Continuing our theme of health conditions that patients avoid discussing with their doctor, we’ll review erectile dysfunction (ED), what causes it, and why it’s important to address.
ED is the inability to get and keep an erection firm enough for sex. Several factors can contribute to ED, including low testosterone and taking some medications, but the most common cause is the narrowing of the arteries as men age.
Among the conditions that promote artery damage are high blood pressure, high cholesterol, diabetes, obesity, sedentary lifestyle, drug and alcohol use, and smoking.
If you recognize those risk factors, it’s because we review them every time we discuss heart disease. ED affects more than sexual function. It can be an indicator of other concerning health conditions, including heart disease.
Erections require unobstructed blood flow and healthy blood vessels. During sexual arousal, nerves release chemicals that increase blood flow to the penis, where specialized tissue traps the blood and makes the penis firm. After orgasm, nerve signals tell these muscle tissues to contract, releasing blood and relaxing the penis.
So, if your blood is not flowing freely, it might affect your sexual health and your heart health. And if you have symptoms of ED, it might mean you should be concerned with your cardiovascular health as well.
The most important first step is to discuss your ED symptoms with your doctor or care team. They can help you create a treatment plan for your ED and also evaluate your heart health based on your risk factors.
Healthy lifestyle decisions, as you might imagine, can make a significant impact on both conditions. Try these to improve your sexual and cardiovascular health:
• Getting moderate-intensity exercise for 30 minutes a day, five days a week.
• Eating a nutritious diet rich in fruits and vegetables, lean meats, low-fat dairy, and healthy fats like avocado, olive oil, and salmon.
• Maintaining a healthy weight.
• Quitting smoking.
• Managing high blood pressure and high cholesterol.
• Reducing stress.
When lifestyle modifications aren’t enough to restore erectile function, several other treatments are available.
Oral medication is the most common first treatment for ED. Viagra, Levitra, and Cialis are among the most commonly prescribed medications. They work by dilating blood vessels that supply blood to the penis, but they can cause side effects like facial flushing, heartburn, headache, and, in some cases, more serious complications. People taking nitrates for their heart should never take these medications.
Injections and suppository medications can help with temporary erections. Using a very fine needle, you can inject a drug into the side of the penis to produce an erection for about 30 minutes. The most common side effect is prolonged erection.
You can also insert a tiny suppository into the penile urethra, which can produce an erection for 30 to 60 minutes. A common side effect is a burning sensation in the penis.
Mechanical devices like a vacuum erection device can pull blood flow into the penis to produce an erection, and a tension ring can be placed around the base of the penis to maintain that erection for about 30 minutes.
Surgery is also an option if you’ve tried other treatments with limited success. An implant can be surgically placed in the penis that helps keep the penis firm and helps you control an erection.
As with all surgeries, there are risks, so discussing options with your doctor is important. Start your conversation today to improve blood flow and all of the critical functions that depend on it.
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Dr. Alfred Casale, a cardiothoracic surgeon, is chief medical officer for surgical services for Geisinger and chair of the Geisinger Heart and Vascular Institute. Readers may write to him via ae@timesleader.com.
