Erectile Dysfunction and Vascular Disease

Medically Reviewed by Nazia Q Bandukwala, DO on September 09, 2023
3 min read

Erectile dysfunction, or ED, is when a man is unable to get or maintain an erection firm enough for sexual relations.

Vascular diseases are those that damage your blood vessels or change the way they work.

One type of vascular disease, atherosclerosis, or “clogged arteries,” is a major physical cause of ED. (There are also psychological causes.) Atherosclerosis is the buildup of cholesterol and fats into a sticky plaque that forms on artery walls.

Atherosclerosis that causes ED is called peripheral artery disease, or PAD.

 “Peripheral” means it forms in blood vessels outside the area of your heart or brain, like your arms and legs. But it can also form in your feet, neck, belly, and sexual organs like the penis. As blood vessels narrow, it’s more difficult to get enough blood into the penis for a firm erection. ED is a common symptom of PAD in men.

Vascular diseases like PAD may be the cause of ED in as many as 50% to 70% of men who have it.

Some common risk factors include:

Coronary artery disease (clogged arteries in the heart)

You’re most likely to get PAD if you smoke or have diabetes. But any one of these factors makes it more likely that you’ll get PAD that could cause erectile dysfunction.

Lifestyle changes and drug treatments usually help fight the PAD that can cause erectile dysfunction.

What you can do:

  • Quit smoking if you're a smoker. It’s good for PAD and it can help with erectile dysfunction too.
  • Exercise consistently. Aim for 30 to 45 minutes on most days of the week. Check with your doctor first.
  • Control your blood sugar if you have diabetes with both lifestyle changes and medication.
  • Monitor cholesterol and blood pressure and lower them with diet, exercise, and medication if needed.
  • Keep a healthy weight. Ask your doctor about a healthy weight for you.
  • Eat a healthy, balanced diet, low in saturated fat.

Your doctor might prescribe medications to help with PAD and resulting ED:

  • Cholesterol-lowering medications like statins that lower risk of heart attack or stroke
  • High blood pressure meds
  • Meds to control blood sugar (typically if you have diabetes)
  • Medications that help stop blood clots
  • Meds that increase blood flow to the penis

Your penis must store blood to keep an erection. If the veins can’t keep blood there during an erection, you'll lose it. This is called venous leak. It may happen with PAD.

It’s also linked to diabetes, Peyronie's disease (a buildup of scar tissue in the penis that leads to curved, painful erections), some nerve conditions, and even severe anxiety.

Doctors treat it in much the same way they treat all PAD-related ED problems. Possibilities include:

  • Medications and lifestyle changes to treat underlying PAD.
  • Medications that increase blood flow to penis
  • Testosterone replacement therapy
  • Penile implants: Hydraulic pump, prosthesis, and others