Sexual Fitness for Men: The Hardness Factor (cont.)

This is something that I think is extremely important for women. They think because the man does not achieve an erection instantaneously as they come to bed or in a certain encounter that somehow it means they are not sexually appealing and the man is probably not interested, and that is not true. What this is really saying is I need more stimulation in order to achieve a proper erection.

So there are a lot of things this man can do:

  • Improve the way he is using the medications.
  • Appreciate that a lot more stimulation is necessary.
  • Have his testosterone checked because when the testosterone levels are very low, the oral medications may not work as effectively.
  • Try it at a different time of the day. I find that men are more potent in the morning, so an encounter early in the morning may be more effective for a variety of circadian rhythm explanations and biologic reasons.

By the way, any underlying medical condition needs to be corrected as well. Whether it's high blood pressure, high cholesterol, a mood disorder such as depression or some other medicine that may be having an adverse effect on the medication, a beta blocker or something like that -- they have to be corrected as well. If all of these changes do not work, then another intervention would be the injection of a vasoactive medicine directly into the penis. I know it sounds barbaric but it's actually painless and this can be extremely effective. This may be something that the man and his partner find perfectly acceptable.

If that doesn't work, then an actual penile implant can be inserted. They are very sophisticated right now and there are thousands and thousands of men who have had a terrific result with these implants.

So, basically I can say that 100% of men who really, really want an erection can achieve an erection.

"If you don't sleep, you're not going to perform or function cognitively or sexually in my opinion."

Well, given that your goal is to get men to take care of their overall health and to deal with any underlying issues, and that it's almost as if sexual health is a reward for taking good care of yourself, what role do you see for medications like Cialis and Levitra and Viagra? How do they fit in with your program? Bluntly, we all tend to think, I don't want to do the hard work, I'm just going to pop a pill and it will make everything work like magic.

You're making this too easy for me! The Hardness Factor is primarily, as you said, a health book to try to get men to take better care of themselves so that they can maintain or enhance their erections. If they elect not to read this book and they elect to live a lifestyle which is injurious to their blood vessels, they are going to need at some point in their life a restoration -- a rescue medication. I view Viagra, Levitra and Cialis as rescue medicines.

Now, these medicines are extremely effective and extremely safe, however they are not treating the underlying comorbidity that is responsible for the problem. They are not lowering cholesterol, not lowering blood pressure effectively, not affecting testosterone levels and not treating depression. They are an effective band-aid but they are not treating any underlying problem.

I think it's extremely important for men who have erectile problems to appreciate that they can get help and that the medications are very effective and very safe. But they need to go to the doctor, at any age, so a program can be established -- a program of weight loss, control of blood pressure or smoke cessation in conjunction with these powerful and effective and safe medicines.

You talk about something in your book called the "4-Day Insurance Policy." It even says: Open only in case of emergency. The Hardness Factor 4-Day Insurance Policy enhances hardness in only four days. You look at it as an emergency kind of program, but I looked at it and thought perhaps this would give someone a sample of what they can do if they actually stuck with the program long term.

I think you're right. I realize that you can't alter a serious biologic problem in four or five days -- you can hardly do it over six weeks. But we wanted to really stress to men that even over a four- or five-day period, you can alter your biology. You can make your blood vessels more reactive, more responsive than you can imagine.

The example was if a man came to my office on Monday and said to me, "I've got to play basketball on Friday night with my teenage son and I would rather not kill myself on Friday, you know, do you have any suggestions?" I can't make him necessarily a better basketball player by Friday, but I could say to him, "Between now and Friday, let's start doing some stretching exercises, some running in place, you know, let's get a little bit more limber, let's avoid that six-pack of beer over the next four or five days."

We can actually start to get you functioning at a higher level over a very short period of time. For example, the supplements, they are going to start working right away.

If you're severely impaired you already are in the restoration business rather than in the maintenance or enhancement business. You're going to really have to go to the doctor and unfortunately you're going to need medications. But if you're otherwise just the typical American male who is not really taking good care of himself, we are very confident that even over a four- or five-day period you can see a noticeable change which will of course, only increase and be augmented over a period of six weeks. It's a tease but it's basically saying come on guys, let's start making some changes.

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