Fast Facts on Erectile Dysfunction and What Are Surgical Treatment Options for ED?

Fast facts on erectile dysfunction:

- - Erectile dysfunction (ED) is defined as persistent difficulty achieving and maintaining an erection sufficient to have sex.
  - Causes are usually medical but can also be psychological.
  - Organic causes are usually the result of an underlying medical condition affecting the blood vessels or nerves supplying the penis.
  - Numerous prescription drugs, recreational drugs, alcohol, and smoking, can all cause ED.

The following list summarizes many of the most common physical or organic causes of ED:

- - heart disease and narrowing of blood vessels
  - diabetes
  - high blood pressure
  - high cholesterol
  - obesity and metabolic syndrome
  - Parkinson’s disease
  - multiple sclerosis
  - hormonal disorders including thyroid conditions and testosterone deficiency
  - structural or anatomical disorder of the penis, such as Peyronie disease
  - smoking, alcoholism, and substance abuse, including cocaine use
  - treatments for prostate disease
  - surgical complications
  - injuries in the pelvic area or spinal cord
  - radiation therapy to the pelvic region

Atherosclerosis is a common cause of blood flow problems. Atherosclerosis causes a narrowing or clogging of arteries in the penis, preventing the necessary blood flow to the penis to produce an erection.

Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex.

Having erection trouble from time to time isn’t necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.

If you’re concerned about erectile dysfunction, talk to your doctor — even if you’re embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.

Inflatable penile prostheses are implanted during outpatient surgery. Once they are part of a man’s body, they enable him to have an erection whenever he desires. The use of a prosthesis preserves penile sensation, orgasm and ejaculation for most men.

The most commonly used penile implant consists of a pair of inflatable cylinders that are surgically implanted in the erection chambers of the penis. The cylinders are connected through tubing to a reservoir of fluid under the lower abdominal muscles, and to a pump inside the scrotal sac.

To inflate the penile prosthesis, the man compresses the pump a number of times to transfer fluid from the reservoir to the cylinders. This causes the penis to become erect. When inflated, the prosthesis makes the penis stiff and thick, which is very similar to a natural erection.

A penile prosthesis does not change the sensation on the skin of the penis or a man’s ability to achieve orgasm or ejaculate. Pressing on a deflation valve attached to the pump returns the fluid to the reservoir, which returns the penis to a flaccid state.

The surgical procedure is performed through one or two small incisions that are generally well hidden. Other people will be unable to tell that a man has an inflatable penile prosthesis. Complications following surgery are not common, but primarily include infection and mechanical device failure.

Approximately 95% of penile implant surgeries are successful in producing erections that enable men to have sexual intercourse. Moreover, patient satisfaction questionnaires show that up to 90% of men who have undergone penile implants say they would choose the surgery again, and overall satisfaction ratings are higher than those reported by men using oral medication or penile injection therapy.

Viagra can Make your Penis Harder and Save your Penis from Injury as well

It’s no secret that Viagra makes your penis harder for penetrative sex. But what you might not know is that it can save your penis from injury — if you start taking it early enough.

If you’re experiencing erectile dysfunction but wait to talk to your doctor until you can’t achieve an erection hard enough for penetrative sex, you may damage your penis. Having sex with an erection that’s barely “hard enough” can bend it and tear tissues that may scar as they heal, Dr. Montague says.

Scar tissue isn’t elastic like healthy penile tissue, so it will force your penis to bend with future erections, creating a condition known as Peyronie’s disease.

This affects 9 percent of men between the ages of 40 and 75. Many of these men have what Dr. Montague calls erectile insufficiency — erections that are not as firm as they used to be. During intercourse, bending may damage the penis. Taking Viagra could help prevent the problem and avoid an injury with lifelong consequences, he says.

No matter what your concern is, talk with your doctor. “If you’re having erectile dysfunction problems, you should feel confident going to your doctor. It’s a common issue,” Dr. Montague says. “Many men are embarrassed, but they shouldn’t be. Help is available, and it’s worth a try.”

What you should know before you take viagra ?

Don’t drink alcohol after taking

If you like a glass of wine or another alcoholic bev to unwind before sexy time, you should be fine.

But drinking more than that after taking Viagra could put a major damper on your rendezvous.

Moderate to heavy drinking can make it — er — harder for you to get an erection. Also, Viagra can lower blood pressure. Combining it with alcohol can increase this effect.

If your blood pressure drops, symptoms like dizziness, lightheadedness, and headache could also hinder your hard-on and mood.

How does the time frame compare with other ED meds?

Like Viagra, most ED drugs can be taken 30 to 60 minutes before sex.

The exception is Stendra (avanfil), which is the fastest-acting ED medication available. It only takes 15 to 30 minutes to kick in, depending on the dose.

When it comes to duration, Cialis (tadalafil) is the longest lasting and works for up to 36 hours.

What Factors Affect the Speed of Sildenafil and Is it Safe to Take Viagra with Alcohol?

The drug duration and the onset of action can be affected y several factors, including:

Alcohol. Alcohol-containing beverages decrease the blood flow to the penis. As a result, it becomes harder to achieve and maintain an erection necessary for sexual intercourse. One glass of good wine or one beer will not decrease the speed of sildenafil, but larger amounts of alcohol will surely slow down the effects of the drug and may even cause adverse reactions making it harder to get an erection;
Old Age. Men over 60 report that the drug starts working later because with age the body’s metabolism slows down. However, this means that sildenafil tablets will last longer in older men;
Dosage. The dosages may range from 25 mg to 100 mg. The higher dose you take, the more potent and long-lasting effects you will notice. Remember that only a doctor can determine the correct dosage of this generic medication for your case. Do not engage in self-treatment!
Heavy foods. If you eat too many fatty foods just before you take a pill, you may need to wait more time until the drug starts working since your body will be busy digesting the food. But if you take the pill on an empty stomach, the onset of action will occur quickly;
Drug interactions. Some medications can slow down the speed of the drug. For, example, antibiotic rifampicin can change the speed of the action. Always consult your doctor about any medications you are taking or going to take. This way you can ensure that generic Viagra (Sildenafil) is safe for your body;
Health condition. If you any pathological problems with kidney or liver, the medication can last longer. The thing is that the pill will be absorbed by your organism much longer. You should always inform a medical specialist about all medical conditions you have.

Is it Safe to Take Viagra with Alcohol?

Viagra was one of the first FDA-approved oral medications to be offered to men who have erectile dysfunction (ED) and is the most well-known ED drug—think “the little blue pill.” ED is a medical condition in which a man cannot get or maintain an erection long enough to have satisfactory sex. Viagra is still a commonly prescribed treatment for ED, which affects 30 million men, according to the American Urological Association (AUA, 2018).

The active ingredient in Viagra is sildenafil citrate, a type of drug called a phosphodiesterase 5 (PDE5) inhibitor. PDE5 inhibitors help treat ED by relaxing the muscles in the penis to allow for more blood to flow to the area. This increased blood flow enables you to have and maintain a satisfactory erection. Other PDE5 inhibitors used to treat ED include vardenafil (brand name Levitra) and tadalafil (brand name Cialis). Viagra is taken anywhere from 30 minutes to four hours before engaging in sexual activity. The drug alone will not give you an erection—you need to be aroused for the medication to work.

Is it safe to take Viagra with alcohol?

Many men drink alcohol on the days they plan to use Viagra. Alcohol can help you relax, and it decreases inhibitions, etc. As long as you are not drinking excessively (and have cleared it with your healthcare provider), it is likely safe for you to have a glass or two of wine (or the equivalent serving of beer or spirits) while taking Viagra.

However, people who abuse alcohol (more than 15 drinks a week) and take Viagra for recreational (non-medical) purposes may have a higher risk of side effects (Kim, 2019). One study showed that over 45% of men who took Viagra with alcohol for recreational purposes had a higher risk of side effects, including facial flushing, headaches, chest pain, changes in vision, and light headedness (Kim, 2019).

The type of alcohol you drink may matter. A study looking at men who drank red wine and took Viagra showed no clinically significant interaction with the combination (Leslie, 2004). However, if you prefer grapefruit juice with your cocktails, there may be an interaction with the Viagra.

Viagra is broken down by the liver, and grapefruit juice may affect how well the liver can accomplish this. Researchers looked at men who took Viagra with grapefruit juice and found that the combination can increase the amount of the drug circulating in your body (Jetter, 2002). While this is not usually a dangerous outcome, higher levels of Viagra may increase the risk of side effects like headaches, flushing, or low blood pressure. To be safe, you should avoid taking Viagra with grapefruit juice.

Alcohol and ED

ED tends to affect men in older age groups, especially those aged 70 years and over. However, ED does not only happen in old age—it can also occur in younger men. Lifestyle factors can also increase the risk of developing this condition. These include obesity, smoking, lack of physical activity, and excessive alcohol consumption.

Impotence: how is it different from erectile dysfunction?

A common term for ED after drinking alcohol is “whiskey dick.” The effects of alcohol on a man’s erectile function will vary. In general, alcohol acts as a depressant, meaning that it has a sedating or relaxing effect on the brain and body. While this sounds good, it can also negatively affect some of the pathways involved in sexual arousal, blood circulation, and nerve sensitivity—all of these need to be functioning properly to have a satisfying sexual encounter.

For example, alcohol intoxication can slow the signals between the brain and the penis responsible for getting an erection. Drinking alcohol can also lead to dehydration, which reduces blood flow and impacts your ability to get an erection.

The amount of alcohol you drink matters. Excessive (more than 15 drinks per week) or binge drinking (5 or more drinks on a single occasion) can contribute to ED by affecting the pathways by which nerves and blood vessels allow you to get and maintain an erection. Heavy alcohol use can also decrease your testosterone levels, thereby reducing your sexual desire and ability to have satisfactory sex (Wang, 2018). One study looked at 100 men with diagnosed alcohol abuse disorders and found that over 72% of them had some form of sexual dysfunction, with ED being one of the most common (Benegal, 2007).

Alcohol is not all bad when it comes to ED. One study showed that moderate alcohol use (which they defined as 14.5 drinks per week) was associated with a 34% decreased risk of ED (Wang, 2018). Studies have also found that moderate alcohol consumption of up to two drinks per day could have other health benefits, like raising “good” HDL cholesterol and lowering the risk of diabetes (AHA, 2019). As with many other things in life, moderation is key.

In summary, if you are going to consume alcohol while taking Viagra, be sure to do so responsibly. Limit your alcohol intake to 1–2 drinks per day. According to the Centers for Disease Control and Prevention (CDC), a standard drink is one of the following:

12 ounces of beer (5% alcohol content)
8 ounces of malt liquor (7% alcohol content)
5 ounces of wine (12% alcohol content)
1.5 ounces or a “shot” of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey)

Drink water or nonalcoholic beverages in between the alcoholic drinks to prevent dehydration. Know your limits, and be sure to stop drinking alcohol when you start to feel intoxicated.

How Long Does Viagra Last?

Sildenafil is a common medication used to stimulate erections in men with erectile dysfunction (ED) and treat pulmonary arterial hypertension (high blood pressure affecting the lungs and heart).

For treating ED specifically, Viagra is the well-known brand-name version of this drug. Viagra is used to treat Erectile Dysfunction (ED) and Pulmonary Arterial Hypertension (PAH). It contains the active ingredient, Sildenafil.

It works by relaxing the blood vessel walls, allowing blood flow to the penis more easily, which is an essential factor in getting and maintaining an erection. Viagra is a blue, diamond-shaped tablet that comes in doses of 25mg, 50mg or 100mg. You should follow the advice of a doctor when taking this medication.

It is possible to buy it online without a prescription, but this is risky as the ingredients may be harmful, so we advise you to consult a doctor before taking Viagra.

They will advise you on the correct dosage and whether any other medication you are taking may interfere with its effectiveness. After taking the medication you should expect to see an effect after about 30 minutes. You will need to be sexually aroused in order for it to take effect.

Many factors can influence how long Viagra takes to start working. In general, Viagra takes about 30 minutes to produce noticeable effects.

But your diet, your overall health, the medications you’re taking, underlying conditions, and much more can all affect the amount of time Viagra takes to work in your body and how long it lasts.

How long does Viagra last for men and women?

The average duration of its action in men is about 4 – 6 hours. The drug is not intended for use in women. Sildenafil stays active for a different period of time, it works individually for every man. Most men say that sildenafil lasts about 4 hours, but others reported that they were able to feel the effect of the medication even the next morning. In some men, it lasts for 6 hours. But this also does not mean that a man will have an erection all this time. Below you can see the approximate duration of 25 mg and 100 mg tablets.

Viagra dosage	How long does it last?
25 mg sildenafil	2-3 hours
100mg sildenafil	5-6 hours

Some men wonder: “How long does Viagra stay in your urine and blood?” Sildenafil usually leaves your system after 2-3 hours. Depending on your metabolism, sildenafil can take 5-6 hours to fully leave your system. A higher dosage of the drug will take longer to leave your urine and blood.

How does it work?

An erection happens when nerves in your penis are stimulated.

As a result, muscles around two cylinder-shaped chambers of spongy material along your penis, known as the corpus cavernosa, relax and allow blood to flow in, causing an erection.

With ED, your nerves don’t communicate properly with your brain and blood doesn’t flow properly into the corpus cavernosa. Taking Viagra relaxes the walls of your blood vessels and lets blood flow more easily into the parts of your penis that cause an erection.

How long does it take to start working?

Viagra normally starts working 30 to 60 minutes after you take it in oral tablet form. It may take up to 2 hours to work.

Viagra doesn’t work on its own. You’ll still need to feel sexually aroused to get an erection. Feeling relaxed and comfortable can also help Viagra take effect sooner.

How long does it last?

On average, Viagra usually lasts between 2 and 3 hours before its effects start to diminish. Viagra can last up to 5 hours or longer depending on your dosage, your body’s metabolism, and other external factors.

Depending on how your body metabolizes it, you may be able to get an erection several times with Viagra in your body. Viagra probably won’t make you last longer in bed, though. No research has proven definitively that Viagra can increase how long you can have sex.

Viagra may not work again immediately after you’ve had sex. Normally, you can’t get another erection right after ejaculating because your body isn’t physically prepared for it.

This is known as the refractory period. It may only last a few minutes, but it can last as long as a few hours or days. However, a 2000 studyTrusted Source found that Viagra may decrease this recovery time.

Can any factors affect how long it lasts?

Several important factors can influence how long Viagra lasts for you:

Dosage. The amount of Viagra you take affects how long it stays in your system. The smallest available dose, 25 milligrams (mg), won’t last as long as the largest available dose, 100 mg. But taking a higher dose isn’t always recommended, as it may not be safe for you.
Age. As you get older, your metabolism slows down. So Viagra may last longer as you age. In general, you may notice Viagra works for a longer period when you’re 65 or older.
Diet and lifestyle. Eating a large meal or a lot of high-fat foods right before you take Viagra can keep it from being metabolized quickly or effectively. But this can also make it last longer as it’s metabolized along with your meal. Drinking alcohol or smoking can also decrease blood flow to your penis, making Viagra less effective or shorter-lasting.
Medications. Some medications, especially antibiotics such as erythromycin (Ery-Tab), clarithromycin (Biaxin), and ciprofloxacin (Cipro), can interact with Viagra and affect how long it lasts.
Overall health. Certain existing conditions can affect how long Viagra lasts and how well it works for you. Diabetes, nervous system conditions like multiple sclerosis (MS), and heart conditions like atherosclerosis (fat buildup in your blood vessels) can all make Viagra less effective and not last as long. Some kidney conditions may make Viagra last longer because of the condition’s effect on your metabolism.
Psychological state. Feeling anxious, nervous, depressed, or stressed can all influence how your body responds to sexual stimulation. If you’re not relaxed or comfortable during sex, or if you have performance anxiety because of past sexual experiences, Viagra may not last long or be fully effective.

How long does it take to leave my system?

Viagra usually leaves your system after 2 to 3 hours. Depending on your metabolism, Viagra can take 5 to 6 hours to fully leave your system.

A higher dosage will take longer to leave your body. A 25-mg dose may wear off after a couple of hours, but a 100-mg dose may take nearly four times as long to leave your system.

Is there anything I should be concerned about?

Viagra often lasts for a few hours. You won’t normally have an erection the entire time, as Viagra is only used to help increase blood flow. If you don’t think Viagra is working fast enough, try masturbation or foreplay to help stimulate arousal.

If Viagra doesn’t work after 30 minutes, don’t take any more than the daily dose that your doctor prescribed. Never take more than 100 mg of Viagra in a 24-hour period.

Taking too much Viagra can cause priapism, a painful erection that lasts longer than 4 hours. This can damage penis tissue because blood stored in the penis isn’t receiving any oxygen. Get emergency treatment right away if this happens.

How Clogged Arteries Cause Erectile Dysfunction ?

Are Clogged Arteries To Blame For Erectile Dysfunction?

A growing body of scientific evidence supports the fact that erectile dysfunction can be caused by a clog or multiple clogs in the penile arteries. As most men know, an erection is produced when arousal causes blood flow to enter the penis through the penile arteries as they widen and allow blood to flow into the network of vessels that travel through the stomach and lead into the penis. The result is swelling which is commonly known as an erection.

But in a man with a blockage in the penile arteries, blood cannot move into the penis the way it would for an otherwise healthy man. The result would be either a partial erection or no erection at all.

The Chicken or the Egg: Clogged Arteries Cause ED

It is true that clogged arteries can cause ED but it is also equally true that clogged arteries in the penis can be a symptom of heart disease which means clogged arteries in the rest of the body. According to Harvard Health they are a warning signal of heart disease.

The path to erectile dysfunction often starts at the heart, which pumps blood through arteries to all areas of the body. Erectile dysfunction often occurs when these pathways are blocked by plaque, a condition known as atherosclerosis. So, clogged arteries can cause ED.

Cholesterol builds up on vessel walls, which causes them to narrow and slow down blood flow. If left untreated, flow can come to a screeching halt. Clogged arteries can cause ED and this condition can also cause angina, heart attacks, strokes, and claudication (pain in the legs with walking). In some cases, erectile dysfunction could be a warning sign that a heart attack or stroke may happen down the road.

Atherosclerosis and Erectile Dysfunction

Atherosclerosis is commonly defined as the hardening of the arteries responsible for pushing blood to various regions throughout the body. As healthy arteries are an essential part of daily health, individual who do develop atherosclerosis may be at a risk for a variety of potentially harmful conditions, one of which is erectile dysfunction.

Men who suffer from atherosclerosis may notice that it is increasingly difficult to develop and sustain an erection. The arousal process may take substantially longer than it has previously, and the strength and quality of an erection will most likely be noticeably reduced. Additionally, men may find that their erections subside quickly, leaving them a very little window of opportunity in which they can engage in sexual intercourse.

The presence of erectile dysfunction in a man’s life can be heartbreaking. And in the most literal sense it can mean that his physical heart is experiencing a lower level of performance.

In his research, Dr. Faysal Yafi, Director of the Men’s Health Services at the UCI Health Center for Urological Care, found that there is a connection between erectile dysfunction and heart disease.

Atherosclerosis, which can cause a penile blood clot, can develop from a variety of risk factors. These include:

Diabetes
Smoking
Alcohol abuse
High blood pressure
Certain medications (such as thiazide diuretics)
High levels of LDL cholesterol
Obesity
Low testosterone
Advanced age
Family history of the condition

How to Improve Blood Flow to the Penis

As a man interested in being at your best, you are not one to accept defeat when victory can be as close as the next move. You know that poor circulation in the penis can cause ED, but you also know that there are specific actions you can take to reduce your risk of heart disease which produces the clogs that can cause your ED. Here is a list of steps you can take to unclog penile arteries:

Quit Smoking. Smoking is on the decline but if you are one of the holdouts your smoking habit is likely not doing you any favors in the bedroom. And stopping can help reduce your risk of ED, which is what can happen when arteries in the penis constrict.
Reduce Your Blood Pressure. There are many ways to do this and the lifestyle changes in this list will help unclog penile arteries. But if you are living a stress-filled life now might be the time to take up some new hobbies that provide relaxation and connection with nature.
Communicate with Your Partner. Set aside some time every day to communicate with your partner about whatever is going on in your life. If you are feeling stress in any area of your life, being able to talk about it openly and honestly will reduce the potential negative effects of whatever may be going wrong.
Lose Weight. Your weight may not be affecting your performance now, but combined with other risk factors it may be only a matter of time; losing weight can help unclog penile arteries.
Manage Your Diabetes. Diabetes affects a lot of things in your body including your circulation. You don’t have to cure your diabetes to improve blood flow and reduce the risk of erectile dysfunction.
Improve Your Eating Habits. Focus on fresh ingredients and limit over processed and chemical laden foods. A sensible diet packed with leafy greens and multi colored vegetables, lean proteins, and healthy oils can become your best friend.
Reduce Inflammation. Inflammation of any kind can negatively impact one’s health.
Check Your Testosterone. A healthy testosterone level is key to healthy erections and many of the items on this list support healthy testosterone levels.
Move Your Body. A solid exercise regimen will improve your overall health, give you more energy and be an aide in reducing inflammation which can help unclog penile arteries.
Get Enough Sleep. Sleep is not just a time to disconnect from the world. It is the time when your body works to repair and replenish itself to set you up for success tomorrow.

What You Need To Know If Your ED Is Caused By a Clog

First, you are not alone. Over 50 percent of American men between the ages of 40 and 70 will experience mild, moderate, or severe erectile dysfunction in their lifetime. It’s pretty clear that atherosclerosis can cause erectile dysfunction. Atherosclerosis by itself accounts for 50-60 percent of ED cases in men over the age of 60. On a related note, experts estimate that 35 to 50 percent of diabetics experience ED.

Second, contrary to popular perception, ED doesn’t just affect older men. One in four men who sought help at an outpatient clinic for the condition were under the age of 40, nearly half of whom had severe symptoms. While these men in some ways appeared healthier than their older counterparts – less weight, more testosterone, fewer medications – they also smoked or used illegal drugs more regularly. Perhaps of most concern is the fact that a majority of men, regardless of age, do not seek treatment for erectile dysfunction.

Third, there is a non-invasive treatment that is ideal for clog caused ED. It’s called GAINSWave® and it offers a unique solution that can achieve impressive results. This simple in-office procedure uses low-intensity acoustic soundwaves to break up plaque and stimulate the release of growth factors, which can lead to the development of new blood vessels in the penis.

The procedure also awakens dormant stem cells and encourages blood flow, an essential component for normal erectile function. GAINSWave is an effective alternative for men who seek to address ED or simply improve their overall sexual performance.

The man who is committed to upping his game recognizes that a clog can cause ED and he takes action to unclog his penile arteries.

The Early Warning Signs

The best way to judge whether or not an individual is at risk for either atherosclerosis or endothelium damage is to observe their lifestyle habits and men who have high cholesterol, smoke regularly, have diabetes or are obese have a significantly higher risk of developing these conditions than those who do not.

Temporary Treatments

Although the development of atherosclerosis cannot be reversed, a variety of pharmaceutical products can be used to dramatically slow the progress of this condition. That being said, the most valuable tool at any man’s disposal for countering the unwanted effects of atherosclerosis is simple lifestyle adjustments. It is absolutely imperative that men engaging in high-risk behavior change their lifestyle immediately in order to ensure that they do not place themselves further in harm’s way.

As stated previously, men who believe they may be suffering from atherosclerosis are advised to discuss these problems with their doctors immediately in order to ensure the real cause of low sexual stamina so that they have the information they need to effectively combat this illness. Good luck!

Treating clogged arteries

Doctors can prescribe medicines to treat atherosclerosis. These include:

antiplatelet medication, such as aspirin or clopidogrel, to reduce blood clotting
anticoagulants, such as warfarin or heparin, to thin the blood
cholesterol-lowering medicines, such as statins
blood pressure medicines

Sometimes, a doctor needs to perform surgery for atherosclerosis. This may include balloon angioplasty or a stent to open a blocked artery. Healthcare professionals can treat angina with a coronary artery bypass. The doctor grafts a piece of a healthy vein to an area above the blockage to allow blood to flow.

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How Clogged Arteries Cause Erectile Dysfunction & What You Can Do About It

What is the Connection of Erectile Dysfunction and the Heart?

What is the connection of Erectile Dysfunction and the Heart?

Erectile dysfunction (ED) is when you are unable to get or keep an erection suitable for sexual intercourse or another chosen sexual activity. The most common cause of ED is a lack of blood supply to the penis. The lining of the blood vessels (arteries) that supply blood to the penis is called the endothelium (pronounced en- do- thee- lee- um).

This controls the speed with which blood enters the penis. If the endothelium does not work properly, blood can not enter fast enough or stay there long enough to get a firm erection that lasts sufficient time for satisfactory sexual intercourse (see our factsheet ‘Erectile dysfunction’).

With aging, particularly when combined with an unhealthy lifestyle, the arteries become narrowed and damaged by a process known as atherosclerosis, which is similar to a pipe furring up. The link between ED and disease of the coronary arteries (those that supply the heart) is that they share the same endothelium, so atherosclerosis in the penile arteries is also likely to be present in the coronary arteries.

This is why up to two-thirds of men with coronary artery disease (CAD) also have ED. The problem is that over half the men with ED may have CAD they don’t know about. Finding and treating atherosclerosis early can help stop it from getting worse, so this is important.

Can ED come before CAD?

Yes! The arteries in the penis are smaller in diameter (1-2mm) than the coronary arteries (3-4mm). This means that while atherosclerosis in the coronary arteries may not currently be causing any heart problems, the same disease in the smaller penile arteries causes them to become narrowed earlier, leading to ED.

It takes longer for the bigger coronary arteries to be affected by the narrowing process, but if it is allowed to continue, a man with ED and no heart complaint may develop a heart complaint within 3-5 years of his ED starting. This is why the penis has been described as ‘the window to the hearts of man’. It means ED can help identify someone at future risk of a heart attack, giving us a chance to prevent it from occurring by lowering cholesterol and treating high blood pressure. The early detection and treatment of diabetes is also important.

What are the risk factors for ED and CAD?

They are the same. High blood pressure, raised cholesterol, cigarette smoking, obesity, diabetes, physical inactivity, low testosterone, depression and stress. So it is easy to see why ED and CAD often occur together – it is really a matter of which comes first.

What if you have ED and no sign of CAD?

It is very important to see your GP to assess your health and see if you have any of the risk factors described above. Lifestyle issues are important. Losing weight if needed, eating a healthy Mediterranean-style diet and increasing physical activity are the easiest changes to make, and these will benefit both ED and CAD (see our factsheets ‘Body Mass Index (BMI)’ and ‘The Mediterranean diet’).

By reducing your risk factors for ED and CAD, you reduce your chances of a serious health problem in the future. You may have had your ED successfully treated by tablets given to you by a friend or bought online, but getting your erection back without a check on the heart is asking for trouble.