To get a natural erection, you must become sexually excited. Your nervous system then sends chemical messages to your pelvic area. Blood flow through your arteries increases. The smooth muscles inside your penis relax. The corpora cavernosa, acting like sponges, fill with blood and make the penis erect. (For more information, see Anatomy of penis)
Damage to blood vessels or nerves can cause erectile dysfunction (ED), or impotence. ED is the persistent failure to get an erection firm enough to start or finish sexual intercourse.
Circulation problems are the most common cause of ED in men over 50. These problems prevent or reduce blood flow to the penis. Heart disease is one of many causes of circulation problems. One clinical study found that men treated for heart disease had a 39% chance of having the most severe erectile dysfunction. Among all men, the chance of having ED is 10%.
The Minneapolis Heart Institute Foundation studied men with damaged blood vessels in the penis.
Blood vessels that supply the penis are narrower than those in other parts of the body. The study found that the process that leads to heart attacks and strokes could be seen as ED before it appears in other arteries.
The study also noted that not every case of impotence was linked to heart disease.
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You can have heart disease and still have healthy sex. ED related to heart disease, however, can be a major problem for you and your partner.
The good news is that erectile dysfunction can be treated. Viagra and other drugs, penile implants, vacuum erection devices, injection therapy, and urethral suppositories are options.
Viagra increases blood flow to the penis. Many men find it effective. However, Viagra fails for 30%-40% of the men who try it.
Many men with heart disease stabilize the condition with nitrates. Use of nitrates is not recommended for men who also use Viagra. See a doctor to decide if Viagra is right for you.
Men who do not have success with Viagra have alternatives, including different drugs and penile implants. Among available treatments, an implant is often the most effective long-term solution as well as the best alternative for maximum sexual spontaneity.
Implants have been modified and enhanced over a period of 29 years. Nearly 300,000 men have a penile implant. Clinical studies show a high degree of satisfaction with the devices.
The best treatment for erectile dysfunction depends on many things. These include a man's health and personal and physical tolerance for the treatment. Work with your doctor (usually a urologist specializing in the treatment of ED) and your partner to determine the best treatment for you.