Whether you have a long-term partner or not, it’s important to feel your best in the bedroom—especially because sexual and erectile health are more closely linked to overall health than you may think. While it’s normal to experience lackluster erections here and there, particularly as you age, if those struggles have become more commonplace than once-in-a-blue-moon, you might want to get checked out, as erectile dysfunction (ED) can actually be an early warning sign for some chronic health conditions.
Here, urologists break down the health issues ED could indicate, plus how you can start supporting your erectile function (and overall health) right now.
- ABOUT OUR EXPERTS: Paul Gittens, M.D., is a urologist specializing in sexual health at Dunn Pellier Media. Justin Houman, M.D., F.A.C.S., is a urologist and assistant professor of urology at Cedars-Sinai Medical Center.
ED Could Indicate Other Health Concerns
Research published in Psychology and Aging suggests that about 80 percent of ED cases are physiological, meaning they’re tied to health conditions that affect other systems of the body. Here are six serious health issues that could be linked to your trouble between the sheets.
1. Cardiovascular disease
To have healthy erections, you need good blood flow, which can be compromised when you have any cardiovascular issue, explains Paul Gittens, M.D., a urologist specializing in sexual health at Dunn Pellier Media. For example, excess atherosclerosis (a buildup of plaque in the arteries) can lead to both coronary heart disease and a decrease in blood flow, including to the penis. Chronic inflammation, which can be related to high blood pressure and high cholesterol, can also affect the endothelium, the blood vessels’ inner lining, which is responsible for vasodilation, or the widening of blood vessel walls to boost blood flow, adds Gittens.
Experiencing endothelial dysfunction, in which the blood vessels can’t dilate enough to improve blood flow throughout the body, can first affect the blood vessels of the penis, putting a damper on erections, according to Johns Hopkins Medicine. That’s why persistent ED is often an early red flag that something is going on with cardiovascular function.
2. Type II diabetes
Up to half of all men with diabetes, particularly those over the age of 50, also have symptoms of ED. “With diabetes, the metabolic syndrome caused by insulin resistance can lead to lower testosterone, which can lead to ED,” Gittens says. The spikes in blood sugar that occur with this condition can also strain blood vessels, including those that need to function well to maintain erections.
Read More: 6 Signs Your Blood Sugar Isn’t As Healthy As You Think
It’s also common for conditions like diabetes and heart disease to be associated with psychological conditions like depression, anxiety, and stress, all of which are also linked to ED, adds Gittens.
3. Liver disease
Any liver dysfunction can increase systemic inflammation, leading to issues with the dilation of blood vessels and thus trouble in the erection department, says Gittens. The liver also produces a protein called sex hormone-binding globulin that binds to testosterone and supports sexual function. When the liver doesn’t function properly, it may overproduce this protein, causing too much testosterone to become “locked up,” preventing the muscle response needed to facilitate erections, Gittens explains.
4. Kidney disease
The liver and kidneys are deeply interconnected, so issues in the kidneys can also contribute to erectile dysfunction. In fact, up to 70 percent of men with chronic kidney disease have ED, according to research published in World Journal of Nephrology. “Chronic kidney issues can lead to hormonal imbalances and vascular problems that contribute to ED,” says Justin Houman, M.D., F.A.C.S., assistant professor of urology at Cedars-Sinai Medical Center. Specifically, the research suggests kidney conditions are linked with low testosterone (which contributes to low libido and erectile dysfunction).
5. Neurological disorders
Understandably, any neurological disorder can affect sexual performance. “Neurological disorders can interfere with the nerves responsible for erections,” Houman says. As such, in some cases, ED may indicate conditions including Parkinson’s disease and even multiple sclerosis. It could also signal the presence of a spinal cord injury.
6. Sleep apnea
Sleep apnea can affect more in the bedroom than just your sleep quality. It’s associated with reduced oxygen levels and vascular health, which can disrupt blood flow—including to the penis—potentially contributing to ED, Houman explains. Sleep apnea can also impact your bedroom performance via testosterone. You see, testosterone is connected to your sleep and body’s natural circadian rhythm, rising during sleep and peaking right before you wake. However, when sleep is continuously interrupted by sleep apnea, testosterone levels may remain low.
Read More: 5 Ways To Optimize Your Daily Routine For Healthy Testosterone
Other factors here: Sleep apnea is also linked to obesity and cardiovascular disease, both of which are linked to ED, according to Houman.
How to support erectile health and ward off chronic disease
Of course, issues with erections don’t automatically mean you have a serious health condition at play beneath the surface. However, sexual health is an important barometer of overall health, so trouble in the bedroom is certainly a good reason to take a closer look at other areas of your well-being. Here are six must-do’s for boosting sexual health and keeping chronic conditions at bay.
1. Check in with a doctor
Gittens advises checking in with a physician as soon as you notice any shifts in your sexual function. If you already have diagnosed type 2 diabetes or high blood pressure, meet with a urologist specializing in sexual medicine to get ahead of things, even if you aren’t experiencing ED, he adds.
If you feel uncomfortable approaching your primary care physician about ED, many telehealth services can provide ED consultations and care, Houman offers. “The conversation might feel awkward, but ED is a common condition and doctors are trained to discuss it without judgment,” he adds. To get this conversation going, Houman recommends starting with something like, “I’ve been having trouble maintaining an erection, and I’m concerned it might indicate a bigger issue,” or “This has been affecting my quality of life, and I’d like to understand what’s going on.”
2. Get plenty of exercise
Exercise is an obvious must-do for cardiovascular health. Ideally, your routine includes at least three to four hours of cardio per week, whether that’s jogging, walking briskly, or using a matching like an elliptical or stationary bike, says Gittens. Just make sure you’re sweating, exerting energy, and getting your heart rate up to reap the benefits.
Don’t forget about resistance training, either. Incorporating strength training at least twice a week can improve blood flow and boost testosterone levels, adds Houman. (These expert tips can help men maximize muscle growth as they age.)
3. Eat A heart-healthy diet
Since solid circulation is important for both eating heart-healthy also means eating for your sexual wellness. Your best bet here is a balanced diet high in vegetables, fruits, whole grains, lean proteins, and healthy fats (think avocado and salmon), says Houman. Cut back on processed meats and snacks, as well as added sugar, as these foods can contribute to plaque buildup in the arteries that can damage blood vessels.
4. Get your supplement regimen right
The omega-3 fatty acids found in fish like salmon support heart and overall vascular health, according to Houman. So, if you don’t eat fish regularly, consider supplementing with omega-3s to keep your intake of these important fats up.
Vitamin D is another great supplement to keep in your rotation, he says. While the research on its benefits for healthy testosterone levels shows mixed results, it’s good for your immune system and mental health, both of which promote sexual health.
Still seeking extra sexual wellness support? Houman also recommends l-arginine, an amino acid that can aid with better blood flow, and Panax ginseng, which can help with circulation and erectile function.
5. Manage your mental health
The psychological aspect of ED can be as important as the physiological side of things. In fact, managing stress—whether by cultivating a mindfulness practice, yoga practice, exercising regularly, or utilizing therapy—can support more regular erections and overall sexual health, especially if you have significant anxiety or depression to address, says Houman.
Open communication with partners is also an impactful practice here. “ED is common and nothing to be ashamed of,” Houman says. “Compassionate communication and discussing concerns upfront with anyone you’re having sex with is a way to reduce performance anxiety,” he adds.
6. Cut back on drinking and smoking
Smoking cigarettes and drinking excessively should be avoided for numerous reasons, but both can certainly impact sexual function.
Smoking, specifically, can damage blood vessels needed to maintain erectile health, according to Houman. Limiting alcohol consumption to no more than two drinks per day is also important for maintaining a healthy weight and lowering your risk of diabetes, high blood pressure, and ED.
“By treating your body well, you not only enhance your sexual health but also reduce the risk of chronic conditions like heart disease, diabetes, and even dementia,” says Houman. “Erectile health and overall health are deeply interconnected, so making lifestyle changes is a win-win approach.”