Difficulty getting an erection is a strong predictor of a major cardiovascular event like a heart attack or stroke within 2-3 years. Most men who experience these events report increasing ED in the preceding months, making sexual health a critical, often ignored, vital sign.
Physicians rarely ask about sexual health not due to personal discomfort, but because major Electronic Health Record (EHR) systems like Epic lack specific, billable fields for it. This systemic flaw means doctors are not incentivized to gather this critical data on cardiovascular and mental health.
The vast majority of men who believe they have ED are actually experiencing a normal aging process where blood leaves the penis faster (venous leak). True ED, the inability to get an erection, is rare and signals a serious arterial problem. This over-medicalization creates unnecessary shame.
Dr. Mohith Kara equates Viagra to the narcotic Vicodin because both treat a symptom while masking the underlying, potentially life-threatening cause. Using a pill for ED can delay the diagnosis of cardiovascular disease, diabetes, or metabolic problems for years, with dangerous consequences.
Relying on spontaneity for intimacy in an established relationship is a common mistake that leads to decline. Like planning a vacation or a fine meal, couples should proactively schedule and plan for sex. This intentionality is crucial for maintaining a healthy and pleasurable connection over time.
Gay doctors tend to view erection rings as a logical tool for performance optimization ("You got a better one?"), whereas straight doctors often dismiss them due to pride ("I don't need that. I'm good."). This highlights a cultural barrier where performance enhancement is seen as a weakness rather than an upgrade.
The perceived success of drugs like Viagra is not just due to a placebo effect, but the more powerful Hawthorne effect—the psychological boost from anticipating a benefit. Original FDA studies showed minimal benefit over placebo, suggesting the drug's direct physiological impact is often overstated.
The biohacking movement's focus on interventions like supplements is flawed without first tracking baseline data. To truly "hack" health, one must measure their normal state to see if interventions are effective. Otherwise, it's impossible to know which of the dozens of changes are actually working.
The traditional 'life-work balance' model is incomplete. Adding sex as a third pillar acknowledges its data-backed benefits: lowering stress hormones, cutting cardiovascular risk, and halving the divorce rate. This framework encourages treating sexual health with the same importance as career and personal life.