Erectile Dysfunction and Heart Disease

Trouble below decks can reveal cardiovascular risks

It’s natural to think of erectile dysfunction (ED) as a sex and relationship issue. But ED—the inability to achieve or maintain an erection adequate for intercourse—can affect affairs of the heart in a different way. “Erectile dysfunction is sometimes an early warning sign of cardiovascular disease,” says cardiologist Andrew Sumner, M.D., of Lehigh Valley Health Network.

The ED-heart connection is easy to understand given that blood flow to the penis is what makes an erection possible. “It is basically a plumbing system, and a blockage in your blood vessels that reduces blood flow can make erectile dysfunction more likely,” says health network internist Jeffery Debuque, D.O. Blood vessels in the penis are smaller and narrower than those near the heart, so reduced flow is likely to show up earlier there.

Men under age 50 who have ED should look at their heart disease risk factors, Debuque says. “Diabetes triples the risk for ED, and smoking doubles erectile risks. If you have three or more cardiovascular risk factors, get your heart checked before beginning any treatment for ED.”

That’s important because ED medications and heart drugs don’t always mix. For example, nitrates for angina combined with ED drugs can lower blood pressure to dangerous levels. “Sometimes ED drugs are appropriate if your heart is stable and your blood pressure is well-controlled, so it’s important to get your doctor’s advice,” Debuque says.

Your doctor also can help determine if ED is a side effect of other treatment. Blood pressure medications such as clonidine, as well as certain beta blockers and diuretics, can trigger erectile problems.

Alternative treatments are available if you can’t use ED medication. “But the best alternative is to control your diabetes, stop smoking and lower your cholesterol and blood pressure,” Debuque says. “These steps can improve both your heart health and sex life.”

Published from Healthy You Magazine, March April 2010

This page last updated 2/23/10 03:24 AM