A man's heart is connected to his penis in more than a figurative way—and not surprisingly, since from a physiological point of view, an erection is certainly an affair of the heart. Both erectile dysfunction and impaired heart function can be caused by reduced blood flow, which can happen when blood vessels become less flexible because of smoking or high blood pressure, for instance, or reduced production of nitric oxide. This substance causes vessels in the penis (and elsewhere) to dilate, allowing for increased blood flow and thus an erection. Some drugs for erectile dysfunction boost nitric oxide.
Erectile dysfunction shares many risk factors with cardiovascular disease, notably increasing age, smoking, diabetes, depression, obesity, physical inactivity and high blood pressure. Thus, erectile dysfunction is often a reliable predictor of heart disease and stroke.
Remember, however, that many other factors can also cause erectile dysfunction besides incipient or actual circulatory problems—notably nerve disorders, excessive alcohol consumption, low testosterone and certain medications, particularly sedatives and some antidepressants.
The heart of the matter: If you have erectile dysfunction, consult your doctor. There are drugs to treat it, but they should not take the place of a careful diagnosis. Moreover, they are not appropriate for all men and may have serious side effects. You may want to talk to a psychotherapist if erectile dysfunction has caused problems in your life (or the other way around). You should rule out diabetes and high blood pressure, and begin treating these conditions if you have them. Whatever improves the health of your heart and blood vessels is likely to improve your erections, too.
Some actions you can take on your own:
• If you smoke, quit. Smoking increases the risk of erectile dysfunction.
• Check your blood pressure and cholesterol levels regularly, and do what's necessary to keep them at healthy levels.
• Exercise for 30 to 60 minutes most days—walking, cycling, swimming or a sport you like.
• Avoid excessive alcohol consumption—no more than two drinks a day.
• If you think medication may be causing erectile dysfunction, ask your doctor if you can switch to another drug.