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You may think that erectile dysfunction, or ED, is strictly a sexual problem. But ED — when you can’t get or keep erections firm enough for sex — can also be a warning sign of heart disease.

What Causes Erectile Dysfunction?

There’s not one single cause of ED. ED has many different causes.

Sometimes, ED has psychological roots. Stress, anxiety, depression, and relationship problems often play a part.

However, most cases of chronic ED are physical.

Causes of erectile dysfunction include:

  • Not enough blood flow to the penis due to heart disease, diabetes, Parkinson’s, or other medical diseases.
  • Nerve damage caused by surgery or radiation in the pelvic area.
  • Side effects from drugs to treat other health problems.

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Is ED “Normal”?

Having trouble getting or keeping an erection happens now and then to all men. Even younger men have occasional bouts of ED, although it’s more common in older men.

But ED is not an inevitable part of aging. It might be a warning sign that you’re developing a chronic disease. If you have ongoing ED, your doctor should screen you for heart disease.

The Connection Between ED and Heart Disease

You may wonder why there is a connection between ED and heart disease. Here’s why: The risk factors that affect your heart health also affect your penis health.

If you have heart disease, plaque builds up in your arteries. Plaque consists of fat, cholesterol, calcium, and other substances found in the blood. The excess plaque build-up leads to atherosclerosis or narrowing of the arteries.

Narrow arteries make it harder for the blood to flow through. The arteries in the penis are already narrow, so cardiovascular problems may show up there first. In fact, erectile problems can be one of the first warning signs of heart disease.

Risk factors for ED and heart disease

ED and heart disease share many risk factors. You’re more likely to develop heart disease and ED if you:

  • Are over 50.
  • Are overweight.
  • Drink too much alcohol.
  • Have diabetes.
  • Have high cholesterol.
  • Lead a sedentary lifestyle
  • Smoke.
  • Use illegal drugs.

When Should You See a Doctor for Your ED?

If your ED is becoming progressively worse, or you can’t get an erection at all, you should see a doctor. You can start with your primary care doctor, but you may need to see a urologist who specializes in ED. You may also need to see a cardiologist, or heart doctor.

Treatment Options for Erectile Dysfunction Caused by Heart Disease

There are several ways to treat ED caused by heart disease.

Lifestyle changes

Sometimes lifestyle changes alone are enough to improve your ED and your heart health. Your doctor may recommend that you:

  • Cut down on alcohol.
  • Don’t take illegal drugs.
  • Eat a heart-healthy diet high in whole grains, lean protein, fresh fruits, and vegetables.
  • Get 30 minutes of moderate exercise 5 times a week.
  • Incorporate pelvic floor exercises into your daily routine.
  • Lose weight if you need to.
  • Stop smoking.


Your doctor may treat your ED with medications such as Viagra and Cialis. You take these medications an hour or so before sex. They increase blood flow to the penis and make an erection possible for many men.

Some ED drugs aren’t safe to use with other medicine. Make sure to tell your doctor what medications you already take.

Surgery and other therapies

If medication and lifestyle changes aren’t enough, your doctor may recommend other options. Specialists can treat ED with:

Whatever treatment your doctor recommends, it’s important to keep in touch regarding any new symptoms or problems. Together you can improve both your heart and your sexual health.

American Heart Association, Erectile Dysfunction May Be Warning Sign for More Serious Health Problems Link

Urology Care Foundation, What Is Erectile Dysfunction? Link

Science Daily, Erectile Dysfunction: A possible warning sign of serious disease Link

British Heart Foundation, Let's talk about…erectile dysfunction Link

About Urology

The UPMC Department of Urology offers a wide variety of specialized care for diseases of the male and female urinary tract and the male reproductive organs, including erectile dysfunction, kidney stones, urinary incontinence, prostate cancer, and more. We have a multifaceted team of physicians and researchers working together to provide the best care to both children and adults. Our team is nationally renowned for expertise in highly specialized technologies and minimally invasive surgical techniques. To find a provider near you, visit our website.