His Most Private Health Risk

His Most Private Health Risk

Erectile dysfunction is a leading indicator of heart trouble. Keep him--and your romance--healthy with our tips.

Turn on the TV, and you'll likely see an ad hyping erection-boosting drugs. But erectile dysfunction, or ED, is a health issue that's rarely mentioned in any other context. It should be--and not for the obvious reasons. Although an injury or a psychological trigger such as depression can cause ED, many studies show that repeated difficulty having or sustaining an erection is a serious indicator of heart trouble, especially with age. "When a man walks into a doctor's office complaining of erection problems, chances are his heart is in trouble as well," says Irwin Goldstein, MD, director of sexual medicine at Alvarado Hospital in San Diego.

Urologist Ian M. Thompson, MD, of the University of Texas Health Science Center at San Antonio, revealed the extent of the problem when he reported in the Journal of the American Medical Association (JAMA), that men ages 55 and older with ED have a 55% greater risk of developing cardiovascular disease, resulting in a heart attack or stroke, than men without this problem.

The older a man gets, the more likely he'll experience ED. Prevalence soars from 9% in 40-something men to 15% for those in their 50s and 29% for those between 60 and 69, according to a study in the Journal of Sexual Medicine. If your partner is experiencing ED, he should review his heart health with his primary care physician and perhaps visit a cardiologist as well.

ED and heart health are linked because both depend on tiny arteries. Vessels in the penis, which deliver the blood that causes this organ to expand, are just as susceptible to narrowing and clogging as those in a man's heart, says Goldstein. Because penile arteries are smaller than those in the heart, they're often the first to show effects of bad habits, such as smoking or eating fatty foods.

If your partner's ED means he has heart issues, his cardiologist may okay Viagra or other ED drugs if the cardiac problems are not extensive, says Thompson. Who can't use them: those with serious heart disease and those who take nitrate medicines. (Men with diabetes can use ED drugs but may find they don't work well.)

Medication isn't the only choice, though. Experts say lifestyle changes can improve ED and even reverse it in some cases--and they'll certainly do his heart good. Here are six options:
Lose Weight. Simply shedding pounds allowed one-third of obese midlife men with ED to regain, within 2 years, their ability to have an erection, reported Italian scientists in JAMA. The extra weight restricts blood flow and increases inflammation in blood vessels, upping risk of both ED and heart disease. The researchers say that the men in the study reversed these changes by cutting calories to about 1,700 per day during the first year of the study and to 1,900 after that. They also exercised--walking, swimming, or playing aerobic sports such as soccer-- for about 3 hours per week.

Start Moving. No matter what a man's weight is, exercise can help solve ED issues, says Elizabeth Selvin, PhD, MPH, an assistant professor of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health. The more energetic the activity, the better. After analyzing a nationwide health and nutrition survey, she reported that men who work out vigorously have an ED risk of just 10%. In contrast, moderate exercisers more than double their risk (22%); sedentary men hit 26%.

But beware: If the exercise a man chooses is bicycling, he should use a wide, noseless seat, not a long, narrow one, researchers say. Narrow seats press on the groin's nerves and blood vessels, affecting blood supply to the penis.

Stop Smoking. According to Thompson, smokers have a 60% higher risk of ED. "Smoking affects the ability of blood vessels to expand and produce an erection," he explains. Nearly 23% of ED in Chinese men ages 35 to 74 was linked to cigarette smoking, report experts at Tulane University. And the more a man lit up, the more problems he experienced: Those who smoked up to 10 cigarettes per day had a 27% greater chance of developing ED, while those who smoked more than 20 cigarettes daily were 65% more likely to have the condition.

Cut Back on Alcohol. Even a drink or two can affect some men's ability to have and sustain an erection. An analysis published in the International Journal of Impotence Research in 2007 found that downing eight or more drinks per week seems to raise the risk of ED, though the reason is unclear.

Fend Off Diabetes. A study by Selvin found that 50% of males with type 2 diabetes have ED. Other studies have found that men with diabetes have lower testosterone levels, which affects libido. However, Selvin says, a man can reduce his probability of getting diabetes by using diet and exercise to avoid what is often its precursor: metabolic syndrome, a constellation of traits including high cholesterol, high blood pressure, and excess abdominal fat.

Get Him Talking. For some men with ED, it's not all physiology. Psychological issues may also be to blame-- and talking can help. According to a Cochrane Collaboration Systematic Review, 95% of the men in a psychotherapy group who discussed their ED with fellow sufferers said good-bye to persistent problems with erectile dysfunction, while others without treatment had no improvement. A man can find a group with the assistance of his physician or a therapist.