Erectile dysfunction, heart disease and other vascular diseases
Although ED can be caused by various conditions, about 7 in 10 cases are due to narrowing of the small arteries in the penis. This causes reduced blood flow to the penis. This is the same problem that can occur in other blood vessels. For example, narrowing of the blood vessels in the heart (the coronary arteries) is a cause of angina and other heart problems. Narrowing of blood vessels to the brain is a risk factor for having a stroke. Narrowing of blood vessels in the legs can cause peripheral vascular disease.
The root cause of the narrowing of the arteries is caused by atheroma. Atheroma is like fatty patches or 'plaques' that develop within the inside lining of arteries. (This is similar to water pipes that get 'furred up' with scale.) Plaques of atheroma may gradually form over a number of years in one or more places in the body, commonly in arteries going to the heart, brain, legs and penis. In time, these can become bigger and cause enough narrowing of one or more of the arteries to cause symptoms and problems.
Certain 'risk factors' increase the risk of more atheroma forming which can make atheroma-related conditions worse. These are discussed in more detail in another leaflet called 'Preventing Cardiovascular Disease'. Briefly, risk factors that can be modified and may help to prevent atheroma-related conditions from getting worse are:
- Smoking. Smoking is one of the biggest risk factors for developing heart disease. Smoking also roughly doubles your chance of developing ED. Young smokers may not be aware that they have a much greater risk of developing ED by middle age compared to non-smokers. If you smoke, you should make every effort to stop.
- High blood pressure. Make sure your blood pressure is checked at least once a year. If it is high it can be treated.
- If you are overweight, losing some weight is advised.
- A high cholesterol. This can be treated if it is high.
- Inactivity. We should all aim to do some moderate physical activity on most days of the week for at least 30 minutes. For example, brisk walking, swimming, cycling, dancing, gardening, etc.
- Diet. You should aim to eat a healthy diet. Details in a leaflet called 'Healthy Eating'
- Alcohol excess.
- Diabetes. If you have diabetes, good control of the blood sugar level and blood pressure can help to minimise the impact of diabetes on the blood vessels.
Note: ED caused by narrowed arteries commonly develops several years before any symptoms or problems develop due to narrowing of the coronary arteries (or other arteries). Therefore, ED is thought of as an 'early warning signal' that heart disease (or other cardiovascular diseases) may develop. This is why some of the tests listed below may be advised if you develop ED. Also, you are likely to be advised by your doctor on how to modify any 'risk factors' listed above with the aim of preventing heart disease from developing.
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