Running: Knowing the Risks and Benefits!

As the warm weather approaches, runners who’ve been using indoor tracks and treadmills during the winter will be coming outdoors to exercise.  Here’s what you need to know before you begin an outdoor running regimen.

PREPARATION

Before you hit the pavement—cement, asphalt or track— see your primary care physician, says St. Joseph Mercy Oakland family medicine specialist Ricardo Cabrera, MD.  He or she will determine if you’re healthy enough to run.  “If you have medical discomfort, bring it to the attention of your physician,” Dr. Cabrera advises.

Secondly, you’ll need the proper equipment and clothing.  Dr. Cabrera recommends dressing appropriately for the weather.  Wear shoes that fit properly.  Then, prepare your body.  Do warm-ups, such as stretches.  Most importantly, start slowly and increase your distance as your stamina improves.  “The biggest mistake is doing too much too soon,” he warns.  “Ease into it and be patient.”

With running shoes, it’s not how much you spend; it’s the right fit that counts. Often, people think that the more expensive the shoe, the better it is.  Dr. Cabrera says that’s not the case.  The shoe should not be too big, too small or loose, and “you need a reasonably good arch support,” he suggests.  Socks should always be worn to prevent friction. Breathable cotton is best since it absorbs sweat.

Dr. Cabrera also recommends whenever possible picking a surface that will limit injury.  Tracks are best because “they are meant to run on.”  A track has a cushion to absorb shock and has some give, where hard surfaces can be tougher on knees or ankles.  At the same time, a soft surface, like the beach “can cause pain and discomfort because you don’t have the support” of a harder surface, he advises.

In inclement weather, runners may want to use a treadmill to keep up the momentum.  Dr. Cabrera says treadmills are “a good alternative to running outside,” but there is a downside.  Runners have been known to fall off treadmills because they are going so fast. If you use a treadmill, take the proper precautions.

And what about diet?  Dr. Cabrera says a balanced diet is best.

BENEFITS

According to Dr. Cabrera, running is good for your health. “Running has cardiovascular benefits that will enhance your overall well-being.  It makes the body run more efficiently, and can help fight illness, lower bad cholesterol (LDL) and increase good cholesterol (HDL).”

Ricardo Cabrera, MD, joined the medical staff of St. Joseph Mercy Oakland in Pontiac in August 2008.  A board-certified specialist in family medicine, Dr. Cabrera earned his medical degree at the Autonomous University of Guadalajara, Mexico, and did his residency at North Oakland Medical Centers (now Doctors Hospital), where he chaired the Department of Family Medicine.  His professional memberships include American Academy of Family Practice, American Board of Family Medicine, Michigan State Medical Society and Oakland County Medical Society.

Women & Heart Disease: Here are the Facts

By Dr. Gail Dawson, MD, MS, FAAEP

About eight million American women live with heart disease, the #1 killer of women (and men) in the United States today!

Studies show the following:

• One in three women will die of heart disease.

• Women are less likely to survive a heart attack than men.

• About 38 percent of women will die within one year of a first recognized heart attack.

• About 35 percent of women heart attack survivors will have another heart attack within six years.

• Two thirds of women who have a heart attack fail to make a full recovery.

• Women tend to underestimate the symptoms of heart disease and are less likely to seek treatment.

• Heart disease is a lifelong condition – once you are diagnosed with it, you will always have it.

The very positive news is that women easily can change these statistics! Most risk factors of heart disease are controllable. Research shows that women can lower their heart disease risk enormously – by 82 percent – if they lead a healthy lifestyle.

What is heart disease?

The most common cause of coronary artery disease – commonly known as heart disease – is a narrowing or blockage of the coronary arteries, the blood vessels that supply blood to the heart muscle. This process happens slowly over time, and is the major reason people have acute myocardial infarction (heart attack).

What are the warning signs of a heart attack?

Heart disease often has no symptoms, however, there are a few signs to watch for, and the signs in women may be different than those men experience. Women may feel pain in the center of the chest; in the ear, jaw or neck; or in the back or shoulder area. (Men tend to have crushing pain in the center of the chest that extends down the arm.) Other signs can be unusual tiredness or sudden extreme fatigue, problems with breathing, indigestion, or anxiety.

Heart disease symptoms may be milder in women than men. About 1/3 of women experience no chest pain at all when having a heart attack, and 71 percent report flu-like symptoms for two weeks to a month prior to having more obvious signs of a heart attack.

Can I reduce my risk of heart disease?

Making relatively simple changes in your daily eating habits will pay off quickly. By following this advice, you can reduce your chance of heart disease significantly:

• Control your blood pressure. Blood pressure is considered high when it reaches 140/90.

• Stop smoking. More than half of the heart attacks in women under age 50 are related to smoking. Women who smoke are at risk of dying 19 years sooner than non-smokers. Women who stop smoking for three years have the same risk as women who have never smoked.

• Get tested for diabetes. This medical condition is considered one of the major factors contributing to heart disease. Women with diabetes are two to three times more likely to have a heart attack. Controlling sugar makes a big difference in the development of coronary artery disease, as well as renal failure and stroke.

• Control your cholesterol levels. Too much cholesterol in your blood can build up (plaque) in your arteries and cause a narrowing of the arteries, which causes heart disease. Good cholesterol (HDL above 50 for women) helps remove bad cholesterol (LDL) from the blood. LDL levels should be at least under 140 for women, and the lower the better. Eating healthy helps maintain the good levels of cholesterol in your blood.

• Eat a heart healthy diet. Keep fat calories to less than 30 percent of the total calories you eat each day, and choose foods low in saturated fats, which raise your LDL. Avoid animal meats, butter, whole milk dairy products, cheese, and tropical oils (coconut, palm). Also limit trans fats, which are found in margarine, donuts, muffins and other processed foods. Choose foods with mono or polyunsaturated fats instead. Wise food choices include vegetables, whole grain foods, and low fat or nonfat dairy products. Some processed foods – frozen dinners and canned foods – can be high in saturated fats. When in doubt, read labels. Also remember to limit sodium to no more than 2.4 grams a day.

• Maintain a healthy weight.

• Try to exercise 30 minutes a day, a minimum of three to four times a week. Remember, your heart is a muscle. It needs regular exercise to stay in shape. At midlife, women can benefit from weight-bearing activities that keep bones healthier – walking, lifting hand weights, and even carrying groceries.

• If you drink alcohol, limit it to no more than one drink (12 ounce beer, five ounce glass of wine, one shot of hard liquor) a day.

• Do not take hormone replacement therapy to prevent coronary artery disease. It actually does more harm than good. Research now shows that estrogen plus progestin therapy increases the chance of developing heart disease, stroke, blood clots and breast cancer. If you need to take hormones, use the lowest possible dose for the shortest time needed.

Only two risk factors for heart disease are not controllable – these are your family history and age. If your father or brother had a heart attack before age 55, or if your mother had one before age 65, you’re more likely to develop heart disease. This does not mean you will have a heart attack; but it means you are at a higher risk.

To protect your heart health, be aware that every risk factor counts. If you have even one risk factor, you are more likely to develop heart disease.

What tests are conducted to determine if a person has heart disease?

If you are worried that you have signs or symptoms of heart disease, check with your physician right away. A physical exam may be all that is needed, but sometimes, more testing is necessary.

Imaging studies such as a stress echo or nuclear test will show the reaction of the heart muscle under stress. Patients walk on a treadmill or receive a drug to dilate the blood vessels or make the heart beat faster. In a stress echo, the cardiologist looks for abnormal heart movement under stress. A nuclear study tracks the flow of blood. If it can’t get to the heart muscle under stress because of a blockage, the heart will appear lighter in some areas on the scan.

A CT scan and cardiac catheterization provide a view of the inside of the coronary arteries, which supply blood to the heart muscle. If there is a blockage, it will show up as a narrow part in the blood vessel. A CT scan takes X-rays very rapidly. Patients lie in a machine while dye is injected. The heart rate needs to be slow enough to obtain clear images of the coronary arteries. During a cardiac catheterization, the cardiologist injects dye through a catheter that enters the leg and goes up into the coronary arteries, and then takes pictures. If an artery is blocked, the physician can open it during the procedure. Often a stent is placed to keep the artery open. A stent looks like a skinny tube made of metallic meshwork.

What should I do if I think I am having a heart attack?

Fast treatment can limit heart damage. Get to the hospital as fast as possible. Do not drive yourself. Chew an uncoated aspirin if you have one. This can reduce damage to the heart muscle. Once you arrive at the hospital, an electrocardiogram (EKG) and blood work will be ordered to help determine if you’ve had a heart attack. Even if the EKG is normal, you still may have had a heart attack, and more testing will take place.

Remember: the good news is that women can make a lot of simple changes in their daily routine to greatly reduce their risk of heart disease. It is never too late to start making these changes!

Dr. Gail Dawson is on the medical staff at Genesys Regional Medical Center in Grand Blanc and practices at Regional Cardiology Associates.  She obtained her medical degree from the University of Michigan and earned a fellowship in Cardiology at the Detroit Medical Center through Wayne State University.  She is board certified in cardiovascular disease, internal medicine, nuclear medicine, echocardiography, and coronary CT interpretation.

Ask the Doctor: September 2007

Question: My doctor told me that my triglycerides are high, and she told me not to eat carbs to bring them down. I thought triglycerides were a type of cholesterol, so I am confused. Can you explain it to me? – D.N., Macomb

Answer: Dear D.N. – You are right. It CAN be confusing when we talk about triglycerides. Triglycerides are a form

of bad cholesterol, however they are what happens to carbohydrates when they turn into fat. We all know that carbohydrates are a form of energy that is readily available but if you don’t burn off all the carbohydrates you ate in a day, your body has to turn them into something that can be stored, and when we check the blood work, that shows up as triglycerides.

There are medications available on the market that specifically target triglycerides and can bring them down, but the first thing to do before starting a medication is to try dietary changes. You need to cut back on the sugars and “white” carbohydrates like white bread, potatoes, pasta and rice. Whole wheat bread, wheat pasta, and brown rice are ok in moderation. You also want to avoid fruit juices and sugary sodas when trying to lower your triglycerides.

Very high triglycerides can cause problems with your pancreas as well as your arteries, so if you can’t bring them down with diet, talk to your doctor about a medication. Some people have a genetic condition that causes them to make too many triglycerides, so diet wouldn’t be helpful for those patients.

Question: My daughter is going to be a freshman in college in the fall. She is required to have the meningitis vaccine before she lives in the dorms. Why is this vaccine required for her? – A.P., Plymouth

Answer: Dear A.P. – The meningitis vaccine has recently been required for all freshmen living in the dorms in

colleges around the country. It protects against a very deadly bacterial meningitis caused by the bacteria Neisseria meningitides. This form of meningitis spreads very quickly through respiratory droplets (coughing, sneezing) when people live in close quarters. Dorm living is a perfect place for this bacteria to spread quickly with the community bathrooms and two to three students sharing a small room.

The initial symptoms can be vague and ignored by students not under the watchful eye of their parents; headache, neck stiffness, fever and fatigue. If not recognized and treated quickly, this form of meningitis can be fatal within 48 hours. Students who are commuting to school from an apartment or their parents’ house are not at any more risk than anyone else in the community and are usually not required to have the vaccine.

I would strongly encourage getting this vaccine for your daughter, even though she probably does not want another shot, because this disease is so rapidly fatal. I grew up in a college town, and when I was in high school (before the vaccine was recommended for college students) a couple of students in the dorms on campus died of meningitis, and I remember how the community was devastated.

Dr. Karen D. Lockwood is board-certified in Internal Medicine and is currently in private practice in Troy, MI.

If you would like to submit a medical question to Dr. Lockwood, please email your question to: askthedoc@healthandleisureonline.com

* Advice found within this article is for informational purposes only and should not replace the advice or recommendations of your physician.

Have You Changed Your Oil Lately?

By Bruce Eisenberg, MD

I have been practicing primary care medicine for over twenty-two years, and I have recently begun to notice a trend that concerns me. Numerous patients with a wide variety of backgrounds – both on and off regular prescription medications – have been missing follow-up visits. Some of these are as far back as two to three years and most of these are male patients. I often ask these patients if they change the oil in their car on a regular basis. The answer is always yes. I then suggest that perhaps their own body deserves the same basic maintenance as their automobile.

Most patients are surprised by the length of time that has passed since their last appointment. Many patients state they have not come in because their diet and exercise have not been consistent, or they were in the process of quitting smoking, and they were waiting to come in when their cholesterol, blood sugar and blood pressure were improved. These are, in fact, the patients which need the most attention because they are at the highest risk. If behaviors are less than perfect, I tailor therapy and screening based on these historical patterns for early disease prevention.

Heart disease is the number one cause of death in America. Cancer is the second leading cause of death and illness. Even with the most meticulous balance of diet and exercise, many individuals are susceptible to these potentially life-threatening illnesses because of family history and what I refer to as a “21st century lifestyle.”

With this lifestyle, one may workout vigorously for one hour every single day and watch his diet. But, the other 23 hours of the day are spent sitting at a desk, using remote controls, operating computers, driving around in cars, riding elevators, and eating processed foods too high in sodium and fat. It is nearly unavoidable.

Historically, women have been better at regular follow-up visits because most of them are getting screenings from a gynecologist. Men, on the other hand, often never get into a routine of regular health maintenance.

Here are some general suggestions on how to improve your own health screening.

By age 20, all individuals should have a complete cholesterol profile and know their “good” HDL and “bad” LDL cholesterol as well as blood pressure. This should be repeated approximately every five years along with a diet, exercise, family history and general health assessment.

If there is a family history of illness such as diabetes, high blood pressure, high cholesterol or cancer the intervals should be adjusted. If there are any abnormalities or lifestyle changes such as smoking, abnormal body weight gain or loss, these intervals should be customized as well.

After the age of 40, prostate screening should be done on a yearly basis. A blood test called a PSA and a digital rectal exam are the usual ways this is done. Body mass index (the ratio of height to weight), blood pressure, heart and lung health, along with general blood and urine checks should also be performed regularly.

At the age of 50, (sooner if there are symptoms or a family history) colon cancer screening with a colonoscopy is recommended, with follow up every five years.

Consumers these days are bombarded with a tremendous amount of health information from the media. It is nearly impossible to make sense of this maze of information. One common mistake often made is when a patient alters a prescription medication, or adds a supplement, because of a study they heard about on the news. Please consult your health care professional before making changes and see if it is actually appropriate for you. Your health care provider should be the first one you consult with, not the last to know.

When your doctor asks you about the medications you are taking, be sure to include all medicines and their doses. Do not forget to also include all supplements and herbs you are taking because they may have important health implications, too.

One example is vitamin C. It has been shown not to prevent colds, but has been linked to lowering good cholesterol (HDL) and can raise the risk of heart disease in some patients.

Another topic in the media these days is erectile dysfunction or ED. Many men are reluctant to discuss this with their physician. Remember that the majority of men will have some degree of ED during their lifetime. What is not commonly known is that it is often related to the early blockage of arteries due to elevated cholesterol, blood pressure and smoking. If you are suffering from this condition be sure to seek treatment and be screened for underlying causes of heart disease as they are one in the same.

The next time you notice that little sticker in the corner of your windshield reminding you of your next oil change, think about when the last time you did a body check-up.

With careful attention to the calendar, you can make a positive step toward early detection and prevention of mechanical breakdown in your most precious vehicle – your own body.

Dr. Bruce Eisenberg is board certified in internal medicine. He is a graduate of Wayne State School of Medicine and has been voted one of the “Best Doctors in America” the last 10 years and has been recognized by Top Docs Detroit Monthly.

Ask the Doctor: February 2007

Question: My mom was recently diagnosed with diabetes. When should I be tested?

Answer: You should be tested for diabetes once a year if you have any risk factors such as family history (like your mom’s diagnosis), if you have had gestational diabetes, or steroid-induced diabetes. You should also be tested if your waist size is greater than 35 inches for women or 40 inches for men.

In addition, symptoms such as unexplained weight loss, blurry vision, frequent urination, increased thirst, or unusual fatigue could be signs you may have diabetes.

Remember, diabetes is an important risk factor for heart disease, kidney problems and blindness. Therefore, it is important to diagnosis and treat diabetes as early as possible so you can minimize these serious complications.

Question: I just turned 50. Do I need a stress test?

Answer: A stress test is a very important test for detection of possible heart disease, but only if you have symptoms of chest pain or shortness of breath during activity or at rest. However, if you are not having these symptoms, I do not usually recommend a routine stress test for screening purposes because the test could give you a false negative result. Therefore, it is not always reliable.

If you are concerned about your risk for heart disease due to age, high cholesterol, or family history, a better test for you is the cardiac calcium score. This is a new technology that allows a CAT scan to detect blockages in you coronary arteries before they become symptomatic. If your test is positive, your doctor may want to perform additional tests to assess the severity of your heart disease.

Question: My doctor said that my total cholesterol was okay, but that my good cholesterol was too low. Is there a way to increase my good cholesterol?

Answer: Good cholesterol (HDL) is important because it removes the bad cholesterol particles from the blood and decreases your risk for heart disease. Your good cholesterol should be at least 40mg/dL, but the higher the better.

You can increase your good cholesterol by exercising regularly and by eating a diet low in saturated fats and high in omega-3 fatty acids. Foods containing omega-3 fatty acids are salmon, almonds and some margarine spreads. You can also take omega-3 fatty acid supplements, which are available over the counter.

In addition, a B-vitamin, niacin can also raise your good cholesterol and is also available over the counter. If this doesn’t work, prescription versions of both omega-3 fatty acids and niacin are also available. Check with your doctor to see which would be best for you.

Dr. Karen D. Lockwood is board-certified in Internal Medicine and is currently in private practice in Troy, MI.

If you would like to submit a medical question to Dr. Lockwood, please email your question to: askthedoc@healthandleisureonline.com

*Advice found within this article is for information purposes only and should not replace the advice or recommendations of your physician.

February is National Heart Month: Get Heart Smart!

KNOW YOUR NUMBERS!

Knowing your numbers is an important part of keeping your heart healthy. These numbers can help you and your doctor determine your risks and mark the progress you’re making toward a healthier heart.

CHOLESTEROL

Total Cholesterol: Less than 200 mg/dL

LDL (“Bad”) Cholesterol goals vary:
— People who are at low risk for heart disease: Less than 160 mg/dL
— People at intermediate risk for heart disease: Less than 130 mg/dL
— People at high risk for heart disease including those who have heart disease or diabetes: Less than100 mg/dL (Some high-risk patient will have a goal of less than 70 mg/dL.)

HDL (“Good”) Cholesterol: 50 mg/dL or higher

BLOOD PRESSURE - Less than 120/80 mmHg

WEIGHT - Body Mass Index (BMI) is a measure of body fat based on height and weight. BMI values from 18.5 to 24.9 are healthy.

HEART DISEASE RISK ASSESSMENT - Log onto www.stjohn.org/SJHheartcare and take a free, two-minute heart check.

5 Simple Ways to Love Your Heart

It’s not hard to reduce your risk for heart disease. The American Heart Association encourages women to start today with small, simple actions like these:

1. Celebrate with a checkup: Let each birthday remind you that it’s time for your yearly checkup and a talk with your doctor about how you can reduce your risk for heart disease.

2. Get off the couch: Step, march or jog in place for at least 30 minutes most days of the week – you can even do it while watching TV.

3. Quit smoking in four steps: Can’t go cold turkey? Cut the number of cigarettes you smoke each day in half; then cut that number in half; cut it in half again; finally, cut down to zero!

4. Drop a pound or two: Cutting out just 200 to 300 calories a day — about one candy bar’s worth — can help you lose up to two pounds per week and gradually bring you closer to a heart-healthy weight.

5. Become a salt detective: Check out the Nutrition Facts panel on packaged foods to see how much sodium (salt) they contain. Aim for a total intake of no more than 2,300 milligrams (about a teaspoon of salt) per day.

Heart Attack Warning Signs

Some heart attacks are sudden and intense, like the “movie heart attack,” where no one doubts what’s happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:

1. Chest discomfort - It can feel like uncomfortable pressure, squeezing, fullness or pain.

2. Discomfort in other areas of the upper body - Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

3. Shortness of breath - May occur with or without chest discomfort.

4. Other signs - These may include breaking out in a cold sweat, nausea or lightheadedness.

HEART-HEALTHY LUNCH IDEAS

A healthy diet and lifestyle are the best weapons you have to fight cardiovascular disease. It’s not as hard as you may think! Start by packing a heart-healthy lunch.

Sandwich – This easy-to-transport lunch staple can still be a healthy option when made with lean meats and piled high with veggies on whole grain bread or tortilla.

Fresh Fruit – Packed by nature, fruits like apples, oranges and grapes take little preparation and are available year round.

Fresh Veggies – Baby carrots and celery add a satisfying crunch, plus they travel well. Or pack a salad full of your favorite veggies of all colors – the more the better!

Yogurt – Non-fat and low-fat yogurt is a great source of calcium.

Water – Most of us don’t get enough – take this opportunity to hydrate yourself.

Dessert – Don’t forget something fun! Try low-fat varieties of pudding, pretzels or animal crackers.

Below are a few suggestions to help take some of the work out of packing a heart healthy, yet exciting lunch each day. The lunches contain 500-700 calories and less than 15 grams of fat. Use them to plan your menu in the days ahead and give your favorites a regular rotation on your lunch schedule.

MENU #1

• Turkey (three ounces), mustard and lettuce on whole wheat bread
• One small bag of baked potato or nacho chips
• One medium banana
• One 12-ounce diet soda

MENU #2

• Whole wheat pita stuffed with tuna, low-fat dressing, celery, sprouts and diced tomato
• One small can of bean soup with six saltine crackers
• One medium orange
• One large glass of water

MENU #3

• Two slices of vegetarian pizza (toppings include mushrooms, onions, tomatoes and pineapple)
• Two graham crackers
• Six ounces skim milk
• One handful of grapes

MENU #4

• One medium bowl of lean meat chili (prepared the night before). Drain the fat!
• Four saltine crackers
• One half-cup low-fat cottage cheese with pineapple slices
• One medium apple
• One large glass of skim milk

MENU #5

• Roast beef (three ounces), horseradish and tomato on rye bread
• A small tossed salad with carrots and low calorie dressing
• One medium peach
• One six-ounce glass of skim milk

MENU #6

• One medium chicken breast steamed with garlic and 1 cup wild rice (prepared the night before)
• One medium peach
• Walnut and orange salad made with low-fat mayonnaise
• One large glass of apple juice

MENU #7

• One chicken and lettuce-stuffed tortilla with 1/8-cup Colby cheese and salsa
• One small bag of baked tortilla chips
• One cup of non-buttered corn (prepared in the microwave at work)
• One large glass of water

MENU #8

• A small plate of penne pasta with red sauce (prepared the night before)
• One slice of whole-wheat garlic bread
• One medium apple
• One large glass of 100% grape juice

Men’s Health: January 2007

by Mitchell Hollander, MD

So, you have been hearing about Erectile Dysfunction (ED) for quite a while now. First, was Bob Dole and Viagra, and now with other various personalities in advertisements for Cialis and Levitra. So what do you really know about ED? Unless you have actually talked to a physician about the condition, you may not know everything that a man needs to know about Erectile Dysfunction.

What is ED? It is a condition in which a man has trouble achieving or maintaining an erection (or both). In addition to affecting intimacy between couples, ED can also serve as an early warning sign for a whole host of other medical conditions, some life threatening. The three most common conditions associated with ED are:

1. Diabetes – Which affects more the 8.7 million men in the U.S.

2. High Blood Pressure – 29.4 million

3. High Cholesterol – 50.4 million

All of these conditions affect the circulatory system and therefore affect a man’s ability to achieve and maintain an erection. Since all three of the above mentioned conditions have signs and symptoms that can progress slowly, ED may be the first symptom that you actually notice. Another possible cause of ED is a hormone imbalance and your doctor may want to run a blood test to check your testosterone levels.

There are other risk factors associated with Erectile Dysfunction, such as:

1. Smoking

2. Lack of Exercise

3. Obesity

4. Heavy Drinking

5. Stress

6. Lack of Sleep

7. Medication Side Effects (such as anti-depressants and beta-blockers)

8. Depression

9. Spinal Cord Injury

10. Prostate Surgery

So what can you do if you think you have ED? The first thing is to see your doctor. He can look over your past medical history and run some tests to help determine the cause of your problem. Since ED may be a sign of underlying disease, your doctor will first need to find out if you are healthy enough to sustain the cardiovascular stress to have intercourse. For this reason, your doctor will perform several cardiovascular tests to assess your heart’s fitness level and make sure you are still a candidate for sexual intercourse.

If those tests show that you are healthy enough to engage in sex, your doctor will make some recommendations to help correct the problem. Some men may only need to make some lifestyle changes such as losing weight, quitting smoking, or getting more exercise (which are always a good idea anyway). Other men may have a more serious underlying condition that will need to be treated medically in addition to some lifestyle changes.

Both the lifestyle changes and treatment of the underlying disease may take some time before they have a positive affect on erectile quality, and therefore your doctor may prescribe a medication to help you achieve and hold an erection.

You see the ads for them all the time, Viagra, Levitra, and Cialis. They all work in a similar way and allow more blood to flow to the penis by relaxing the blood vessels. There are some people who should not take these drugs, especially those on a type of drug know as a nitrate, often prescribed to treat chest pain or angina. Using both of these medications together may cause an unsafe drop in blood pressure.

There are other possible side effects and your doctor can go over those if they decide to prescribe one of these drugs. If drug therapy is unsuccessful or eliminated due to nitrate use, you may have to use alternate therapies. Some of these other therapies are: suppositories that are inserted into the penis to increase blood flow; injections into the penis to also increase blood flow, and vacuum pump systems. When more conservative measures fail, surgical implants are also a safe and effective means for achieving an erection.

So, now you know a little more about Erectile Dysfunction. You may be surprised to know that even with all those ads talking about ED and the treatments available, that the vast majority of men do not seek the care of a doctor. Many are embarrassed, and some just don’t want to admit they are having a problem.

There is nothing to be embarrassed about ED. It is a common occurrence in men. In fact, all men in their 50’s, 60’s, and 70’s have some level of erectile dysfunction, and your doctor is well trained to evaluate and treat this condition. Secondly, ED may flag a more serious medical condition and help get you treated earlier in the disease progression, which may allow for much better outcomes. Finally, if you think you have a problem, then your partner probably does too. This can lead to stress and depression in a relationship.

The bottom line – if you think you have Erectile Dysfunction go see your doctor, get a physical and get treated. The earlier you take care of it, the better it can be treated, and earlier you can get back to being that guy you always remember.

Dr. Mitchell B. Hollander is a board certified Urological Surgeon, and is the Director of Male Reproductive Medicine at William Beaumont Hospital in Royal Oak, Michigan.