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    Happy, Healthy, and Hard

    Experts explain the connection between a man's overall health and his sexual health.

    Toward the Ideal Erection continued...

    By definition, having ED means a man cannot get an erection hard enough for penetration or one that lasts long enough for him to reach orgasm. But in Lamm's opinion, wellness isn't "the absence of illness." There are shades of gray between excellent sexual function and dysfunction.

    The American Heart Association has defined an optimal cholesterol level. There should be a similar measure for erectile function, Lamm says. "I think we need to do this in all areas so that people have some sort of benchmark."

    Researchers usually assess erectile function by the International Index of Erectile Function, a set of five questions such as, "How do you rate your confidence that you could get and keep an erection?" A patient's answers are scored, and that score determines whether or not he has ED.

    In 2005, when he wrote his book, Lamm was using a tool called a rigidometer to measure erectile function. A man presses the head of his erect penis against a sensor attached to the digital device, which measures the precise hardness of his penis in grams of pressure.

    Lamm says he's now studying ED using an even newer device that measures the function of the endothelium, instead of the hardness of an erect penis.

    "When we wrote the book, we had no way of looking at endothelial function," Lamm says.

    This new technology uses a blood pressure cuff and two sensors placed on a man's index finger. The sensors, hooked up to a computer, measure blood flow returning to the fingers after the inflated cuff squeezes off the blood supply for about five minutes. Based on data from the sensors, the computer generates a score of endothelial function.

    Lamm says he has been able to perform about 1,000 of these tests a year on patients, and he's hoping that the data will help him find an optimal range related to hardness and heart disease risk.

    Harder Questions

    Lamm says he thinks men want harder erections, even if they're not worried about ED or heart disease.

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