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Johns Hopkins Health - First Signs

Winter 2016
Issue No. 31

First Signs

Date: February 2, 2016


A Johns Hopkins men’s health expert discusses the ways your sexual vitality may predict your future well-being.

When it comes to taking action on preventive health care, men “are just wired differently” than women, says Kevin Billups, M.D., director of the Johns Hopkins Men’s Health and Vitality Program. That’s something he would like to see change. A good start: getting men to recognize the close link between their sexual vitality and their overall health. Erectile dysfunction, defined as either an inability to get an erection or a problem maintaining a strong erection, says Billups, “is the canary in the coal mine” when it comes to a host of serious health issues, chiefly cardiovascular disease.

You’re familiar with the mechanics of an erection: Blood flows into the penis and collects in lake-like structures. These swell, then pinch off the outflow of blood, creating an erection. “Many men with ED have blood inflow problems, but the earliest symptom of ED is often an inability to keep a rigid erection. This happens when you have venous leak,” he says. “The tissues in the penis aren’t relaxing, so those lakes can’t expand fully and pinch off the veins. Blood leaks out, like a bucket with a hole in it.”

That venous leak isn’t just a sign of problems in the bedroom—it’s an early, clinical symptom of heart disease. “The vascular system in the body is all connected,” says Billups. “The problem manifests first in the penis, because it’s easy for a man or his partner to notice ED, but the oxidative stress and inflammation that are causing poor relaxation of the penis vascular tissue is also likely happening in other parts of the body.

“If ED brings a guy in,” he continues, “it’s great because we can address other health issues he may not know about,” like hypertension and prediabetes. He would also like men to get a full physical exam so he can discuss exercise, nutrition, sleep and stress. “Erectile dysfunction ends up being a useful way to engage men in taking better care of themselves and making their health a priority.”

Good men’s Health Habits at Every Age

What men (and the women who love them) need to know about preventive health care as they get older:

20s and 30s

Determine your baseline numbers for blood sugar, cholesterol and blood pressure.

Quick boost: Do a monthly cancer self-check in the shower by rolling each testicle between fingertips, to feel for abnormal lumps and growths.

40s and 50s

Make necessary lifestyle changes to protect your heart and fend off cancer, like getting more sleep, maintaining a healthy weight, quitting smoking and drinking alcohol in moderation only.

Quick boost: Ask your doctor to check your testosterone levels—a “low T” level can signal prediabetes.

60s and Up

Yearly checkups are increasingly important; ask about a full cardiovascular evaluation and more detailed tests (such as a stress test) if you have any symptoms.

Quick boost: Remember that sexually transmitted diseases can occur at every age—so don’t skip protection.

At age 40, 40 percent of men are affected by ED to some degree .
Watch Kevin Billups, M.D., discuss the state of men’s health and ways to improve it on the Men's Health and Vitality site.


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