April 2010

Erectile dysfunction and your heart

What is the connection? 
The most common cause of Erectile Dysfunction is a problem with the circulation to the penis. The lining of the arteries that supply blood to the penis is called the endothelium. This controls the speed with which blood enters the penis and if it fails to operate properly blood does not enter quickly enough or for long enough to get a rigid erection that lasts enough time for satisfactory sexual intercourse. The arteries can suffer a narrowing and damaging process known as atheroma which is similar to a pipe furring up.

The link between Erectile Dysfunction and coronary artery disease is that they share the same endothelium so a problem in one place may be present in another. This is why over 50% of men with coronary artery disease have Erectile Dysfunction. The problem is that over 50% of men with Erectile Dysfunction may have coronary artery disease they don't know about.

Can Erectile Dysfunction come before coronary artery disease? 
The short answer is yes. The arteries to the penis are small in diameter (1-2mm) whereas the coronary arteries to the heart are 3-4mm. This means that a similar problem in the coronary arteries may be silent because the arteries are big enough not to be restricted whereas the smaller penile arteries suffer earlier leading to Erectile Dysfunction. It takes longer for the bigger arteries to be affected by the narrowing process but if it is allowed to continue a man with Erectile Dysfunction and no heart complaint may develop a heart complaint in the five-year period after his Erectile Dysfunction began. This means Erectile Dysfunction can identify someone at future risk of a heart attack giving a chance for us to prevent it occurring.

What are the risk factors for Erectile Dysfunction and coronary artery disease? 
They are the same. High blood pressure, raised cholesterol, cigarette smoking, obesity, physical inactivity, depression and stress. So it is easy to explain why Erectile Dysfunction and coronary artery disease often coexist – it's really a matter of which comes first.

What to do if you have Erectile Dysfunction and no heart disease history 
It is very important you see your doctor for a full check-up – you could have a raised blood pressure or high cholesterol for example. Lifestyle issues are important – losing weight if needed and increasing physical activity are the easiest to adopt and benefit both Erectile Dysfunction and coronary artery disease. Heart disease risks can be treated reducing the chances of a problem in the future. You may have had your Erectile Dysfunction successfully treated by tablets given you by a friend or bought on the internet, but getting your erection back without a check on the heart is asking for trouble.

What is the Take Home Message? 
ED may be a warning of an impending heart problem – heed the warning because your life may depend on it – get checked out. If you would like more information please read our sections on Coronary Heart Disease and Erectile Dysfunction and we would also suggest having a read of the Change4life website. If you would like to ask any questions about your sexual health please contact us in complete confidence.