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Dr Duncan

Erectile dysfunction and heart disease - what's the connection?

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According to Dr Stephen Kopecky from the Mayo Clinic in America, "If you start lecturing a man about his risk of heart disease, his eyes start to glaze over. Everyone knows someone who's had a heart attack, has had a stent, and is back on the golf course in a week or two. But when you tell them the risk factors for heart disease are the same as those for erectile dysfunction and dementia, they are immediately interested. Men don't sit around worrying about heart disease, but they do worry about not being able to have sex and getting Alzheimer's."

That’s one of the things about the male of the species, they do appear to have not only great interest in “reproducing the species” in their younger years, but they still hold a life long concern about what we medicos call their “Lower Urinary Tract” - or LUT - well into old age! Promoting  heart health is fairly easy as it’s a fairly “clean” subject, but when it comes to the functioning of the male bladder and genitalia, then there can be a lot of shuffling of feet and a general reticence to “shine a light in a dark area”!

One of the challenges about the male LUT is that a lot of the focus has traditionally been on screening tests for cancer of the prostate gland - a subject that continues to produce conflicting and confusing reports. And another challenge is that when it comes to Erectile Dysfunction - ED - greater emphasis has been put on treating it with pills than has been on what ED may actually be a symptom of.

According to Dr Kopecky, "If a 60-year-old man has erectile dysfunction, his risk of heart disease is raised by about 1.3. But if a 40-year-old has erectile dysfunction, he has a 50 times greater risk of heart disease and needs to start preventive action."

So ED is not just a symptom of failing manhood, but may also be a pointer for impending cardiovascular disease, and if that’s the case, then treating the cardiovascular disease would take priority over the temporary physical inability to maintain an erection! In fact recent studies have also shown that when you treat the underlying cause of CV disease with appropriate lifestyle changes (eg stop smoking, lose weight, get fit and eat your five veggies and fruit) then the incidence of ED will be greatly reduced and may not require  medications after all.

The group of men who should be most vigilant about ED are those who have pre-existing diabetes, and who are two to four times more likely to suffer a stroke as a result. Those diabetics who do have ED should take it as a “red flag” moment and get a thorough health check to look for other signs of cardiovascular disease. And ED isn’t just a disease of “old men”, it can manifest itself as early as the 30’s or 40’s, and if you are a diabetic in this age group, then it needs to be taken seriously.

Other causes of ED include taking medications prescribed by your doctor for blood pressure or for mood disorders such as depression. If this is the case, then discussing alternative medications with your treating doctor can often resolve the issue. Another common cause is alcohol - which, by the way, if it were invented today would be banned for human consumption for its toxic and cancer producing properties.  Other things that can contribute to ED include:

  • damage to the nervous system by diseases such as Parkinson’s disease, strokes and MS;
  •  prostate disease - either from enlargement of the gland or because of cancer;
  •  trauma to the pelvis, penis or spinal cord;
  • low testosterone levels (this an evolving area of research as testosterone levels do decline with advancing age, and yet testosterone is known to be involved in the overall male “sexual drive” process);
  • depression and anxiety, which can compound ED and should always be taken seriously and managed sympathetically and appropriately
Many men are great examples of how to live a healthy lifestyle with the aim of reducing risks from the many chronic health issues that will affect them as they age. But so many men aren’t! Obesity and inactivity, smoking and overuse of alcohol continue to blight the lives of literally millions of Australians at great cost to both themselves, and in dollar terms, to the wider community too, with the resultant massive burden on the healthcare system.

Problems with a mans “Lower Urinary Tract” and the development of erectile dysfunction may not be just “plumbing problems”, but could herald the start of serious life-threatening heart, dementia and stroke problems. And each of these could be improved or even prevented by making positive health choices - so if things are Looking Down, it’s time you had a Check Up!

Article written by Dr. Duncan Jefferson. More articles here. For more information on health care and private health cover, visit HBF Insurance at www.hbf.com.au.

The content of these articles is not tailored for any particular individual's circumstances. The author does not take into account your physical condition, medical history or any medication you may be taking. Any advice or information provided by the author cannot replace the advice of your health care professional. The views expressed in this article are those of the author and do not represent those of HBF unless clearly indicated.

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