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There are multiple causes of Erectile Dysfunction (ED), which can be divided into organic and psychological causes. Organic causes of ED include atherosclerosis (artery stiffening),...
There are multiple causes of Erectile Dysfunction (ED), which can be divided into organic and psychological causes. Organic causes of ED include atherosclerosis (artery stiffening), nerve damage and low testosterone levels.
Heart Disease is a syndrome made up of many conditions, including coronary artery disease (caused by atherosclerosis), chronic heart failure, heart attacks or any inherited heart conditions.
One of the biggest causes of heart disease and ED is atherosclerosis. This is when there is a narrowing and stiffening of the arteries supplying the heart and penis, due to a buildup of a fatty layer of plaque on the inside of the vessel.
The arteries supplying the penis tend to be a lot narrower than those supplying the heart. If there is atherosclerosis, it is likely to affect the penile arteries and cause ED long before it causes a major cardiac event such as a heart attack or stroke.
In this way, ED can be a very early sign of heart disease, and men experiencing a sudden onset of ED should seek an appointment with their healthcare provider to have a full health check-up.
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Erectile Dysfunction (ED) and Heart disease are connected because the pathologies (problems) that cause ED also cause Heart disease (Figure 1). There is significant overlap between ED and Heart Disease, with ED being present in 50% of men with heart disease and atleast 12.5% with ED reporting a history of Cardiovascular issues.
Both the penis and the heart are supplied by blood vessels called arteries. The innermost layer of the arteries is called the endothelium. When the lining isn’t working as it should (called endothelial dysfunction), this lessens blood flow to the organ the artery is supplying. This organ can be the heart or the penis.
Endothelial dysfunction can also cause plaque build-up in the arteries over time. This is a condition called atherosclerosis. Atherosclerosis lowers blood flow to the organ in question and further causes heart disease or ED.
The arteries supplying the penis are much smaller than those supplying the heart, symptoms of ED may appear long before symptoms of heart disease (if they are both caused by atherosclerosis or endothelial dysfunction).
Figure 1: Is ED a symptom of Heart Disease? – How ED and heart health are connected.
Erectile Dysfunction (ED) can be a very early sign of Heart Disease. Erections are in part caused by the dilation of blood vessels called helicine arteries in the penis. Heart disease, caused by different conditions, can cause reduced blood flow to the penis which can lead to Erectile Dysfunction.
Heart disease is a syndrome encompassing different conditions, one of which is atherosclerosis. In atherosclerosis, there is damage to the endothelium (inner layer of the arteries) and fat buildup (called plaques). This narrows the canal of the arteries and reduces blood flow to organs. These organs can be the heart and the penis. Atherosclerosis of arteries supplying the heart is called Cardiovascular disease and increases the risk of a heart attack.
Reduced blood flow to the penis because of atherosclerosis of the arteries supplying that organ can cause problems with having and maintaining an erection. It is in this way that atherosclerosis can cause ED.
Other forms of heart disease include: heart failure, heart attacks, and arrhythmias. These forms of heart disease can also cause heart damage and reduced heart output. Reduced blood supply to the body’s organs, including the penis, can cause insufficient blood for erections. This can be the cause of ED.
Atherosclerosis can cause ED just as it can cause heart disease due to the narrowing of arteries and plaque buildup. Other forms of heart disease can also cause ED due to a reduction in the heart’s ability to pump blood.
Because conditions like atherosclerosis (plaque buildup in the inner layer of arteries) can cause both cardiovascular disease and ED, there are some common risk factors, such as:
If you’re looking to answer questions such as: “ Can Ed be a sign of heart disease ?”, then this article is for you.
Erectile Dysfunction due to reduced blood flow could be a warning sign of Heart Disease.
Erectile Dysfunction (ED) can occur due to a variety of reasons. These include organic causes or psychological causes. Organic causes of ED include a lack of blood flow, nerve issues or low testosterone.
ED can be an early warning sign for Heart Disease if it is caused by a lack of blood flow.
Blood is pumped to the rest of the body by the heart; problems with blood flow can indicate established or impending heart disease.
Atherosclerosis is a disease that occurs when the endothelium (the inner lining of the arteries) is dysfunctional and fatty plaque builds up. This buildup of fatty plaque in the artery impairs blood flow and reduces blood supply to an organ. This organ can be the heart or the penis.
The arteries that supply the penis are much narrower (hence more prone to occlusion) than the arteries that supply the heart. Hence, if atherosclerosis is the cause of ED, it can be an early warning sign of impending heart disease.
Medicines called PDE-5 inhibitors can be helpful in 2/3rds of patients with Erectile Dysfunction (ED). These medicines can be particularly helpful in patients with heart disease if caused by atherosclerosis.
These medicines help cause vasodilation (broadening of the arteries) that supply the penis and reduce the effects of occlusion of the artery. This increases blood flow to the penis and helps in the establishment and sustenance of an erection. PDE-5 inhibitors include Sildenafil (Viagra), Tadalafil (Cialis) or Vardenafil (Levitra).
People who have other Cardiovascular conditions, such as low blood pressure or those taking certain heart medications (Nitrates or Nicorandil) should not take PDE-5 inhibitors. The combined effect of PDE-5 inhibitors in these situations can cause systemic low blood pressure.
Patients using Nitrates (such as GTN) or Nicorandil for heart conditions should leave an optimum space between using these medications and their PDE-5 inhibitor. Ideally, leave 12 hours between using nitrate sprays and PDE-5 inhibitors and 24-48 hours between using nitrate tablets or PDE-5 inhibitor tablets.
Some patients with heart disease may also be eligible for a vacuum pump to get an erection and maintain it for the course of sexual activity. These are a non-drug option and usually take some getting used to, but are usually very effective with practice.
If you notice ED symptoms suddenly or cannot explain the cause, then it is a good idea to keep in mind that the reason for this might be vascular. In this way, you can use ED as a marker for heart health.
The following is an overview of some of the steps to take with respect to heart health if you notice ED symptoms.
Request a thorough check-up – Contact your GP to talk about your symptoms (Figure 2), they will then order relevant blood tests, and write relevant referrals to a cardiologist or urologist (if need be) to discuss your symptoms.
Request and ask about specific heart screenings – Speak to your doctor about specific tests to do with heart health, such as:
Have a medication review: Some heart of blood pressure medications can worsen ED. Please speak to your healthcare provider if you are on any beta-blockers or Diuretics (Water pills).
Consider lifestyle changes and medications – speak to your healthcare provider about lifestyle changes to improve blood flow through the body and any medications that can cause dilation of blood vessels (vasodilation) to improve vascular health.
Overall, for any concerns regarding ED and Heart Check/health check, please consult with your healthcare provider so you can make the best decision for your continued good health.
Figure 2: ED and Heart Check- speak to your primary care physician about ED and they can tell you if you need a fully body review including getting your heart checked