Is Trouble in Bed an Indication of Future Heart Disease?
Erectile dysfunction (ED) may be the first sign of impending cardiovascular
troubles, say experts. And while anti-impotence drugs can help to treat your
problems in the bedroom, taking these pills without evaluating your heart may
spell big trouble for your health.
Scientists are now discovering that erectile dysfunction may serve as an early
warning sign for angina, heart disease and stroke.
"Erectile dysfunction is frequently a manifestation of underlying cardiovascular
problems." says Dr. Andrew McCullough, director of male sexual health, fertility
and microsurgery at New York University School of Medicine.
While the connection may be no surprise to some, as anti-impotence drugs, like
Viagra and Cialis, were first studied as cardiovascular treatments, doctors are
only recently beginning to understand the true connection between erectile
dysfunction and cardiovascular disease.
Finding The Link
Erectile problems may be caused by psychological obstacles, such as
"performance" anxiety, but many more cases are the result of physical issues
caused by arteries that do not expand well and prevent sufficient blood flow to
the penis needed to create an erection.
"We know that up to 90 percent of patients with ED have a vascular cause." says
Dr. Alan Bank, medical director of research at St. Paul Heart Clinic in
This correlation was first seen to be strongest in patients with erectile
dysfunction and type 2 diabetes, a one-two punch in terms of cardiac risk. As
researchers found in a 2003 study published in Circulation, almost 40 percent of
men with type 2 diabetes and silent coronary artery disease also had some degree
of erectile dysfunction, compared to only 5 percent of diabetic men without
coronary artery disease.
Sometimes, however, the cardiac problems associated with erectile dysfunction
aren’t seen until much later.
For example, in a July 2005 study published in European Urology, researchers
found that men with moderate-to-severe erectile dysfunction had a greater risk
of stroke over the course of 10 years when compared to those who had no erectile
When to Call the "Plumber"—a Cardiologist
Whether the erectile problems are seen with or precede heart trouble seems to
come down to a matter of plumbing, explains McCullough.
"If you turn on your kitchen faucet and you don’t get any flow, either the
faucet is broken or the pipes are clogged." he says. This means that erectile
dysfunction is either caused by a problem directly related to the penis—the
"faucet"—or to the blood vessels—the "pipes"—leading to the penis.
This latter explanation of "pipe clogging" seems to explain why heart problems
and erectile dysfunction are so often seen together.
High levels of cholesterol or arterial damage can cause arteries to clog. As a
result, there is not enough blood flow to the penis during sexual stimulation,
which can cause impotence.
If it’s not a matter of "clogged pipes." then it’s time to look to the "faucet"
for the source of the problem. And when the cause of erectile dysfunction is a
problem within the penis itself, the cause is probably more subtle than clogged
Sexual Troubles that Precede Heart Disease
In a review of recent studies, published in July 2005 in The American Journal of
Cardiology, researchers note the increasing evidence that erectile dysfunction
may be caused by a reduced amount of nitric oxide in the blood vessels of the
As the demand for blood flow to the penis increases during sexual activity,
nitric oxide is released by the body to help the blood vessels expand. In men
with erectile dysfunction, nitric oxide levels are low, so blood vessels cannot
expand to allow the additional blood to reach the penis. Drugs like Viagra are
so useful, says Bank, because they work along the same pathway that increases
the amount of nitric oxide in the body.
But low levels of nitric oxide can affect more than just sexual health; nitric
oxide also acts to keep blood vessels flexible by resisting atherosclerosis, or
hardening of the arteries from cholesterol deposits. So, a reduced amount of
this substance can also signal future cardiac troubles.
Instead of just getting a prescription to treat their condition, experts
recommend that men with erectile dysfunction see a doctor who can check for
underlying vascular problems.
"Men with erectile difficulties should stop and consider the possible underlying
cause of that dysfunction." says McCullough.