Is ED a Warning Sign of a More Serious Health Issue?

If you feel reluctant or embarrassed to seek help for sexual dysfunction, you’re not alone. A recent survey found that 39% of men never talk to their doctors about ED, and 20% of men in this category reported feeling uncomfortable discussing ED with their doctor as the primary reason.¹

Your physician wants a full picture of your health, from the most pressing medical concerns to the smaller lifestyle inconveniences. That way, they can recommend the most appropriate and effective treatment to promote your overall health and wellness. While ED may seem to fall into the “lifestyle inconveniences” category, it could be a warning sign of an underlying health issue. A conversation with your doctor will help determine if you have or are at risk for any additional health concerns.

Heart & Vascular Disease

From a cardiovascular standpoint, arteriosclerosis is the most common cause of ED.² This occurs when the arteries begin to harden as a result of long-term damage, most often caused by high blood pressure and high cholesterol. Heart disease, including coronary artery disease, is also a major cause of sexual dysfunction — and it’s the leading cause of death nationwide for both men and women.³

All these conditions restrict blood flow to the penis by narrowing the arteries carrying blood from the heart, either by thickening the walls (arteriosclerosis) or building plaque deposits (coronary artery disease). Because of this clear connection, the medical community now recognizes ED as a potential indicator of major cardiac events. One study evaluating 1,757 male patients for almost four years found that ED patients were more than twice as likely to have or die from a heart attack, cardiac arrest, and stroke (6.3% versus 2.6%).⁴

Metabolic Issues

A well-known cause of sexual dysfunction is obesity, which can reduce testosterone levels and create widespread inflammation that damages an artery’s ability to dilate or constrict.⁵ In addition to decreasing blood flow to the penis, obesity can have other serious complications. Up to 90% of people with type 2 diabetes are either overweight or obese.⁶ Type 2 diabetes occurs when the pancreas doesn’t make enough insulin or when cells don’t respond to insulin, leaving sugar (glucose) in the blood with no way of getting into cells.

Excess blood sugar can make blood vessels less elastic and, as a result, more narrow. Like obesity and cardiovascular diseases, type 2 diabetes interferes with sexual function by disrupting blood flow to the genitals. However, diabetes can become fatal by damaging blood vessels and nerves in other organs, significantly increasing the risk of stroke and heart disease.⁷

Neurological Conditions

Nerves are as important as blood vessels for achieving and sustaining an erection. This requires a properly functioning nervous system. Diseases like Alzheimer’s, Parkinson’s, and multiple sclerosis can disrupt this balance. Alzheimer’s is caused by a buildup of proteins around the brain cells which can lead to a loss of memory, cognition, and many physical functions. Given the major brain involvement in this disease, ED is considered a signpost of cognitive decline in Alzheimer’s patients.⁸

With Parkinson’s disease, the brain cells that make the neurotransmitter dopamine stop functioning, giving rise to various physical challenges, including shaking, uncontrollable movements, and a lack of balance. ED is a notable side effect of Parkinson’s, as disease progression further impacts physical and mental function.

Lastly, multiple sclerosis (MS) describes the breakdown of the outer shell (myelin) around nerve cells in the brain and spinal cord. Without this insulating layer, nerves can’t fire as quickly, disrupting communication with the rest of the body. One example is sexual challenges — most commonly ED, according to 50-75% of men with MS.⁹

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Sources

1. New erectile dysfunction survey finds 39% of men with ED never seek treatment. (2021, February 26). SingleCare. https://www.singlecare.com/blog/news/erectile-dysfunction-survey/ 
2. Erectile Dysfunction. (n.d.). Johns Hopkins Medicine. Retrieved April 4, 2023, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/erectile-dysfunction 
3. Heart Disease Facts. (n.d.). Centers for Disease Control and Prevention. Retrieved April 4, 2023, from https://www.cdc.gov/heartdisease/facts.htm 
4. Uddin, S.M.I., Mirbolouk, M., Dardari, Z., Feldman, D.I., Cainzos-Achirica, M., DeFilippis, A.P., Greenland, P., Blankstein, R., Billups, K.L., Miner, M.M., Nasir, K., Blaha, M.J. (2018). Erectile Dysfunction as an Independent Predictor of Future Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis. Circulation 138(5), 540-542.
5. Deb, A.A., Okechukwu, C.E., Emara, S., Gillott, L., Abbas, S.A. (2019). Central obesity and erectile dysfunction in men. International Journal of Family & Community Medicine 3(6), 290-294.
6. Nianogo, T.A. & Arah, O.A. (2022). Forecasting Obesity and Type 2 Diabetes Incidence and Burden: The ViLA-Obesity Simulation Model. Frontiers in Public Health 10, 818816.
7. Heart Disease and Stroke. (n.d.). Centers for Disease Control and Prevention. Retrieved April 4, 2023, from https://www.cdc.gov/chronicdisease/resources/publications/factsheets/heart-disease-stroke.htm 
8. Yang, C.M., Shen, Y.C., Weng, S.F., Wang, J.J., Tien, K.J. (2015). Increased Risk of Dementia in Patients With Erectile Dysfunction: A Population-Based, Propensity Score-Matched, Longitudinal Follow-Up Study. Medicine, 94(24), e990.
9. Guo, Z. N., He, S. Y., Zhang, H. L., Wu, J., & Yang, Y. (2012). Multiple sclerosis and sexual dysfunction. Asian Journal of Andrology, 14(4), 530–535.