Men’s Health

“A man too busy to take care of his health is like a mechanic too busy to take care of his tools.”

- Spanish Proverb

Heart of the matter

Erectile dysfunction

Erection troubles could be a tell-tale sign of future heart problems. 

Did you know that there’s a very strong link between erectile dysfunction and heart disease?

In a recent survey conducted by Pharma Dynamics, 23 percent of men admitted to suffering from erectile dysfunction (ED) and 12 percent said they had lived with the condition for years. With the help of Cape Town-based urology consultant, Dr Kenny du Toit, we explore the connection between these two conditions and how they can be prevented.

ED demystified 
The inability to achieve and sustain an erection for pleasing sexual penetration is called erectile dysfunction. This is often a symptom of an underlying disease process. In this case, it’s atherosclerosis. Atherosclerosis describes the hardening of the arteries due to an excess of plaque build-up, and is the most common cause of erectile dysfunction. This affects the blood vessels supplying the heart and the blood vessels throughout the body.

As time goes on, atherosclerosis results in less blood flowing through the affected blood vessels, which may cause cardiovascular problems such as angina, heart attacks and strokes. Because an erection requires a steady flow of blood to the penis, it can also cause erectile dysfunction.

Early warning
The blood vessels to the penis are much smaller than the vessels to the heart. The smaller the blood vessels, the earlier they are affected. This is why erectile dysfunction often precedes heart disease.

Another explanation for the onset of erectile dysfunction before heart disease is a condition known as endothelial dysfunction, which is the inability of the blood vessels to dilate properly. This condition causes insufficient blood supply to the heart and impairs blood flow to the rest of the body including the penis. It also aids in the development of atherosclerosis.

According to The Heart and Stroke Foundation of South Africa, erectile dysfunction usually occurs three to five years before a heart attack or stroke.

Are you at risk?
Erectile dysfunction shares many risk factors with heart disease.  As such, both conditions could be regarded as two different manifestations of the same systemic disorder. Risk factors to be aware of include:

Obesity: being overweight is associated with low testosterone, the main male sex hormone, which can cause or worsen erectile dysfunction.
Diabetes: diabetes can cause nerve and artery damage, which can make achieving an erection difficult.
Hypertension: high blood pressure can damage your arteries, which can restrict blood flow to the penis, causing erectile dysfunction.
High cholesterol: high cholesterol levels can clog your arteries, which can lead to atherosclerosis.
Familial dyslipidemia: this is a genetic disorder characterised by very high blood cholesterol levels. As mentioned above, high cholesterol can lead to atherosclerosis, and over time, erectile dysfunction.
Alcohol use: nearly half of South African men could be at risk of erectile dysfunction due to excessive drinking. Clinical studies suggest that three or more standard alcoholic drinks a week significantly impair erectile function and sexual satisfaction.
Smoking: smoking causes blood vessels to constrict, which can reduce blood flow to the penis. In the long run, this can bring on issues around obtaining and maintaining an erection.
Age: erectile dysfunction is common as men age. As you get older, erections may take longer to develop and may not be as firm. Having erection problems at an early age, however, may indicate a risk of heart disease.

Prevention is better than cure
Your lifestyle plays an important part in preventing and managing erectile dysfunction, as well as heart disease. Do this now:

  • Quit smoking.
  • Exercise regularly.
  • Maintain a healthy body weight (A BMI below 25 is ideal).
  • Consume alcohol in moderation – if at all.
  • Follow a balanced diet.

These lifestyle tweaks are especially important if you already have one or more of the risk factors. Don’t skip visits to your GP either. Have your blood pressure, cholesterol levels and blood glucose checked regularly. Knowing your risk for both conditions can save your life.

If you are currently experiencing erectile dysfunction and/or have heart disease, get treatment as soon as possible. Talk to your doctor about your treatment options. Early treatment has the best results and success rates.

Myths, busted

Myth: It’s going to get better on its own.
Fact: It never does. Get treatment as soon as you can.

Myth: Erectile dysfunction is impossible to treat.
Fact: There are easy and effective treatments available.

Myth: Since it is treatable, delaying treatment should be fine.
Fact: The earlier you treat erectile dysfunction and its underlying causes, the better.

Myth: You have been cursed by an ex.
Fact: As much as you want to believe this, it’s far from the truth!

(Disclaimer: The purpose of this article is to provide general background information and not to substitute any medical diagnosis or advice received from a qualified healthcare professional.) 


Erectile dysfunction – a red flag for cardiovascular disease. The Heart and Stroke Foundation South Africa. 2015. (Online) Available at: Accessed: w/c 27 October 2015

Schwartz, B. G., & Kloner, R. A. Cardiovascular implications of erectile dysfunction. Circulation, 123(21), e609-e611. 31 May 2011. (Online) Available at: Accessed: w/c 2 November 2015

Beyond Sex: Erectile Dysfunction Could Spell Heart Trouble. U.S. News & World Report. 14 October 2015. (Online) Available at: Accessed: w/c 2 November 2015

Heart Disease & Erectile Dysfunction. Cleveland Clinic. 13 April 2012. (Online) Available at: Accessed: w/c 27 October 2015

Erectile dysfunction: A sign of heart disease? Mayo Clinic. 1 August 2015. (Online) Available at: Accessed: w/c 27 October 2015

SA men lose more hair than erections. Health24. 13 March 2015. (Online) Available at: w/c 2 November 2015

Reviewed by
Dr Kenny du Toit, Urology Consultant

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