Heart Disease & Sexual Health

 

Heart Disease & Sexual Health

ED and heart disease linked
Men who have coronary heart disease often have ED. One study of 300 men with angina and documented coronary disease found that 49% had ED. Conversely, men with ED have a high likelihood of coronary disease. A study analyzing nearly 13,000 men found that after adjustment for other risk factors, men with ED had double the risk of myocardial infarction compared with men without ED.

Sexual dysfunction may precede the onset of coronary symptoms. One analysis found that ED developed nearly three years prior to the onset of angina.

Why erections fail
When a man becomes sexually excited, nerve signals trigger release of a chemical that dilates the arteries supplying the penis. Blood flows into the penis, causing an erection. At the same time, veins draining the penis compress, maintaining the erection by preventing the outflow of blood. Disorders that either interfere with the nervous system or blood supply of the penis can cause ED.

Drugs to the rescue
Treatment of ED was revolutionized in 1998 with the release of sildenafil (Viagra). This drug was followed by vardenafil (Levitra) and tadalafil (Cialis). All work by inhibiting an enzyme (PDE5) that breaks down a chemical that dilates blood vessels (cGMP). With more cGMP, penile blood flow is enhanced and the erection is improved. These medications will not produce an erection in the absence of sexual arousal.

Viagra and Levitra are relatively short-acting drugs, beginning to work within 30-60 minutes with an effect lasting four hours. Cialis begins to work within 30 minutes, but has a much longer duration of action of 24-36 hours.

 

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Last Modified Date: May 15, 2013

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