Erectile Dysfunction Linked to Higher Risk of Death and Cardiovascular Disease

Having erectile dysfunction puts men at a higher risk of death and cardiovascular disease, say scientists.

New research presented at ENDO 2020, the Endocrine Society's annual meeting, found erectile dysfunction and poor morning erections—but not necessarily a lower libido—was associated with a higher risk of death. The study is yet to be published and undergo peer-review, when it will be assessed by experts in the field.

The study, which involved 1,913 men aged 40 to 79 years old. Each had participated in the European Male Ageing Study (EMAS) between 2003 and 2005, self-reporting sexual symptoms on the questionnaire.

The researchers compared these responses to each man's testosterone levels, which were taken at the time, and whether or not they were alive 12 years later (±3.3 years) when a follow up was carried out. According to the study, a quarter of men died between taking part in EMAS and the follow-up, roughly 12 years later.

Men with the lowest levels of free testosterone (FT) and highest levels of follicle stimulating hormone (FSH) had the highest risk of death. Free testosterone is the fraction of total testosterone not bound to proteins. While follicle stimulating hormone is produced in the pituitary gland and stimulates the testes.

The researchers also found that men who reported sexual symptoms—and erectile dysfunction, in particular—faced a greater chance of dying, regardless of their testosterone level. Even those with healthy testosterone levels faced a hazard ratio of 1.4 (range 1.15-1.73) compared to those who did not report sexual symptoms.

The study authors suggest this may be because testosterone is not the only factor affecting erectile function. Vascular disease can also be a cause. Sexual symptoms such as erectile function may be a sign of cardiovascular risk and mortality.

"Our study does not allow us to conclude that treating sexual symptoms in itself will add years to their life," study leader Leen Antonio, an endocrinologist and associate professor at KU Leuven-University Hospitals in Belgium, told Newsweek.

"However, implementing a healthy lifestyle and treatment of other cardiovascular risk factors can certainly be beneficial to improve general health and reduce mortality risk in men suffering from sexual dysfunction.

"Men dealing with sexual symptoms should keep in mind that sexual symptoms could be an early warning sign of a poor or worsening health status as well as increased risk for cardiovascular disease and mortality," said Antonio.

She emphasizes the importance of discussing sexual symptoms with a medical professional in order to identify and treat other cardiovascular risk factors or apparent cardiovascular disease.

Ronald Tamler, MD, Endocrinologist at the Mount Sinai Diabetes Center, who did not work on the study, told Newsweek the research backs up existing studies which have suggested that both low testosterone and impaired sexual function in men are predictive of increased morbidity and mortality.

According to the Centers for Disease Control and Prevention, up to 30 million men in the U.S. may be suffering from erectile dysfunction but it is treatable in 95 percent of cases. While it can happen at any age, it is more likely to affect men middle aged and older. Around 5 percent of men aged 40 and 15 percent of men aged 70 have complete erectile dysfunction, states UW Health.

"For older men experiencing problems with erections, this is akin to getting a "yellow card" in a game of soccer, indicating an early warning sign that they are at increased risk of dying prematurely, likely from cardiovascular disease," Dr. Richard Quinton, Consultant and Senior lecturer in endocrinology at the Royal Victoria Infirmary and Newcastle University, told Newsweek.

Quinton, who was not involved in the study, explained it is likely there are steps that men deemed at risk can take to mitigate that risk. These include lifestyle changes, such as losing weight or taking up exercise, and appropriate drug therapy to control lipids or blood pressure or whatever else might be posing a risk.