• Erectile Dysfunction (ED)


    Erectile dysfunction (ED) is a common problem in men with heart disease. It is the repeated inability to obtain and maintain an erection of the penis. Of course, the inability to obtain an erection now and then is not necessarily cause for concern. But an ongoing problem can significantly affect your quality of life. Even more importantly, ED can sometimes be the first sign of a larger health problem, such as heart disease or diabetes.

    ED is a complicated problem that involves the brain, hormones, nerves, muscles, blood vessels, and emotions. When you have ischemic heart disease, the following factors can contribute to sexual problems:

    • It is possible that blood vessels in the penis may become clogged with plaque, much like the arteries in your heart. Without adequate blood flow to the penis, it becomes more difficult to obtain and maintain an erection.
    • When you also have diabetes, which affects many people with heart disease, neuropathy (the long-term damage to your nerves as a result of high blood sugar) may affect your ability to obtain and maintain an erection.
    • Certain heart medications such as beta-blockers may affect the physiological steps involved in sexual arousal. 
    • And especially if you’ve had a heart event, psychological factors may also get in the way of an erection. You may be afraid that sex will strain your heart, cause more heart problems, or even cause death.

    Talking about your heart-related sexual activity concerns with your doctor will help alleviate your fears and help you find the underlying causes of ED so that you may start looking for solutions.

    Medications for Treatment of Erectile Dysfunction

    If your doctor decides that medications can be used for the treatment of ED, there are three to choose from. Each of them can be safely used in many men with cardiovascular disease, as long as there are no contraindications. 

    For example, if you take nitrates for chest pain (angina), even occasionally, you cannot take any of the ED medications. Doing so could result in life-threatening low blood pressure.  This is a great example of why it’s so important to tell ALL of your providers about ALL the medications you are taking.

    If you also have any of the following conditions, ED medications may not be advised:

    • Certain high-risk heart problems, including chest pain (angina), heart failure, abnormal heart rhythms (arrhythmias), or a recent heart attack.
    • Uncontrolled high or low blood pressure.
    • A history of stroke within the last six months.
    • Eye problems such as retinitis pigmentosa.
    • Sickle cell anemia, leukemia, multiple myeloma, or another health problem that can cause an erection that won't subside (priapism).

    Side effects from any of these medications may include headache, flushing, indigestion or nausea, stuffy or runny nose, back pain and muscle aches (with Cialis), and temporary vision changes (with Viagra). It is unlikely that you’ll have a serious side effect, but if you have a sudden loss of hearing or vision, or an erection that lasts longer than four hours, seek medical help immediately.

    Here are a few other things you should know about the different medications:

    Meds and Sex

    Other Possible Treatments for ED

    Because ED is so complicated, it can be difficult to determine the cause (or causes). As a result, it can also be difficult to determine an effective treatment. Medications are not always the answer. Below are a few more treatment options for ED:

    Ed Other