Erectile function is a common sexual disorder which adversely affects a man’s quality of life, psychological health and sexual relationship. Despite this, only 30% of men with erectile dysfunction discuss their problem with a doctor, and of those who speak with their doctor, only 58% receive treatment. Men may be embarrassed to discuss "below the belt" issues with their doctor and perceive them as personal rather than medical issues.
Historically, erectile dysfunction was regarded as a psychological disorder, and this may contribute to men’s perceptions that it is a personal, not a medical issue. However, there is now evidence that the majority of cases of erectile dysfunction are not just in the mind, but are caused by disorders which affect the blood vessels of the penis.
A disorder of the blood vessels
In addition, doctors now recognise that men who experience erectile dysfunction have a higher risk of other vascular disorders (disorders of the blood vessels, which cause blood flow to be obstructed). These include conditions such as cardiovascular disease, high blood pressure and coronary artery disease, which increase the risk of life-threatening events such as heart attack and stroke. Men with erectile dysfunction also have an increased risk for other chronic health conditions, including diabetes and high cholesterol.
Vascular and other chronic health conditions have common causes, which are often related to the individual’s lifestyle. They include factors such as diet, exercise and smoking. Because of this, individuals who are at risk of one vascular disorder (because they have a poor diet, do not get enough exercise, and smoke), are also at risk of developing another. Vascular disorders are often co-morbid, meaning that individuals with one vascular disorder (e.g. high blood pressure), often also experience another (e.g. erectile dysfunction).
Erectile dysfunction increases the risk of chronic health conditions
The blood vessels of the penis are much smaller than those in other parts of the body. As such they are more susceptible to disease and are often the first to become damaged by the effects of poor lifestyle habits. This means that erectile dysfunction often occurs before other vascular conditions, and can be the first symptom of broader health problems. For example, men with erectile dysfunction are almost 1.5 times more likely to develop cardiovascular disease than men who can maintain erections. More than 20% of men diagnosed with diabetes mellitus receive their diagnosis after seeking treatment for erectile dysfunction.
Treating erectile dysfunction
Erectile dysfunction is now successfully treated with medications called phosphodiesterase type 5 (PDE-5) inhibitors in the majority of cases. More men are seeking treatment for the condition as a result.
This provides doctors with an opportunity to assess men for other chronic health conditions, and means that these conditions may be detected earlier, while they pose less serious threats to the man’s health and are more readily managed. Treatment with medication (including PDE-5 inhibitors for erectile dysfunction) may be part of managing vascular problems; however, improving lifestyle by, for example, exercising, maintaining a Mediterranean-style diet and quitting smoking is also essential.
Maintaining a healthy lifestyle now also reduces the risk of vascular disorders (including erectile dysfunction). So improving erectile function by maintaining a healthy lifestyle might do more than improve a man’s sex life – it might also save his life.
- Holzapfel S. The physician’s role in dealing with men’s sexual health concerns. Can J Hum Sex. 1998;7(3):273-86.
- Nehra A. Erectile dysfunction and cardiovascular disease: Efficacy and safety of phosphodiesterase type 5 inhibitors in men with both conditions. Mayo Clin Proc. 2009;84(2):139-48.
- American Urological Association. Guideline on the management of erectile dysfunction: Diagnosis and treatment recommendations [online]. 2006 [cited 25 February 2010]. Available from URL: http://www.auanet.org/ content/ guidelines-and-quality-care/ clinical-guidelines.cfm?sub=ed
- Giugliano D, Giugliano F, Esposito K. Sexual dysfunction and the Mediterranean diet. Public Health Nutr. 2006;9(8A):1118-20.
- Hannan JL, Maio MT, Komolova M, Adams MA. Beneficial impact of exercise and obesity interventions on erectile function and its risk factors. J Sex Med. 2009;6(Suppl 3):254-61.
- Derby CA, Mohr BA, Goldstein I, Feldman HA, Johannes CB, McKinlay JB. Modifiable risk factors and erectile dysfunction: Can lifestyle changes modify risk? Urology. 2000;56(2):302-6.
- Gades NM, Nehra A, Jacobson DJ, McGree ME, Girman CJ, Rhodes T, et al. Association between smoking and erectile dysfunction: A population-based study. Am J Epidemiol. 2005;161(4):346-51.