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Men, don’t die of embarrassment

09 February 2016

Health Care

Having trouble downstairs? It’s a sensitive issue but ‘performance issues’ could actually be an early indicator of heart disease.

Valentine's Day and sex, the two go together like, well, you know. But evidence suggests that men who have issues in the bedroom may have issues of the heart, not in the love sense, but potential heart disease.

Erectile dysfunction (ED) is the persistent inability to maintain a penile erection sufficient for a satisfactory sexual performance, it is often the source of jokes and titters, and it's not generally something either partner goes round admitting. But silence could be a killer in the form of a heart attack waiting to happen.

Crucially this isn't something impacting just older men it can also affect younger men in their early 40s due to lifestyle choices, which is exactly why there are more young people being seen with diabetes as well.

Staff from the cardiac and medical day stay centre at Southend University Hospital are now hoping to raise awareness of this issue and help safe lives of Essex men.

Emma Matthews, a sister on the ward, said: "For men it can feel like losing part of their masculinity, just in the same way as some women say they can feel less like a women if they lose a breast. And that can have a serious effect on a marriage or relationship which then causes depression. This only adds to the heart disease issue so other related side effects of the condition are just as serious."

Sharon Wallace, also a sister on the ward, added: "Men are renowned for not speaking up about health issues or going to see their doctor, and especially something that could be seen as being embarrassing like erectile dysfunction. It's important they and their partners get past that and look at the more serious health implications as a large number of men with erectile dysfunction show early signs of coronary artery disease (CAD), and this group may develop more severe CAD than men with erectile dysfunction. 

How is it an early indicator?

Sharon said: "The blood vessels of the penis are smaller than those of the heart, the diameter of a piece of dry spaghetti in comparison to that of a drinking straw. Because of this it can become what is often referred to as becoming furred up, that's the inside of arteries becoming narrower.

"With less blood passing through the penile artery the result can be 'unsatisfactory', and that isn't the sort of thing that someone casually drops into conversation. If erectile dysfunction is caused by narrowed arteries then there is significant risk of heart disease."

This furring up process can occur due to high blood pressure, diabetes, high cholesterol, smoking, being overweight or being physically inactive. To combat its onset it's the usual balanced lifestyle message of low salt, low cholesterol, a low calorie diet, exercise, quitting smoking and medications. All of which have been reported to improve function.

So what can be done?

Emma said: "If anyone or their partner is experiencing ED then they should book an appointment with their GP. It doesn't have to be if it happens once or twice but whenever it becomes a concern or a significant issue.

"A GP may talk to them about any other symptoms that they are experiencing and that could flag up something more serious, in that instance they may get referred to a specialist or to an erectile dysfunction clinic."

The time interval between the onset of ED symptoms and the occurrence of coronary artery disease symptoms and a cardiovascular event, such as a heart attack, is estimated at two to five years. That's not long but there is a real window of opportunity for aggressive risk factor reduction, such as medication and weight loss. The earlier it can be diagnosed the better.

Sharon concluded: "When people come to use we already know about their heart disease, this is about raising awareness in men of all ages and trying to prevent that situation. Erectile dysfunction is a critical predictor of cardiovascular disease, so if this article helps just one person recognise the relationship between erectile dysfunction and coronary artery disease then it will help improve and save lives. The early warning signs are there but people just need to know where to look."

The message is clear, erectile dysfunction may be seen to be humiliating by its sufferers, but they certainly shouldn't die of embarrassment.