
O que a disfunção erétil pode significar para o seu coração
Revisado por Dr Sarah JarvisÚltima atualização por Dr Anna Cantlay, MRCGPÚltima atualização 6 Fev 2018
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Disfunção erétil (DE) - or impotence - is when a man has trouble either getting or maintaining an erection. It's extremely common, with up to half of 40-70 year olds experiencing it to some degree.
Despite this, many men find it difficult to talk about and so suffer in silence, not wanting to bother their GP. The fact that Viagra® is now easily accessible online or over the counter without a prescription means many self-treat without support. But what most don't realise is that such behaviour could spell bad news for their heart.
Erectile dysfunction reasons
Erections happen when two sponge-like chambers in the penis, called the corpora cavernosa, become engorged with blood. Problems with this process are the leading cause of erectile dysfunction. And now a growing body of evidence states that impotence can predict heart disease.
ED can happen for a variety of reasons. Most men occasionally experience problems 'getting it up' but this doesn't necessarily mean there's a problem. For instance, it might occur after drinking alcohol or when you are tired or estressado.
More prolonged erection problems could be a sign of an underlying issue. The cause could be psychological or physical and sometimes certain medication may also contribute. Physical causes are more common, being responsible for 8 out of 10 cases of ED.
A good way of distinguishing between psychological and physical causes is to see if you are still getting night-time or morning erections. If you are, it points to it being psychological. Impotence associated with poor mental health also tends to come on more gradually, and can also be associated with problems such as premature or delayed ejaculation.
Causas psicológicas
Psychosexual factors - relationship issues, lack of arousability, previous bad sexual experiences or sexual abuse.
Estresse.
Physical causes
Conditions that affect the blood flow to the penis, such as diabetes, cardiovascular disease and colesterol alto. These can lead to atherosclerosis (a build-up of a fatty limescale) in the blood vessels of the penis.
Neurological conditions such as derrame, esclerose múltipla, Doença de Parkinson and spinal injuries.
Hormonal imbalances, such as doença da tireoide or low testosterone levels.
Complications from surgery, such as prostate surgery.
Anatomical problems, such as Doença de Peyronie.
Recreational drug use and alcohol can also lead to ED. Prescribed medication such as certain blood pressure medication, antidepressivos and antipsychotics can also contribute. If you think your medication could be the cause, discuss this with your GP.
Take heart
In 2006, the late cardiologist Graham Jackson stated in a paper published in European Heart Journal: "A man with erectile dysfunction and no cardiac symptoms is a cardiac patient until proven otherwise."
Since then, more and more estudos have pointed to a link between ED and the development of cardiovascular disease such as heart attacks and strokes.
Christopher Allen, senior cardiac nurse at The British Heart Foundation explains the relationship between the heart and erections:
"Erectile dysfunction can be a symptom of doença coronariana. This is because blood flow to the penis can be restricted by the build-up of fatty deposits in the arteries, called plaques. Because the arteries in the penis are so narrow, erectile problems are often one of the first warning signs of blocked arteries, which increases your risk of having a ataque cardíaco ou derrame."
We know now that ED can precede the development of heart disease by 2-5 years, and is as important a predictor as moderate smoking. Heart disease and ED also share the same risk factors, including obesidade, diabetes, high cholesterol, physical inactivity and smoking.
"So if you're experiencing problems with erectile dysfunction we'd advise you book an appointment with your doctor, as it is important that if it is caused by an underlying medical condition, it is detected early," adds Allen.
Age is also important. The younger men are (especially those <50 years), the more likely it is that that ED could be a sign of heart disease. Severity should also be considered; the worse the ED, the greater the impact on your heart.
Doença cardíaca is a leading cause of death in men. Men who come to their GP with ED should have a cardiovascular risk assessment. This includes checking your weight, blood pressure and smoking status as well as arranging some blood tests.
Keep it up
Your doctor will aim to treat the cause of your ED. The first step is speaking to your GP so they can get you the help you need.
Mudanças no estilo de vida
Maintaining a healthy lifestyle is a really important part of both ED prevention and treatment. Keeping physically active, maintaining a healthy weight, avoiding smoking and excessive alcohol consumption can all help to keep ED at bay and improve symptoms if it does develop. This will also have a positive impact on your overall well-being, including your heart health.
Tratamentos
Several treatments are available to help treat ED, either through your GP or through a specialist referral to a urologist. These include tablets, cremes, injections and vacuum pumps. Speak to your GP about the right option for you.
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Perguntas frequentes
What is the likelihood of ED being caused by psychological factors versus physical factors?
Physical causes are much more common, accounting for 8 out of 10 cases of erectile dysfunction. Psychological factors are less frequent but can also contribute to the problem.
If I am experiencing ED, should I be concerned about my heart health?
Yes, you should be concerned. Erectile dysfunction can be an early warning sign of underlying cardiovascular disease, such as heart attacks and strokes. This is because the arteries in the penis are narrow, and issues with blood flow often show up there first before becoming apparent in larger arteries elsewhere in the body.
How long before the development of actual heart disease might ED appear?
Erectile dysfunction can precede the development of heart disease by 2-5 years. This makes it an important early predictor, similar in significance to moderate smoking.
What kind of tests might my doctor perform if I discuss ED with them?
Your doctor will likely conduct a cardiovascular risk assessment. This typically involves checking your weight, blood pressure, and smoking status. They may also arrange for some blood tests to further evaluate your health.
Can certain medications I'm already taking cause ED?
Yes, some prescribed medications can contribute to erectile dysfunction. Examples include certain blood pressure medications, antidepressants, and antipsychotics. If you suspect your medication might be the cause, you should discuss this with your GP.
Sobre o autorVer biografia completa

Dra. Anna Cantlay, MRCGP
Médico Generalista, Autor Médico
BMBS, BMedSci, MRCGP, DRCOG, DFSRH, DOCCMED
Dr Anna Cantlay is an experienced NHS and private GP based in London.
Sobre o revisorVer biografia completa

Dra. Sarah Jarvis
Consultora Clínica
MA (Cantab), BM, BCh (Oxon), DRCOG, FRCGP, MBE
Após se formar em medicina em Cambridge e Oxford, a Dra. Sarah Jarvis MBE tornou-se médica de clínica geral.
Histórico do artigo
As informações nesta página são revisadas por pares por clínicos qualificados.
Artigo também disponível em Inglês, Alemão, Espanhol, Francês, Italiano, Português, Hindi, Hebraico, Árabe, e Sueco.
6 Fev 2018 | Última versão

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