Going with the flow for great sex
January 12th, 2012
07:46 AM ET

Going with the flow for great sex

Ian Kerner, a sexuality counselor and New York Times best-selling author, blogs about sex on Thursdays on The Chart. Read more from him on his website, GoodInBed.

When you hear the words 'heart' and 'sex life' in the same sentence, odds are the speaker is probably talking about love. But your heart - or, more accurately, your cardiovascular system - actually has a lot to do with your ability to perform in the bedroom.

This concept was brought home to me recently when I caught up with my colleague, Dr. Madeleine Castellanos, author of a recent book dealing with male sexual issues. She reminded me that there’s no way we can talk about sexual issues like erectile dysfunction (ED) or other arousal disorders without talking about cardiovascular health.

"When you break it all down, everything in the body, including sex, is dependent on good blood flow," says Castellanos. "Our body's way of nourishing itself and keeping itself vibrant and alive is by carrying oxygen, hormones, and nutrients via the bloodstream to all tissues and cells. The more activity that a certain part of our body engages in, the more blood flow is directed to that area."

Although you might typically associate blood flow with your heart, brain or muscles, it's also a crucial factor in the way your genitals function. In men, blood flow to erectile tissue produces an erection and stimulates the prostate gland to start releasing pre-ejaculatory fluid. Blood flow also benefits women by increasing the clitoris’s size and sensation and by enhancing vaginal lubrication.

Good blood flow also affects our biggest sex organ - the brain - by ensuring proper flow of hormone signals back and forth from the brain to the genitals.

Often, a sexual issue like ED is the first sign that blood flow is impaired throughout the body, and a trip to the doctor’s office for a Viagra prescription could end with a diagnosis of atherosclerosis or another serious cardiovascular problem. A recent analysis of 12 previous studies, published in the Journal of the American College of Cardiology, found that men with ED are significantly more likely to have cardiovascular disease.

So how can you keep blood flowing optimally? Dr. Castellanos recommends addressing these three areas:

Arteries. When arteries become clogged, or 'hardened,' due to atherosclerosis, they can’t respond as well to the hormonal signals that occur during sexual arousal. As a result, “there may not be enough increase in blood flow to engorge the erectile tissues in either men or women,” says Castellanos.

Eat a balanced diet low in sugars (including fructose and high-fructose corn syrup), trans fats, high-glycemic carbohydrates, and salt to keep arteries in good shape. For more on eating for a healthy sex life, see my previous column on the topic.

Nerves. If your nerves aren’t working properly, you lose sensation and your body - including your genitals - doesn’t respond as well as it should. Diabetes and elevated blood sugar are the biggest threats to nerve damage, so keep blood sugar under control, eating smaller, more frequent meals, and limiting alcohol intake.

Tissues. Just as the advice 'move it or lose it' applies to our muscles, it also applies to sex.

"If you want to have good blood flow to your genitals," explains Castellanos, "you need to keep using them." In fact, people who have sex at least once a week are more likely to retain good sexual function as they get older.

If you’re following the steps above but want to do more to encourage proper blood flow, consider this: Your body depends on the molecule nitric oxide to keep blood vessels healthy and relaxed so that blood can flow through them.

"If you want more nitric oxide, you need more of the amino acid L-arginine," says Dr. Elizabeth Owings, a Missouri-based physician who is passionate about the benefits of L-arginine. Viagra and other members of a class of drugs called phosphodiesterase (PDE) inhibitors also influence nitric oxide - but they only enhance its effects. On the other hand, L-arginine helps your body produce more nitric acid, improving blood flow all over.

L-arginine is naturally found in protein-rich foods such as peanuts and walnuts, meats, seafood and legumes such as soybean and chickpeas, but you may need a supplement to give your sex life that extra boost.

Although more research is needed, some evidence suggests that supplemental L-arginine may have sexual benefits for both men and women. A 1999 study of men with ED found that those who took L-arginine for six weeks had greater improvement in symptoms than those who didn’t take this supplement. And a 2002 study published in the Archives of Sexual Behavior showed that women who took a combination of L-arginine and the herb yohimbine experienced more signs of sexual arousal while watching an erotic film than those who took a placebo.

Dr. Owings recommends that healthy people try taking 5 grams of L-arginine a day and points out that this supplement appears to lack the side effects associated with PDE inhibitors, including visual disturbances and hearing problems. That said, some research does suggest that L-arginine isn’t a good idea for people with liver or kidney failure or cancer.

As always, it's best to talk to your doctor before taking any type of supplement. It may seem difficult, but sharing your concerns with a professional can help open an honest conversation about sex, and about health in general - and that's always a good thing.

soundoff (896 Responses)
  1. docdewitt

    Respectfully, from where did Dr Owings pull the recommendation for 5 gm of L-arginine? I'm a physician, and think it is his opinion, rather than medical advice. Shame on him. My advice is work up to walking 40 min twice daily, and eat a generally health diet, and watch cartoons at least one hour a week....

    January 12, 2012 at 08:05 | Report abuse | Reply
    • James the elder

      Walk 40 minutes a day? Setting the bar a little low aren't you?

      January 12, 2012 at 15:55 | Report abuse |
    • Dr. B

      He said "40 minutes twice daily." Perhaps you might brush up on your reading skills.

      January 12, 2012 at 20:27 | Report abuse |
    • Asav

      James, he is setting the bar low, but that's because studies have shown that about 30 minutes of walking is enough to make a big difference for hearts. He said "at least", and more is of course better. But he did indeed set the bar low, because that's where the bar is.

      January 15, 2012 at 23:00 | Report abuse |
  2. palintwit

    Sarah Palin believes that a golden shower is something you get at a jewelry store.

    January 12, 2012 at 09:51 | Report abuse | Reply
    • J. Crobuzon

      "Sarah Palin" Who?

      January 12, 2012 at 10:53 | Report abuse |
    • melvinslizard

      she looks great in pearls

      January 13, 2012 at 12:20 | Report abuse |
    • Evan

      at taxpayer expense.

      January 15, 2012 at 19:57 | Report abuse |
    • Guest

      I will give her a golden shower tax free
      Ill even throw in a pearl necklace and a pink sock

      January 24, 2012 at 08:40 | Report abuse |
  3. J. Crobuzon

    I jump up and down on my wife for exercise. Good cardio and a great view!

    January 12, 2012 at 09:52 | Report abuse | Reply
    • John Q Pubbb

      You need to do this TWICE a day...

      January 14, 2012 at 21:52 | Report abuse |
  4. Hahahahahahaha

    I give my neighbors' doctors' and lawyers' wives some great cardio. They are the easiest. They only married for the money!!! Hahahahahahahaahaha.

    January 12, 2012 at 09:58 | Report abuse | Reply
    • Tom, Long Beach, California

      sure you do.......watch out for the last laugh

      January 12, 2012 at 14:19 | Report abuse |
  5. Jinro

    "Eat a balanced diet low in sugars (including fructose and high-fructose corn syrup), trans fats, high-glycemic carbohydrates, and salt to keep arteries in good shape."

    Impossible to do in America. Everything is loaded with HFCS, trans fats, and sodium.

    January 12, 2012 at 10:33 | Report abuse | Reply
    • Ed

      Agree, but disagree. You just have to read labels and buy fresh, unprocessed foods. Yeah, you spend a little more, but you can't put price on your health or your B0ner!

      January 13, 2012 at 16:33 | Report abuse |
    • wcus445

      Ed has it right. I eliminated HCFS, all white foods and alcohol 5 months ago. That leaves fish, fowl, meat and dark vegetables. I have lost 30 pounds without reducing how much I eat. I snack on sugar free yogurt, cheese and nuts, but try to limit this. Of course, this diet is only possible if you do not go to any restaurants.

      January 13, 2012 at 21:08 | Report abuse |
    • Memo

      So stop eating processed foods then.

      January 13, 2012 at 23:04 | Report abuse |
  6. James the elder

    Being healthy doesn't guarantee good sex. Just erections.

    January 12, 2012 at 11:10 | Report abuse | Reply
    • Shawn

      What are you, Charles Schwab? A healthy diet and exercise doesn't guarantee a long life, either.

      January 13, 2012 at 19:06 | Report abuse |
  7. Rich

    Actually getting a good chiropractic adjustment to the lower back will increase nerve and blood flow as well!

    January 12, 2012 at 11:18 | Report abuse | Reply
    • portland tony

      Actually sleazy massage parlors will do the trick!

      January 12, 2012 at 12:34 | Report abuse |
    • Winston

      Make sure you dont write a check for more than your credit limit and also look at what the rate goes to after the intro rate. Also some have a unrpoft fee of say 3 percent of the cash advance

      July 3, 2012 at 05:55 | Report abuse |
  8. Menthu

    Ahhhh....just have that pump thing installed. What a old lady attention getter at the beach. I'm a hit to serve!

    January 12, 2012 at 12:16 | Report abuse | Reply

    MILLIONS TO BE ASSASSINATED FOR THE SAKE OF $$$ LIABILITIES(mk-ultra, chip implants, electroshocks etc. performed on them) AND NEW WORLD ORDER(multiculturalism = terrorism) POLITICAL AGENDA KNOWN AS "YOU ARE NEXT"(financial liabilities are 2 expensive for the government and it is cheaper to get read of you instead) !!! IF YOU WERE TREATED WITH ELECTROSHOCKS OR DRUGS USED FOR WIPING OUT MEMORY(numerous Americans and Europeans were and are) AFTER ENDURING FORCED CHIP IMPLANTS(or to retard individual = also how homeless people are produced), YOU ARE SCHEDULED NEXT !!!

    NOW YOU KNOW WHAT ORWELLIAN UNITED STATES CONGRESS(USSR#2 which consists of lawyers or what are liars and physicians...lawyers, so crime per physicians can get away with it) AND OTHER GOVERNMENTS WORLDWIDE ARE SOOO BUSY WITH WHEN PLAYING/CLOWNING(acting) IN FRONT OF CAMERAS ONLY HOW SOMETHING HAVE TO BE DONE(deliberately omitting/delaying facts of genocide as seen on this complain) !!!






    January 12, 2012 at 14:48 | Report abuse | Reply
    • James the elder

      Got yer tin foil hat on today?

      January 12, 2012 at 15:53 | Report abuse |
    • J. Crobuzon

      A little research will tell you that this kind of delusion is common with schizophrenia; the interference in your head is the other lobe of your brain talking out of turn. This can make you hear voices or feel you are being controlled by outside forces, and the fact that it comes from your own physical brain doesn't mean it is benign; suicidal impulses and uncontrolled anger can come out with a childish lack of control. Find a doctor you can trust and talk to him about dopamine antagonists and how they work, and see if you can get something that will get you back in control. I'm serious for once and not trying to insult you, but the 'tin foil hat' crack will remind you again that this is a common problem and that people have over and over tried to insulate their heads from what they think is outside interference.

      January 12, 2012 at 16:13 | Report abuse |
  10. caverta

    I've really enjoyed having a look around your blog today, keep up the good work!
    Thank for sharing .

    January 13, 2012 at 06:38 | Report abuse | Reply
  11. Texas Harry

    Don't you think that we, as Americans, need to stop being so concerned with sex?

    January 13, 2012 at 12:11 | Report abuse | Reply
    • melvinslizard

      I'm sorry, what? That's just crazy

      January 13, 2012 at 12:37 | Report abuse |
    • randybear


      January 13, 2012 at 15:06 | Report abuse |
    • Shawn

      Negative, sky captain.

      January 13, 2012 at 19:08 | Report abuse |
    • lance corporal

      no, but we do need to stop worrying about how OTHER people enjoy s ex

      January 15, 2012 at 12:19 | Report abuse |


    January 13, 2012 at 23:33 | Report abuse | Reply
  13. Paul

    Instead of sex I'd rather go to the gym, that way I'm away from my wife.

    January 13, 2012 at 23:47 | Report abuse | Reply
    • Joey

      I prefer working in the garage, but I'm right there with you.

      January 15, 2012 at 18:56 | Report abuse |
    • cacique

      I suppose you two already have an assistant...

      January 15, 2012 at 19:14 | Report abuse |
  14. Tom

    This article is bs. I would have great sex if my wife looked like that cute girl who gives samples in the food court, or the hot one at starbucks. Looking at them never fails to get me in the mood.

    January 14, 2012 at 17:56 | Report abuse | Reply
    • lance corporal

      sorry your too ugly to get the cute girl

      January 15, 2012 at 12:20 | Report abuse |
    • Joey

      The #1 cause of ED is trying to get it up for a naggy, saggy old battleaxe who calls herself a "cougar" and hasn't touched a treadmill in a decade. Find yourself a nice young twenty-something lady with daddy issues and you're good to go. Lance Corporal is clearly one of the women.

      January 15, 2012 at 18:54 | Report abuse |
  15. r

    happiness and ecstacy to all

    January 14, 2012 at 21:20 | Report abuse | Reply
  16. cacique

    It is all fine and good....lucky those of us who have no problem with cardio vascular stuff and enjoy sex fully. But those of you, who have to rely on diets that include oysters, shrimp, chilies and all those good foods thought to be aphrodisiacs, plus a few of the blue pills every now and then...Let me add, just in case it bypassed you, that the best way for the bird to ake flight is a 15 minute blow. Or less depending on the bird's weight...

    January 15, 2012 at 19:01 | Report abuse | Reply
  17. marie

    dang it isn't bad enough having some minimum wage mall job a girl has to put up with creepy older guys harassing her. yuck

    January 16, 2012 at 22:00 | Report abuse | Reply
  18. Andrew

    Don't be mean. Creepy older guys need love, too.

    January 27, 2012 at 18:27 | Report abuse | Reply
  19. creamoftarter

    Ask not what your country can do for you but,what can you do for your country.

    January 28, 2012 at 01:24 | Report abuse | Reply
  20. creamoftarter

    I like money and I like sex.Just be honest.

    January 28, 2012 at 01:28 | Report abuse | Reply
  21. Nat

    OK! I'll be honest I like money and as far as sex goes well my wife and I hadn't had sex in 45 years. Only had sex once and that was the last time. I just wasn't important, ment nothing, was messy and disgusting. I swore never again

    February 28, 2012 at 23:45 | Report abuse | Reply
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    Arginine when taken orally also helps prevents tooth decay. this is because arginine is basic and helps reduce oral acids. ^

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    Nitric oxide is a gas naturally found in the body; its function is conveying information between cells. One of its main jobs is increasing blood flow by dilating blood vessels, and that's why it's sometimes given in supplement form to heart patients, orally and intravenously. In at least one study it's been shown to be effective for lowering blood pressure.,;'`

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    July 2, 2013 at 03:06 | Report abuse | Reply
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    ooh yes wath a nice health tips.

    June 25, 2014 at 04:29 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.