Let’s face it – erectile dysfunction (ED) is a topic many prefer to avoid. But paying attention to it could be one of the most important things you do for your health. It’s usually thought of as a frustrating challenge in the bedroom, but it can also serve as a warning flag for your heart health.

The link between ED and heart disease is stronger than many people realize. The same vascular system that keeps your heart healthy also plays a role in getting and maintaining an erection. When your blood vessels aren’t working as they should, it can often result in ED – and it may be your body’s way of saying it’s time to check in on your heart.

The physiology of an erection

First, it’s important to understand how the body produces and maintains an erection. Here’s how it works:1,2 

  1. The penis is mostly made up of two columns of spongy tissues called the corpora cavernosa. 
  2. When a man becomes sexually aroused, signals from the brain and nerves tell the smooth muscle inside the corpora cavernosa to relax. 
  3. This allows blood to flow into the blood vessels of the corpora cavernosa, making the penis firm. At the same time, the veins that normally drain blood from the penis are compressed, helping to maintain the erection.

But here’s the catch – this whole system is surprisingly easy to throw off. Sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles, and blood vessels. ED can result from a problem with any of these.3 

However, among men over age 40, ED is most commonly caused by damage to the arteries that supply blood to the penis.4

Healthy blood flow is key

The link between ED and heart disease is blood flow. Healthy arteries are flexible and open, allowing blood to flow smoothly throughout the body. But a buildup of plaque on artery walls, called atherosclerosis, causes arteries to narrow, blocking blood flow.

The arteries in the penis are very small – much smaller than those leading to the heart. So if plaque begins to build up, those smaller arteries are often the first ones affected.  

A red flag for heart disease

ED is a strong indicator of heart disease, especially in younger men. Research has shown that men in their 40s with ED are almost 50 times more likely to develop heart disease compared to those without ED.5

The upside? ED can act as an early warning sign of heart disease. Research shows that ED often shows up 3-5 years before heart symptoms like chest pain or heart attacks.6

That’s because ED is often caused by endothelial dysfunction, one of the earliest stages of heart disease and a risk factor for atherosclerosis.7 Endothelial dysfunction prevents blood vessels from expanding properly, reducing blood flow. When this affects the arteries supplying the penis, it becomes difficult to get or keep an erection.8

In the early stages, endothelial dysfunction might not cause any other symptoms except for ED. Endothelial dysfunction can progress to atherosclerosis, which can obstruct blood flow through the arteries. Untreated atherosclerosis causes angina, heart attacks, strokes, and leg pain while walking (peripheral artery disease or PAD).8

Treatment starts with healthy changes

ED can be a deeply personal and emotional experience, affecting a man's sense of confidence and self-worth. It's important to remember that this is a common health issue that doesn’t define who you are. 

By addressing ED problems early, you have the chance to improve your heart and sexual health while protecting yourself from future health problems. Medications are available, but embracing healthy habits can be just as powerful.3 

Here are some tips to keep your heart and your penis healthy:

  • Get moving. Physical activity improves circulation, boosts your heart health, and lowers risk of ED.9 Research shows that moderate-to-vigorous exercise four times a week improves erectile function in men with ED.10
  • Eat a heart-healthy diet. Foods rich in fruits, vegetables, whole grains, and healthy fats (like nuts and olive oil) can reduce plaque buildup in your arteries and improve erectile function.11,12
  • Maintain a healthy weight. Obesity is linked to endothelial dysfunction and increases the risk of cardiovascular disease, all of which contribute to ED.3  
  • Stop smoking. Tobacco use increases your risk of developing vascular disease and can cause erectile dysfunction.3 

Nervous about talking to your health-care professional about ED?

Remember that you’re not alone – ED is a very common condition. Be honest and direct, and don’t be afraid to use terms you are comfortable with. Write down what you’re experiencing along with a list of questions before your appointment. 

Taking ED seriously isn’t just about your sex life – it could save your life. 

A word from Thorne

Nutritional supplements that contain the amino acid L-arginine can help support endothelial function, resulting in improved blood flow.* Explore Thorne’s selection of men’s health products here.

References

  1. Corpus cavernosum. National Cancer Institute. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/corpus-cavernosum. [Accessed Jan. 22, 2025.]
  2. Dean RC, Lue TF. Physiology of penile erection and pathophysiology of erectile dysfunction. Urol Clin North Am. 2005;32(4):379-v.
  3. Erectile dysfunction. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776. [Accessed Jan. 23, 2025.]
  4. Ostfeld RJ, Allen KE, Aspry K, et al. Vasculogenic erectile dysfunction: The impact of diet and lifestyle. Am J Med. 2021;134(3):310-316.
  5. Yannas D, Frizza F, Vignozzi L, et al. Erectile dysfunction is a hallmark of cardiovascular disease: Unavoidable matter of fact or opportunity to improve men's health? J Clin Med. 2021;10(10):2221.
  6. Imprialos K, Koutsampasopoulos K, Manolis A, et al. Erectile dysfunction as a cardiovascular risk factor: Time to step up? Curr Vasc Pharmacol. 2021;19(3):301-312.
  7. Davignon J, Ganz P. Role of endothelial dysfunction in atherosclerosis. Circulation. 2004;109(23 Suppl 1):III27-III32.
  8. Schwartz BG, Kloner RA. Cardiology patient page: Cardiovascular implications of erectile dysfunction. Circulation. 2011;123(21):e609-e611.
  9. Cheng JY, Ng EM, Ko JS, et al. Physical activity and erectile dysfunction: Meta-analysis of population-based studies. Int J Impot Res. 2007;19(3):245-252.
  10. Gerbild H, Larsen CM, Graugaard C, et al. Physical activity to improve erectile function: A systematic review of intervention studies. Sex Med. 2018;6(2):75-89.
  11. Esposito K, Ciotola M, Giugliano F, et al. Mediterranean diet improves erectile function in subjects with the metabolic syndrome. Int J Impot Res. 2006;18(4):405-410. 
  12. Oteri V, Galeano F, Panebianco S, et al. Influence of Mediterranean diet on sexual function in people with metabolic syndrome: A narrative review. Nutrients. 2024;16(19):3397.