We often think of erectile dysfunction (ED) as a mere consequence or side effect of getting older, and that makes sense. After all, some data show that more than half of all men ages 40 to 70 have some form of erectile dysfunction. But did you know that having trouble getting or maintaining an erection could also be a sign of other health problems?
Here are six diseases linked to erectile dysfunction:
1. Stroke and/or Heart Attack
“ED is one of the first signs of blockage in arteries, which could lead to a stroke or heart attack,” says Mohit Khera, M.D., Associate Professor of Medicine at Baylor College of Medicine. “In fact, 15 percent of men with ED will have stroke or heart attack in seven years,” he warns. According to Dr. Khera, in the last five years, there have been many new studies showing a relationship between erectile dysfunction and heart disease.
Think of it like survival of the fittest. “If you block an artery, you start getting damage to the organ that it supplies,” Dr. Khera says. He points out that the arteries which feed the penis get blocked first because they are smaller. Dr. Khera also says that between 20 and 30 percent of men who have ED have some form of hidden heart disease or blockage in their blood vessels if they also have at least two other risk factors for developing heart disease. So if you are a smoker with ED and high cholesterol, for example, you might want to ask your doctor to check out your heart, too.
2. Coronary Artery Disease (CAD)
CAD, a condition in which cholesterol and plaque collect inside the arteries and cause them to become stiff and narrow, is the main cause of heart disease in both men and women and the number one cause of death in the United States. Diseased arteries can also be a telltale sign of other heart issues later on in life. One study shows having ED under the age of 45 is a major risk factor for CAD. While CAD can cause stroke and heart attack, it can also lead to heart failure and irregular heartbeat. According to Dr. Khera, doctors now believe that there’s a link between erectile dysfunction and the lining of the blood vessels, called the endothelium.
“The endothelium tells the blood vessels when to contract and relax,” he says. The endothelium can become damaged from things like stress and tobacco use, making it harder for the lining to function properly and for blood to reach the penis because the blood vessels supplying the penis are unable to relax.
According to Dr. Khera, diabetes has one of the most devastating impacts on erectile function for two reasons: Not only does it affect blood flow but it also affects the nerves.
“Men with diabetes are four to six times more likely to develop erectile dysfunction,” Dr. Khera says. And like erectile dysfunction, diabetes can also lead to strokes and heart attacks.
According to a 2015 study, men with ED are 1.68 times more likely to develop dementia than men who don’t have ED. But Dr. Khera explains that, while this study shows a relationship between erectile dysfunction and dementia, it doesn’t actually prove that dementia causes erectile dysfunction—or vice versa. Right now, there is not enough research to say for sure whether one causes the other. However, he points out, that the two conditions often have some of the same risk factors—like atherosclerosis, elevated cholesterol, and diabetes, etc.
5. Prostate cancer
This is a tricky one: When it comes to prostate cancer, there are two things happening. According to Dr. Khera, having prostate cancer itself does not cause ED, but the treatments used to fight the cancer—like surgery or radiation— can. In fact, he says surgery is the most common cause of ED in men who have prostate cancer. “When a prostate is removed, the nerves can get injured, resulting in erectile dysfunction,” he explains. Nerves and blood vessels damaged by radiation can also cause ED, Dr. Khera says.
6. Liver disease
From the looks of it, the more severe the liver disease, the worse your odds for and the seriousness of ED. One study shows that ED was more common in people with early stage hepatitis C-induced liver cirrhosis than people who had a chronic hepatitis B infection.
“Patients with liver disease have elevated SHBG (sex hormone binding globulin) and less albumin, and that’s a bad thing…because [these proteins] decrease your free testosterone levels,” Dr. Khera explains.
And not only can low testosterone kill your sex drive, but it also makes it more difficult to achieve an erection. Also, since alcohol abuse can cause liver disease, Dr. Khera warns that it’s really important for men to limit their alcohol intake.
What you can do
Nearly 75 percent of men who have ED do not seek treatment, but Dr. Khera wants people to know that there is hope. He says that there are studies that show that erectile dysfunction can be completely reversed with diet and exercise.
While medications like sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) can treat ED, they cannot cure it. However, Dr. Khera says,“stress reduction, diet, exercise, and sleep—those are all the pillars of success.”