The Link Between ED and Heart Health

By Natalya Lopushnyan, MD
Medically reviewed checkmarkMedically reviewed
February 10, 2021

What Is Erectile Dysfunction?

Erectile dysfunction (ED), or impotence as it sometimes referred to, is the inability to get and keep an erection that is firm enough for sexual intercourse. One of the reasons why it may happen is that there is not enough blood flow to the penis.

While ED is not something that most people talk about, it is very common. Approximately 40% of men in their forties experience some degree of ED, and the number of men with this condition increases progressively with age

In order to have a good erection, you need three things:

  1. a penis
  2. open blood vessels to deliver blood to the penis
  3. functional nerves to cause excitement and signal blood vessels to increase the blood flow

If the blood vessels are clogged or damaged, or blood flow is not strong enough, erections will suffer.

If we look at the medical studies, there are a couple of mechanisms for how ED may be a result of cardiovascular disease.

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Atherosclerosis (Plaque in the Arteries)

The most obvious way that heart health & ED are linked is through the buildup of plaques in the arteries (atherosclerosis). This process does not preferentially affect some arteries and not others, it affects the vasculature in the whole body.

The smaller the artery the sooner the negative effect of atherosclerosis will be seen and the artery will be blocked (occluded).

It just so happens that some of the smallest arteries in a man’s body are the penile arteries. The diameter of those vessels is only about 1mm or 1/25th of an inch! Given that, it is not surprising that they get occluded in no time and blood flow to the penis worsens. 

The next smallest arteries in a body are the ones that supply the heart. The diameter there is only about 3-4mm or 1/8th of an inch.

Because of this, it is common to see serious heart issues (such as heart attack) happen in men about five years after they start experiencing ED. This is most important to note in younger men (under the age of 40) with ED, as your doctor will want to make sure you do not have early signs of heart issues.

What are the Common Risk Factors for ED & Heart Disease?

Since ED and heart disease have a lot in common in terms of causes, they also share similar risk factors. Pretty much anything that can affect the vasculature can cause both ED and heart disease.

The most common risk factors that are seen in both are:


Both heart condition and erection quality reflect the man’s overall health. The healthier you are the better your heart and penis will work!

Lifestyle choices have a huge impact. Eating healthy, maintaining normal weight, treating high blood pressure and diabetes, controlling your cholesterol levels, and avoiding smoking and drug use can reduce the risk of cardiovascular disease and improve the erections.

What are the Treatment Options for ED Caused by Heart Disease?

Certain lifestyle changes can improve both ED and heart disease.

The most obvious changes that any man can implement are smoking cessation, weight loss, and improved diet. Specifically, men who stopped smoking for a year, have reported 25% improvement in their erections while a third of men who committed to a weight loss program reported that their ED has virtually disappeared. 

If the lifestyle changes are not enough, then we would want to focus on treatments that improve erections by bringing better blood flow to the penis. There are a couple of options for that.

Oral medications

The most common medications for ED are:

All of these medications work on increasing blood flow to the penis by relaxing the blood vessels that deliver blood. 

Penile injections or suppository

These are generally used for men who do not respond to the oral medication treatment options for ED.

Intraurethral suppository is essentially a small pellet of Alprostadil (medication that improves blood flow to the penis) that is inserted into man’s urethra to aid the erection. It is absorbed and starts working within 10-15 minutes. 

Penile injections also contain compounds that allow a better blood flow to the penis. A man will self-inject a small amount of medication into a side of the penis 10-15 minutes before intercourse. Because these injections are delivered directly to the penile tissue, they frequently work in men who have failed oral medications. The dose can also be titrated easily to achieve the desired effect.

Penile implant

For men with severe ED, who do not respond to other options, there is an option called Inflatable Penile Prosthesis (IPP). IPP is a hydraulic device that is implanted inside the penis and replaces the erectile tissue. It is a very reliable method to treat ED, however, it involves surgery and post-surgical recovery. 

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How K Health Can Help

At K Health, we offer comprehensive erectile dysfunction care & treatment options from your phone. Download the K Health app to see a doctor and receive a prescription delivered discreetly to your door. Read more about the K Health ED treatment options here.

When to See a Doctor

You should see a doctor if you have any suspicion your heart health is in trouble. Those signs include chest pain or discomfort, shortness of breath with exertion, and decreased exercise tolerance. 

In terms of ED, if you are having occasional trouble it is generally not a cause for concern. Oral medication can help treat your symptoms when you have them. However, if you have persistent problems with getting or maintaining your erections, it is a good idea to get evaluated. It is especially important in men with ED younger than 40 and those who have a family history of heart attacks or other heart issues.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Natalya Lopushnyan, MD

Dr. Natalya Lopushnyan is a board certified Urologist specializing in Men's Health. She earned her degree in Biochemistry from University of Massachusetts Boston, graduating Summa Cum Laude. Her MD is from Yale. She completed Urology Residency at the University of Washington in Seattle.

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