Erectile dysfunction isn't just about sex. It could be a major sign of heart disease, study report in American Heart Association, Circulation Journal says
Erectile dysfunction may double heart disease/attack risk. Even Erectile Dysfunction of American Urology Association (2018) is as follows:
Men should be counseled that ED is a risk marker for underlying cardiovascular disease (CVD) and other health conditions that may warrant evaluation and treatment
A 2011 Harvard report, for instance, warned that erectile dysfunction may be a sign that plaque had blocked penile arteries and was preventing blood-flow to that area of the body. There is a link between erectile dysfunction and the lining of the blood vessels, called the endothelium. “The endothelium tells the blood vessels when to contract and relax,” The endothelium can become damaged from things like stress and tobacco use, making it harder for the lining to function properly and for blood to reach the penis because the blood vessels supplying the penis are unable to relax.
Men with erectile dysfunction are at greater risk for heart attacks, strokes, and sudden cardiac death. New study provides a strong link to date between sexual dysfunction and cardiovascular risk.
Erectile dysfunction can be an important factor for doctors in gauging cardiovascular risk.
Men with erectile dysfunction warrant further testing and more aggressive management of cardiovascular risk factors.
The latest study was done over 4 years following up 1900 men with erectile dysfunction.
1. Coronary artery disease (CAD) and erectile dysfunction
Erectile dysfunction can be a primary symptom of cardiovascular disease, meaning it may be one of the first signs of trouble. The hardening of the arteries is a normal part of the aging process, especially when combined with an unhealthy diet and lack of exercise. “Somebody who doesn’t have any other problems, but notices he is having a hard time either getting or maintaining an erection, that may be the first sign that he needs an UroAndrologist evaluation.
Research has found that when a man presents with severe erectile dysfunction, it could be a marker for increased risk of stroke, heart attack or even death within three to five years of the erectile dysfunction diagnosis. “Any gentleman who presents with a heart condition has probably already experienced hardening of the arteries and smaller vessels,”
Erectile dysfunction is also often an early warning sign of more serious problems like hypertension, diabetes, obesity, and cholesterol.
2. Stroke and/or heart attack
“ED is one of the first signs of blockage in arteries, which could lead to a stroke or heart attack,” says Associate Professor of Medicine at Baylor College of Medicine. “In fact, 15 percent of men with ED will have stroke or heart attack in seven years,” he warns.
The arteries which feed the penis get blocked first because they are smaller, much smaller than vessels of heart and brain. Think of it like survival of the fittest. “If you block an artery, you start getting damage to the organ that it supplies. 20 and 30 percent of men who have ED have some form of hidden heart disease or blockage in their blood vessels if they also have at least two other risk factors for developing heart disease. So if you are a smoker with ED and high cholesterol, for example, you might want to ask your doctor to check out your heart, too.
While CAD can cause stroke and heart attack, it can also lead to heart failure and irregular heartbeat.
3. Dementia
According to a 2015 study, men with ED are 1.68 times more likely to develop dementia than men who don’t have ED. Though this is still under research, two conditions often have some of the same risk factors like atherosclerosis, elevated cholesterol, and diabetes, etc.
4. Medically Induced ED
Many commonly used drugs can cause erectile dysfunction. Prescription medication and over-the-counter drugs can decrease libido, interfere with normal blood flow, or even cause absent seminal emission or retrograde ejaculation. In fact, 7 of the 12 most commonly prescribed medications list ED as a side effect. Medications that commonly cause ED include:
• SSRIs – Anti psychiatry medication
• Beta Blockers - BP medication
• Diuretics - BP medication
• Antifungals such as Ketoconazole
• Histamine H2-receptor antagonists used in the treatment of GERD – Gastritis medicine
• Non-steroidal anti-inflammatory drugs – pain killers
• Muscle relaxants
• Antihistamines – cold medication
If you’re experiencing ED, discuss your medication.
5. Recreational drugs
Almost all recreational drugs have been implicated in ED.
• Alcohol
• Amphetamines
• Barbiturates
• Cocaine
• Marijuana
• Methadone
• Nicotine
• Opiates
Illegal drugs don’t just affect and suppress the central nervous system. They cause serious damage to blood vessels. And any damage to blood vessels or normal blood flow will eventually cause erectile dysfunction. Some experts even argue that a single use of any of these chemicals can lead to subsequent ED. Chronic use raises the risk even more.
6. Diabetes Mellitus
A study of 7,689 participants found that 61% of men with diabetes aged 45 to 59 years had ED. And it makes sense that poor blood sugar control leads to erectile dysfunction.
Men with diabetes are four to six times more likely to develop erectile dysfunction and like erectile dysfunction, diabetes can also lead to strokes and heart attacks.
Diabetes leads to vascular complications throughout the body and the penis is no exception. A large survey reported that the majority of men with diabetes and ED had never even been asked about their sexual function by their doctor. That means they never received treatment for ED or assessment of their heart risk.
7. Cycling
The research has shown longtime cycling seat puts pressure on the main artery which supplies penis blood and can result in penile numbness and erection problems. The pudendal arteries supply blood to the sex organs and the bottom part of the body.
“The onset of ED should prompt men to seek comprehensive cardiovascular risk evaluation from a preventive UroAndrologist. “It is incredible how many men avoid the doctor and ignore early signs of cardiovascular disease, but present for the first time with a chief complaint of ED. This is a wonderful opportunity to identify otherwise undetected high-risk cases.”
“The latest research findings suggest that clinicians should perform further targeted screening in men with erectile dysfunction, regardless of other cardiac risk factors and should consider managing any other risk factors such as high blood pressure or cholesterol that much more aggressively.”
(The writer is a noted andrologist with Manipal Hospital. He is also president-elect, South Asian Society for Sexual Medicine (SASSM). Views expressed are personal)