Some men are surprised to learn that erectile dysfunction (ED) in men younger than 50 may be connected to heart disease. In fact, the younger you are, the more likely it signals a heart disease risk.
“Erectile dysfunction, low testosterone and infertility can all be indicators of greater health risks,” says Dr. H. Merrill Matschke, a urologist and men’s health medical director at Aurora Health Care. “When the patient is young and there’s no clear cause such as trauma, it’s a good idea to screen for heart disease before starting any treatment. Patients are surprised to learn the two issues are linked.”
Just how are they linked? The connection is likely due to dysfunction of the inner lining (endothelium) and smooth muscle of the blood vessels. This is called endothelial dysfunction, which is the main culprit of the narrowing of arteries that supply blood to the heart as well as damage to the vascular hydraulics of the penis.
Plaque buildup in the arteries (atherosclerosis) also reduces blood flow in the penis.
“When a patient comes to me for an ED or fertility issue, it’s like a canary in the coal mine. I know he could be a cardiac patient,” Dr. Matschke says. To make his point, Dr. Matschke uses the mnemonic device: “ED = ED = ED” — which translates as “endothelial dysfunction equals erectile dysfunction equals early death.”
Understanding the underlying issues of ED and its connection to heart conditions also influences treatment decisions. “When there is a potential heart condition, we opt for regenerative therapy through low intensity shock wave therapy (LISWT) rather than the pharmaceutical treatment,” Dr. Matschke explains.
With LIWST, the shockwave harnesses the body’s own healing pathways by releasing vascular, nerve, and stem cell growth factors to heal the damaged tissue in the erectile cylinders of the penis. “It’s a reasonable part of an integrated treatment approach for the right patient. It’s low to zero risk and can be successful with no long-term medication required.”
Men’s health centers offer patients a deeper, holistic view to help them stay healthy through their lives, rather than treating isolated issues as they come up. “The issues of ED and cardio health are directly related, so your care team will help you find a solution that keeps both conditions in mind,” he explains.
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