Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“Erectile dysfunction…[is] defined as the recurrent or persistent inability to attain and/or maintain an erection in order for satisfactory sexual performance.” It is “present in up to 30 million men in the U.S. and approximately 100 million men worldwide.” Wait a second. The U.S. has less than 8% of the world’s population, yet up to 30% of the impotence? We’re #1!

Who cares, though? We’ve got red, white, and blue pills, like Viagra. The problem, though, is the pills just cover up the symptoms of vascular disease, and don’t do anything for the underlying pathology. Erectile dysfunction and our #1 killer, coronary artery disease, are just two “Manifestations of the Same Disease”—inflamed, clogged, and crippled arteries—regardless of which organ.

Atherosclerosis is considered “a systemic disorder that uniformly affects all major [blood vessels in the body.]” Hardening of the arteries can lead to softening of the penis, because stiffened arteries can’t relax normally, open wide, and let the blood flow. So, erectile dysfunction may just be the flaccid “tip of [an] iceberg,” in terms of a “systemic…disorder.” In two-thirds of men showing up to emergency rooms for the first time with crushing chest pain, their penis had been trying to warn them for years that something was wrong with their circulation.

Why does it tend to hit the penis first? Because the penile arteries in the penis are half the size of the coronary arteries in our heart—that particular artery is the so-called widowmaker. So, the same amount of plaque in the heart, that you wouldn’t even feel, could half clog the penile artery, causing a symptomatic restriction in blood flow. You may not feel chest pain until about here. That’s why erectile dysfunction has been called “penile angina.” In fact, by measuring blood flow in a man’s penis, you can predict the results of his cardiac stress test with an accuracy of 80%. “[M]ale sexual function [is like a] penile stress test…[,] a ‘window to the hearts of men.'”

“40% of men over 40” have erectile dysfunction. Men getting erection difficulties in their 40s have a 50-fold increased risk of having a cardiac event—like sudden death.

You’ve heard me say various things, you know, increase heart disease risk 20%, 30%. That’s nearly 5,000%, leading the latest review to ask: “is there any risk greater?” That’s because it’s not so much a risk factor for atherosclerosis; it is atherosclerosis.

A man with erectile dysfunction (even if he has “no cardiac symptoms) should be considered a cardiac…patient until proved otherwise.” It’s considered to be a “cardiac equivalent,” right? It’s a marker of the coronary artery disease you likely already have. “There is therefore more to treating [erectile dysfunction] than just establishing an erect penis, as [it] offers an opportunity for reducing cardiovascular risk.

The reason that even young men should care about their cholesterol is because it predicts erectile dysfunction later in life. And, that predicts heart attacks, strokes, and a shortened lifespan. Just going to keep eating crap because you can pop some pills? All the Viagra in the world may not help your sex life, after a stroke. The take-home message is a simple equation: ED stands for “early death.”

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