Heart Disease and Erectile Dysfunction

What is Erectile Dysfunction?

Erectile dysfunction is a common condition that affects the ability to get or maintain an erection. It is important to understand that erectile dysfunction can be a sign of a pre-existing health condition. There are many causes of erectile dysfunction ranging from physical to psychological.

How is Erectile Dysfunction a sign of heart disease?

Heart disease affects the heart and blood vessels. Build-ups of fat known as plaque in blood vessels reduce blood flow through the body. When you get an erection, blood flows to the penis through many of these blood vessels. The reduced blood flow caused by heart disease often results in erectile dysfunction in men, as not enough blood is being circulated to the penis. However, erectile dysfunction is not always a result of an underlying heart condition and there can be other factors that can cause this to happen. 

Nonetheless, people assigned male at birth (AMAB) who experience erectile dysfunction for no apparent reason should get screened for heart disease. 

Other Symptoms of Heart Disease

Heart disease symptoms are associated with narrow arteries and obstructions. This includes chest pain, tightness, discomfort, and pressure. These symptoms are mainly caused by restricted blood flow to the tissues in the chest and heart.

 A reduced blood flow means that less oxygen and other nutrients reach the tissues. The insufficiency of these important components often leads to loss of function and other problems within the body. 

This can result in you suffering from the above symptoms. Sometimes, the pain can also be felt in the abdomen, back, neck, jaw, throat, or arms. Numbness, tingliness, weakness, or coldness in your arms could also be a warning sign as this is a result of poor blood circulation within the body. Shortness of breath, irregular heartbeat, increased blood pressure, weakness, fatigue, or fainting may also be experienced. 

Diagnosing Heart Disease

Heart disease can be diagnosed using a range of tests and methods. Some of the most common techniques include blood tests coupled with a physical examination. A blood test can give more information on the presence of fats in the bloodstream. The presence of fats is a sign of plaque, a characteristic of heart disease. 

Non-invasive tests are the golden standard when testing for heart disease. These include ECGs, stress tests, and CT and MRI scans.

ECG or electrocardiograms, also known as EKGs, are painless tests that involve placing sensors on the skin. The procedure records electrical signals produced by your heart. For more information from the NHS regarding electrocardiograms, click here.

Stress tests are exercise tests. They check heart activity when it is under more stress than usual (when using a treadmill, for example). This is important because the heart works differently when at rest and when exercising. This procedure involves either a dye being inserted before exercise or a transducer machine being used to record heart activity. You will be monitored by specialists at all stages of this procedure. 

CT (Computed Tomography) scans use radiation to measure the presence of calcium deposits in the heart. These are formed due to a variety of reasons and cause obstructions in the body’s blood flow. Another type of CT scan uses an iodine dye which can be visualized with an X-ray. For more information about CT scans, click here.

MRI (magnetic resonance imaging) machines do not use radiation and involve the use of a machine with a magnetic field. They produce accurate and detailed images of the body. They can also help in visualizing tissue structures that are usually difficult to see in other imaging tests. For more information, click here.

Invasive tests are less common and only be used when non-invasive tests are insufficient. In these tests, an angiography can be conducted. This is a simple process that involves inserting a dye into the blood, followed by visualization on an X-ray. For more information about angiographies, click here.   

Other Causes of Erectile Dysfunction 

Erectile Dysfunction can be caused by a variety of conditions. The reproductive system is made up of nerves, blood vessels, muscles, hormones, emotions, and more. In addition, psychological and physical problems can cause erectile dysfunction. 

The physical causes include: 

• Metabolic conditions such as diabetes, obesity, and metabolic syndrome 
• Lifestyle choices, such as excessive consumption of alcohol, tobacco, or illegal drugs, sleeping disorders, and a lack of exercise or unhealthy diet. 
• Physical Injury due to surgery in spinal/pelvic area
• Medications used in treatment for prostate cancer, side effects of prescribed medications, and opioid painkillers 
• Hormonal issues involving hyperthyroidism (overactive thyroid gland), hypothyroidism (underactive thyroid gland), hypogonadism (underactive sexual hormones - low testosterone), or Cushing’s syndrome
• Neurological problems like Parkinson's disease or Huntington's disease
• Gum diseases can also contribute to erectile dysfunction. These diseases can make some tissues inflamed. This damages cells associated with blood vessels. These blood vessels may also be present in the penis, thus causing erectile dysfunction

The psychological causes include: 

• Depression, anxiety, borderline personality disorder, schizophrenia, and other mental health conditions
• Stress, relationship issues, lack of communication in relationships, sexual boredom, sexual problems, surviving sexual abuse, sexual orientation questions, or performance anxiety
• It is important to understand that erectile dysfunction may be caused by factors other than those listed above

Managing Erectile Dysfunction 

Treatment for erectile dysfunction depends on what is causing it. In the case of heart disease-related erectile dysfunction, treatment involves supporting heart and vascular health.

The first line of treatment, however, is making lifestyle changes. For example, giving up smoking and drinking or getting help for any substance abuse can help to tackle both of these problems. Eating well and exercising can also help to improve circulation and combat obesity, thus reducing the risk of erectile dysfunction occurring.

Age can also play a significant role. Erections may not be as firm or last as long. This can reduce the quality of intercourse and increase the likelihood of erectile dysfunction. 

In case of hormone-related erectile dysfunction, hormone replacement therapy such as the administration of testosterone may help to support natural erections. In cases where erectile dysfunction is a result of psychological problems, cognitive behavioural therapy might be suggested. This can help combat any mental health disorders that affect sexual health.

 If you are experiencing problems in your relationship, you and your partner may consider couples therapy to work out the problems with help from professionals.

A common way to treat erectile dysfunction is using prescribed medications before intercourse. It is important to consult your doctor before taking any medications so that you understand the associated risks. 

Surgical treatment can be administered as a last resort. Surgery involves penile implants, where an inflationary device is inserted into the penis. A vacuum or ‘pump’ device can also be used, which can mechanically produce an erection. The pump can help in drawing up blood. However, there are other safer ways of combating erectile dysfunction. Although there are many solutions to erectile dysfunction, it can be uncomfortable and difficult to talk about. However, it is important to understand that you are not alone. Roughly 30-50% of people AMAB between the age of forty and seventy suffer from erectile dysfunction. That equals about 4.3 million people AMAB in the U.K alone. Additionally, health care professionals are trained to deal with these problems, and provide the best treatment possible. Treatments are available and most people can find an effective solution.