How Can Sleep Affect Men’s Health?

By Hidaya Aliouche, B.Sc.
Reviewed by Sophia Coveney

This article is a repost which originally appeared on News Medical

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key Points

‧ Adults should get an average of 8 hours of sleep per night.

‧ A lack of good sleep can cause many serious maladies.

‧ The use of a CPAP can be beneficial in many cases of sleep apnea

Sleep is known to affect several systems and processes in the body. Overarchingly, sleep deprivation is associated with negative health consequences.

With regards to specific effects of sleep on men’s health, dysfunctional sleeping patterns have been shown to impact erectile dysfunction, lower urinary tract symptoms, hypogonadal symptoms, low testosterone, and male infertility.

What is considered to be appropriate sleep?

The average number of hours of sleep required for an adult is between 7–9 for optimal health. However, a considerable number of adults do not meet this requirement.

A study conducted in 2012 demonstrated that 29.2% of men achieved an average of 6 hours or less of sleep each evening. the institute of Medicine further estimates that between 50 and 70 million Americans suffer from a chronic sleep disorder; this epidemic is associated with societal changes which include increased reliance on technology, increased working hours, and poor sleep hygiene.

In addition, non-standard shift working patterns can divulge significantly from circadian patterns which further increases the risk of impaired sleep quality.

The interrelationship between disrupted or inadequate sleep and the manifestation of disease

The relationship between health and sleep is bi-directional. There are several medical conditions associated with inadequate or disrupted sleep which include restless leg syndrome, insomnia, hypogonadism, sleep apnea, and depression.

Furthermore, several studies have revealed that short and sleep or disrupted sleep can produce health conditions including diabetes, coronary heart disease, hypertension, heart attacks, stroke, and several endocrine and cardiovascular disorders. Moreover, poor sleep also impacts the patients’ perception of symptoms and their severity alongside the clinical responses observed.

Combined with independent risk factors such as age, body mass in tax, mental health conditions that affect the perception of symptoms such as depression, and clinical characteristics, sleep functioning can moderate clinical symptoms and impact the quality of life experienced by patients.

Sleep and erectile dysfunction

In the general population, longitudinal studies have revealed that approximately 50% of men experienced erectile dysfunction to some degree. Several studies have reported that sleep can affect erectile dysfunction. For example, a cross-sectional analysis of 2676 men over the age of 67 found that those with a sleep dysfunction called nocturnal hypoxemia were more likely to experience moderate or complete erectile dysfunction.

In the same study, a similar condition that disrupts sleep, sleep apnea, was studied in relation to erectile dysfunction. In a randomized sham-controlled trial, a total of 61 men were assigned to groups to investigate whether the use of continuous positive airway pressure (CPAP) could improve erectile function in men who suffered from both erectile dysfunction and obstructive sleep apnea.

Overall, men who were randomized to CPAP showed no change in erectile dysfunction; however, when further examined in terms of patients who used the CPAP machine for over four hours per night, those who did so experienced a significant improvement. A placebo trial showed that a medication commonly used to treat erectile dysfunction did not significantly improve erectile dysfunction in these men.

These results suggest that in men with obstructive sleep apnea, sleep quality contributes to the condition, and may not respond to first-line treatment for erectile dysfunction with a PDE5 inhibitor; suggesting that in fact, correcting the underlying sleep impairment could produce more significant improvement in erectile dysfunction.

Alongside obstruction to breathing, non-standard shift work that has a significant effect on sleep has been shown to impact erectile dysfunction. A correlation between insomnia and erectile dysfunction has been confirmed by several studies. Some of these studies suggest that the correction of poor sleep in isolation may lead to a clinical improvement in manifestations of erectile dysfunction. This body of research continues to grow.

Sleep and lower urinary tract symptoms

Aging male populations commonly experience lower urinary tract symptoms. This is frequently associated with benign prostatic hypertrophy. Symptoms include poor urine stream, incomplete emptying of the bladder, straining, changes to the frequency of urination, urination hesitancy, and nocturia.

The urge to urinate is often exacerbated during the night, which leads to disrupted sleep and a decrease in overall sleep quality. A survey conducted on 5335 men who were diagnosed with lower urinary tract symptoms demonstrated that only 13% reported continuous sleep periods of more than two to three hours, illustrating the degree to which urinary tract symptoms can affect sleep.

Other studies have verified an association between lower urinary tract symptoms and other sleep-affecting conditions. For example, men with obstructive sleep apnea are more likely to experience urinary tract symptoms compared to those who do not. The severity of obstructive sleep apnea in this context has been found to correlate the most strongly with daytime frequency, urgency, and frequency of nocturia.

CPAP machines have been found to reduce lower urinary tract symptoms in those with obstructive sleep apnea. For example, a man with both lower urinary tract symptoms and obstructive sleep apnea who implemented CPAP for 12 months showed a significant increase in bladder compliance, as well as decreases in nocturia frequency and nighttime urination volumes.

Insomnia is also considered to be an aggravator of lower urinary tract symptoms as well as non-standard shift work.

Sleep and male fertility

Several studies have demonstrated that sperm counts have been decreasing over the past 40 years (50 to 60%). Unlike the linear correlation between erectile dysfunction and sleep, the relationship between sleep and male fertility is less clear.

Evidence suggests that an inverted U shape relationship exists, meaning that excessive and insufficient sleep are equally associated with reduced fertility. In a study of 198 infertile men, this relationship was found. However, interestingly no differences in semen volume, sperm motility, luteinizing hormone, or follicle-stimulating hormone were observed.

An additional study found via testicular biopsies in idiopathic infertile men that full circadian disruption – as manifested by too little or too much sleep – may affect the oxidation state of the testicle, shifting spermatogenesis.

Despite these correlative studies, no studies have assessed the impact of obstructive sleep apnea on fertility. With regards to non-standard shift work which impairs sleep quality, this has been suggested to impair spermatogenesis, although findings from studies have been inconsistent: some studies have demonstrated that men performing shift work had higher odds of experiencing infertility, while others have found no effect.

Conclusion

Poor sleep affects men and women alike. However, the unique effects in men concern urological problems, including erectile dysfunction, lower urinary tract symptoms, hypogonadism, and male infertility.

Alongside these, poor sleep is associated with a higher risk of several health problems that affect the quality of life including but not limited to cognitive impairment, social impairment, mood disturbances, and an increased risk of cardiovascular disease and associated manifestations such as atrial fibrillation.

References

‧  Kohn TP, Kohn JR, Haney NM, et al. (2020) The effect of sleep on men’s health. Transl Androl Urol. doi:10.21037/tau.2019.11.07.
‧  Irer B, Celikhisar A, Celikhisar H, et al. (2018) Evaluation of Sexual Dysfunction, Lower Urinary Tract Symptoms and Quality of Life in Men With Obstructive Sleep Apnea Syndrome and the Efficacy of Continuous Positive Airway Pressure Therapy. Urology. doi:10.1016/j.urology.2018.08.001.
‧  Soterio-Pires JH, Hirotsu C, Kim LJ, et al. (2016)The interaction between erectile dysfunction complaints and depression in men: a cross-sectional study about sleep, hormones, and quality of life. Int J Impot Res. doi:10.1038/ijir.2016.4.
‧  McBride JA, Kohn TP, Rodriguez KM, et al. (2018) Incidence and characteristics of men at high risk for sleep apnea in a high volume andrology clinic. J Urol. 10.1016/j.juro.2018.02.1358.

 

 

Does sex count as exercise?

By Gretchen Reynolds
February 15, 2023 at 4:15 p.m. EST

This article is a repost which originally appeared on The Washington Post

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key Points

‧ Sexual activity counts as physical exercise.

‧ The more fit you are, the further you can engage in vigorous sexual activities without impediments.

‧ Contrary to popular belief, sex before exercise does not negatively affect performance.

Whether it’s Valentine’s Day, the next day or pretty much any day throughout the entirety of a typical year, many couples will be indulging in sexual relations. Some, glancing at their activity trackers or watchers, might idly wonder, so, are we exercising right now?

Curious scientists have wondered, too. Sexual activity is a popular and pleasing way to spend 32.38 minutes (more on that later). But is it physically intense or leisurely? Can it burn as many calories as jogging, or is it more like a mild stroll? Does it spike heart rates? Can it initiate heart attacks? And what if you have a big competition tomorrow? Should you remain chaste tonight?

Given the prevalence of sexual relations — it may be the physical activity least likely to be skipped — the answers matter, and a bevy of recent studies offer preliminary answers, including some surprising new statistics about the typical age of someone who experiences a “sudden cardiovascular arrest” during sexual relations and the extent to which exercise improves sexual function and satisfaction.

But probably the most pressing question about sex and exercise is, “Is sex exercise?”

The answer, in various ways, appears to be yes. In a review article published in the Archives of Sexual Behavior, researchers at the University of Almería and the University of Murcia in Spain gathered every past study they could find that examined the physical exertions involved in coitus.

There weren’t many. As an activity, intercourse is difficult to study, for reasons ranging from politeness to politics. The studies the researchers found involved mainly committed, heterosexual couples, usually married, who often visited a lab for scientific observation of their exertions. On occasion, the coitus took place at the volunteers’ homes. Some of the couples wore heart rate monitors or other trackers. Others were filmed and their movement patterns analyzed. No one was blinded as to whether sex was taking place.

But even with these limitations, patterns emerged, the Spanish researchers found.

Sex counts as moderate exercise

Most obviously, sexual relations sped up the heart and burned through energy. In the studies in which people wore trackers, heart rates averaged between 90 and 130 beats per minute and peaked at anywhere from 145 to 170 bpm. Women’s heart rates tended to be lower than men’s.

The average caloric burn during intercourse also ranged widely, depending on people’s positioning, gender and more ineffable factors, such as whether they were at home or under observation at the lab. In one study, total energy expenditure during a single session of sexual activity reached 130 calories, while in another experiment, it topped out at about 101 calories for men and 69 calories for women.

These measurements indicate that “sexual activity can cause physical demands of moderate or even vigorous intensity,” said José M. Muyor, a professor at the Health Research Centre at the University of Almería, who led the review study.

The numbers are similar to those for a gentle run, except for the heart rate peaks, which rose higher than typical while jogging, and usually during orgasm, which is uncommon then.

As for the length of the sexual episodes, they likewise varied. In young, healthy couples in one study, sex lasted for an average of 32.38 minutes, while it continued for only about 19 minutes in another study among couples with health conditions, such as heart disease.

In all of the studies, duration was considered to start with foreplay and end with the male orgasm. Whether those parameters adequately capture the experience of both partners is disputable, but “we are limited to describing the methods and protocols that each study conducted,” Muyor said.

Can sex stop your heart?

Other researchers recently have been probing whether sex, while briefly invigorating hearts, might also, under certain circumstances, stop them — and not metaphorically.

A noteworthy 2022 study in JAMA Cardiology, for instance, of casualties in London due to sudden cardiac arrest within an hour of sexual relations found that such deaths were reassuringly uncommon.

Of 6,847 fatal sudden cardiac arrests referred to one pathology center in London between 1994 and 2020, only 17 occurred during or almost immediately after intercourse.

But of those 17, six were women, which was unexpected, and most were relatively young. The mean age was 38.

Similarly, a 2018 study in Paris of people who survived sudden cardiac arrests between 2011 and 2016 found that about 0.6 percent, or 17 in total, all of them men and most in their 50s, went into cardiac arrest during or soon after sex. By comparison, 229 of the other cases occurred during sports or other exercise, and 2,782 in other situations.

Interestingly, resuscitation attempts on the men who became afflicted during or soon after sex tended to begin later than in the other situations, perhaps because of partners’ disbelief or “some degree of embarrassment,” said Eloi Marijon, a professor of cardiology at Paris University and co-author of the study.

“We do not have the marital status of the partners,” he added.

But the primary finding of his and other research in this area is that cardiac arrests during or due to sex remain vanishingly rare, he said. And the more someone engages in intercourse, the more the risks drop.

“During any physical activity,” he said, including sex, “the risk of cardiac arrest is higher than at rest.” But hearts, like other muscles, strengthen and grow more resistant to arrest the more people exert themselves, including with sex. “Sexual activity,” he said, “should not be seen as a riskful situation.”

Sex does not weaken legs

It also is unlikely to compromise tomorrow’s competition or workout, despite widespread myths to the contrary. (“Women weaken legs,” Rocky’s trainer warned him in the 1976 film.)

A 2022 review published in Scientific Reports concluded that “sexual activity within 30 [minutes] to 24 [hours] before exercise does not appear to affect aerobic fitness, musculoskeletal endurance or strength/power.”

The review, which pooled data from nine studies, involving 133 people, almost all male, who had sex in the hours before some type of physical test, also found that coitus did not improve physical performance.

Sex, in other words, was a wash, which is perhaps comforting both for people who are and those who are not sexually active.

“I would say there is no reason to avoid or promote sex before a race or sexual competition,” said Gerald Zavorsky, an incoming professor of physiology and membrane biology at the University of California at Davis, who led the review.

Of course, thinking about sex solely as a competitive tool or even just as another form of moderate exercise is to risk diminishing some of its poetic mystery and intimacy.

On the other hand, if you should choose at any time to think about exercise as a way to improve sex, that would seem to be fine. In a 2019 study of more than 6,000 men and women, the more people exercised, the less likely they were to report erectile dysfunction, among the men, and sexual dysfunction, among the women.

 

 

 

 

Stamina Training/Erection Quality Questions: Ask The Experts

Stamina Training/Erection Quality Questions: Ask The Experts

Big Al, of MaleEnhancementCoach.com, answers questions about stamina training and developing better EQ.

If you have questions you’d like answered in an Ask the Experts article, please PM Big Al

Q. I’m performing 10 reps of the Erect Kegels for now. My kegels are still not at optimum erection that I would like but I could say 70-80%. I stop 3 times to get erect. The first set always is not as strong as the 2nd and 3rd. But still, lots of improvement from when I started.

What do you think?

Al: For now, keep the reps on the Kegels static but focus on getting a higher erection level- until you can perform them all at 90% erect or better. From there, add 1 rep per session.

You should also strive to continue to stimulate yourself DURING the Kegels. As long as you can maintain the form of the exercise, you can do this without issue.

Q. you said cardiovascular exercise is important for developing EQ. What should I do to get started?

Al: Much will depend on your CURRENT level of fitness. If you haven’t performed cardio in awhile, take up walking or swimming- at whatever pace you may comfortably challenge yourself with.

It also doesn’t need to be limited to a singular activity. Constant activity sports like basketball and soccer are great for cardio.

The key is to train in a progressive manner. As time goes by add more duration and intensity to your exercise while maintaining a heart rate of 60-80%.

Q. Since start and stop is not so much about getting close to PONR and stopping and repeating as much as it is about maintaining an erection, what do you say would be a good time to aim for? How long is “frivolous” unhelpful masturbation and how long does it cross into useful for PE?

Al: The Stop and Starts exercise (controlled edging)is for maintaining an erection (EQ) and getting close to the PONR (ejaculatory control). These are just a couple of the exercises target aspects. The goal should be to get to 20-25 minutes.

You should avoid frivolous masturbation altogether. Either you’re not sexually active- and you can route your energies into the Stop and Starts, or you’re active and can route your energies into live sexual activity.

*                *                *

Do you want Al to answer your questions?  Please check out MaleEnhancementCoach.com

Scientists show how AI may spot unseen signs of heart failure

A special artificial intelligence (AI)-based computer algorithm created by Mount Sinai researchers was able to learn how to identify subtle changes in electrocardiograms (also known as ECGs or EKGs) to predict whether a patient was experiencing heart failure.

This article is a repost which originally appeared on Medical Xpress
The Mount Sinai Hospital - October 19, 2021 
Edited for content and readability Images sourced from Pexels 
DOI: https://www.jacc.org/doi/10.1016/j.jcmg.2021.08.004

“We showed that deep-learning algorithms can recognize blood pumping problems on both sides of the heart from ECG waveform data,” said Benjamin S. Glicksberg, Ph.D., Assistant Professor of Genetics and Genomic Sciences, a member of the Hasso Plattner Institute for Digital Health at Mount Sinai, and a senior author of the study published in the Journal of the American College of Cardiology: Cardiovascular Imaging. “Ordinarily, diagnosing these type of heart conditions requires expensive and time-consuming procedures. We hope that this algorithm will enable quicker diagnosis of heart failure.”

The study was led by Akhil Vaid, MD, a postdoctoral scholar who works in both the Glicksberg lab and one led by Girish N. Nadkarni, MD, MPH, CPH, Associate Professor of Medicine at the Icahn School of Medicine at Mount Sinai, Chief of the Division of Data-Driven and Digital Medicine (D3M), and a senior author of the study.

Affecting about 6.2 million Americans, heart failure, or congestive heart failure, occurs when the heart pumps less blood than the body normally needs. For years doctors have relied heavily on an imaging technique called an echocardiogram to assess whether a patient may be experiencing heart failure. While helpful, echocardiograms can be labor-intensive procedures that are only offered at select hospitals.

However, recent breakthroughs in artificial intelligence suggest that electrocardiograms—a widely used electrical recording device—could be a fast and readily available alternative in these cases. For instance, many studies have shown how a “deep-learning” algorithm can detect weakness in the heart’s left ventricle, which pushes freshly oxygenated blood out to the rest of the body. In this study, the researchers described the development of an algorithm that not only assessed the strength of the left ventricle but also the right ventricle, which takes deoxygenated blood streaming in from the body and pumps it to the lungs.

“Although appealing, traditionally it has been challenging for physicians to use ECGs to diagnose heart failure. This is partly because there is no established diagnostic criteria for these assessments and because some changes in ECG readouts are simply too subtle for the human eye to detect,” said Dr. Nadkarni. “This study represents an exciting step forward in finding information hidden within the ECG data which can lead to better screening and treatment paradigms using a relatively simple and widely available test.”

Typically, an electrocardiogram involves a two-step process. Wire leads are taped to different parts of a patient’s chest and within minutes a specially designed, portable machine prints out a series of squiggly lines, or waveforms, representing the heart’s electrical activity. These machines can be found in most hospitals and ambulances throughout the United States and require minimal training to operate.

For this study, the researchers programmed a computer to read patient electrocardiograms along with data extracted from written reports summarizing the results of corresponding echocardiograms taken from the same patients. In this situation, the written reports acted as a standard set of data for the computer to compare with the electrocardiogram data and learn how to spot weaker hearts.

Natural language processing programs helped the computer extract data from the written reports. Meanwhile, special neural networks capable of discovering patterns in images were incorporated to help the algorithm learn to recognize pumping strengths.

“We wanted to push the state of the art by developing AI capable of understanding the entire heart easily and inexpensively,” said Dr. Vaid.

The computer then read more than 700,000 electrocardiograms and echocardiogram reports obtained from 150,000 Mount Sinai Health System patients from 2003 to 2020. Data from four hospitals was used to train the computer, whereas data from a fifth one was used to test how the algorithm would perform in a different experimental setting.

“A potential advantage of this study is that it involved one of the largest collections of ECGs from one of the most diverse patient populations in the world,” said Dr. Nadkarni.

Initial results suggested that the algorithm was effective at predicting which patients would have either healthy or very weak left ventricles. Here strength was defined by left ventricle ejection fraction, an estimate of how much fluid the ventricle pumps out with each beat as observed on echocardiograms. Healthy hearts have an ejection fraction of 50 percent or greater while weak hearts have ones that are equal to or below 40 percent.

The algorithm was 94 percent accurate at predicting which patients had a healthy ejection fraction and 87 percent accurate at predicting those who had an ejection fraction that was below 40 percent.

However the algorithm was not as effective at predicting which patients would have slightly weakened hearts. In this case, the program was 73 percent accurate at predicting the patients who had an ejection fraction that was between 40 and 50 percent.

Further results suggested that the algorithm also learned to detect right valve weaknesses from the electrocardiograms. In this case, weakness was defined by more descriptive terms extracted from the echocardiogram reports. Here the algorithm was 84 percent accurate at predicting which patients had weak right valves.

“Our results suggested that this algorithm may eventually help doctors correctly diagnose failure on either side of the heart,” Dr. Vaid said.

Finally, additional analysis suggested that the algorithm may be effective at detecting heart weakness in all patients, regardless of race and gender.

“Our results suggest that this algorithm could be a useful tool for helping clinical practitioners combat heart failure suffered by a variety of patients,” added Dr. Glicksberg. “We are in the process of carefully designing prospective trials to test out its effectiveness in a more real-world setting.”

How Much Muscle Can You Gain in a Month?

How Much Muscle Can You Gain in a Month?

Written by Daniel Preiato, RD, CSCS on February 2, 2021 — Medically reviewed by Daniel Bubnis, M.S., NASM-CPT, NASE Level II-CSS

This article is a repost which originally appeared on Healthline

Edited for content.

When looking to gain muscle, it’s no secret that exercise and proper nutrition are key.

Additionally, numerous factors contribute to the rate of muscle gain, including your training experience, sex, age, and the type of exercise you do. As such, you may wonder how much muscle you can really gain in a month.

This article covers how much muscle you can gain in a month, including how to get started and supplements that may be worth taking.

How much muscle can you gain?

In most cases, gaining muscle is a slow, gradual process, and it can take years rather than months to see sizeable results.

That said, beginners and some intermediate lifters may be able to see small changes after just a few months of intense training.

Though it’s nearly impossible to determine exactly how much muscle you can gain in a month, some studies can give you a good idea.

One study in 30 college-aged men with previous training experience observed a 23% increase in vastus lateralis size — one of the leg muscles — after 6 weeks of purposeful resistance training.

However, it’s important to note that this muscle growth was largely attributed to increases in water and glycogen stores, which is the stored form of carbs.

Similarly, one small older study observed a 5.6% increase in muscle size after 21 weeks of strength training in 8 non-strength-trained athletes, while 8 strength-trained athletes experienced less growth.

This suggests that trainees without prior strength training experience have a greater potential for muscle gains than athletes with training experience. What’s more, your genetic makeup may also mean you respond better to muscle growth stimulus.

While data is limited on exactly how much muscle you can gain in a month, these studies suggest that short-term muscle growth is modest in natural athletes.

Summary

Though data on the specific amount of muscle you can gain in a month is limited, select studies suggest that new trainees can yield noticeable muscle gains in less time than those with resistance training experience.

How to get started

When looking to gain muscle quickly, there are a few factors you can focus on to get the most efficient results for your efforts.

High intensity resistance exercise

Arguably, the most important factor is to focus on high intensity resistance exercises in the 8–12 rep range.

These include compound movements like variations of the squat, bench press, deadlift, overhead press, snatch, and clean and jerk. These work multiple muscle groups at once, thus improving exercise efficiency and stimulating muscle growth.

In addition to compound exercises, include various isolation exercises to target specific muscle groups. Unlike compound exercises, isolation exercised target one muscle group at a time, providing maximal stimulation and growth potential.

While cardiovascular exercise is important for overall health, it does not play a major role in muscle gain.

Ultimately, it may be helpful to consult a certified trainer to help you put together a suitable exercise program.

Proper nutrition

Another significant component of gaining muscle quickly is proper nutrition.

For the best results, it’s recommended that you eat 10–20% more calories than your metabolic rate, which is also known as your total daily energy expenditure. This means consuming slightly more calories than you burn, as gaining muscle is an energy-expensive process.

This is often referred to as bulking and sometimes accomplished using a “clean” or “dirty” approach depending on your dietary choices and dedicated time for the process.

In addition to a calorie surplus, it’s important that you ensure a sufficient protein intake of 0.7–1 gram per pound (1.6–2.2 grams per kg) of body weight, as protein serves as the major building block of muscle.

You may want to seek advice from a registered dietitian for further nutritional guidance.

Summary

Two important factors when looking to maximize short-term muscle gains include high intensity resistance exercise and proper nutrition that prioritizes a calorie surplus and adequate protein.

Different populations

One of the main factors in the rate of muscle gain is your training age, or how long you’ve been training.

Two other important factors to consider are age and sex, which can also greatly affect muscle building.

Beginners

When just getting started with strength and hypertrophy (muscle building) training, you have great potential for muscle growth.

This is because training is a new stimulus, and as your muscles are worked, growth occurs to prepare them for future training.

That said, muscle growth is still limited during the initial stages of resistance training, while most of your strength gains are due to neural adaptions. This means that as you train, your brain gets better at recruiting muscle fibers to contract during a particular exercise.

Therefore, if you’re a beginner to resistance training, you’re unlikely to see any sizeable muscle gains in your first month of training, even if you’re gaining strength.

Intermediates

After training consistently for at least 1 year and grasping the fundamental movements, you move toward the intermediate phase of training.

This tends to be where trainees spend the most time, with some never progressing onto the advanced phase.

During the late–beginner and early–intermediate training phase, you have the most potential for muscular growth, as you have moved past the neural adaptation phase.

At this point, you can proficiently perform most movements and stimulate significant muscle growth.

Advanced trainees

The advanced phase of training takes a significant amount of time and effort to reach, usually at least 2 years for even the most gifted athletes.

At this point, most trainees have achieved most of their muscle and strength gains, and new muscle mass is hard to come by.

Progressing as an advanced trainee often requires advanced training techniques that provide maximal muscle stimulation.

Even in the best-case scenario, natural advanced trainees may not see more than a few pounds of muscle gain per year.

Men

In general, men have a few advantages over women when it comes to gaining muscle.

According to both older and new research, men tend to have larger, more numerous muscle fibers, allowing for overall bigger muscles and increased strength potential.

What’s more, men have higher levels of testosterone, the major circulating male sex hormone that’s responsible for male characteristics like muscle development, body hair, and deepening of the voice.

Considering these factors, men tend to gain more muscle than women over a month’s time.

Women

Women are at a slight disadvantage when it comes to quick muscle and strength building due to genetic and hormonal differences.

That said, women have an advantage over men when it comes to exercise fatigue and recovery, as they’re often able to handle more exercise volume and recover quicker.

This is mainly due to higher levels of estrogen, one of the primary female sex hormones, which is thought to have a protective effect on skeletal muscle.

Thus, although men may gain muscle at a faster rate than women, women appear to recover from exercise more efficiently, potentially allowing them to handle more training volume over time.

Older adults

Muscle and strength loss, also called sarcopenia, is one of several factors associated with the aging process in both men and women.

Fortunately, resistance training has been shown to slow, or even slightly reverse, this effect in older individuals.

While the rate of muscle gain tends to be slower in the aging population, improvements in muscle strength and functional mobility are still seen. This stresses the importance of following a regular exercise regimen that includes resistance training as you age.

Summary

The rate at which you can gain muscle varies greatly between populations, with beginners and intermediates seeing significantly more progress than advanced trainees.

Do supplements help?

During your quest for muscle gains, various supplements may enhance your results.

While many supplement companies claim their products can help you pack on muscle quickly, only a few types of supplements boast extensive scientific backing.

Here are the muscle-building supplements with the most scientific support.

Protein powder

Protein powders are the isolated form of various types of protein, including milk proteins like whey or casein or plant proteins like pea or brown rice.

When looking to promote muscle gain, getting enough protein is essential, as it provides the building blocks of skeletal muscle.

Experts recommend getting 20–40 grams of a high quality protein, meaning protein that contains all essential amino acids and is easily digested, within 2 hours of resistance exercise to maximize muscle gains.

While protein powders are not necessary, they can serve as an excellent tool to help you meet your daily protein needs, especially if you have trouble reaching them through your regular diet.

Creatine

Creatine is another highly researched supplement shown to promote muscle gains by increasing exercise capacity during high intensity training.

It plays a vital role in the phosphocreatine system. This system provides energy for muscle contractions that last less than 15 seconds, such as when you start sprinting or complete a heavy lift.

Creatine is found in foods like salmon and beef, but supplementing with it is an easy way to maximize its stores in your skeletal muscle and may be a worthwhile strategy when you’re looking to promote muscle gains.

HMB

Beta-hydroxy beta-methylbutyrate (HMB) is a metabolite — an end product of metabolism — of an essential amino acid called leucine. It has shown some promise in promoting muscle and strength gains when combined with resistance training.

Supplementing with HMB appears to increase muscle protein synthesis and reduce muscle protein breakdown, leading to gains in muscle mass. However, these benefits have mainly been observed in new trainees and the elderly.

This means that HMB may be worth trying for those who are new to resistance training, as well as older adults looking to retain muscle mass, but not for those with resistance training experience.

Summary

While numerous supplements claim to boost muscle mass, only a few are backed by research. The main ones include protein powders, creatine, and HMB.

The bottom line

How much muscle you can gain in a month varies greatly depending on factors like your sex, age, and training experience.

While select populations can see noticeable muscle gains in just 1 month, achieving significant changes in your body’s musculature takes effort and time — often several years rather than months.

To maximize your muscle gains, follow a consistent, high intensity resistance training program, stick to a proper diet that includes sufficient calories and protein, and consider taking select supplements.

It’s best to consult a qualified healthcare professional before starting an intense resistance training regimen, especially if you have any underlying ailments or injuries.

Veiny Penis: Is It Normal?

Is it normal to have a veiny penis?

By Jamie Eske
Reviewed by J. Keith Fisher, M.D.

 

* This article is a repost which originally appeared on MEDICALNEWSTODAY

 

In most cases, seeing veins beneath the skin of the penis is perfectly normal and does not require medical attention.

Several factors influence vein visibility, including:

  • genetics
  • age
  • frequency and intensity of physical activity
  • cardiovascular health
  • underlying medical conditions

In this article, we discuss why the veins in the penis might appear prominent and what this means.

We also review potential underlying medical conditions that contribute to penis vein visibility and when to see a doctor.

Why does it happen?

There are several veins and arteries that carry blood to and from the spongy erectile tissue in the penis.

Veins may look larger than usual during and immediately following an erection. Although the appearance of prominent veins may cause alarm, they indicate healthy blood flow.

Genetics and age can influence skin thickness, which may make veins appear more prominent or bigger than usual.

Also, blood clots and other conditions that affect the cardiovascular system can trap blood in the veins, which may affect how these blood vessels look.

Do prominent veins affect erection or ejaculation?

Typically, prominent veins do not affect erectile function.

Conditions that affect blood flow, such as blood clots and atherosclerosis, can have a minor impact on erectile function.

Research suggests a close relationship between cardiovascular health and erectile function.

In a 2015 study, for example, researchers conclude that erectile dysfunction could be an early sign of cardiovascular disease.

Also, in an earlier study by the Heart Institute, the authors state that erectile dysfunction may precede heart attacks by 3–5 years.

Possible causes

Vein size and visibility may vary over a person’s lifetime. They can also change as a result of sexual activity, or due to an underlying health condition.

Some possible causes of prominent veins in the penis include:

Erection

During an erection, oxygenated blood from the heart flows through the cavernous artery, which supplies the three chambers of spongy tissue that make up the corpus cavernosum and the corpus spongiosum.

The increase in blood flow causes the spongy tissue to expand, resulting in an erection. The tunica albuginea keeps blood in the corpus cavernosum.

The blood will then drain through the veins near the surface of the penis and travel back to the heart and lungs. The spongy tissue will remain engorged with blood until the erection goes away.

Varicocele

A varicocele refers to enlargement of the veins that make up the pampiniform plexus in the scrotum, which is the loose skin that surrounds the testes.

Varicoceles develop during puberty and affect about 10-15% of young males.

The exact cause remains unknown, but the following factors may contribute to the formation of varicoceles:

  • reduced blood flow
  • swollen lymph nodes
  • injury or trauma to the testes

Varicoceles do not require treatment unless there is also:

  • pain
  • low sperm count
  • a lump on or near the testes
  • swelling of the scrotum

Blood clots

A blood clot, or thrombosis, is a medical condition that occurs when blood cells stick together to form solid masses in the blood vessels. Blood clots can interrupt or completely stop blood flow.

Penile blood clots can develop in the dorsal vein in the penis, resulting in a rare condition called Mondor’s disease. Mondor’s disease can lead to significant pain and swelling in the affected veins.

According to a 2018 case study, penile blood clots typically resolve on their own within 1–4 weeks.

Lymphedema

Lymphedema refers to swelling that occurs when lymph fluid incorrectly flows through the body.

Swelling due to lymphedema can make the veins more visible than usual.

Causes of lymphedema include:

  • blockages in the lymphatic system
  • cancer treatment
  • infection
  • injury
  • removal of lymph nodes
  • scar tissue buildup from surgery

Peyronie’s disease

Peyronie’s disease occurs when scar tissue, or plaque, forms in the top or bottom of the penis. The buildup of scar tissue can cause the penis to curve or bend, which can lead to severe pain during sexual intercourse.

The scar tissue that develops may feel slightly firm to the touch. Scar tissue that calcifies can feel like a hard, solid mass beneath the skin.

Causes of Peyronie’s disease include:

  • injury
  • autoimmune disease
  • vigorous sexual activity
  • aging

Lymphangiosclerosis

The abnormal hardening of a lymph vessel in the penis characterizes lymphangiosclerosis.

Lymphangiosclerosis can develop due to:

  • injury causing tissue damage in the penis
  • circumcision
  • scarring from circumcision
  • sexually transmitted infections
  • vigorous sexual activity

Unlike a prominent vein, lymphangiosclerosis will look similar to the rest of the skin. The hardened lymph vessel usually forms just below the head of the penis and measures about 3 millimeters thick.

A doctor may perform blood tests and analyze a small tissue sample to diagnose lymphangiosclerosis.

Lymphangiosclerosis typically goes away on its own within 4–6 weeks and rarely causes complications.

People with lymphangiosclerosis should try to abstain from sexual activity, including masturbation until completely healed.

When to see a doctor

In most cases, a person will have no reason to worry if the veins in their penis appear more prominent than usual.

However, people may want to consider speaking with a doctor if the appearance of veins in their penis causes them distress, or if they experience any of the following symptoms:

  • pain during erection, ejaculation, or urination
  • swelling of the penis or testicles
  • hard, flesh colored cord on the penis
  • lumps on the penis or scrotum
  • pain in the lower abdomen or back

If any of these symptoms occur alongside prominent veins in the penis, it may indicate an underlying medical condition.

Summary

The appearance of prominent veins in the penis may cause some concern.

However, enlarged penile veins usually occur as the result of normal blood flow to and from the penis.

In rare cases, an underlying medical condition can contribute to the appearance of penile veins. These conditions include:

  • cardiovascular diseases, such as blood clots
  • Peyronie’s disease
  • lymphangiosclerosis

People may want to consider contacting their doctor if they have noticeable cord-like structures on their penis or testicles.

People should seek immediate medical attention if they experience:

  • painful erection or ejaculation
  • swelling or lumps on the penis or scrotum
  • pain in the lower back or abdomen
  • unusual discharge from the penis