure, diabetes and a host of other health related issues. Many doctors (and patients) are operating under the erroneous assumption that if you merely smear some testosterone gel on your body or take some “natural testosterone booster” than all will be fixed. This simplistic notion and approach is very often ineffective and may even be downright dangerous!

No Lead in My Pencil! What Should I Do?

The good news is that if you (and your doctor) find and fix the underlying metabolic imbalances causing your ED and/or “low T”, then you have now genuinely fixed your problem and you can expect to improve your health in countless ways.

When working with Dr. Rothman on a treatment plan, he will prioritize his treatment plan in the following manner;

• Recommend a diet that is truly heart healthy (and brain healthy and skin healthy and hormone healthy ….). He will also recommend other lifestyle changes that need to be addressed to facilitate well-being, proper hormone levels and adequate sexual functioning (proper sunlight, sleep, exercise)
• Measure imbalances in your body chemistry and physiology that can lead to dysfunction (and eventually disease) and then apply specific metabolic therapies to shift these imbalances in the proper direction. For example, you may have excessive alkalinity in your systemic system (this is actually very common). This alkalinity could lead you to have problems metabolizing carbohydrates, hence raising your blood sugar levels, leading you to have high insulin levels, elevated aromatase levels and finally to high estrogen, low testosterone and thyroid dysfunction (and of course weight gain and high risk for heart disease and diabetes)
• Prescribe bio-identical hormone replacement therapy (like testosterone) when appropriate bearing in mind how testosterone replacement can impact your metabolic balance systems. For example, testosterone therapy will increase your sympathetic nervous system tone (your “fight or flight response”), increase your oxygen dependent processes at your tissue level (therefore increasing your oxidative stress and “free radical production”), make you less alkaline at the systemic level, increase your thyroid function and many, many other physiologic effects.
• Prescribe medications, when needed for short-term, acute problems that would benefit from pharmacological interventions.

This Metabolically Directed approach has achieved significant success for his patients and can help you! And finally, the biggest aphrodisiac is your mind and using it to your fullest potential, knowing that your internal issues are solved, should help you overcome erectile dysfunction. See, it wasn’t that hard!