
What erectile dysfunction could mean for your heart
Revisado por pares por Dr Sarah JarvisÚltima actualización por Dr Anna Cantlay, MRCGPLast updated 6 Feb 2018
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Erectile dysfunction (ED) - or impotence - is when a man has trouble either getting or maintaining an erection. It's extremely common, with up to half of 40-70 year olds experiencing it to some degree.
Despite this, many men find it difficult to talk about and so suffer in silence, not wanting to bother their GP. The fact that Viagra® is now easily accessible online or over the counter without a prescription means many self-treat without support. But what most don't realise is that such behaviour could spell bad news for their heart.
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Erectile dysfunction reasons
Erections happen when two sponge-like chambers in the penis, called the corpora cavernosa, become engorged with blood. Problems with this process are the leading cause of erectile dysfunction. And now a growing body of evidence states that impotence can predict heart disease.
ED can happen for a variety of reasons. Most men occasionally experience problems 'getting it up' but this doesn't necessarily mean there's a problem. For instance, it might occur after drinking alcohol or when you are tired or stressed.
More prolonged erection problems could be a sign of an underlying issue. The cause could be psychological or physical and sometimes certain medication may also contribute. Physical causes are more common, being responsible for 8 out of 10 cases of ED.
A good way of distinguishing between psychological and physical causes is to see if you are still getting night-time or morning erections. If you are, it points to it being psychological. Impotence associated with poor mental health also tends to come on more gradually, and can also be associated with problems such as premature or delayed ejaculation.
Causas psicológicas
Psychosexual factors - relationship issues, lack of arousability, previous bad sexual experiences or sexual abuse.
Estrés.
Causas físicas
Conditions that affect the blood flow to the penis, such as diabetes, cardiovascular disease and colesterol alto. These can lead to atherosclerosis (a build-up of a fatty limescale) in the blood vessels of the penis.
Neurological conditions such as accidente cerebrovascular, esclerosis múltiple, enfermedad de Parkinson and spinal injuries.
Hormonal imbalances, such as enfermedad tiroidea or low testosterone levels.
Complications from surgery, such as prostate surgery.
Anatomical problems, such as Enfermedad de Peyronie.
Recreational drug use and alcohol can also lead to ED. Prescribed medication such as certain blood pressure medication, antidepresivos and antipsychotics can also contribute. If you think your medication could be the cause, discuss this with your GP.
Take heart
Volver al contenidoIn 2006, the late cardiologist Graham Jackson stated in a paper published in European Heart Journal: "A man with erectile dysfunction and no cardiac symptoms is a cardiac patient until proven otherwise."
Since then, more and more estudios have pointed to a link between ED and the development of cardiovascular disease such as heart attacks and strokes.
Christopher Allen, senior cardiac nurse at The British Heart Foundation explains the relationship between the heart and erections:
"Erectile dysfunction can be a symptom of enfermedad coronaria. This is because blood flow to the penis can be restricted by the build-up of fatty deposits in the arteries, called plaques. Because the arteries in the penis are so narrow, erectile problems are often one of the first warning signs of blocked arteries, which increases your risk of having a ataque al corazón o accidente cerebrovascular."
We know now that ED can precede the development of heart disease by 2-5 years, and is as important a predictor as moderate smoking. Heart disease and ED also share the same risk factors, including la obesidad, diabetes, high cholesterol, physical inactivity and smoking.
"So if you're experiencing problems with erectile dysfunction we'd advise you book an appointment with your doctor, as it is important that if it is caused by an underlying medical condition, it is detected early," adds Allen.
Age is also important. The younger men are (especially those <50 years), the more likely it is that that ED could be a sign of heart disease. Severity should also be considered; the worse the ED, the greater the impact on your heart.
Enfermedad del corazón is a leading cause of death in men. Men who come to their GP with ED should have a cardiovascular risk assessment. This includes checking your weight, blood pressure and smoking status as well as arranging some blood tests.
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Continúa así
Volver al contenidoYour doctor will aim to treat the cause of your ED. The first step is speaking to your GP so they can get you the help you need.
Cambios en el estilo de vida
Maintaining a healthy lifestyle is a really important part of both ED prevention and treatment. Keeping physically active, maintaining a healthy weight, avoiding smoking and excessive alcohol consumption can all help to keep ED at bay and improve symptoms if it does develop. This will also have a positive impact on your overall well-being, including your heart health.
Tratamientos
Several treatments are available to help treat ED, either through your GP or through a specialist referral to a urologist. These include tablets, creams, injections and vacuum pumps. Speak to your GP about the right option for you.
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Los problemas de erección no solo afectan a los hombres, sino que también pueden tener un impacto real en la pareja y en la relación. Y son más comunes de lo que piensas. Se estima que la mitad de todos los hombres entre 40 y 70 años sufren de disfunción eréctil (DE) en alguna medida, y esta cifra aumenta a 7 de cada 10 hombres mayores de 70 años.
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Preguntas frecuentes
What are the common psychological factors that can lead to erection problems?
Psychological causes can include issues in relationships, a lack of sexual arousal, and past negative sexual experiences or abuse. Mental health conditions such as anxiety and depression, along with stress, can also contribute to erectile dysfunction.
How can I tell if my erectile dysfunction might be due to a psychological cause rather than a physical one?
A good indicator that your ED might be psychological is if you still experience erections during the night or upon waking in the morning. Additionally, ED linked to mental health issues often develops gradually and can sometimes be accompanied by other sexual problems like premature or delayed ejaculation.
Are there specific medications or substances that can cause erectile dysfunction?
Yes, certain prescribed medications, such as some blood pressure drugs, antidepressants, and antipsychotics, can contribute to ED. Recreational drug use and alcohol consumption can also lead to erectile dysfunction.
Why is it recommended for younger men with ED to get a heart disease check, especially if they are under 50?
For men, particularly those under 50, erectile dysfunction can be an early indicator of underlying heart disease. The arteries in the penis are narrow, so blockages from fatty deposits, which also affect the heart, often show up as ED symptoms first. The younger a man is, and the more severe his ED, the greater the likelihood it signals a risk for heart disease.
What kind of assessment will my doctor perform if I seek help for erectile dysfunction due to concerns about my heart?
If you visit your GP with concerns about ED and its potential link to heart health, they will likely conduct a cardiovascular risk assessment. This typically involves checking your weight, blood pressure, and smoking status, as well as arranging for some blood tests.
What lifestyle changes can help prevent or improve erectile dysfunction?
Maintaining a healthy lifestyle is crucial. This includes staying physically active, keeping a healthy weight, and avoiding smoking and excessive alcohol. These changes not only help with ED but also have a positive impact on your overall well-being, including your heart health.
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About the authorView full bio

Dra. Anna Cantlay, MRCGP
Médico General, Autor Médico
BMBS, BMedSci, MRCGP, DRCOG, DFSRH, DOCCMED
Dr Anna Cantlay is an experienced NHS and private GP based in London.
About the reviewerView full bio

Dra. Sarah Jarvis
SEO Executive
MA (Cantab), BM, BCh (Oxon), DRCOG, FRCGP, MBE
After training in medicine at Cambridge and Oxford, Dr Sarah Jarvis MBE became a GP.
Historial del artículo
La información en esta página es revisada por pares por clínicos calificados.
6 Feb 2018 | Última versión

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