When it comes to sex, we Brits have a unique attitude and reputation. We seem to be obsessed with it – although judging by the number of people watching Love Island, the obsession is with others having sex, as surveys show we’re having it less and less (and even then we’re not very good at it, according to satisfaction level surveys).
Meanwhile, problems such as erectile dysfunction are often not taken seriously; The attitude is very bad: if you suffer from impotence, just take Viagra – it will solve it, and you don’t have to worry.
Impotence is actually very serious: and although its causes are a complex mix of psychological and physical, the main problem for a significant number of men is reduced blood flow to the penis.
Meanwhile, problems such as erectile dysfunction are often not taken seriously; The attitude is very bad: if you suffer from impotence, just take Viagra – it will solve it, and you don’t have to worry.
Many men get Viagra without a prescription or over the Internet without consulting their doctor
In fact, the risk factors for heart disease and stroke also lead to the inability to achieve an erection; that is high cholesterol, elevated blood pressure, lack of exercise, obesity and metabolic syndrome (where your insulin levels are consistently high because you eat too many carbohydrates and sugar).
It’s a ‘canary in the mine’ type condition – the first sign that there may be blocked arteries elsewhere in your body, especially in the heart. That’s why it’s so important to seek medical help as soon as you experience it.
About two-thirds of men who have had a heart attack have suffered from erectile dysfunction in the past five years. And your risk of having a heart attack is almost 50 percent greater if you have erectile dysfunction.
I have seen so many patients who have come to the emergency room with a heart attack and who, when you ask them about other medical problems, reveal that they are having trouble getting erections.
However, many never talked to their doctors about it or simply got Viagra over the counter or over the Internet, and so the risk factors that led to the heart attack went unmanaged.
So if you’re suffering from erectile dysfunction, a broader health assessment is warranted – and you don’t just have to buy a prescription online.
Not least because we know it is also associated with developing dementia. This was proven beyond a shadow of a doubt in a 2015 study published in the journal Medicine, which looked at a million men over a seven-year period: those with erectile dysfunction during that time had a 68 percent higher chance of also developing dementia.
So it wasn’t a big surprise to me when I saw the headlines a few weeks ago that ‘Viagra can help stop dementia’. And the study, published in the highly respected journal Neurology, provides really good evidence for this link: The researchers compared two groups of men with erectile dysfunction: those who used Viagra and those who didn’t; a total of well over a quarter of a million men.
At the end of the study, 1,119 of them had been diagnosed with Alzheimer’s. Those who took Viagra were 18 percent less likely to develop dementia – and the benefits of Viagra were greater the more you took, with more than 20 prescriptions leading to a 44 percent reduction in the risk of dementia.
If Viagra is the key (and that dementia benefits aren’t just due to sex), how does it work in reducing dementia? And could women benefit in the same way if they used it?
The drug was originally developed to treat angina, a condition caused by a lack of blood flow to the heart. Viagra helps dilate blood vessels, improves blood flow, and reduces symptoms of angina, such as chest pain.
The mechanism is complex, but essentially the drug enhances the effect of nitric oxide, a substance that helps relax blood vessels.
An unexpected – but welcome – side effect was that men in the studies reported that it helped their erectile dysfunction.
From this we can reasonably conclude that the dilation of blood vessels that Viagra so effectively causes in the penis also takes place in the brain.
And increased blood flow in the brain means more oxygen to the cells and less cell damage.
Could this also work for women? Viagra for female sexual dysfunction has not shown any benefit – no doubt partly because there are far fewer receptors for the drug to act on in women’s genital areas than in the penis, but also because female arousal is so much more complex than blood flow.
But what about preventing dementia in women – or in people without erectile dysfunction? This research hasn’t been done yet, but it could be that one day more of us, not just men struggling with impotence, could be prescribed Viagra to save their brains.
Personally, I don’t think that’s a good idea because of the side effects (such as headaches, flushing, poor digestion and visual problems).
More interesting for anyone wanting to protect their brain is what this unexpected Viagra study reveals about the debate over what actually causes dementia.
It has long been believed that Alzheimer’s disease – the most common cause of dementia – is caused by a tangle of proteins that damage neurons in the brain.
In fact, billions have been poured into drugs to address them for more than three decades, and even the new “breakthrough” treatments of the past year, such as lecanemab, have many question marks attached to them.
And if these proteins were the cause, it couldn’t explain the study results showing that men who took Viagra had a lower risk of dementia.
But if it’s the lack of blood flow that causes the dementia, and the protein tangles are a side effect of cell damage, then this could explain Viagra’s impact.
And we can easily mimic the way Viagra works by increasing nitric oxide levels in the blood going to the brain.
In the so-called ‘blue zones’ – places like Sardinia in Italy and Okinawa in Japan, where life expectancy is incredibly high and dementia levels incredibly low – their diets are rich in foods rich in nitrates, which the body converts into nitric oxide. These are leafy vegetables such as seaweed, spinach, kale, beetroot, celery and radish.
Eating foods rich in L-arginine – which is converted into nitric oxide – can also help: these include nuts, seeds and beans; as well as foods containing L-citrulline – found in pumpkin, pumpkin, cucumber, cantaloupe and watermelon. L-citrulline is converted into L-arginine in the body and is more easily absorbed.
Supplements of L-arginine and L-citrulline are also being studied for their potential benefits. In 2020, L-citrulline was shown in the journal Alzheimer’s and Dementia to slow cognitive decline in mice – while a 2022 study published in the journal Frontiers in Cardiovascular Medicine, involving 72 vulnerable patients with high blood pressure, showed that those given L-arginine had improved cognition levels over four weeks – not just a slower decline – better than a placebo group.
Antioxidants can also help: these molecules neutralize the harmful effects of free radicals, formed after various chemical reactions and which damage cells; Antioxidants also stimulate the production of nitric oxide. Higher levels of antioxidants mean more nitric oxide.
Foods rich in antioxidants include fruits, vegetables and dark chocolate. (Be careful about taking antioxidant supplements, though, as they can reduce your body’s own production of them and cause damage).
Some eloquent evidence that antioxidants can help prevent dementia came from a study published in 2022 in the journal Neurology, which found that higher levels of antioxidants in the blood were linked to lower levels of the condition.
High blood pressure can hinder the production of nitric oxide by directly damaging the lining of the blood vessels that causes it. And finally, regular physical activity is also crucial to boost nitric oxide production and naturally increase antioxidant levels.
So what can we learn from this? If you are suffering from erectile dysfunction, it is crucial that you do not just pop a pill and seek medical help to address the underlying problems. And for the rest of us, a healthy and active lifestyle is, as always, crucial.