Is Erectile Dysfunction a Warning Sign of Heart Disease? All You Need to Know

Sex may permeate our popular culture, but conversations about it are still associated with stigma and shame in Indian households. As a result, most individuals dealing with sexual health issues or trying to find information about sex often resort to unverified online sources or follow the unscientific advice of their friends.

To address the widespread misinformation about sex, is running this weekly sex column, titled ‘Let’s Talk Sex’. We hope to initiate conversations about sex through this column and address sexual health issues with scientific insight and nuance.

In this article, Dr Jain explains the link between Erectile Dysfunction & Heart Disease and what are the common risks involved.

Trouble getting or keeping an erection seems like it’s just a “down there” problem. For many men, though, it is much more. It is formally known as Erectile Dysfunction, and is often an early warning sign of heart disease or future heart problems.

There is a very strong link between erectile dysfunction and heart disease. Several studies have shown that if a man has Erectile Dysfunction, he has a greater risk of having heart disease. Having Erectile Dysfunction is as much a risk factor for heart disease as a history of smoking or a family history of coronary artery disease.

What is erectile dysfunction?

Erectile dysfunction, or impotence, is the inability to achieve and sustain an erection suitable for sexual intercourse. The condition is not considered normal at any age. Premature ejaculation, infertility, or low sex drive are not the same as erectile dysfunction, though one or more of these conditions may be associated with it.

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How are erectile dysfunction and heart problems linked?

In order to understand the relation between ED and Heart Disease we first need to understand how erections work. To achieve an erection, three conditions must occur:

  • The nerves to the penis must be functioning properly
  • The blood circulation to the penis must be adequate
  • There must be a stimulus from the brain

If there is something interfering with any or all of these conditions, a full erection will be prevented.

In the past, it was thought that atherosclerosis, or the accumulation of plaque in your body’s arteries, was the cause of the frequent occurrence of erectile dysfunction before heart problems. The idea was that plaque build-up reduces blood flow in the penis, making an erection difficult.

However, experts now believe that erectile dysfunction preceding heart problems is more often due to the dysfunction of the inner lining of the blood vessels (endothelium) and smooth muscle. Endothelial dysfunction causes inadequate blood supply to the heart and impaired blood flow to the penis, and aids in the development of atherosclerosis.

What are the common risk factors between ED & Heart Disease?

Besides sharing a common disease process, erectile dysfunction and heart disease also share many risk factors, including:

  • Alcohol Intake: Excessive alcohol consumption can lead to heart disease and may contribute to other causes of heart disease, such as high blood pressure or abnormal cholesterol. Erections are also hampered by alcohol.
  • Low Testosterone Levels: Men with low testosterone levels are more likely to suffer from erectile dysfunction and cardiovascular disease than men with normal testosterone levels.
  • Ageing: As you get older, erections might take longer to develop and might not be as firm. The younger you are, the more likely that erectile dysfunction signals a risk of heart disease. Men younger than 50 are at especially high risk.
  • High Blood Pressure: High blood pressure damages the lining of your arteries over time, hastening the progression of vascular disease. Certain antihypertensive medications, such as thiazide diuretics, can also affect sexual function.
  • Tobacco Intake: Smoking increases your risk of developing vascular disease and can cause erectile dysfunction.
  • High Cholesterol: A high level of low-density lipoprotein (LDL, or “bad”) cholesterol can lead to atherosclerosis.
  • Diabetes & Obesity: Men who have diabetes are at high risk of erectile dysfunction and heart disease. Excess weight typically worsens other risk factors for heart disease.
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Available treatment options for Erectile Dysfunction caused by Heart Disease

Consider making lifestyle changes if your doctor believes you are at risk of heart disease. Any lifestyle change that improves heart health also improves penis health. Increase your physical activity, maintain a healthy weight, quit smoking, and drink alcohol in moderation or not at all. Serious signs and symptoms of heart disease may require additional tests or treatment.

Talk to your doctor about treatment options if you have both erectile dysfunction and heart disease. Many erectile dysfunction medications are unsafe to use if you take certain heart medications, particularly nitrates.

Prof (Dr) Saransh Jain is the winner of the Swasth Bharat Rattan Award and is a Certified and Licensed Sexologist by the American Board of Sexology. He is currently a Senior Consultant at Dr SK Jain’s Burlington Clinic in Lucknow. The views expressed in this article are those of the author and do not represent the stand of this publication.

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