Erectile Dysfunction is not just part of aging. It can be caused by a variety of issues ranging from illnesses to medical problems, with the most common causes being vascular issues like heart disease or diabetes.1
Cardiovascular disease, or heart disease, has an important connection with ED.2 Symptoms of erectile dysfunction may develop a few years before symptoms of heart disease.2 I've had about a decade of experience in urology, and I frequently have patients who come in for ED and a few years later have a heart attack, stroke, or chest pain due to heart disease. ED precedes coronary artery disease (CAD) symptoms in almost 70% of cases.3 Essentially, erectile dysfunction is one of the early warning signs of cardiovascular disease.4,5 It is typical for symptoms of heart disease to develop with 2-3 years of erectile dysfunction.4
The real connection between ED and heart disease is the blood vessels found in both the heart and the penis. The vessels are similar except in their size, as the penis contains much smaller vessels.7 Anytime about 50% of a vessel is obstructed, blood flow downstream is significantly affected.6 In the penis, the artery is only about 1-2 millimeters in diameter, compared to the vessels supplying blood flow to the heart which are about 3-4 millimeters in diameter.7 It doesn't take a lot of plaque and build-up to cause a blockage in the penis compared to the much longer amount of time to block one of the arteries that go to the heart or the brain. That's why symptoms of ED may occur before symptoms of heart disease or vascular disease.7 ED is an independent risk factor for future heart related events.5 The severity of ED is correlated with the extent of coronary artery disease.8
A healthy lifestyle can greatly improve symptoms of erectile dysfunction while simultaneously lowering the risk of diabetes and heart disease. It's not a surprise that eating a healthy diet, having an active, physical lifestyle, losing weight, maintaining a healthy body weight, staying away from smoking, and reducing stress—or at least managing stress—can all reduce your risk for heart disease and erectile dysfunction.4,9,10
That's not to say that there isn't a slew of treatments for those already experiencing Erectile Dysfunction. You can learn more at https://www.edcure.org/understanding-ed/heart-disease/ or visit my website, https://www.themensmd.com/, to make an appointment with me!11,12
- Shabsigh R, Lue TF. A Clinician’s Guide to ED Management. New York: Haymarket Media Inc.; 2006.
- Montorsi P, Ravagnani PM, Galli S, et al. Association between erectile dysfunction and coronary artery disease. Role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. Eur Heart J. 2006 Nov;27(22):2632-9.
- Montorsi F, Briganti A, Salonia A, et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol. 2003 Sep;44(3):360-4; discussion 364-5.
- Jackson G, Boon N, Eardley I, et al. Erectile dysfunction and coronary artery disease prediction: Evidence-based guidance and consensus. Int J Clin Pract. 2010 Jun;64(7):848-57
- Vlachopoulous C, Jackson G, Stefanadis C, et al. Erectile dysfunction in the cardiovascular patient. Eur Heart J. 2013 Jul;34(27):2034-46.
- Montorsi P, Roumeguère T, Montorsi F, et al. Is there a link between erectile dysfunction and coronary artery disease? EAU Update Series. 2004 Jun:2;43-8.
- Montorsi P, Ravagnani PM, Galli S, et al. The artery size hypothesis: a macrovascular link between erectile dysfunction and coronary artery disease. Am J Cardiol. 2005;96:19M–23M.
- Schouten BW, Bohnen AM, Bosch JL, et al. Erectile dysfunction prospectively associated with cardiovascular disease in the Dutch general population: results from the Krimpen Study. Int J Impot Res. 2008 Jan-Feb;20(1):92-9.
- Esposito K, Giugliano F, Di Palo C et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA 2004; 291: 2978–84.
- Derby CA, Mohr BA, Goldstein I, et al. Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk? Urology. 2000 Aug 1;56(2):302-6.
- The link between ED and heart disease. Boston Scientific. https://www.edcure.org/understanding-ed/heart-disease/. Accessed August 2022.
- Erectile Dysfunction Q & A. J. Abram McBride, MD. https://www.themensmd.com/services/erectile-dysfunction. Accessed August 2022.
EDCure.org is a website sponsored by Boston Scientific.
J. Abram McBride, MD is a Boston Scientific consultant and was compensated.
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