Sexual health

Erectile dysfunction can be an early warning for your heart

Most men think of erectile dysfunction (ED) as a private problem, or a sign of getting older. Sometimes it is something more useful: an early signal about the health of your blood vessels.

Why the two are linked

An erection depends on healthy blood flow. The arteries that supply the penis are narrow, so damage to blood vessels from diabetes, high blood pressure, high cholesterol or smoking often shows up there first. The same process can be developing, more slowly, in the arteries of the heart.

In many men, erectile difficulty appears a few years before any heart symptoms. That gives you time to act.

When to take it seriously

• Erections have become weaker or less reliable over months, not just on a stressful night.
• You are under 50 and this is new for you.
• You have diabetes, high blood pressure, high cholesterol, excess weight, or you smoke.
• There is heart disease or stroke at a young age in your family.

What a proper assessment includes

A good assessment looks at the whole picture, not only the erection. It usually covers:

• Your history: when it started, whether morning erections still happen, stress, mood and relationship factors.
• Blood pressure, weight and waist measurement.
• Blood tests where indicated: blood sugar (HbA1c), cholesterol, and sometimes testosterone, thyroid or prolactin.
• A vascular assessment when your risk profile calls for it.

Anxiety and low mood can cause or worsen ED, and often sit alongside a physical cause. Treating both usually works better than treating either alone.

A note on tablets bought online

Medicines for ED work well for many men, but they are not safe for everyone. They must never be combined with nitrate medicines used for chest pain. Buying them without an assessment also means the underlying cause, which may be your heart, goes unchecked.

This article is general information and does not replace a consultation with a doctor who has assessed you.