Three major vascular crises in middle-aged men Men entering middle age, a variety of crises will follow. They will face three major crises, namely cerebrovascular, cardiovascular and penile cavernous vessels will begin to have problems. The root cause of the mid-life crisis comes from the blood vessels. Imagine, a farmland if the loss of water irrigation, will undoubtedly lose vitality. The same is true for the human organism. If the blood vessels become diseased, various problems of the related organs will follow. With age and other internal and external factors, when accumulated to a certain extent, the heart, brain, kidneys, eyes and other organs will successively have problems, resulting in myocardial infarction, stroke, kidney failure, diabetes and other serious diseases. Fortunately, however, men have a very good health warning indicator. When blood vessels are just beginning to be partially damaged, erectile function of the penis will manifest itself. In this sense, erectile function is a barometer, a weathervane, of great health! In other words, when erectile function becomes a problem, various problems such as cardiovascular and cerebrovascular problems will follow. Erectile dysfunction (ED) is only the tip of the iceberg of men’s health, and there are many potential problems that we should be alert to. When the warning signs of penis appear, we should take measures, not only for the benefit of men’s health and family well-being, but also to move the line of defense of men’s general health forward. This is because the blood vessels in the penis are smaller compared to other blood supply vessels in the body. The large blood vessels of the heart and brain generally show symptoms later due to their strong compensatory function. In addition, compared with the symptoms of cardiovascular and cerebrovascular diseases, which appear in the decompensated phase of blood supply, the erectile dysfunction of the penis appears at the earliest stage of vascular lesions, and once the erectile function is slightly reduced (e.g., erectile hardness decreases, duration shortens), it is easily detected by the patient or his family. The average time between the onset of ED and the development of vascular disease in the heart and brain is 53.4 months. There is much evidence that the degree of vascular blockage and lesions is directly proportional to the degree of erectile dysfunction. Testing vascular endothelial function to detect major health problems Erectile function and penile vascular endothelial function are correlated. The innermost layer of the vascular lumen has a layer of cells called the vascular endothelium. This layer of endothelium secretes active substances that play a regulatory role. The endothelium secretes a factor that dilates the blood vessels of the penis, causing them to dilate, which results in an erection, and a factor that constricts the blood vessels, which causes the penis to weaken. Under normal circumstances, the two are in balance, but once the balance is disturbed, erectile function is affected. The endothelial function of large blood vessels can be checked by color Doppler ultrasound or special endothelial function testing instruments, which can indirectly reflect the endothelial function of penile blood vessels. So, do we have a way to improve the endothelial function of blood vessels? ED patients can make lifestyle improvements early on, such as ensuring adequate sleep, increasing exercise, paying attention to diet, relaxing, and avoiding smoking. If the results are not satisfactory, Viagra (PDE5 inhibitor) can be used in small doses for a long time. Taking Viagra as needed (i.e. once before each sexual encounter) is only a symptom, but if taken daily for a long time, small doses of Viagra can improve vascular endothelial function. In the improvement of erection at the same time, improve the health of the blood vessels of the whole body. This also achieves “both the symptoms and the root cause” – not only treating male diseases, but also treating diseases that affect the health of the whole body at the same time. Some herbs may also be effective in improving endothelial function, but further research is needed on their mechanism of action and safety.