Erectile Dysfunction
Overview
Erectile dysfunction is defined as the inability to acquire or maintain an erection for sexual intercourse. Sexual dysfunction has been reported in men as young as 18 years old, although the majority of men with erectile dysfunction typically start to experience symptoms in their 40s. Most men with erectile dysfunction falsely chalk it up to a natural consequence of aging. However, many men with erectile dysfunction may face an even tougher health problem: heart disease. That's the conclusion of a number of studies presented at an annual meeting for the American Urological Association (AUA). All studies found strong connections between the two conditions. In one paper, Austrian researchers note a relationship between high blood levels of homocysteine, an amino acid marker for heart disease, and erectile dysfunction. The researchers found that 20 of the 30 patients with erectile dysfunction they studied also had high homocysteine levels. Both erectile dysfunction and heart disease are also caused by a dysfunction in the lining of the blood vessels, or endothelium.
Symptoms
Typical symptoms of heart disease--chest pain, shortness of breath, excessive fatigue, etc.--may not be present. Many people without the classic symptoms of heart disease are often not worried about their heart. Often times, most people will present to their healthcare provider with erectile dysfunction as their only concern. However, erectile dysfunction can often be the first symptom to alert patients and their healthcare providers that their may be a larger problem at play.
Risk Factors
Risk factors for heart disease include obesity, advanced age, smoking, high blood pressure, high cholesterol, diabetes and family history of premature heart disease. If you have one or more of these risk factors, as well as erectile dysfunction, talk to your doctor about your risk for heart disease.
Screening
Prior to treating your erectile dysfunction with prescription drugs, see your doctor and discuss your risk for heart disease. Screening for heart disease may involve an EKG, and depending on your EKG results and/or risk factors, your physician may also order a cardiac stress test. Aside from screening for heart disease, review your medication list with your healthcare provider. Bring a list of all of your medications to your appointment for your physician to review. There are several medications that can cause or worsen erectile dysfunction, such as anti-depressants, certain diuretics and some anti-fungals. Your physician may also want to order some blood tests to examine your hormone levels, including thyroid hormone, testosterone and prolactin. You may want to mention to your healthcare provider if you think that psychological issues such as anxiety surrounding sex, or a poor relationship with your partner, may be contributing to your sexual dysfunction. Remember that most good, experienced healthcare providers are genuinely interested in getting to the root of your problem, and are trained to be non-judgmental. You should feel comfortable having a frank and honest discussion. Omitting important details regarding your symptoms may keep your physician from reaching an accurate diagnosis. If you don't feel comfortable discussing your symptoms with your current healthcare provider, shop around until you find someone who you think is non-judgmental and with whom you feel comfortable.
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