SHOW NOTES

Dr. Yale Smith, MD of the The Center for Anti-Aging Aesthetic and Rejuvenation Medicine in Viera provides insight into the cause of erectile dysfunction (ED) as well as the many underlying conditions that can contribute to the condition. He also addresses options to help resolve ED.

Dr. Yale Smith will cover: 

• What is Erectile Dysfunction Is ED a normal process of aging?
• Is ED a common condition?
• What can be done to prevent ED?
• Recommendations to resolve underlying health conditions contributing to ED.
• Common treatments for ED.
• What is Acoustic Pressure Wave Therapy (APWT) and what to expect.

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Transcription:

Today we're talking to Dr. Yale Smith, about what causes erectile dysfunction, and the good news, natural approaches to resolve it. So, when it comes to medical care, men are less likely to seek care than women. And while men may avoid typically seeing their health care provider, there are some problems that may prompt men to take action. And one complaint that can bring a man to a doctor's office is erectile dysfunction. So here today to discuss this with me is Dr. Yale Smith, from the center of anti aging aesthetic and rejuvenation medicine. Thank you so much for joining me today, Dr. Smith.

 

Dr. Yale Smith  1:05  

Thanks for having me again.

 

Kris Urquhart  1:13  

Glad to have you. So let's just jump right in and let you explain to us what exactly is erectile dysfunction.

 

Unknown Speaker  1:21  

Erectile dysfunction is when a man has the inability to obtain and maintain an erection for penetration and normal sexual activity, and also having a satisfying sexual experience. Most men are very shy about discussing this and about their manhood. And they won't see medical help, they'd rather take a pill or just avoid it.

 

Kris Urquhart  1:57  

Understandable. So is loss of erectile function, a normal process of aging?

 

Dr. Yale Smith  2:05  

It is as men get older and their hormones drop and their testosterone drops. But that is not the main reason for ED. The main reason is poor blood flow. As we get older, we find that we have various things and I'll list those. That a man has decreased blood in his penile tissue. One of the earliest indications of cardiovascular disease in men is ED. Some of the, it is the normal process of aging, but there are various risk factors that men should be aware of. And these include low nitric oxide level, low testosterone, cardiovascular disease, and diabetes is a big, big problem. Poor diet, poor sleep, a lot of stress. That their hormones are off, that they have Crohn's disease, and you see that on TV. If the penis is bent. Men that have hypertension on blood pressure medications, men that unfortunately or using drugs, either prescribed or un-prescribed, abnormal lipids, stressors. With COVID, that's going on, losing your job or can't pay the bills, these all impact a man's performance in the bedroom. Patients that are hypothyroid is a big thing that's not checked. These are some of the big things that we need to check for patients.

 

Kris Urquhart  3:52  

So you've listed quite a number of things there. So this sounds like it might be a fairly common condition. Is that true? 

 

Dr. Yale Smith  4:00  

1/3 of men now suffer from ED.

 

Kris Urquhart  4:04  

Yeah, that's a significant number. And so with all of those underlying health conditions that can be related. Are there things that can be done preventatively for ED or other recommendations?

 

Dr. Yale Smith  4:18  

Well, any patient that comes in with that we have to do a deep dive on the physiology. A lot of times it's not just low T (testosterone), that's only 20%. It's flow, we need flow. So we need to do laboratory testing, on lipids, his blood sugar, testosterone, the thyroid, all these things impact this. It's not just one thing. And once we find what the initial thing is, and you start treating it, they start feeling better. And then there are treatments that can be done. You can increase nitric oxide by checking a lab value on them to see how much abma and stma is made in the blood stream. This causes blood vessels to relax. inflammation is a big thing. If you're diabetic, we have to get that under control for these patients not only develop plaque in their vessels, they have problems with sensation. Patients and as a sign of diabetics, who have cardiovascular events may not have chest pain. The nerves are damaged to send that pain receptor they may become diaphoretic, they sweat or they just don't feel well. So all these things need to be looked at before you start treating them for ED.

 

Kris Urquhart  6:00  

As a functional medicine doctor, you have that this approach is not just for ED, I mean, this is something that you work with every day. So you have a lot of tools in your toolbox, for recommendations to not just help with ED, but also all of these other health conditions?

 

Dr. Yale Smith  6:17  

Yes, we do. We look at everything from sleep problems to you know, patients can be exposed to toxic mold, and don't even know it. Or what they call MARCoNS which stands for Multiple Antibiotic Resistance Coagulase Negative Staphylococci. In their airways they have these bubbles, that are parasites and bacteria and viruses that release toxins in your body, in your brain and, and just with mold, it mess up their neurotransmitters and hormones and they don't even realize it. So we look at all these different things, and most men will see someone and they're just giving them testosterone without finding the root cause. We look at everything and if their testosterone is low, we look at why it is low. And we try to fix that problem. So the testosterone normalizes on its own. It's not just giving testosterone because once you give that, it tells your brain you don't need to make any more. We'd rather the body make its own.

 

Kris Urquhart  7:50  

Right, right, you don't want to shut off the production of testosterone. So we know there's pills for ED. So what are some of the common treatments? You've already acknowledged that you're going to look at the overall health and the underlying conditions to help with the blood flow and the other supportive functions that you need to turn ED around. But there's pills and what are some of the common treatments for eating.

 

Dr. Yale Smith  8:17  

So the most common is a Phosphodiesterase type five inhibitor which causes your blood pressure to drop. It's not really good in older men who have cardiovascular issues, where it's like taking a nitroglycerin. It can dialite them and drop the blood pressure. And they can have a cardiac event and that's why cardiologists are very careful with this medicine it can make them hypertensive and worsen the effects. There's another thing called protaglandin E injections, which I don't know a lot of men that want to take this and inject into the penis so they can have and erection. We can use a pump device to force engorgement into the penile tissue and enlarge it, but you have been on blood thinners you have to be very careful to use safely as you can cause trauma and can end up in the emergency room. And have to have surgery. There's something new called acoustic pressure wave therapy (APWT). It's been around in Europe and recently brought over to the US. What it uses is sound waves and pressure that's applied to the penile tissue. And what it does is it sends these sound waves high frequency sound waves into the penile tissue and surrounding tissue. And it's had amazing results in about 70 to 80% of the patients. What it does is it increases angiogenesis when neovascularization that's new blood flow into the penile tissue. It breaks up plaque micro plaque in your blood vessels, so you have more flow, it creates new nerve growth factors in the penile tissue, so there's more sensation, it prolongs a man's erection, it increases the strength of the orgasm. And from what I understand from speaking patients, it is a more pronounced sensation during orgasm. So it's non invasive. The procedure takes about 20 minutes, twice a week, for anywhere from three weeks to six weeks. And a patient comes in and we give them a green, a local anesthetic cream that they apply about 30 minutes before the procedure, they come in, they go into the procedure room where the machine is used, and it sends pulsed waves through, where they may feel some discomfort. But that's okay. Because then we know it's working and, and virtually no pain. And then after the procedure, we normally tell them to use it. Because you want to have an erection and get blood flow in there and help break up plaque and this procedure works so well that when I was training to do this, I was told that a lot of the performers use this. They come in routinely for this. And I looked at the nurse and I said Listen, I don't live down here. What are you talking about? She said, You don't I mean? I say no, She says, the stars. They come in on a routine basis, because this is their business.

 

Kris Urquhart  12:42  

Right? So apparently that's pretty good recommendation or testimonial.

 

Dr. Yale Smith  12:46  

Yeah. And this is done. Now it's very, very commonly done.

 

Kris Urquhart  12:57  

So if a man undergoes these treatments, and you said it could be three to six weeks, do you expect... I guess if they don't change their lifestyle, plaque could re accumulate and they may have to come back or what's the opinion.

 

Dr. Yale Smith  13:14  

What we tried to do, we follow them and their health. So if their blood sugar is very high, we want to get that back under control. If their lipids are abnormal, we want to get that under control with generally natural treatments. We want it to be easy. To get your blood sugar under control, it's less likely plaque and less damage to the blood vessel and more sensation with the nerves and nothing damaged. So it's a complete thing. It's just not one, like what you see on TV. You have ED? Then okay, it's low T (testosterone). That's not accurate. Only 20% of men have low T. And there's ways to treat that. And the ways are you can change their diet, by exercising resistance and aerobics will increase testosterone. But everybody goes to this give 'em T give 'em T. Well, most men don't need that. Especially younger men in their 30s. You can give them a drug called Clomid, which tells the brain to make early testosterone. we trial that for about eight weeks to see what their testosterone levels are and how they're feeling and then we look at the lab work and if it's going up then we continue. If that doesn't work, then you would go to other things like a cream or an injection. I don't do pellets. I don't believe in it. To put a pellet in it can't come out. So we're trying to titrate these all these things for their own individual physiology.

 

Kris Urquhart  15:15  

Well, it sounds like a win win. And I mean if a man, maybe that's maybe his first sign that something's wrong, his symptoms of ED, but you have a whole-health way of approaching it and getting back on track, as well as, a strategy for some immediate support with the APWT, the pressure wave therapy. So I think it's all good news. I think everything you've had to say is really good news for for men who maybe are concerned about ED as a problem for them.

 

Dr. Yale Smith  15:47  

They just need to realize it and bite the bullet and accept it and realize that there's an issue and they need to come in and fix it. 

 

Kris Urquhart  15:57  

yeah, come in and fix it. Well, thank you so much for sharing your expertise with us today. I really appreciate your time. 

 

Dr. Yale Smith  16:03  

Thanks so much.

 

Kris Urquhart  16:04  

Everyone. Be well stay connected.