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The Heart of Erectile Dysfunction

July 30th, 2014


The Heart of Erectile Dysfunction

Recently, there has been a study that shows relationship between erectile dysfunction and coronary artery disease. This does not come as a surprise, actually, since both are a result of insufficient blood flow to support the organs to work properly.

Coronary artery disease or ischemic heart disease occurs when there is atherosclerotic plaque (buildup of cholesterol and other materials) within the heart own blood vessels, narrowing down the blood vessel and obstructing the blood flow to the heart muscle.


The arteries are 2-4 millimeters in diameter, but there are also smaller capillaries invisible to the naked eyes or X-ray machine. The three main arteries, when narrowed, will give the body various symptoms such as tiredness, breathlessness, tightness in the chest, and pain in the jaws, shoulders and arms when doing strenuous activity. These symptoms usually go away on their own after rest, which is when the heart slows down.  This symptom is called “angina pectoris” or “angina” in short.

As for erectile dysfunction, it is quite the same. In order for the male reproductive organ to erect, it needs extra blood flow to the organ until it swells up in size and hardens. Think of injecting water inside a balloon.

But if something is wrong with the blood vessels that supplies blood to the penis, there will be less blood flow. The cause could be narrowed blood vessels of the organ, or a result of less blood being pumped from the heart to the penis. Other than those two causes, some medicine, especially heart disease medicines, can cause erectile dysfunction as a side effect.

A study conducted among 221 men who had an abnormal treadmill (stress test for the heart) test revealed that half of them had erectile dysfunction. However, erectile dysfunction seemed to be more prevalent among the older men, as well as those with diabetes and high blood pressure. More interestingly, there is high chance that people with these risk factors but had normal treadmill test result will also be diagnosed with erectile dysfunction later in life. Other studies have found that erectile dysfunction could be an early warning for impending heart disease.

As a matter of fact, narrowed artery can befall any part of the body, but the symptoms would only show at parts that need more blood supply, such as the heart, brain and kidneys. The penis, sometimes, needs that extra blood supply to be, let’s say, alive.

It is quite a surprise that there is report from China that the External CounterPulsation (ECP), a new non-invasive treatment for artery blockage of the heart, is reportedly effective in improving erectile dysfunction among those with coronary artery disease.

I was at an international conference in China about the use of ECP, and I was informed that using this machine, usually used on legs, were used to treat other parts of the body such as treating paralysis, kidney failure, retinal artery blockage, meniere’s disease (disorder of the inner ear), wounds at feet and legs as a result of insufficient blood flow, and erectile dysfunction. It is particularly popular in China.  But benefit in these conditions needs to be confirmed by larger studies.

I had a male patient in his 80’s who had coronary artery disease and he had received a bypass surgery a few years before he came to see me. Only a year after the surgery, the tightness in the chest returned despite the fact that he was on medications.  An imaging test showed that the three out of four bypassed arteries were blocked, and they were not in the condition possible for balloon angioplasty.

I sent him for an ECP treatment for 7-8 times. The tightness went away completely and he became strong enough to exercise for 30-40 minutes.

Before the 35-session course ended, he asked, “Doctor, my boy had not been up in the morning for 20 years! But this treatment brought it back to life. What’s up with that?”

Well, at least it’s good to know that his improvement was on its way up.

Prof Nithi Mahanonda is consultant cardiologist and interventionist, Perfect Heart Institute.


Reference :


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