The surprising link between ED and heart disease

By Mandy Armitage, MD

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If you’ve ever experienced frustration in the bedroom, you’re far from alone. But a recent study suggests that ego may not be the only thing to worry about if you continue to have performance issues. In fact, erectile dysfunction, or ED, might be a sign of a more serious medical issue–one that you may not even have known existed.

The big news is this: A review of several studies published in the Journal of Sexual Medicine found that patients with ED are at higher risk for heart disease, stroke, and even death. These studies looked at over 150,000 patients and found that, in men with ED, the risk of cardiovascular disease was increased by 59%, stroke by 34%, and dying of any cause by 33% when compared with men without ED. The numbers may be ominous, but read on. When it comes to taking on ED and heart disease risk, knowledge really is power.

What is ED?

Erectile dysfunction is defined by the American Urological Association (AUA) as the “consistent or recurrent inability to get or keep an erection firm enough for sex” and it affects around 30 million men in the US, according to the organization. Understandably, it can have a significant influence on quality of life and relationships. 

In many cases, ED is related to other medical conditions, such as stress, diabetes, obesity, insomnia, or depression. And now, of course, research is showing that it can also be a warning sign for serious issues like cardiovascular disease, which should be evaluated and treated. 

Why is ED an indicator for stroke and heart attack?

To understand the connection between ED and heart disease, it helps to know a little about how an erection happens. The system is complex, involving hormones, nerves, muscles, and blood vessels. But a basic way to look at it is as follows: an erection occurs when the blood vessels in the penis dilate and the blood flow to the area increases. 

Moving over to how things go wrong, ED can be caused by a problem in the inner lining of blood vessels, called the endothelium. This “endothelial dysfunction” leads to poor blood flow, which then prevents erections. Cardiovascular disease enters the picture because if there’s endothelial dysfunction in the vessels of the penis, it likely exists in other vessels, such as those in the heart. In short, this kind of blood vessel disease is unlikely to occur in just one area of the body. 

What you can do.

Given all the advertising for ED treatments, you might think the first step is to head straight for the doctor to get that magic little pill. But this will only mask the problem–and if the concern is heart disease, ignoring it could take you down down a risky path, especially if you’re getting your prescription without a thorough physical evaluation. 

Rather, the first step in treating both ED and heart disease is to address any underlying issues that may be contributing. For example, if you have diabetes, it’s important to be sure it is well controlled. Similarly, if you have significant stress or anxiety in your life, or problems with sleep, it may help to address those first. It’s also time to quit smoking.

Doctors also recommend addressing your overall health as a mainstay of any treatment. This includes improving your diet, losing weight, exercising regularly, and cutting back on alcohol and other recreational drugs. 

How your doctor can help.

As always, it’s important to talk to a doctor about how to safely make lifestyle changes. This is probably also a good time to get a general workup. Your physician can test for high cholesterol and blood pressure, and with this and other information, they can help determine where your health stands and whether you need heart or cholesterol medication.

Certain medications are available that can improve your ability to get or maintain an erection with sexual stimulation. These are generally effective, but as mentioned above, these are temporary solutions. Instead, the AUA recommends that men with ED should have their testosterone level checked. Low testosterone may play a part and can be treated.

Other options are also available. Among the newest is a procedure that uses low-frequency ultrasound to break up plaques in the penile vascular system, leading to stronger erections. It’s not yet part of the AUA guidelines, but a qualified medical professional can determine if you are a candidate. 

If you think you have ED, contact Vault today to be connected with a physician. It’s important to get checked out for other medical issues and to discuss which treatment options may be the best and most effective for you.

This article was reviewed by Aaron Grotas, MD