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Erectile dysfunction: A sign of heart disease?

Though erectile dysfunction is distressing, it isn't life threatening. But heart disease can be. Erectile dysfunction — trouble keeping an erection sufficient for sex — can be an early warning sign of heart disease. Understanding the connections between erectile dysfunction and heart health can help you recognize signs and symptoms of heart disease early on. Likewise, if you have heart disease, getting the right treatment can help you maintain or improve erectile function. Factors linked to heart disease that can cause erectile dysfunction include:

    * Atherosclerosis. This damaging process reduces blood flow to your heart and contributes to coronary artery disease. It can also affect the blood vessels to the penis, causing erectile dysfunction. Conversely, if you're having trouble with erections, it could be a sign that your heart is also at risk.
    * Medications. Some prescriptions that men take to protect their hearts can cause erectile dysfunction. Additionally, medications that are often prescribed for erectile dysfunction may not be safe when combined with certain heart medications.
    * Depression and anxiety. Researchers have found a connection between depression, heart disease and erectile dysfunction. Feeling anxious can also lead to erectile dysfunction. If you have heart disease, you may worry that having sex could trigger a heart attack.

Medications and erectile dysfunction

Some medications that treat heart disease can make you more likely to develop erectile dysfunction. These include:

    * High blood pressure medications such as clonidine (Catapres), and beta blockers such as metoprolol (Lopressor)
    * Diuretics such as spironolactone (Aldactone), used for high blood pressure as well as heart failure

Although you can't stop taking your medications, there may be other drug options that are less likely to cause erectile dysfunction. Discuss your symptoms and potential options with your doctor.
Erectile dysfunction medications and nitrates: A dangerous mix

Medications prescribed for treatment of erectile dysfunction may cause significant side effects when mixed with certain heart drugs called nitrates.

Nitrates are often prescribed to reduce chest pain, dilate the blood vessels and lower blood pressure. Because erectile dysfunction medications, such as sildenafil (Viagra), also reduce blood pressure, combining these two types of medication can cause a dangerous drop in blood pressure.

Do not take sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis) if you use nitrate medications (NitroBid, Nitro-Dur, Imdur, others) for chest pain.

If you have coronary artery disease or have had a heart attack in recent months, check with your doctor before you begin taking any of these drugs for erectile dysfunction.
Depression, heart disease and erectile dysfunction

There's mounting evidence that depression is associated with an increased chance of having heart problems — and erectile dysfunction. Work with your doctor to make sure you're getting the right treatment if you're feeling down. Treatment can help alleviate erectile dysfunction and may prevent heart problems.

Depression is treated with counseling and medications. Although treating depression can help with erectile dysfunction, some antidepressants have sexual side effects. If you do have bothersome sexual side effects, you may need to try another antidepressant. Your doctor can also decrease the dose or add another medication to offset the effects of the antidepressant on erectile dysfunction.