Posts Tagged ‘plaque’

Eating Yourself Limp

January 2, 2016

Andrew Siegel MD   1/2/16


Today’s entry is on the topic of how overeating and obesity affect one’s manhood and vitality (this holds true for female sexual function as well).  While optimal sexual function is based on many factors, it is important to recognize that our food choices play a definite role. What we eat—or don’t eat—impacts our sex lives.  It’s a new  year– a fresh start–and time for many resolutions, which often involve weight loss and a healthier lifestyle.  Yet another benefit of becoming leaner and fitter is improved sexual function. 

Sexuality is an important part of our human existence. Healthy sexual function involves a good libido, the ability to obtain and maintain a rigid erection and the ability to ejaculate and experience a climax. Although not a necessity for a healthy life, diminished sexual function can result in loss of self-esteem, embarrassment, a sense of isolation and frustration and even depression.

Sexual functioning is complicated and dependent upon a number of systems working in tandem– the endocrine system (which produces hormones); the central and peripheral nervous systems (which provide nerve control); the vascular system (which conducts blood flow); and the musculo-skeletal system (specifically the pelvic floor muscles that help maintain the high blood pressures in the penis necessary for erectile rigidity).

Sexual function is a good indicator of underlying cardiovascular health. A healthy sexual response is largely about blood flow to the genital and pelvic area. The penis is a marvel of engineering, uniquely capable of increasing its blood flow by a factor of 40-50 times over baseline, this surge happening within seconds and responsible for the remarkable physical transition from flaccid to erect. This is accomplished by relaxation of the smooth muscle within the penile arteries and erectile tissues. Pelvic muscle engagement and contraction help prevent the exit of blood from the penis, enhancing penile rigidity and creating penile blood pressures that far exceed normal blood pressure in arteries. For good reason, Gray’s Anatomy textbook over 100 years ago referred to one of the key pelvic floor muscle as the “erector penis.”

Blood flow to the penis is analogous to air pressure within a tire: if there is insufficient pressure, the tire will not properly inflate and will function sub-optimally; at the extreme the tire may be completely flat. Furthermore, slow leaks (that often occur with aging and failure of the smooth muscle within the penile arteries and erectile tissues to relax) promote poor function.

Just as your car suffers a decline in performance if it is dragging around too much of a load, so you penis will function sub-optimally if you are carrying excessive weight. Obesity steals your manhood and reduces male hormone levels. Abdominal fat converts the male hormone testosterone to the female hormone estrogen. Obese men are more likely to have fatty plaque deposits that clog blood vessels–including the arteries to the penis–making it more difficult to obtain and maintain good-quality erections. Additionally, as your belly gets bigger, your penis appears smaller, lost in the protuberant roundness of your large midriff and the abundant pubic fat pad.

Remember the days when you could achieve a rock-hard erection—majestically pointing upwards—simply by seeing an attractive woman or thinking some vague sexual thought? Chances were that you were young, active, and had an abdomen that somewhat resembled a six-pack. Perhaps now it takes a great deal of physical stimulation to achieve an erection that is barely firm enough to be able to penetrate. Maybe penetration is more of a “shove” than a ready, noble, and natural access. Maybe you need pharmacological assistance to make it possible.

If this is the case, it is probable that you are carrying extra pounds, have a soft belly, and are not physically active. When you’re soft in the middle, you will probably be soft where it counts.  A flaccid penis is entirely consistent with a flaccid body and a hard penis is congruous with a hard body. If your is penis difficult to find, if you have noticed man-boob development, and your libido and erections are not up to par, it may be time to rethink your lifestyle habits.

Healthy lifestyle choices are of paramount importance towards achieving an optimal quality and quantity of life. It should come as no surprise that the initial approach to managing sexual issues is to improve lifestyle choices. These include proper eating habits, maintaining a healthy weight, engaging in exercise, adequate sleep, alcohol in moderation, avoiding tobacco and minimizing stress.

Eating properly is incredibly important, obviously in conjunction with other smart lifestyle choices. Maintaining a healthy weight and fueling up with wholesome and natural and real foods will help prevent weight gain and the build-up of harmful plaque deposits within blood vessels. Healthy fuel includes vegetables, fruits, legumes, nuts, whole grains and fish. Animal products—including lean meats and dairy—should be eaten in moderation. The Mediterranean-style diet is an excellent one for minimizing both sexual dysfunction and heart disease. Poor dietary choices with meals full of calorie-laden, nutritionally-empty selections (e.g., fast food, processed foods, excessive sugars or refined anything), puts one on the fast tract to obesity and clogged arteries that can make your sexual function as small as your belly is big.

Bottom Line: If you want a “sexier” lifestyle, start with a “sexier” style of eating that will improve your overall health and make you feel better, look better and enhance your sexual function.  Smart nutritional choices are a key component of sexual fitness. If you are carrying the burden of too many pounds, now is the perfect time to start on the pathway towards better health and reversing the sexual dysfunction that has been brought on by poor lifestyle choices. 

Wishing you a healthy, peaceful, happy (and sexy) 2016,

2014-04-23 20:16:29

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Amazon Kindle, Apple iBooks, Barnes & Noble Nook, Kobo) and paperback: Coming soon is The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health.

Author of Promiscuous Eating: Ending Our Self-Destructive Relationship With Food:

Co-creator of Private Gym, a comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training program. Built upon the foundational work of Dr. Arnold Kegel, Private Gym empowers men to increase pelvic floor muscle strength, tone, power, and endurance: or Amazon.


Peyronie’s Disease: What You Need To Know

December 28, 2012

Andrew Siegel. MD    Blog # 88

Peyronie’s Disease   is an inflammatory condition of the penis that causes scarring of the sheath surrounding the paired erectile cylinders within the penis.  As a result of this scarring, when an erection occurs, there is asymmetrical expansion of these erectile cylinders resulting in a penile curvature/angulation.  Peyronie’s causes a deformed and often uncomfortable erection that can dramatically interfere with a male’s sexual health.

Scar formation on the sheath of the erectile cylinders can cause pain with erections; penile curvature during erections; the presence of a penile scar or “plaque” that can be felt as a hard lump under the skin; a visual indentation of the penis described as an hour-glass deformity; and failure of the erectile bodies to properly fill with blood, causing erections of poor rigidity. Penile pain, curvature/angulation, and poor expansion of the erectile cylinders collectively can contribute to difficulty in having a functional and anatomically correct rigid erection suitable for satisfactory intercourse. The curvature can range from a very minor, barely noticeable deviation to a deformity that requires “acrobatics” to achieve vaginal penetration to an erection that is so angulated that intercourse is physically impossible.  The angulation can occur in any direction and sometimes involves more than one angle, depending on the number, location and extent of the scarring.


The angulation results from the scarring of the sheath of the erectile cylinders that, upon engorgement with blood, expand in an asymmetrical fashion. This situation is analogous to placing a piece of cellophane tape on a child’s balloon and then inflating it—where the tape (scar) is, the balloon cannot expand properly, resulting in an angulation at the point of the tape placement.

The prevalence of Peyronie’s is roughly 5% of the male population with a mean age of 57 years old. The underlying cause of Peyronie’s is unclear, but is suspected to be penile trauma, perhaps associated with vigorous sexual intercourse. The acute phase is characterized by painful erections and an evolving scar, curvature and deformity. The chronic phase that typically occurs a year or so after initial onset is characterized by absence of pain, stable deformity, and possible erectile dysfunction. Peyronie’s regresses spontaneously in about 15% of men, progresses in 40% of untreated men, and remains stable in 45% of men. Many men—understandably so—become very self-conscious about the appearance of their penis and the limitations it causes, and they avoid sex entirely.

Various treatment options include oral medications, topical agents, injections, shock wave therapy, and surgery.  Upon initial diagnosis, most men are started on oral Vitamin E, 400 IU daily, as this has the potential to soften the scar tissue causing the plaque. Unfortunately, however, none of the non-surgical options have proven to be very effective, because the essence of the issue is scar tissue in a very bad location.   This scarring sabotages the ability to obtain a straight and rigid erection. Erectile dysfunction can be managed with one of the oral E.D. medications including Viagra, Levitra, or Cialis.

If there is no response to conservative management of erectile dysfunction, a penile implant may be appropriate—this can manage the dual problems of erectile dysfunction and penile angulation. If erections are adequate, but angulation precludes intercourse, options include procedures that attempt to neutralize the angulation effect of the plaque by doing a nip and tuck opposite the plaque in an effort to make expansion more symmetrical.  Although this technique is effective in improving the angulation, it does so at the cost of some penile shortening, and I have yet to find a man who is pleased with losing penile length. Other more complex procedures involve incising or removing the scar tissue and using grafting material to replace the tissue defect.

Bottom Line: When scar tissue is only an anatomic consideration but not a functional consideration, it may be cosmetically unappealing, but is actually not such a bad situation.  However, when scar tissue occurs on an area of the body that moves, expands or acts as a conduit, it affects form as well as function, which is not a good thing. Thus a scarred elbow can impact mobility of the joint, scarred lungs can disturb breathing dynamics, a scarred bile duct can cause jaundice and scarred erectile cylinders can cause Peyronie’s disease. Unfortunately, it comes down to scar tissue in a bad place.


Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food:

Available on Amazon in paperback or Kindle edition

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