Erectile Dysfunction: A Sign of Heart Disease?

The same process that creates heart disease can also cause erectile dysfunction, only sooner.

By Mayo Clinic staff

Erectile dysfunction, the inability to achieve and maintain an erection firm enough for sexual intercourse, can be an early warning sign of current or future heart problems. Similarly, if you have heart disease, getting the right treatment could help with erectile dysfunction. Understand the connection and what you can do about it.

How are erectile dysfunction and heart problems related?

In the past, the buildup of plaque in the arteries of your body (atherosclerosis) was believed to be the reason why erectile dysfunction often precedes heart problems. The idea was that plaque buildup reduces blood flow to the penis, making it difficult to get an erection.

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

How strong is the connection between erectile dysfunction and heart problems?

Erectile dysfunction does not always indicate an underlying heart problem. However, research suggests that men with erectile dysfunction who do not have an obvious cause, such as trauma, and who do not have symptoms of heart problems, should be screened for heart disease before starting any treatment.

Which are the risk factors?

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

  • Diabetes. Men who have diabetes are at high risk for erectile dysfunction and heart disease.
  • Tobacco use. Smoking increases the risk of developing vascular diseases and can cause erectile dysfunction.
  • use of alcohol Drinking too much alcohol can cause heart disease and could contribute to other causes of heart disease, such as high blood pressure or abnormal cholesterol. Alcohol also impairs erections.
  • High blood pressure. Over time, high blood pressure damages the lining of the arteries and accelerates the process of vascular disease. Certain 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 lead to atherosclerosis.
  • Years. As you get older, erections may take longer to develop and may not be as firm. The younger you are, the more likely it is that erectile dysfunction indicates a risk for heart disease. Men under the age of 50 are at especially high risk.
  • obesity Being overweight generally worsens other risk factors for heart disease.
  • Low testosterone. Men with low testosterone levels have higher rates of erectile dysfunction and cardiovascular disease than men with normal testosterone levels.

What are the treatment options for erectile dysfunction caused by heart disease?

If your doctor thinks you might be at risk for heart disease, consider making lifestyle changes. Any lifestyle change that improves heart health also improves penile health. Increase your physical activity, maintain a healthy weight, stop smoking, and drink alcohol only in moderation, or not at all. More serious signs and symptoms of heart disease may lead to more testing or treatment.

If you have erectile dysfunction and heart disease, talk to your doctor about treatment options. If you take certain heart medications, especially nitrates, many of the medications used to treat erectile dysfunction are not safe to use.

Our caring team of Mayo Clinic experts can help you with your health concerns. Visit Mayo Clinic Men’s Health to get started.

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