Erectile Dysfunction

By George Touliatos, MD

Erectile dysfunction (ED) is directly linked to endothelial dysfunction. Coronary artery disease, apart from atherosclerosis and plaque formation, depends on endothelial lining. The inner wall of arteries has permeability. Depending upon nitric oxide (NO) synthesis. NO is vasodilator and when the endothelium is damaged, such as in case of smoking, hypertension, or the abuse of aromatase inhibitors, then thrombocytes (platelets) are attracted for aggregation. This results in thrombus formation. Nicotine, for instance, messes up the endothelial structure and this is how smoking favors clotting. Hypertension also deforms the endothelium; it forces pressure in the inner wall of arteries. Estrogen blockers as well, since estrogens improve HDL (the good cholesterol) that cleans up arteries, but also their deficiency affects the endothelial lining. This was demonstrated by women who abused aromatase inhibitors during breast cancer treatment. 5PDEi medications (sildenafil, tadalafil) improve NO synthesis. Testosterone as well (that’s why vascularity and blood flow are improved). Pentoxifylline also improves circulation, throughout NO production. Arginine, citrulline as well.

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George Touliatos, MD is an author, lecturer, champion competitive bodybuilder and expert in medical prevention regarding PED use in sports. Dr. Touliatos specializes in medical biopathology and is the medical associate of Orthobiotiki.gr and Medihall.gr, Age Management and Preventive Clinics in Athens, Greece. He is the author of four Greek books on bodybuilding, has extensively developed articles for www.anabolic.org and is the medical associate for the book “Anabolics, 11th Edition” (2017). Dr. Touliatos has been a columnist for the Greek editions of MuscleMag and Muscular Development magazines and has participated in several seminars across Greece and Cyprus, making numerous TV and radio appearances, doing interviews in print and online. His personal website is https://gtoul.com/

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