Sexual Health Q&A

Can erectile dysfunction (ED) be a symptom of other medical conditions?

Erectile dysfunction (ED) has been associated with a number of other medical conditions:

  • Cardiovascular disease (heart disease). It’s quite common for men with ED to have cardiovascular disease. The connection usually stems from atherosclerosis, or hardening of the arteries. When a man has an erection, his penis fills with blood. So, to have an erection suitable for sex, he needs to have good blood flow to the penis. Plaque buildup in the arteries from atherosclerosis interferes with this blood flow. With less blood in the penis, a man has erectile dysfunction. Often, ED is a sign of cardiovascular disease, as atherosclerosis usually begins in smaller arteries, such as those in the penis.
  • Diabetes. Diabetic men may be four times more likely to have ED than men without diabetes. Also, diabetic men may start having erectile problems at a younger age, sometimes 10-15 years earlier than men without diabetes.

High blood sugar from diabetes can damage blood vessels and lead to hardening of the arteries, preventing good blood flow into the penis. It can also cause neuropathy, or nerve damage, which interferes with the transmission of messages between the brain and the penis that start an erection.

In addition, diabetes can interfere with the production of nitric oxide, an important chemical for erections. It may also contribute to the stiffening of erectile tissue.

  • High cholesterol. Too much low-density lipoprotein (LDL or “bad” cholesterol”) can build up on artery walls, leading to atherosclerosis and erection problems.
  • Obesity. It’s estimated that obese men are two and a half times more likely to have erectile dysfunction than men who are not obese. Obesity raises a man’s risk for cardiovascular disease and diabetes which, in turn, can lead to erectile dysfunction.
  • Respiratory disorders. Research has shown that men with ED are more than twice as likely to obstructive sleep apnea as men without ED.

ED has also been associated with chronic obstructive pulmonary disease (COPD), possibly because of atherosclerosis that develops from smoking cigarettes.

  • Neurological problems. Because erections depend largely on communication between the brain and penis through a network of nerves, men with neurological problems such as stroke, multiple sclerosis, Parkinson’s disease, and spinal injuries may have trouble with erections.
  • Kidney disease. Chemical changes prompted by kidney disease can cause problems with nerve function, hormones, and blood flow, all of which can lead to erectile dysfunction. Some medications used to treat kidney disease can cause ED, too.
  • Liver disease. Hormones, including testosterone, may fluctuate in men with liver disease, prompting ED.
  • Depression

Men with ED who are concerned about any of these conditions should speak to their doctor.