The Penis: A Barometer for the Heart?

When the arteries in one part of your body are clogged, you can expect arteries to be filling up with sticky plaque in other parts of the body as well. One of these parts is the penis.

Heart doctors have long understood this concept, routinely ultrasounding the arteries of the neck (carotids) to provide a barometer for the tiny arteries (coronaries) that supply the heart.

Now, a new study provides evidence that the penis is another crucial barometer of arterial disease.The study, published in the August issue of the Journal of Sexual Medicine, reveals that men with erectile dysfunction (ED and depression) are much more likely to go on to develop heart disease than those without ED.

A team of Italian researchers led by Dr. Elisa Bandini, screened 1687 patients with erectile dysfunction and found that men with ED who were also depressed were much more likely to have a heart attack or angina. ED is clearly an alert to larger emotional and physical problems including heart disease.

Here's why_ The arteries that supply the penis are only able to provide a strong sustained erection when they are working perfectly. So ED is often an indication that something is wrong with your arteries, and since the arteries of the penis are smaller than the arteries of the heart (coronary arteries), they tend to get clogged earlier. ED usually occurs before heart disease occurs. The penis is a likely barometer, a canary in the coal mine, for impending problems in the coronary arteries.

Of course, ED can be caused by many different things, including low testosterone, medication side effects, and depression alone. Not all patients with ED have arterial problems or will go on to have problems with their hearts. But a significant number will. We recommend all men who begin having problems getting erections to see their doctor for a more thorough total body examination. And the concept of formally screening men for heart disease on the basis of ED should be investigated further.

An ideal study would separate men into two groups; one with erectile dysfunction and one without. Each group would be followed to see which men went on to develop heart problems and which didn't. In the meantime, there is every reason to consider ED as a warning sign for heart disease and a window into problems in a man's total health.

David B. Samadi, MD is the Chief of Robotics and Minimally Invasive Surgery at Mount Sinai School of Medicine in New York City. As a board-certified urologist and an oncologist specializing in the diagnosis and treatment of urologic diseases, kidney cancer, bladder cancer, and prostate cancer, he also specializes in many advanced minimally invasive treatments for prostate cancer, including laparoscopic radical prostatectomy and laparoscopic robotic radical prostatectomy. His Web site, Robotic Oncology, has been translated into six different languages and is one of the most popular urology sites on the Internet.