Challenges in the bedroom could be a symptom of serious underlying health issues.
Erectile dysfunction (ED) can be a frustrating, embarrassing experience for many. But working up the courage to seek treatment might do more than simply remedy any issues in the bedroom.
It could actually save your life.
That’s exactly what happened to Robert Garcia* when he saw a new doctor in 2014. Then 66 years old, he casually mentioned to his physician, Dr. Edward Karpman, co-medical director of the Men’s Health Program at El Camino Hospital, that his body had stopped responding to the Viagra he’d been taking for four years.
“We tried changing my prescription and shots [penile injection therapy], but they didn’t work,” Garcia says. “Dr. Karpman ran an ultrasound and found blockages in the artery to my penis. He told me that if I had blockages down there, I probably had them in my heart, and that scared me.”
Soon after, an angiogram confirmed Dr. Karpman’s suspicions: Garcia had two blocked arteries and was at risk for a major heart attack. He ended up getting four stents placed in his heart.
“I could have died at any time,” Garcia says. “I had no idea a problem in my heart was the cause of my difficulty getting an erection. I wouldn’t have gone to see a cardiologist at that time without the push from Dr. Karpman. He saved my life.”
ED is common. As many as 30 million men in the United States have ED, or the inability to get or maintain an erection while trying to have sex. But it’s more than just a bedroom issue. ED can be a symptom a serious underlying heart condition.
“Erectile dysfunction has been thought of as a stand-alone disease. It’s always a surprise when a guy comes in for ED and you tell him afterward he might have clogged arteries in his heart. That’s obviously a shock. Most patients don’t understand the correlation between erectile dysfunction and cardiovascular disease,” Karpman notes.
ED is typically associated with people ages 40 and up who may already be at an increased risk for cardiovascular disease.
But it can also be a symptom of heart problems that might otherwise go undetected in younger people, like Zachariah Reitano, who first experienced ED when he was 17 years old.
His dad, a physician and sexual health expert, asked him about depression, drug use, and other factors that might cause a teenager to struggle with getting an erection. When he couldn’t find a cause, he scheduled Reitano for a stress test.
“I collapsed on the treadmill during the test,” Reitano says. He’s now the founder and CEO of Ro, creator of Roman, which diagnoses, prescribes, and delivers medication to those with ED.
“It turned out there was an electrical issue with my heart causing it to beat too quickly. I had to have an ablation procedure and take medication to regulate my heart rate,” he explains.
ED was the only symptom Reitano noticed that could’ve indicated a problem with his heart.
“I was lucky I collapsed in the doctor’s office and not while playing soccer or basketball,” he says.
This isn’t to say ED always means an impending heart attack.
“We refer to ED as a check engine light for guys. Getting an erection requires so many parts of your body to work in perfect harmony. If that’s not happening, something might be wrong, but you don’t know exactly what,” Reitano says.
ED can be the result of something as benign as a medication side effect to a different health condition entirely. Other causes of ED can include:
- hormonal imbalances
- neurological issues
- nerve disorders
- untreated mental health problems, such as depression, PTSD, and anxiety
But an underlying condition doesn’t even have to be present for ED.
A lack of sleep, tension in your relationship, a stressful day at work, performance anxiety, or having one drink too many can also cause challenges in the bedroom. The important thing is to track your symptoms and see your doctor if it’s an ongoing issue.
What to track
- morning erection
- sexual desire
- ability to maintain an erection with a partner and alone
- if it’s situational or general
- your feelings about it
“You don’t have to run to the doctor if it happens once or twice. But around 90 percent of erectile dysfunction [cases] can be attributed to genuine organic causes, and that would make the ED consistent,” Karpman says.
“It’s not that the arteries will flow sometimes and every 10th time you have a bad performance. If they’re clogged, they’re clogged. I would encourage men to seek help if they see a consistent difficulty with obtaining or maintaining an erection,” he recommends.
Your doctor might write you a prescription for the little blue pill and send you on your way. Or they may catch a serious medical issue before it’s too late.
You may also be referred to sex therapy if the cause is nonbiological. To find a sex therapist in your area, the AASECT has a provider directory.
*Name has been changed
Joni Sweet is a freelance writer who specializes in travel, health, and wellness. Her work has been published by National Geographic, Forbes, Christian Science Monitor, Lonely Planet, Prevention, HealthyWay, Thrillist, and more. Keep up with her on Instagram and check out her portfolio.