Let’s talk about... erectile dysfunction
We explain what erectile dysfunction is, the causes of it, the links with cardiovascular disease and how to treat it.
Erectile dysfunction (ED), or impotence, is when a man has difficulty getting or maintaining a strong enough erection for sexual intercourse or other sexual activity. It is commonly caused by stress, anxiety or excessive alcohol consumption. It can also be a symptom of an underlying condition such as atherosclerosis, diabetes or high blood pressure. Some medications can lead to ED, for example beta-blockers and diuretics (commonly used to treat a variety of heart-related conditions).
Erectile dysfunction and cardiovascular disease
During an erection, the arteries carrying blood to the penis dilate and more blood flows into the penis, causing it to swell.
If arteries in the body are affected by atherosclerosis, this can cause a reduction in the blood flow, which can mean problems getting or maintaining an erection.
Having atherosclerosis increases your risk of heart attack and stroke. Because the arteries in the penis are so narrow, erectile problems can be one of the first warning signs of atherosclerosis.
It’s crucial that any underlying medical condition, such as atherosclerosis or diabetes, is detected. So if you’re experiencing problems with ED, book an appointment with your doctor. He or she will assess and examine you to try to establish the cause of the problem, and may refer you for tests. Don’t take any medicine for ED without first discussing it with your doctor.
Erectile dysfunction treatment
Medicines known as PDE5 inhibitors can help two-thirds of men with ED. These include Viagra (sildenafil), Cialis (tadalafil) and Levitra (vardenafil). You may need to take several doses over time before they work properly, and you may need to adjust the dose. You can be prescribed these drugs from six months after a heart attack, providing your condition is stable. These drugs won’t make any heart problems worse, but aren’t recommended for people with low blood pressure.
They can be taken with most medicines for your heart, but not nitrates (GTN) or nicorandil. If you use a spray for angina, leave at least 12 hours between taking a PDE5 inhibitor and using your spray, or if you take nitrate tablets, allow at least 24 hours (48 hours for Cialis).
Another erectile dysfunction treatment is a hormone called alprostadil, which is applied as an injection or a pellet placed inside the man’s urethra. A non-drug treatment is a vacuum pump – these may take some practice, but are usually very effective.