Erectile Dysfunction: A Warning Sign for Cardiovascular Disease?

Erectile dysfunction – the inability to get and maintain an erection firm enough for sexual intercourse – can be an early symptom of heart disease or other circulatory problems. 

Having an erection problem isn’t necessarily a cause for concern. If erectile dysfunction is an ongoing difficulty, however, it can cause stress, shatter your self-confidence and contribute to relationship issues. Trouble to get or keep an erection can also be a warning sign of an underlying health condition that needs to be treated and a risk factor for heart disease.

Previously, the development of plaques in the arteries of your body (atherosclerosis) was considered to be the reason why erectile dysfunction often leads to heart problems. The idea was that plaque buildup decreases blood flow in the penis, making an erection troublesome.

However, experts now believe that erectile dysfunction preceding heart problems is because of the dysfunction of the inner lining of the blood vessels (endothelium) and smooth muscle. Endothelial dysfunction causes an insufficient blood supply to the heart and reduced blood flow to the penis and contributes to the development of atherosclerosis.

Symptoms

Erectile dysfunction symptoms might include persistent:

• Difficulty getting an erection
• Problem in keeping an erection
• Reduced sexual desire

What are the risk factors?

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

• Diabetes

Men who have diabetes have a higher chance of erectile dysfunction and heart disease.

• Tobacco use

Smoking increases the risk of having vascular disease and can cause erectile dysfunction.

• Alcohol use

Consuming too much alcohol can cause heart disease and contributes to other causes of heart disease such as high blood pressure or abnormal cholesterol. Alcohol also causes difficulty in getting erections.

• High blood pressure

With time, high blood pressure impairs the lining of your arteries and accelerates the development of vascular disease. Some high blood pressure medications such as thiazide diuretics can also affect sexual function.

• High cholesterol

A high level of low-density lipoprotein (LDL, or “bad”) cholesterol can cause atherosclerosis.

• Age

As you grow older, erections might take more time than usual to develop and might not be as firm. The younger you are, there are more chances that erectile dysfunction signals a risk of heart disease. Men below the age of 50 are at especially high risk. In men older than 70, erectile dysfunction is much less likely to be a sign of heart disease.

• Obesity

Being overweight typically worsens or increases other risk factors for heart disease.

• Low testosterone

Men with low levels of testosterone have a greater chance of erectile dysfunction and cardiovascular disease compared to men with normal testosterone levels.

Diseases that commonly cause ED 

• Vascular diseases

Vascular diseases are the type of diseases that affect the blood vessels. Common diseases include atherosclerosis (hardening of the arteries), hypertension (high blood pressure), and high cholesterol. They cause 70% of physical-related causes of ED, restrict blood flow to the heart, the brain, and the penis

• Kidney disease

Kidney disease causes chemical changes that have an effect on the hormones, circulation, nerve function, and energy level. These changes can weaken libido (sex drive) or sexual ability. Medications used to treat kidney disease may also cause ED.

• Neurological (nerve and brain) diseases

The nervous system plays a vital role in getting and maintaining an erection. It is common for men with conditions such as stroke, multiple sclerosis (MS), Alzheimer’s disease, Parkinson’s disease, and spinal cord injuries to develop ED. This is because there is an interruption in the transmission of nerve impulses between the brain and the penis.

• Prostate cancer

Prostate cancer alone doesn’t cause ED, but treatment for prostate cancer can lead to erectile issues.

Causes

Sexual arousal for men is a complicated process that involves the brain, hormones, emotions, nerves, muscles, and blood vessels. Erectile dysfunction can be caused by any of these problems. Likewise, stress and mental health concerns can cause or make erectile dysfunction even worse.

Sometimes, both physical and psychological issues combined can cause erectile dysfunction. For example, a minor physical condition that slows your sexual response might cause stress about keeping an erection. The resulting anxiety can worsen your erectile dysfunction.

Physical causes of erectile dysfunction

In many cases, erectile dysfunction can be caused by something physical, including: 

• Heart disease
• Clogged blood vessels (atherosclerosis)
• High cholesterol
• High blood pressure
• Diabetes
• Obesity
• Metabolic syndrome — a condition where one has high blood pressure, increased insulin levels, body fat around the waist and high cholesterol
• Parkinson’s disease
• Multiple sclerosis
• Certain prescription medications
• Use of tobacco
• Peyronie’s disease — development and growth of scar tissue inside the penis
• Alcohol consumption and other kinds of substance abuse
• Sleep disorders/insomnia
• Treatments for prostate cancer or enlarged prostate
• Surgical procedures or injuries that affect the pelvic area or spinal cord
• Psychological issues of erectile dysfunction

The brain plays a vital role in stimulating the series of physical events that cause an erection, starting with feelings of sexual excitement. Several things interfere with sexual feelings and cause or worsen erectile dysfunction. These include:

• Depression, anxiety or other mental health conditions
• Stress
• Problem in relationships due to stress, poor communication or other concerns

Preventing Erectile Dysfunction 

There are a few ways to combat erectile dysfunction. If your doctor thinks you might have chances of having heart disease, consider making some healthy lifestyle changes. Increase your physical activity, work towards maintaining a healthy weight, quit smoking and drink moderate amounts of alcohol— or have none at all. 

Viagra and other erectile dysfunction medications work for some men. However, further tests or treatment may be required if you have highly serious symptoms of heart disease.

If you have both erectile dysfunction and heart disease, talk to your doctor about the treatment options available for eliminating it. If you consume certain heart medications, especially nitrates, it is not safe for you to use many of the medications used to treat erectile dysfunction.