Thus, prevention and treatment of ED represents an important means Prostate treatment vancouver bc to improve patient and partner wellness prostate treatment vancouver bc and overall men’s health. Previous publications have recognized modifiable lifestyle factors such as obesity, physical activity, smoking, diet and others as major contributors to the onset prostate treatment vancouver bc and evolution of both CVD and ED (8,9,23). Guidelines developed during the 2009 International Consultation on Sexual Dysfunction included “lifestyle modification” as a foundational Step in the treatment algorithm of Prostate treatment vancouver bc ED (23,24). However, patient knowledge about modifiable risk factors for ED, in particular smoking, control of CVD risk factors and sedentary lifestyle, is poor, and specific recommendations regarding implementation of lifestyle modification have not previously been outlined (25). Additionally, questions remain as to the quantitative effects lifestyle modification and supplemental therapies can have on the natural history of ED. The aim of this prostate treatment vancouver bc review is to delineate lifestyle choices prostate treatment vancouver bc which may impose an increased risk of developing ED, present relevant studies addressing behavioral factors correlated with ED, as well as Highlight proposed mechanisms for intervention aimed at improving erectile function in prostate treatment vancouver bc men with ED.
Go to: Smoking Smoking prostate treatment vancouver bc has been shown in several studies Prostate treatment vancouver bc to be positively associated with an increased risk of ED. Longitudinal epidemiologic studies have reported a relative risk of developing ED 1.5–2 times more in smokers in comparison to non-smokers (7,Prostate treatment vancouver bc 8,26,27).
In the Boston Area Community Health survey, a cross-sectional study of 2,301 men, a dose-response relationship prostate treatment vancouver bc was demonstrated between smoking and ED (28).
Significance was achieved at 20-pack years cumulative exposure after adjusting for risk factors of age, CVD, and diabetes. Though not found to be significant, passive smoking exposure trended toward a significant Prostate treatment vancouver bc risk of ED. While this study design is subject to recall bias, it may provide important information when quantifying risk of ED due to smoking exposure. Positive prostate treatment vancouver bc dose-response association between quantity and duration of smoking with risk of ED was confirmed in a meta-analysis of observational epidemiologic studies (29).
The investigators found an incremental increased risk of ED per 10 cigarettes smoked per day and 10 years of smoking, by 14% and 15%, respectively.
An individualized inverse dose-response relationship was seen in male smokers undergoing polysomnographic assessment of nocturnal penile tumescence (NPT), where the highest consumers of cigarettes (>40 cigarettes per day) had the fewest minutes of nocturnal tumescence and detumesced fastest (30). At a molecular and cellular level in the animal model, cigarette smoking (CS) is linked to significantly higher markers of oxidative stress prostate treatment vancouver bc prostate treatment vancouver bc and cavernosal tissue apoptosis (31). CS exposed rats were noted to have prostate treatment vancouver bc significantly lower expression of cavernosal neuronal nitric oxide synthase (nNOS) and decreased endothelial and smooth muscle content, supporting the role of endothelial dysfunction in pathophysiology of ED (12). The effect of smoking cessation on erectile function has also been examined.
Prospectively studied a sample of prostate treatment vancouver bc men with ED and smoking as their prostate treatment vancouver bc only risk factor; excluded were men with other risk factors for ED such as diabetes, hypertension, dyslipidemia, peripheral vascular disease, psychiatric disorders, and renal failure. At baseline, severity of ED was found Prostate treatment vancouver bc to be significantly correlated to duration of exposure in pack-years (32). At follow-up 1 year after smoking cessation, patients who successfully stopped smoking (ex-smokers) had a 25% improvement in erectile function, while prostate treatment vancouver bc men who continued (current smokers) did prostate treatment vancouver bc not improve. Additionally, a larger proportion of prostate treatment vancouver bc prostate treatment vancouver bc current smokers (7%) than ex-smokers (2.5%) had worsening of their baseline ED.
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