February 18, 2011
Dear Mayo Clinic:
What is the connection between erectile dysfunction and heart disease?
Erectile dysfunction — difficulty getting or maintaining an erection sufficient for sexual intercourse — can have many causes, but is commonly associated with heart disease. The connection between these two disorders stems from blood flow, or lack of it.
Prominent among that connection is a condition known as atherosclerosis, sometimes called hardening of the arteries. Cholesterol laden plaques build up in the arteries, which causes them to narrow, harden, and clog, and limit blood flow. Clogged arteries can lead to both erectile dysfunction and heart disease. Because clogged arteries in one area of the body likely indicate clogged arteries in other areas, erectile dysfunction can be a sign that a man has a higher risk for heart disease, and vice versa.
The risk factors for erectile dysfunction and heart disease are basically the same. The main factors that increase the risk of both disorders include high cholesterol levels, high blood pressure, lack of exercise, being overweight, obesity, smoking, diabetes and age.
As men age, their risk for heart disease and erectile dysfunction increases. Heart disease and erectile dysfunction are uncommon in men in their 40s. Research studies have shown that a man in his 40s who does not have erectile dysfunction has a very small risk of heart disease at that time. In this situation, a man's chance of having narrowed coronary arteries is less than 1 percent. But a man in his 40s who has erectile dysfunction has a risk for heart disease that is almost 50 times higher than normal. In that case, erectile dysfunction indicates the likelihood of early heart disease.
A man who has erectile dysfunction, especially a man in his 40s or 50s, should see his doctor. To accurately assess risk, the doctor will need to review the medical history, conduct a physical exam and, in many cases, order tests that can determine if the arteries to the heart have begun to narrow.
Once a man understands his risk, he should discuss with the doctor how to decrease that risk. That may include lifestyle changes, such as losing weight or quitting smoking, and medications that can help, such as drugs to reduce cholesterol or high blood pressure.
By modifying risk factors, a man can dramatically lower his risk for heart disease and perhaps help improve erectile function. For example, obesity is a risk factor for both erectile dysfunction and heart disease, and losing weight has been shown to help reduce symptoms of erectile dysfunction. In most men, the risk of heart attack goes down significantly within just a few years of making changes that decrease their risk. Although not as much research has been done concerning erectile dysfunction, early studies seem to indicate the same is true for that disorder. Modifying heart disease risk factors with regular exercise, a healthy diet, effective diabetes management and smoking cessation, for example, decreases significantly the risk of erectile dysfunction.
Another reason men should see their doctors when they experience erectile dysfunction, no matter what their age, is that the condition may be the first significant sign that a man's arteries are becoming clogged. Because the arteries supplying blood to the penis are smaller than those supplying the heart, symptoms of atherosclerosis may first show up as erectile dysfunction and studies have shown that erectile dysfunction precedes the onset of heart disease symptoms by three to five years.
If you have erectile dysfunction, don't wait until other symptoms appear. Go to your doctor and ask if the condition could be an early indication of heart disease. If it is, you may be able to get treatment before heart problems become serious. Likewise, if you have heart disease, getting the right treatment may help with erectile dysfunction.
— Stephen Kopecky, M.D., Cardiovascular Diseases, Mayo Clinic, Rochester, Minn.