It’s all about blood flow – treating erectile dysfunction - Baltimore Post-ExaminerBaltimore Post-Examiner

It’s all about blood flow – treating erectile dysfunction

If you’ve heard commercials for the erectile dysfunction (ED) drug Cialis®, you’ve heard that ED is “all about blood flow.” While blood flow is crucial, there are also psychological reasons that prevent men from obtaining and/or maintaining an erection. Men who think that ED is part of the general decline associated with aging often lose confidence about their sexual performance and this makes the problem worse. No one has told them that ED is NOT a normal sign of aging.  It is a sign of clogged inflamed arteries that can be healed with lifestyle changes.

To understand the cause of ED you have to understand some basic male physiology.The penis contains 2 spongy balloons that are made up of a network of arteries and veins. The arteries bring blood in and the veins carry blood out. When a man is aroused his brain signals the arteries in his penis to relax and allow blood to flow in. As the arteries fill up they squeeze the veins and shut them off. This prevents the outflow of blood and maintains a firm erection. The faster blood flows into the arteries, the firmer an erection will be.

penis blood circulationIf the arteries in the penis are clogged by atherosclerosis this slows down blood flow and weakens erections. We normally worry about atherosclerosis in the arteries that supply the heart because blockage in those arteries can cause a heart attack and death. While ED won’t kill you, it should still be taken seriously because it is a warning that your small arteries may be clogged and it’s only a matter of time before the larger arteries are also clogged.

Arteries comparative sizes.jpg

Drugs like Viagra® and Cialis® temporarily relax arteries but they don’t unclog them. These drugs work by boosting the effects of nitric oxide, a gas that signals blood vessels to relax. Nitric oxide widens blood vessels all over the body. These drugs work for about 83 percent of people who try them but they may have serious side effects as you’ve heard in the commercials.

If you’re concerned about ED and want to improve blood flow naturally you have to change how you eat. The ONLY way to reverse atherosclerosis and unclog your arteries is to stop eating cholesterol-containing foods. These foods include meat, chicken, fish, eggs, milk, and cheese. This may take a while, so in the meantime you can eat foods that contain nitrates to boost nitric oxide production.

Be careful, nitrates are not nitrites. Nitrites are used to preserve meats and react with protein to form nitrosamines that can cause cancer. Foods that are naturally high in nitrates include:


Pistachios also boosts nitric oxide and sexual performance.

Foods high in citruline also boost nitric oxide production. Nitric oxide is made from the amino acids arginine and citruline. Taking arginine is not helpful because it is broken down by digestion. Citruline forms arginine that is then converted to nitric oxide in the cells. Foods high in citruline improve sexual performance. Watermelons are very high in citruline, especially yellow watermelons. Yellow watermelons have four times as much citruline as red watermelons. Blended watermelon pulp makes a delicious refreshing drink.

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If you decide that it’s worth eating arugula and giving up chicken to have good sex, you may also want to work on your relationship with your partner. Less than 50 percent of prescriptions for drugs like Viagra are actually refilled each year. This may be because underlying emotional reasons for lack of interest in sex, such as long-standing unresolved resentment and anger, cannot be fixed by taking a pill, eating vegetables or unclogging arteries.




About the author

Dr. Jennifer Rooke

Dr. Jennifer Rooke is an Assistant Professor in the Department of Community Health and Preventive Medicine at Morehouse School of Medicine. She recently joined the faculty at Morehouse to start a lifestyle medicine clinic. Lifestyle Medicine is the use of interventions such as evidenced-based nutrition, physical activity and stress management to treat disease. Dr. Rooke has practiced medicine for over 27 years and is board certified in both Occupational Medicine and Public Health/Preventive Medicine. Dr. Rooke is a fellow of both the American College of Occupational and Environmental Medicine, and the American College of Preventive Medicine. Dr. Rooke serves as adjunct faculty in the Department of Family and Preventive Medicine at Emory University. Contact the author or visit her website Contact the author.