The pursuit of longevity has led some to unconventional methods of self-assessment, as exemplified by billionaire Bryan Johnson’s recent focus on tracking his nocturnal erections. While his methods have drawn both ridicule and attention, experts suggest his underlying message – that erectile function is a valuable indicator of overall health – holds merit.
Johnson, a report details, has been meticulously monitoring various biomarkers to “reverse” his biological age. This includes a strict diet, regular blood tests, and, most recently, measuring the frequency, duration, and rigidity of his nighttime erections, even comparing his results to those of his 19-year-old son.
The practice, while unusual, stems from a growing understanding within the medical community that erectile dysfunction (ED) is often an early warning sign of underlying health problems. “Healthy erections are testament to a good sleep routine, diet and regular exercise,” explains Mr. Marcus Cumberbatch, a consultant urological surgeon at Thornbury Hospital in Sheffield.
Erections as a Canary in the Coal Mine
Studies have demonstrated a correlation between ED and a higher risk of cardiovascular disease, diabetes, and stroke. The small blood vessels in the penis are often the first to be affected by poor circulation, inflammation, and metabolic disease, making erectile function a sensitive indicator of vascular health. A study published in The Journal of Sexual Medicine found men with ED had a 70 percent increased risk of early death from any cause. A Dutch study revealed a 250 percent higher likelihood of developing cardiovascular disease in men experiencing ED.
However, many men remain unaware of the subtle early signs of ED, often believing the condition only manifests as a complete inability to achieve an erection. One Japanese study highlighted this gap, finding that while 40 percent of men aged 40 to 69 reported ED, clinical assessments revealed the true prevalence to be closer to 92 percent. A US study from last year showed a similar underreporting among younger men, with 19 percent self-reporting ED while assessments indicated a rate closer to 26 percent.
Beyond Blood Flow: What Changes Signal a Problem?
Experts emphasize that a key early indicator isn’t necessarily the complete absence of erections, but rather a change in their quality. “A loss of rigidity in your erections is one of the common early signs of erectile dysfunction,” says Cumberbatch. “For the majority of people, erectile dysfunction is not sudden, and a loss of rigidity can happen over a number of years. This should signal it is time to act before function fully deteriorates.”
Nocturnal penile tumescence (NPT), or erections during sleep, is a normal physiological process. During REM sleep, nerve signals that control blood flow to the penis relax, combined with fluctuating hormone levels, leading to multiple erections throughout the night – typically three to five, lasting 20 to 30 minutes each. Changes in this pattern, such as fewer erections or reduced rigidity, can be a sign of underlying issues.
Underlying Causes and When to Seek Help
While psychological factors like anxiety or depression can contribute to ED (accounting for around 10 percent of cases), it’s often a symptom of a more serious medical condition. High cholesterol, high blood pressure, and type 2 diabetes can all impair blood flow and nerve function, leading to ED. Up to three-quarters of men with diabetes will experience some degree of erectile dysfunction, often a decade earlier than those without the condition. Obesity also plays a significant role, impacting hormones, inflammation, and vascular health.
For those whose ED is linked to cardiovascular risk factors, approximately 160 minutes of moderate exercise per week for six months has been shown to improve erectile function. Adopting a Mediterranean diet, rich in whole grains and lean protein, has also been linked to a 20 percent reduction in ED risk in men over 60, according to a 2020 study.
Treatment options range from lifestyle modifications to medications like Viagra (sildenafil) and Cialis (tadalafil), which enhance blood flow. Vacuum erection devices are also available for those who don’t respond to other treatments. However, experts stress the importance of seeking medical evaluation to identify and address any underlying health conditions.
Breaking the Stigma
A significant barrier to addressing ED is the stigma surrounding the issue. Men often delay seeking help for an average of three years after experiencing symptoms. “Most men do not feel able to talk to their doctor and will do anything they can to avoid it,” says Dr. Jeff Foster, a GP specializing in men’s health. “In other words that before they come to us, they have often tried to self-medicate with over-the-counter Viagra – and as we know, heart conditions are often the underlying cause.”
recognizing changes in erectile function – even subtle ones – and seeking medical advice is crucial, not only for sexual health but also for overall well-being. As Johnson’s unconventional approach highlights, paying attention to this often-overlooked aspect of health can serve as a valuable early warning system for potentially life-threatening conditions.
