(2011.09) High Performance Man
Award-winning doctors and sex health specialists talk about Male sexuality.
Q and A
Below are the full answers to questions asked after the High Performance Man event. Answered by our event experts.
Q: Does long-distance cycling affect fertility?
A: There is a significant relationship between cycling-induced perineal compression leading to vascular, endothelial, and neurogenic dysfunction in men and the development of ED. Other less common symptoms include priapism, penile thrombosis, infertility, hematuria, torsion of spermatic cord, prostatitis, perineal nodular induration and elevated serum PSA, which are reported only sporadically. Infertility more likely results from compression of the testicles tightly against the body in bicycle shorts resulting in subsequent temperature increase, which reduces sperm quality. Studies suggest, no overall association between regular physical activity and semen quality, except bicycling ≥ 5 h/wk was associated with lower sperm concentration and total motile sperm count (Wise LA, et al, Physical activity and semen quality among men attending an infertility clinic. Fertil Steril 2011; 95:1025-30 ).
Q: Viagra increases blood flow – can niacin or a niacin flush increase circulation to the penis in the same manner?
A: Taking oral niacin dilates blood vessels and creates a sensation of warmth, called a "niacin flush", which is often accompanied with a blushing of the skin and a feeling of warmth. Sexual activity also causes the skin to flush, through the natural release of histamines. Taking niacin prior to sex, many claim, increases tactile sensations, electrifying the sense of touch, and enhancing orgasms. The niacin rush feels prickly and uncomfortable for many in general but during sex the flood of histamines may make one feel warmer and glowing. However, the dilation of the blood vessels does not include those in the penile tubes to give an erection per se. Studies looking at niacin as a lipid-lowering agent as an alternative to statin drug use (statins have been shown to reduce ED in men with mild to moderate erectile problems but can have unwanted side-effects), can improve the erectile function in patients suffering from moderate to severe ED and dyslipidemia.
Ng CF et al, Effect of Niacin on Erectile Function in Men Suffering Erectile Dysfunction and Dyslipidemia. August 2011 J Sex Med
Q: How effective are phalloplasty?
A: Phalloplasty means the construction of a new phallus for the purpose of having penetrative sex, and of being bale to stand at a urinal and void. Persons who have had traumatic accidents and lost their penis or who are undergoing sex reassignment surgery are candidates for Phalloplasty. A person with an intact, normal functioning penis would not be a candidate, regardless of the size of the penis. Phalloplasty is major construction utilizing large skin grafts/flaps with a source of rigidity within the rolled tube (bone, insets) as the Phalloplasty itself does not have erectile ability. There are often problems with the urethra tube construction and fistulas between the urinary tube and bowel developing. It is a major surgery only undertaken for specific medical indications, and requires an experienced plastic surgeon and urologist.
Q: Are Zinc supplements helpful for men’s sexual health? If so, in what amounts?
A: Zinc levels are typically found to be high in seminal plasma (mainly from the prostate gland), and may act as a protective antioxidant and antibacterial agent. However, these levels get diluted by the vaginal and cervical fluids immediately after ejaculation. Low zinc levels in the semen are correlated with inflammatory conditions (extra white cells), toxic heavy metals in the testes, chronic prostatitis and frequent ejaculation. Low zinc content of semen can affect sperm quality through reduced antioxidant capacity or poor counteractivity of toxic metal effects. However, more studies need to be done to see whether zinc supplementation in men with subnormal zinc levels or subnormal semen parameters is actually effective and improves function.
Zinc has a role in regulating testosterone in the prostate, but that does not mean that extra Zinc supplementation given to normal men will improve their semen quality such as the Internet claim “Zinc supplementation has been shown to increase number of sperm and sperm motility by 80% to 200% by aiding testosterone synthesis”. Zinc is correlated with selenium and magnesium in the semen. In fact, extra zinc supplementation in men with normal levels may actually impede semen quality and sperm function in fertility, as excess will act like a metal toxicity.
While zinc is relatively nontoxic (normal male dose is about 15 milligrams), high doses (over 10 times this amount or higher) over long and short periods have produced side effects. High doses of supplemental Zinc have also been shown to decrease levels of HDL (the good cholesterol) and increase LDL ( bad cholesterol), mainly by creating a copper deficiency, and can impair the immune system and increase the need for Vitamin A.
1)Barratt CL et al Sperm DNA: organization, protection and vulnerability: from basic science to clinical applications--a position report. Hum Reprod. 2010 Apr;25(4):824-38.
2) Kirschmann et al Nutritional Almanac 1996
Q: What is the recommended age for men to go for prostate test (for cancer)?
A:40 is a recomended starting age but take into account your family history (prevalence of cancer, prostate issues).
Q: Should more men be adopting a vegan/plant based diet to decrease cholesterol?
A: Eating vegan or plant/based (vegetarian) diets will decrease dietary cholesterol intake because cholesterol is only found in food derived from animals. Vegetarian diets are also known to decrease overall blood cholesterol levels and improve HDL/LDL ratios, which make them heart healthy. Although animal products can be part of a healthy diet, men often tend to over-consume meat – especially red meat which is high in cholesterol and saturated fats that can increase blood cholesterol levels or promote unhealthy HDL/LDL ratios. Eating vegan might not be acceptable for most men, but reducing the amount of meat and fat in your diet and eating more plant-based foods such as whole grains, vegetables and fruit, will improve most men’s blood cholesterol profiles.