Erectile dysfunction (impotence) may be an early sign of heart disease.
Greek researchers evaluated the incidence of asymptomatic coronary artery disease in 26 men with erectile dysfunction and found 23 per cent had coronary artery disease confirmed by angiography (x-rays of the coronary vessels).
Italian researchers studied 162 patients and found the prevalence of erectile dysfunction was high (66 per cent) among those with chronic angina and multivessel disease and low (18 per cent) among those who had had an acute myocardial infarction with only one vessel affected.
Patients with erectile dysfunction, with no obvious cardiac problems, are at a risk of a heart attack within two to three years. In these kinds of patients, erectile dysfunction is considered to be a warning sign of heart attack to come. For this reason, it is being suggested that patients with erectile dysfunction, with no obvious cardiac symptoms, should be evaluated for cardiovascular disease.
There are several reasons why patients with heart disease will have erectile dysfunction. Atherosclerosis (clogging and hardening of the blood vessels) narrows the blood vessels and reduces blood flow to your heart, brain, extremities and the penis. Reduced blood supply to the penis causes erectile dysfunction.
Certain medications taken for heart disease can cause erectile dysfunction (high blood pressure pills and diuretics). It is also important to remember medications taken for impotence may not be safe when combined with certain heart medications (for example nitrates). There is a connection between depression, heart disease and erectile dysfunction. Feeling anxious can also lead to erectile dysfunction. Fear of having a heart attack while having sex can lead to impotence.
Usually, this is an unfounded fear. After a heart attack, you can resume your sexual activity as soon as your doctor says ok. Sexual intercourse seldom causes heart attacks. Having sex with your usual partner in a familiar setting doesn’t lead to a particularly high blood pressure level or heart rate. Even if you’re at high risk of having a heart attack, weekly sexual activity only slightly raises the risk. In fact, regular sexual activity leads to a happy and satisfactory relationship and is good for your heart.
There are a number of risk factors that can contribute to both heart disease and erectile dysfunction. These factors are well known: diabetes, obesity, high cholesterol level, smoking and high blood pressure fall into this category. So, erectile dysfunction may have multifactorial cause and will require investigations and long term planning to get the situation under control.
Let us go back to the real life scenario – you have erectile dysfunction but have no other obvious health problem. What should you do?
First, you have to look at your personal scenario. Is your relationship with your partner stressful or unpleasant? Are you living or working in an environment which is depressing? Such factors will affect your performance in bed.
Your next step is to talk to your doctor. After evaluating your history and physical examination, your doctor will decide on what kind of investigations to undertake. Your doctor may decide to refer you to a urologist, a cardiologist or to a psychiatrist.
So, don’t be shy. If you are having problems maintaining an erection during sexual intercourse then see your doctor. It may save your life and your sex life.
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