Northeast Wisconsin
  • Northeast Wisconsin
  • April 2018
Written by 

Erectile dysfunction and heart disease

If you’ve ever paid close enough attention to the commercials for the “little blue pill,” you will hear a disclaimer that, “Erectile dysfunction may be a sign of a serious heart disease,” followed by the advice to see your health care practitioner to make sure your heart is healthy enough for sexual activity. This is an important warning that should get a little more attention than five seconds at the end of a commercial.

Erectile dysfunction can be an early warning sign of heart disease or other circulatory problems

Erectile dysfunction (ED) is characterized as the inability to get or keep an erection firm enough to have sexual intercourse. An erection is achieved when arteries in the penis relax and open up to let more blood flow in, while at the same time, the veins close up and trap the blood inside the penis. The penis must be able to store blood in order to achieve and maintain an erection. Vascular disease restricts blood flow to different areas of the body and can cause ED. There are other possible causes of ED, including relationship problems, anxiety, diabetes, kidney disease, neurological disease, certain medications, injuries, and chronic illness. However, according to the Cleveland Clinic, vascular diseases, which include atherosclerosis (hardening of the arteries), hypertension (high blood pressure) and high cholesterol, accounts for 70 percent of physical-related causes of ED. Atherosclerosis alone accounts for 50 to 60 percent of ED cases in men over age 60.

While scientists continue to work on demonstrating the direct cause and effect relationship between low testosterone and hardening of the arteries (atherosclerosis), it has been concluded in many recent studies that low testosterone is considered a marker for cardiovascular risk. In a recent article published on, the author summarizes several studies on low testosterone and its association with cardiovascular disease. Of particular interest is a study published in the Journal of Sexual Medicine, which concluded that low testosterone levels are associated with harmful elevations in nine of 10 cardiovascular biomarkers.

Testosterone Replacement Therapy to Reduce Cardiovascular Risk

Early studies of testosterone replacement therapy suggested a link between testosterone therapy and an increased risk in heart disease. However, more recent studies have indicated the opposite and the previous studies have been found to be faulty. In an April 2017 article published in the Jama Internal Medicine Journal, the findings of the Kaiser Permanente study concluded that, “When use in androgen-deficient men with documented low morning testosterone levels, TRT was not associated with an increased risk of cardiovascular outcomes. During long-term follow-up the risk of cardiovascular outcomes was lower in testosterone-treated men.”

According to Dr. Neal Rouzier, Director of The Preventative Medicine Clinic of the Desert and specialist in bioidentical hormone replacement therapy, “Having good testosterone in your system decreases incidents of heart attacks, strokes, Alzheimer’s, diabetes, high blood pressure. It has a beneficial effect in protecting against cardiovascular disease in every study. It decreases the instance of heart attacks because of its effect on blood vessels. It has a beneficial effect of improving your good cholesterol and lowering your bad cholesterol. It has a beneficial effect of improving all of the good lipoproteins and reducing all the bad lipoproteins.”

Testosterone replacement therapy, when done correctly with careful monitoring and follow up labs, can make a world of difference. If you or someone you know is experiencing signs/symptoms of low testosterone, be proactive, get tested and start making changes today.

“Heart Disease & Erectile Dysfunction.” Cleveland Clinic.

“Low Testosterone is Associated with Elevated Cardiovascular Disease Biomarkers.” Nebido Research News.

“Low Plasma Testosterone is Associated with Elevated Cardiovascular Disease Biomarkers.” Journal of Sexual Medicine. Pastuszak et al.

“Association of Testosterone Replacement with Cardiovascular Outcomes Among Men with Androgen Deficiency.” JAMA Intern Med. T Craig Cheetham et al.

Vicky Romanski, FNP-BC, APNP

Vicky Romanski, FNP-BC, APNP, is a functional medicine Nurse Practitioner at Wise Woman Wellness, LLC. Romanski combines the best of conventional, functional and integrative medicine to help women with female, thyroid and adrenal hormone issues to live healthier, more abundant, joy-filled lives. She is also the Wise Woman Wellness Men’s Vitality Program Director and helps men eliminate their uncomfortable hormone imbalance symptoms and increase energy and longevity. Wise Woman Wellness is an innovative wellness and hormone care center located at 1480 Swan Rd, De Pere. Please contact her at 920-339-5252 or via the internet at

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