Erectile Dysfunction: A Sign of Heart Disease

“The penis is the gate way to the heart”

This week I had a patient who was scheduled to undergo a surgery for enlarged prostate.  I was excited to finally be back in the operating room after weeks without being able to perform elective procedures due to the Covid-19 pandemic.  As soon as I step into the surgery center’s building, I received a call from the anesthesiologist who suggested postponing the surgery.  We found that the patient’s blood pressure was very high and not well controlled. Upon questioning, the patient mentioned he decided to stop his blood pressure medications several weeks prior without consulting with his primary care physician.  After listening to the story, one of the nurses then told me:  “My husband does the same.  They notice that medications cause erectile dysfunction and he would rather continue with elevated blood pressure than lose his erections.”  This remark drove me to write today’s article.

June is the official month for Men’s Health!

Therefore, today I wish to focus on a very important topic.   Erectile dysfunction (ED) can be an indication of a man’s risk for heart disease and early death.   Yes, you read that correctly.   Erectile dysfunction is not only a problem that can affect the intimacy between you and your partner but can also be a symptom of something far more serious.

Remember there are 4 types of Erectile Dysfunction

(Do not worry, we will soon discuss and describe each and every one of these in the near future!)

1. Psychogenic
2. Neurogenic
3. Hormonal (low testosterone)
4. Vascular

However, the most common type is vascular erectile dysfunction.   Vascular ED occurs when there is not enough blood flow getting to the penis (arterial insufficiency) or the penis is unable to “trap” the blood inside (corporo-venous occlusion, also known as ‘venous leak’).  In order to understand how this works we have to remember that the blood vessel that brings blood flow to the penis (penile artery) is extremely small and much smaller than the vessels feeding the heart.  A clogged artery will impede the blood flow necessary to create an erection. Therefore, if a man has heart disease (also known as coronary artery disease), it is very likely that the penile artery will get clogged before the coronary arteries in the heart.

That is why erectile dysfunction can indicate if a man is at risk for heart disease and early death.  The phrase “The penis is the gateway to the heart” stems from this concept.  Men with atherosclerosis, or build-up of plaque in the arteries that cause blockage of blood flow, will have problems with blood flow in the penile artery before the coronary artery.  As we celebrate Men’s Health Month, I feel obliged to let all men know:

Erectile dysfunction can be both prevented and treated by practicing a healthy lifestyle. 

If we treat risk factors for heart disease, which include smoking, high blood pressure, high cholesterol, diabetes, obesity, among others, you will not only be able to perform in the bedroom, but also live a longer life.   It is very important that men discuss sexual symptoms with their doctors to help us identify cardiovascular or other risk factors that might be affecting your overall health.

In Conclusion…

So… please, follow your doctor’s orders.  Take those blood pressure medications. Control your cholesterol levels. Try to quit smoking. Do not let the diabetes to get out of control.  We (doctors) are only here to help you.  If you have problems with your erections, we have all the tools to help you.  If you are searching for an urologist, Come visit us!   It will be an honor to help you get back in the game and continue playing the game for a loooooooong time!