International Men's Health Week is generally observed in the third week of June. This year it is observed from June 12 to 18 with an aim to focus on men's health. We talked to Dr Aditya Pradhan, Director - Uro-oncology and Kidney Transplantation, Venkateshwar Hospital, Dwarka, New Delhi, to learn about one of the most common health issues in men, Erectile Dysfunction (ED) and how it is related to heart disease. It is a common phenomenon among men who have coronary heart disease. It is a condition where men are unable to achieve or keep an erection firm enough for sexual intercourse.
"Often people overlook one health condition when they are suffering from other severe health conditions. The interconnection between two conditions is often ignored without proper medical attention. However, we must understand that disease is often caused by multiple factors and could be an indicator of more than one problem," said Dr Pradhan. Citing an example, he said that people do not relate a sexual ailment like ED with heart disease.
Erectile Dysfunction and Heart Diseases: How Are They Linked?
According to estimates from 1995, the number of men globally affected by ED exceeded 152 million. However, projections for 2025 indicate a significant rise, with approximately 322 million men expected to have ED, marking an increase of nearly 170 million individuals, as per the journal BJU International. The most substantial growth is anticipated in the developing regions, namely Africa, Asia, and South America, the journal noted.
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Considering its prevalence we should learn how it can lead to other health-related complications, such as heart disease. "ED could be an early manifestation of heart-related ailments. This is why it is crucial for men with ED to check for risk factors to prevent Cardiovascular Diseases (CVDs) in future," said Dr Pradhan.
He noted that not all patients at high CVD risk have traditional risk factors. "It's critical to include both conventional and non-conventional risk factors in men with ED. Several variables that result from a thorough clinical examination of people with ED have shown to be reliable indicators of CVD diseases. High blood sugar, elevated triglycerides, obesity, metabolic complications, and decreased penile blood flow are some of these," he said.
"Other risk factors include alcohol abuse, fatherhood, decreased partner sexual interest, and severe impairment in erection during sex or masturbation," he added.
Currently, some experts hold the belief that the occurrence of erectile dysfunction before heart issues is primarily attributed to the dysfunction of the inner lining of blood vessels, known as the endothelium, as well as smooth muscle problems. When the endothelium is impaired, it leads to insufficient blood supply to the heart and compromised blood flow to the penis. This dysfunction of the endothelium also contributes to the development of atherosclerosis.
"Understanding these risk factors may aid in determining whether ED patients require lifestyle modifications or surgical treatment options for both ED and heart problems," said Dr Pradhan. "Along with lowering CVD risk, effective management of high-risk factors in men suffering from ED can also enhance erectile function," he added.
Causes and Treatment
A modern lifestyle characterised by sedentary activities, inadequate nutrition, an increase in cortisol, and consumption of substances, such as alcohol and tobacco has proven to be one of the key contributing causes for both diseases. "All of these can lead to several health issues, such as diabetes, high blood pressure, and obesity which are considered to be risk factors for ED as well as heart problems," said Dr Pradhan.
"As far as timely treatment is concerned, a major step in this direction would be to facilitate a safe and healthy environment for men to discuss sexual health openly and honestly," he said.
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"A lifestyle change leading to better heart health would inevitably lead to better reproductive health. One should consider increasing their physical movement, maintaining a healthy weight, and avoiding substance abuse, such as smoking and alcohol. Symptoms of higher intensity should be assisted with additional testing or medical intervention," he added.
According to Dr Pradhan, sex therapy is found to be helpful when there is a significant psychological component to ED and when management through medication seems inadequate. "In addition to dietary and lifestyle changes, oral medical therapy is also prescribed by doctors depending upon the medical condition of the person," he added.
Penile implantation is also a quite successful treatment option. "They are devices that are inserted inside the penis to help people with ED to get an erection. Penile implants are frequently advised usually after other ED therapies fail," he said.
"With this implantation, Peyronie's disease, which results in curved, painful erections due to scarring inside the penis, can also be treated. They can be utilised at any time and gives the male control over his body again," said the doctor. He explained that a penile implant restores spontaneity and enables a man to acquire an erection without any planning or waiting, in contrast to traditional therapies for ED.
Need for Awareness
Dr Prasdhan said, "A lot of men find it difficult to talk about ED as any other health problem due to the stigma attached to the condition. Many also believe in the myth that there is nothing that can be done about it." He added that more than 30 per cent of men ages 40–70 years suffer from ED, as per Massachusetts Male Aging Study. Hence, there is an urgent need to spread awareness regarding ED in order to minimise the stigma attached to it and the notion that it is something embarrassing to be talked about. "Seeking the right medical help and treatment at the right time can provide a complete cure," he concluded.
[Disclaimer: This article is issued in the public interest and for educational purposes only. The content of this article is not meant to provide medical or clinical advice. Consult your doctor for more information to get a thorough diagnosis and treatment as per your health needs.]
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