Erectile dysfunction (ED), as one of the common conditions in andrology, refers to the persistent inability of the penis to achieve and maintain an adequate erectile state, making it difficult to obtain a satisfactory sexual life, and the course of the disease is usually more than 3 months. Not only does it have a serious impact on the quality of life, on sexual partnerships, but it can even threaten the stability of the family. Even more serious, it has a pathogenesis that is partially common to cardiovascular and cerebrovascular diseases, as well as the same risk factors, which can be called “early warning signs” of cardiovascular and cerebrovascular diseases.
ED and cardiovascular and cerebrovascular diseases: some common pathogenesis and risk factors
ED is mainly related to vascular, neurological, hormonal abnormalities and psychological factors, among which vascular factors are one of the extremely important factors. At the same time, vascular factors are also key factors in the onset of cardiovascular and cerebrovascular diseases. In terms of pathogenesis, vascular endothelial dysfunction is the common pathological basis for ED and cardiovascular and cerebrovascular diseases. Vascular endothelial cells act like “guardians” of the lining of blood vessels, maintaining the normal diastolic and systolic function of blood vessels. The penile arteries are more minute, the cavernous arteries of the penis are only 1 – 2 mm in diameter (about 3 – 4 mm in the coronary arteries), and are therefore more sensitive to vascular endothelial damage. Once the vascular endothelium is damaged, a chain reaction is initiated. On the one hand, vascular endothelial dysfunction of the cavernous artery of the penis can cause insufficient blood supply to the penis and make it difficult to have a congestive erection, which in turn induces ED. On the other hand, systemic vascular endothelial dysfunction will promote the occurrence and development of atherosclerosis, leading to thickening of blood vessel walls and lumen stenosis, affecting the blood supply of important organs such as the heart and brain, and increasing the risk of cardiovascular and cerebrovascular diseases such as myocardial infarction, stroke, and coronary heart disease.
In terms of risk factors, increasing age, smoking, diabetes, hypertension, hypercholesterolemia, obesity, lack of exercise, among others, are both predisposing factors for erectile dysfunction (ED) and high-risk factors for cardiovascular and cerebrovascular diseases. Taking smoking as an example, harmful substances such as nicotine in tobacco can damage vascular endothelial cells, reduce the elasticity of blood vessels, and cause blood vessels to contract. This not only leads to a decrease in blood flow through the cavernous arteries of the penis, which in turn triggers erectile dysfunction (ED), but also increases the chance of developing cardiovascular and cerebrovascular diseases. Similarly, being in a hypertensive state for a long period of time puts the vessel wall under excessive pressure, causing damage to the blood vessels, which both affects the erectile function of the penis and tends to trigger cardiovascular and cerebrovascular accidents.
ED: Early pre-signaling of cardiovascular and cerebrovascular diseases
Clinical studies have shown that erectile dysfunction (ED) often precedes cardiovascular and cerebrovascular diseases as an early warning signal from the body. Penile arteries have thinner diameter and greater sensitivity to vascular lesions than large vessels such as coronary arteries. When the body develops lesions such as vascular endothelial dysfunction and atherosclerosis, the penile arteries bear the brunt of the impact, which in turn leads to erectile dysfunction. According to statistics, numerous patients with cardiovascular and cerebrovascular diseases already present ED symptoms 2-5 years before the onset of the disease. Therefore, the emergence of ED reminds male friends to be wary of the potential risk of cardiovascular and cerebrovascular diseases.
Paying attention to ED: timely screening and comprehensive prevention and control
Given the strong association between erectile dysfunction (ED) and cardiovascular and cerebrovascular diseases, men should never neglect or be ashamed to seek medical attention once they have symptoms of erectile dysfunction (ED) and should promptly visit the andrology or urology departments of regular hospitals.
Physicians usually carry out a comprehensive evaluation, covering detailed medical history inquiries, physical examinations, laboratory tests (such as blood glucose, lipid profile, blood pressure, testosterone level testing, etc.), as well as evaluation of erectile function (such as using the International Erectile Function Index-5 scale, or IIEF-5). With the help of these examinations, physicians are able to judge the etiology of erectile dysfunction (ED) while assessing the risk of cardiovascular and cerebrovascular diseases.
In the treatment of ED, the cause of the disease and the specific condition of the patient need to be considered comprehensively. If ED is triggered by psychological factors, then psychotherapy and psychosexual counseling are particularly critical. They can help patients relieve negative emotions such as anxiety and depression and re-establish sexual self-confidence. If ED is caused by organic factors, in addition to using treatment methods that combine traditional Chinese and Western medicine to improve erectile function, it is also necessary to actively treat basic diseases, such as controlling blood sugar, blood pressure, and blood lipids, quit smoking, limit alcohol consumption, and maintain a healthy lifestyle. For patients at higher risk of cardiovascular and cerebrovascular diseases, further screening and treatment of cardiovascular and cerebrovascular diseases are needed to prevent the occurrence of cardiovascular and cerebrovascular events.
Value prevention: the “line of defence” that protects men’s health
The key to preventing the occurrence of ED and cardiovascular and cerebrovascular diseases lies in developing a healthy lifestyle. It is necessary to “eat a reasonable diet, reduce the intake of high-salt, high-sugar, and high-fat foods, and increase the consumption of vegetables, fruits, whole grains and other foods rich in dietary fiber; it is necessary to exercise regularly and carry out appropriate aerobic exercise every week, such as brisk walking, jogging, swimming, etc.; you should quit smoking and limit alcohol to avoid damage to blood vessels caused by tobacco and alcohol; you should control your weight to maintain the body mass index (BMI) within the normal range; Regular physical examinations are required, especially for men over 40 years of age and those suffering from basic diseases such as hypertension, diabetes, and hyperlipidemia, and regular tests of erectile function and cardiovascular and cerebrovascular related indicators are required for early detection and intervention.
ED is by no means just a “small problem” that affects sexual life. Its association with cardiovascular and cerebrovascular diseases warns every man to pay attention to his own health. When ED symptoms occur, do not hide the disease and avoid medical treatment, respond actively, and go to the hospital for examination in time to check for cardiovascular and cerebrovascular disease risks. At the same time, by practicing a healthy lifestyle, we can prevent the occurrence of ED and cardiovascular and cerebrovascular diseases at their root and protect our health.
Disclaimer: All photos used in this blog are generated by artificial intelligence (AI). These images are original creations produced by AI technology and do not depict real people, places, or events. They are provided for illustrative purposes only and cannot be claimed or used as real photographs.
Dr. Ashish Singh is not just a consultant orthopaedic surgeon but a visionary leader in the field. Serving as the Medical Director at Anup Institute of Orthopaedics & Rehabilitation in Patna, Bihar, he holds an illustrious academic background with MBBS, MS Ortho, MCh.Orth. (UK), PG Diploma CAOS (UK), and SICOT Diploma Orth. (Sweden).
