Excessive use of alcohol and cigarettes can negatively affects sexual function.
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Randall B. Meacham: I think that one of the important messages that we need to allow our patients to understand, that we need to take to our patients is that there certainly are things that they can do to maximize their sexual function. Two of those are avoidance of cigarettes, and avoidance of excess alcohol consumption. If I had to name one toxic substance, one environmental issue that contributes to sexual dysfunction, I think, cigarette smoking would probably be it. Cigarette smoking, in addition to the huge variety of other real health threats, lung disease, heart disease, cancer of a variety of forms, has a very negative effect on sexual function. It literally will cause spasm; it will cause narrowing of the arteries that supply blood to the penis, thereby making it very difficult for the penis to have normal blood supply and therefore normal sexual function. Any degree of cigarette smoking is a great threat to man's ability to have a normal sexual life. Frank J. Costa: Alcohol in excess could alter the liver in such a way that hormones are changed and that in fact also has a direct effect on testosterone, so that that in fact would also be associated with erectile dysfunction, particularly if there is abuse of alcohol. So, as with anything else, moderation may, in fact, not have a severe impairment on erectile dysfunction. However, abuse or excessive use of either cigarettes or alcohol can certainly contribute and in many cases cause erectile dysfunction. Randall B. Meacham: If you think about alcohol consumption, men who excessively consume alcohol, it's difficult -- it causes difficulties with liver function, it causes difficulties with a number of different organ systems, it also could have a very telling effect on ability of an individuals to achieve and maintain an erection. Frank J. Costa: Now when we talked about a cessation of cigarette smoking cessation of excessive alcohol intake, can it reverse the erectile dysfunction? The answer to that question is in many cases, it may. I've seen many patients where they stopped smoking and if they have not had a significant impairment, that their sexual function can in fact improve. Similarly, patients that have a abnormal alcohol intake, if they stop the alcohol or at least moderate alcohol intake, many times they can improve their sexual function. However, in these patients there is also lifestyle issues that are important, whether they eat properly, whether they exercise, whether they take general overall good health of themselves, and it's really important in these patients to individually assess what factors are contributing to their dysfunctions and to their overall health and being able to create and modify lifestyle changes certainly goes a long way in being able to improve or restore their sexual function. Jeffrey Brady: Well, we do know there are some studies that look at smoking, and when you take and this is obviously a lab study where they took rats and when rats were exposed to smoke, they had damage to the blood vessels that went to the penis. When you took way the exposure to smoke, those vessels improved, so there is at least some ability to regenerate that tissue, the erectile tissue in the blood vessels that go to the penis. So I think if you do quit smoking, and once again, if you are a smoker, stop smoking, because that gives you a better chance of having erections down the line or keeping your erections. So I think there is the ability for the body to regenerate, all the things you do to damage your body to make erections more difficult. It's a cumulative effect, so the more you do, the more soft you are going to be. So I think there is a way to improve your -- keep your erections over time.