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Is your cardiovascular system affecting your sex life?

Are you finding that your sexual arousal organs are not working as well as they should? Let’s face it, we need proper blood flow to not only get aroused but to also orgasm with strength and pleasure!

When a person is aroused, their body increases blood pressure, heart rate, breathing and temperature. Blood flow is necessary to increase the nipples, labia and the clitoris for sensitivity. The penis needs proper blood flow to have an erection.



We know that everyone has different erogenous zones of pleasure, but they all include the key player, blood flow!  

If your cardiovascular system is compromised you are going to see changes to your sexual organs and their function during stimulation, that can be pretty upsetting. Humans typically enjoy having sexual relations and pleasure. We have erogenous zones in our body that induce pleasure and the chemicals released are good for you!


(see below for erogenous zones to explore with your partner/partners, it’s a good one from Healthline so I encourage a quick read!)


Today I want to discuss our cardiovascular system and if that becomes compromised, how this negatively impacts your overall health, including sexual health.


Protecting your cardiovascular system is key for experiencing pleasure in life, as well as having a long and healthy life.


Too many loved one’s have been lost to this preventable disease and with more recognition and early interventions we can prevent or even stop this disease from progression.



Cardiovascular disease is the Number #1 cause of death in the United States


One person dies every 33 seconds in the United States from cardiovascular disease


Cardiovascular disease costs the United States about $239.9 billion each year


Cardiovascular disease accounts for 19.05 million deaths global



Cardiovascular disease (CVD) is a general term for conditions affecting the arteries and blood vessels. When one has CVD, it means they have plaque, which is a buildup of cholesterol, fat, calcium, and other substances in the inner lining of the arteries. Over time plaque can accumulate, narrowing the arteries and restricting blood flow. If a blood clot forms in the arteries, it can block the blood flow to organs and this can lead to heart attacks (heart) or strokes (brain), which can be deadly.


Calcifications are calcium deposits that build within the walls of the arteries. Calcification is the process that can exacerbate the effects of plaque buildup in the arteries. Therefore, it can contribute to the hardening of the arteries, making them less flexible and more prone to reduced blood flow, arterial stiffness and therefore increased cardiovascular events. Calcifications and plaque can occur in organs such as the heart, brain, kidneys and eyes.



Four main types of Cardiovascular disease 

Coronary artery disease (heart)

Strokes and Transient Ischemic Attacks (TIA) (brain)

Peripheral arterial disease

Aortic Disease



Risk Factors

Lack of enough physical activity

Diet high in refined carbs, sugar, Omega 6 oils, saturated and trans fats

Being overweight or obese




Excessive alcohol use

Environmental toxins such as Lead

Oral health and disease




I am going to get a little scientific here so you can understand the basics of your circulatory system. 

If you are short on time, skip down to the blood testing and heart scans that I recommend for you to check on your cardiovascular system


The Endothelium 

The endothelium consists of endothelial cells, which line the interior surface of blood vessels throughout the body. These cells play a crucial role in maintaining vascular tone, regulating blood flow and preventing blood clotting. They contribute to the immune response, inflammation and formation for new blood vessels.

Dysfunction of the endothelial system leads to vascular disease (and more).


The damage to the vessels is the biggest concern that drives up disease. Inflammation is the root cause of cardiovascular disease. The idea that lipids are the problem is limiting, it excludes the biological pathway that happens that causes plaque buildup.


Plaque is formed by accumulation of the cholesterol, fatty substances, cellular waste and calcium in the walls of the arteries. This accumulation triggers an inflammatory response, causing white blood cells to migrate to the area and release chemicals that damage the arterial walls. Then over time this will create plaque, and narrow the arteries. If plaque is soft it can “break off” and  a blood clot can get loose and block off the blood supply and cause a heart attack or stroke.



photo by Oleg Gapeenko 

How do you know if you have plaque in your arteries? We actually don’t even know this based our cholesterol numbers. We don’t even know that by just doing a stress test by a Cardiologist. It is known that a Cardiac Stress Test will only flag that something is abnormal if you have over 70% blockage, at which place they recommend a stent to open that vessel. By that time one’s disease is very significant.

So how do find out if you are making plaque and calcifications that can lead you to having atherosclerosis?

You can get a Heart Scan!

The official name is a Coronary Calcium Scan or

“coronary artery calcium" (CAC) scoring.


This noninvasive test will assess the presence of calcium deposits in the arteries. Because calcium deposit and plaque don't manifest symptoms until there is significant disease, this scan can be critical to assess plaque before it becomes occlusive.

  This is a computed tomography “CT” scan. I personally like to use the Ultrafast CT Heart Scan from Front Range Imaging, a local service in Boulder because it’s a low radiation scan and interpreted by a local cardiologist.


There is also newer technology using a Coronary Computed Tomography Angiography (CCTA) that is using artificial intelligence (AI) to analyze the types of plaque (hard or soft) to help determine risk factors even more. One company using this technology is Cleerly Health.


I have been using CT scans with my patients for 13 years now and it’s an invaluable tool to truly measure risk factor of having a cardiac event. 

You can also do a carotid artery ultrasound to measure your risk of a stroke.


So what’s your calcium score?

It's a great time to get your heart scanned during this heart healthy month!

What is a Glycocalyx?

I want to take this education of our vascular system a step farther since many of you may have never heard of the Glycocalyx that our body makes to protect us.


The Glycocalyx is a layer of glycoproteins and proteoglycans that coat the luminal surface for the endothelial cells, forming a protective barrier. This layer plays an essential role in vascular function by regulating vascular permeability, leukocyte adhesions and vascular tone.


Dysfunction of the glycocalyx is associated with cardiovascular disease (and endothelial dysfunction in hypertension).


The glycocalyx acts as a protective barrier for the endothelium, helping to prevent the direct contact of lipid molecules with the endothelial cells. If this becomes damaged or degraded, from oxidative stress, high blood pressure, high sugar levels for example, then the lipid molecules will penetrate the endothelium more easily. Once inside, these lipid molecules can initiate a cascade of events leading to endothelial dysfunction, inflammation and damage to the blood vessel walls. This then contributes to the development of plaque formation and narrows the arteries. When this happen, one is heading into a dangerous situation of having a stroke or heart attack.


What helps support the Glycocalyx?

Antioxidants neutralized the reactive oxygen species (ROS) and reduce the oxidative stress and damage to this lining.

Take Arterosil, a green seaweed extract called Monostroma nitidum

(we carry this at the office) 

Nitric Oxide and why you need it

How do you know if you have enough nitric oxide (N.O.) to support your cardiovascular health?


Nitric Oxide is a molecule that helps regulate blood flow and vascular tone. It’s a vasodilator, which means it relaxes the inner muscles of your blood vessels, causing them to widen and increasing blood flow.

Nitric Oxide is the main chemical mediator, neuromodulator and neurotransmitter involved in sexual response, especially for penile erections and clitoris stimulation.


We make nitric oxide naturally, however we make less as we age.

There are dietary influences and other risk factors that negatively impact one’s ability to make N.O. which include:


Diets high in saturated fats that damage the endothelial production of N.O.

Having high cholesterol, hypertension, diabetes mellitus and smoking

Lack of foods that support N.O. production

Eating salty foods

Lack of exercise

Mouth breathing


Don’t forget that our sexual organs need blood flow to work properly!


I tested my levels and I basically had none! I have since started taking a supplement to support my nitric oxide levels, called Vasconox.


You can test your nitric oxide levels using a simple saliva test on a strip


Breathing through your nose not your mouth at night is key to supporting nitric oxide. Hello mouth taping!


Foods to support N.O. levels if you are low: beets, leafy greens, arugula, celery, pomegranate juice, garlic, nuts and seeds like almonds, walnuts chia and flax and dark chocolate (find a brand low in heavy metals)   

(avoid high Arginine foods if you have the Herpes Virus)



L Arginine may convert to N.O. but not in all patients, therefore taking a direct N.O. support with beet root is key, such as Vasconox by Calory or Nitric Oxide Foundation by Berkely Life (see below resources) can be very helpful.  Best taken at bedtime or in the evening when N.O levels are typically the lowest.


We carry Vasconox at the office


(Vasconox and Arterosiol Special 15% off Month of February)


Cholesterol, the good, the bad and the ugly


Basic Lipid Panel includes Total Cholesterol, Triglycerides, LDL, HDL

Many of you know that having higher Triglycerides (TG)  and Low Density Lipoproteins (LDL) “bad” proteins in the blood are a significant risk factor for heart disease. And yes, while High Density Lipoproteins (HDL) “good”  can carry out the LDL, therefore adding protection, it is not just a matter of this ratio that determines your heart disease risk. You also can’t simply measure a basic lipid panel and know your heart disease risk either.


This apolipoprotein transports lipids into the bloodstream and the B is one that carries LDL (there is an A that carries the HDL) and penetrates the endothelium and can stay there, driving up the damage and risk for plaque formation.

Another little (not so insignificant) protein is called a Lipoprotein little a (Lp(a))

“the ugly”.

The structure of this protein is similar to LDL but has an additional protein components and the size varies based on genetics. This protein promotes an accumulation of cholesterol in the arterial walls and promotes inflammation and clot formation. Therefore, elevated levels are associated with an increased risk of CVD and that risk can be significant! This lipoprotein is passed on by a genetic variant and it can be very difficult to lower. A healthy diet and exercise do not seem to impact the Lp(a).

Statin therapy will NOT lower Lp(a) but Niacin, or Vitamin B3 as Nicotinic Acid with Aspirin 81mg can help. I have seen some patients respond well to this, but many other’s do not and only the newer generation of a drug can do this. This drug class is called a PCSK9 inhibitor, trade name “Repatha” lowers both LDL and Lp(a) by targeting a certain protein and it’s synthesis.

I won’t get into more details now, but of course this medication is expensive and one has to try statin therapy before going on this based on insurance approval. I have several patients on Repatha and are having excellent success!

Are statins all that bad?


Many of my clients are a hard no against taking drugs to reduce their bad cholesterol numbers. While I understanding not wanting to go on a medication, it is rare that I see my client’s numbers change significantly enough to change this disease progression by the time we find abnormal numbers with lifestyle changes alone.

Of course I am a fan of trying lifestyle and dietary changes first! One should start with a Mediterranean diet, making sure you are exercising DAILY, work to control your stress, measure your Heart Rate Variability (HRV) and keep blood pressure optimal, which is below 120/70. One also needs to reduce toxic chemicals and other oxidative stressors, since oxidative stress drives up inflammation and this is how the endothelium can get damaged!

(photo credit Photo by Heather Ford on Unsplash)

You can also try some of these supplements mentioned above for supporting your nitric oxide production and glycocalyx.


In addition try adding Kyolic Aged Garlic Extract, plant sterols and Omega 3’s to your supplementation regimen.


If that is not enough what are your options?

The Gold Standard is using Statins therapy to help lower LDL and ApoB levels through inhibiting an enzyme called HMG-CoA reductase, which reduces the production of cholesterol.


We know that Statin therapy reduces risk factors, and they reduce inflammation as well, therefore they are the first line medications used to reduce risk factors. FYI Red Yeast Rice is a natural statin.


There is an inherent problem that exists in taking a Statin, which is that it also blocks the formation and production of CoQ10, which is key for energy to all cells, especially our muscles. Therefore people can get achy muscles and become tired when taking statin therapy.

This naturally occurring compound is a major antioxidant that we make as well, so it’s not a good idea to block this when we are concerned about oxidative damage being a root of inflammation and CVD. However, by taking CoQ10 and restoring your levels, you can mitigate this risk and tolerate statin therapy better (and it’s needed if taking Red Yeast Rice).


Statins are metabolized through the liver and they can stress one’s liver, causing inflammation and therefore increasing the liver enzymes as a result. Taking liver support if you are on statin therapy can help you mitigate these risks.


The other risk of statins therapy is an increased risk of Diabetes.

Some studies suggest that statins may reduce insulin sensitivity, leading to higher glucose levels. Statins may also affect pancreatic beta cells function, which is key to making insulin.

However, the benefits of reducing cardiovascular disease with statin therapy generally outweighs these potential small risks and insulin, glucose and HgA1c levels should be monitored if you are taking a statin.


Other medication options

Fibrates are a class of drugs that reduce blood triglyceride levels.


Ezetimibe (Zetia) is a cholesterol absorption inhibitor. It is also used to lower LDL and ApoB, which is done by inhibiting the absorption of cholesterol from the small intestine. Zetia mostly works on reducing LDL but it has some TG reducing properties and can increase HDL levels as well.


PCSK9 Inhibitors such as (Repatha) attack a protein called PCSK9 that degrades LDL receptors, clears Apo B and Lp(a) by about 30%.

Bile acid sequestrants are bile acid binding resins that are used to lower LDL by blocking bile acid in your stomach and therefore the liver then needs the cholesterol from your blood to make more bile acid, therefore it reduces your blood cholesterol levels. This medication has no effect on triglyceride levels and is not a first-line treatment.


Obviously it would be best to not need any medications and I am a big proponent of making lifestyle changes and not relying on drugs to do your work. That being said, sometimes changes in lifestyle is simply not enough to reverse a disease process and one would then need to lean into supplements (many have been studied to be supportive) or even medication therapy.



Ultimately I want my clients, and our society,  to be free of Dis-Ease and keep living our abundant and wonderful lives for as long as we can. I want you to have great blood flow and sex too!!!


Blood tests to ask for from me or your primary medical provider

Advanced lipid profile with particle #




sdLDL (to see size of the LDL particle)

Apolipoprotein A and B





NT-proBNP (myocardial stress marker)

Uric Acid

Omega 3 and 6 Fatty Acid / Ratio


Remember these are advanced panels and sometimes not recognized as medically necessary by insurance so insurance coverage can vary.



Heart Scan for Coronary Calcium Score test

These tests can often be self pay for most people unless you have known heart disease, then the insurance may pay for imaging at hospitals or imaging centers


For an easy “ultrafast” CT scan in Boulder, this is who I use



We have the ability to have longevity if we choose to, but it takes focus and engagement in our health. We have to resist “temptations” in a country where we have access to anything we want. It’s a choice to grab a carrot, a beet and a handful of nuts instead of a bag of chips or cookies. It’s a choice to feel good actually. Exercise is naturally “free” to us and we evolved by moving and migrating. So if we choose to move and get those lovely endorphins rolling, we will also feel more vibrant and alive! When we feel more vibrant and alive, we can offer a more uplifted attitude towards ourselves and others. We can lead with love, because in the end, that all that matters!!!


Yours in health and vitality,

Carrie Ballas






The Role of Nitric Oxide in Erectile Dysfunction: Implications for Medical Therapy


Endothelial Nitric Oxide Synthase Regulation in Female Genital Tract Structures


Female Sexual Arousal: Genital Anatomy and Orgasm in Intercourse


Everything you need to know about erogenous zones




Glycocalyx video





Nitric Oxide and Healthy Vessels



Apolipoprotein B vs LDL and non HDL Cholesterol as the primary measure of Apolipoprotein B relates risks


Do we know when and how to lower Lipoprotein (a) ?


PCSK9 Inhibitor and Lp(a)



Coronary Artery Calcium Score- A Reliable Indicator of Coronary Artery Disease



Top Image photo credit Photo by Nicola Fioravanti on Unsplash


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