Men who experience erectile dysfunction may be experiencing the onset of more serious cardiovascular diseases, according to at least two British doctors.
One doctor went as far as to suggest screening men for erectile dysfunction and low levels of testosterone are two of the most effective ways to assess coronary risk in the future.
"For years, I have seen patients referred (to me) with erectile dysfunction after a coronary event to hear that they developed erectile dysfunction two to three years beforehand," Dr. Geoffrey I. Hackett, consultant in sexual medicine at Good Hope Hospital in Birmingham, U.K., wrote in an open letter posted on the British Medical Journal website.
When small arteries in the penis become blocked, it can be an early warning sign of a myocardial infarction -- or a lack of blood to the heart -- Hackett noted.
Anne L. Appleton, a clinical research physician in the U.K. agrees with Hackett's theory.
"The clinical manifestation of such dysfunction occurs earlier in the penis than elsewhere, due to the narrower bore of the penile vessels in comparison to those of, say, the lower limb or even the coronary arteries," Appleton wrote on the British Medical Journal website.
Doctors have long been overlooking this critical indicator, suggested Hackett. The taboo subject matter may be keeping doctors and patients from discussing the condition openly.
"Continuing to ignore these issues on the basis that cardiologists feel uncomfortable mentioning the word 'erection' to their patients is no longer acceptable and probably clinically negligent," Hackett wrote.
Most medications prescribed for coronary heart disease can make erectile dysfunction worse, but there are some drugs that improve the problem, said Hackett.
In Britain patients often pay from pocket for these brands since erectile dysfunction is treated as a "lifestyle" issue.
"It is time to change societal attitudes towards erectile dysfunction, from that of a 'lifestyle' or 'choice' issue, to that of a serious public health concern," Appleton wrote.
Men who suffer from erectile dysfunction carry an additional 50 per cent risk of experiencing a major coronary event, a rate comparable to the risks associated with moderate smoking and even a family history of heart disease, wrote Hackett.
He also said erectile dysfunction in men with type 2 diabetes is a better predictor of cardiovascular risk than the following conditions:
- hypertension (high blood pressure)
- microalbuminuria (a kidney defect)
- hyperlipidaemia (high levels of fat in the bloodstream)
Hackett suggest screening type 2 diabetes patients for erectile dysfunction and low testosterone levels could help those men develop a preventive plan.
There is an ongoing and polarized debate in the medical community about screening males for relative risks of suffering a major cardiovascular event.
On one side of the debate are those in favour of assessing only high-risk patients, and on the other are those campaigning for population-wide approaches.
The British Department of Health suggests up to 9500 heart attacks and strokes and 2000 deaths could be prevented each year by an active screening program, including blood tests and history checks, to manage vascular risk in people aged 40 to 74.
The letters were published on the British Medical Journal's website.
