They may not readily discuss it, but there are moments when men just can’t rise to the occasion. Although short-term triggers for erectile dysfunction (ED) such as stress, alcohol consumption and fatigue are remedied relatively easily, long-term ED – which affects about one in 10 adult males – can be harder to treat.
This is especially so for men suffering from diabetes, a common phenomenon that is predicted to afflict 15% of Singapore’s adult population by 2050. Research reveals that up to 75% of men with diabetes will not only have ED, but also develop it 10 to 15 years earlier than those without diabetes.
But a study has emerged showing that intermittent fasting can significantly lower the incidence of ED. To find out more about the topic, we chat with Dr. Sriram Narayanan, a Senior Consultant Vascular and Endovascular Surgeon with The Harley Street Heart and Vascular Centre in Singapore.
Intermittent fasting is a form of time-restricted eating. It involves alternating between periods of fasting and consuming your normal caloric intake on a strict, regular schedule. It has increased in popularity in recent years.
It’s less restrictive than many diets – think dubious juice cleanses or those diets that require you to eliminate entire food groups or only eat raw food. Intermittent fasting has been proven to have myriad health benefits. These include effectively reducing body fat content; as well as decreasing the risk of developing heart and vascular disease, type 2 diabetes and possibly even certain forms of cancer.
According to Dr. Narayanan, diabetes can cause ED because it damages the nerves and blood supply in the penis. Upon sexual arousal, nitric oxide – a naturally occurring chemical – is released in the walls of the arteries in the penis. This signals the arteries to relax and dilate. This allows more blood to rush into the penis, which causes an erection.
“When a man’s blood sugar levels are consistently high, such as with diabetes or pre-diabetes, nitric oxide levels are reduced. This causes insufficient blood flow to start and maintain a strong erection,” he reveals.
Furthermore, up to 85 per cent of diabetics are overweight, which can lower the amount of testosterone in the body – a hormone that required for sexual arousal and erection. They may also have higher oestrogen levels, which can make the problem worse.
Whether or not you suffer from diabetes, intermittent fasting can help reduce the risk factors for ED by curbing blood sugar levels. “Intermittent fasting is believed to prevent ED, because lower blood sugar levels increase nitric oxide production in the arteries, which allows optimal blood flow to the penis for initiating and maintaining an erection,” Dr. Narayanan says.
“Since intermittent fasting is proven to reduce body weight by three per cent to eight per cent over three to 24 weeks. This means that men who practice intermittent fasting will also have less fat tissue, which results in higher functional levels of testosterone and lower levels of estrogen – vital for ensuring a healthy sex drive and a stronger erection,” he adds. “Decreased fat in the lower belly and pelvic region also leads to a more visible penis that looks longer – a confidence booster!”
When you eat, you raise levels of glucose in your blood. Intermittent fasting means you eat only at set times, so glucose levels in the blood are only elevated for a short window each day. This can help your body “reset itself”. This daily reset may help your body from developing insulin resistance – which can go on to become Type 2 diabetes.
“Clinical studies reveal that pre-diabetics showed decreased insulin levels and increased insulin sensitivity after five weeks of time-restricted eating,” Dr. Narayanan says. “In other studies, diabetic patients exhibited a significant reduction in blood sugar levels after 12 weeks of fasting for two days a week.”
Furthermore, based on research covering the diets of 271 patients at a men’s health clinic, those who practiced intermittent fasting were substantially less likely to have ED than men who were vegetarian or pescatarian – which is a vegetarian diet with fish added. The men who fasted intermittently also had less ED than the men who ate low-carb, high-protein, or low-fat diets.
There are two main approaches.People who adopt daily time-restricted eating only eat within a specific time period: usually it’s a 16-hour fast followed by an 8-hour feeding window, usually during the day.
If 16 hours sounds a lot, remember that we don’t eat when we’re sleeping, so you probably already fast for six to eight hours a day, anyway. If you can wait till lunchtime to eat and don’t snack after dinner, you can probably clock up enough hours. Watching TV without a snack may seem weird at first, but gradually, it should feel more natural.
Another option is to fast two days a week – with just a single small meal of between 300 to 400 calories on each of those two days.
When you are intermittently fasting, you can still drink zero-calorie beverages such as water, coffee, tea and drinks without sugar or dairy.
Do note that just skipping a snack here and there will not give you the same benefits as a disciplined intermittent fasting programme – especially if you still eat unhealthy foods. “To reduce ED, you will need to reduce its risk factors, including diabetes and obesity,” Dr. Narayanan says. So when you do eat, he suggests eating lots of fresh fruits, vegetables, whole grains, fish and olive oil, as studies show that it helps reduce the risk of type 2 diabetes by approximately 20%.
It’s been said a million times, but it bears repeating. Always consult a healthcare professional before you drastically change your eating patterns. And there are some individuals who should not try intermittent fasting;
People with eating disorders: Intermittent fasting means you have to be disciplined about when and what you eat. This can be difficult for people who suffer from any kind of eating disorder, including anorexia, bulimia or binge eating disorder. It may trigger a relapse.
Those with diabetes, or chronic health conditions: Fasting can affect blood sugar levels and even lower them to dangerous levels. So people with diabetes should take nutritious meals at regular times. Especially if they are dependent on taking insulin. People suffering from chronic health problems such as cancer, are also advised against intermittent fasting because it can affect how medications are absorbed, and lower energy and resistance levels.
Serious athletes in training: Tough sports which require endurance and strength training also require solid nutrition, with the right balance of electrolyte, calories and protein eaten at specific times. This balance can be impossible to manage with intermittent fasting.
Pregnant women: Being on a diet can deplete energy levels, lower blood sugar levels and rob the baby of nutrition, so pregnancy and breastfeeding is not the time to try any kind of fasting.
After giving birth, women are often advised to do Kegel exercises to strengthen the pelvic floor – but it turns out these exercises can also help men also. Kegel exercises for men can strengthen the pelvic floor muscles, which supports the bladder and bowel and affect sexual function.. “These exercises can also benefit men as they strengthen the bulbospongiosus muscle, which allows the penis to properly engorge during an erection,” reveals Dr Narayanan. With practice, Kegel exercises for men can be done just about anytime. See how to do Kegel exercises for men here, step by step.