By Rachael Rettner
MyHealthNewsDaily

The more severe a man's erectile dysfunction is, the greater his risk of being hospitalized for heart problems, a new Australian study finds.

Among men in the study who had no history of heart disease, those with moderate erectile dysfunction (ED) were 23 percent more likely to be hospitalized for a cardiovascular problem, such as a heart attack, during a two-year period compared to men who did not have ED. And those with severe ED were 35 percent more likely to be hospitalized for cardiovascular problems than those without ED.

Men who already had heart problems and severe erectile dysfunction at the study's start were 64 percent more likely to be hospitalized for another heart problem during the study period compared to men without ED.

The results held even after the researchers accounted for factors that might increase the risk of heart problems, such as age, smoking, alcohol consumption and obesity.

The findings agree with previous studies that have linked erectile dysfunction to an increased risk of cardiovascular disease. [See For Men, Sex Life Gets Better with Improved Heart Health.] But the new study is one of the first to investigate whether or not the risk of heart problems increases with the severity of ED.

The findings suggest erectile dysfunction may be a marker that signals underlying heart disease, the researchers, from Australian National University, said. It has been hypothesized that atherosclerosis (plaque in the arteries that limits blood flow) might first manifest itself in smaller blood vessels, such as those in the penis, the researchers said.

When a man sees the doctor for erectile dysfunction, the visit might be an opportunity to evaluate him for other problems, said Dr. Andrew Kramer, a urologist at the University of Maryland Medical Center, who was not involved in the study.

"You can use ED to get men in the door. It might be the only thing that brings them in," Kramer said. Urologists should encourage men with moderate or severe ED to visit a primary care doctor or cardiologist for heart disease screening, he said.

The researchers examined information from more than 95,000 Australian men ages 45 and over who filled out a health questionnaire between 2006 and 2009, and linked this information to records of hospital admissions and deaths in 2010.

During the study period, there were 7,855 hospital admissions related to cardiovascular disease and 2,304 deaths, the researchers said.

Men with erectile dysfunction of any severity (mild, moderate or severe) were at increased risk for hospitalization for heart failure compared to men who did not have ED.

Those with severe ED were about twice as likely to die during the study period than men without ED, the researchers said.

The study only found an association, not a cause-effect link. The researchers also did not have information about any medications participants were taking (some medications have ED as a side effect.)

The study was published today (Jan. 29) in the journal PLOS Medicine.

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Joseph Brownstein, MyHealthNewsDaily 

Better-smelling breath may not be the only way that treating gum disease benefits your sex life. New research says improving the gums may also improve erectile dysfunction. 

Previous studies have linked erectile dysfunction (ED) with periodontitis (inflammation of the gums), and now, a new study of patients in Turkey shows that treating periodontitis in affected patients appears to lessen the symptoms of erectile dysfunction after three months.

"To our knowledge, this is the first study to assess a potential link between the severity of ED and the treatment of periodontal disease," wrote the authors, who are affiliated with Inonu University in Malatya, Turkey. "The results revealed that the severity of ED improved following periodontal treatment."

The study involved 120 patients with severe or moderate erectile dysfunction and chronic periodontitis. Half received treatment for their gum disease, while half did not. They filled out questionnaires about their erectile function, and patients who received treatment for their gum disease reported that levels of erectile function improved after three months.

The Turkish research group is not the first to link the two conditions. Past studies in India, Israel and Taiwan have linked periodontal disease with erectile dysfunction; some authors have speculated that gum disease and erection problems share a common cause, while others have suggested that gum disease can cause erectile problems.

The new findings add weight to the idea that gum disease may cause erectile problems.

But the issue is difficult to study, and there has been no strong explanation for why gum disease could have such low-reaching effects.

"Yes, I feel that an association does exist," said Dr. Andrew Kramer, an associate professor of urology at the University of Maryland School of Medicine. However, "there is nothing causal between the two," he said.

There doesn't appear to be an explanation for how tooth and gum diseases could affect nerves or blood flow to the male genitalia, Kramer said. However, there are many common denominators that may be behind the apparent link.

"I feel that the causal element is probably vascular disease, poor general health status, lack of medical attention (gum disease), underlying diabetes/hypertension, or all of the above," he said. "They are related and correlated, but due to an underlying common factor."

For their part, the authors sounded a similar note of caution in their conclusions.

"Theresults of the present study provide evidence that periodontal treatment can help to reduce ED," the authors wrote. "In addition, the findings are consistent with those of previous studies in which ED was found to be associated with low-grade inflammation caused by periodontal disease."

However, further studies should clarify exactly how the two conditions may interact, they said.

The findings have been peer-reviewed and accepted for publication in the Journal of Clinical Periodontology, where they will appear in a future issue.

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By Karen Rowan
MyHealthNewsDaily 

Men with prostate cancer often experience erectile dysfunction as a side effect of their treatment, and many find this to be upsetting to the point where it undermines their wellbeing. Moreover, men's distress about ED often does not improve over time — in some men, it worsens.

A new study sheds light on the causes of this prolonged distress. While some researchers have thought that the severity of a man's ED is linked with how distressed he feels, the new findings show that regardless of men's ED severity, they are much more likely to be distressed when they feel they've lost their masculinity as a result of treatment.

Not all men experience this feeling of lost masculinity, said study researcher Talia Zaider, a clinical psychologist at Memorial Sloan-Kettering Cancer Center in New York City. But those who do are most at risk of feeling deeply troubled, embarrassed or ashamed about their ED.

A feeling of lost masculinity is an aspect of prostate cancer treatment that's not often talked about, Zaider said. "Gender norms work against men," and can keep them from discussing it, she said.

In the study, about one-third of men who had been treated for prostate cancer in the last year reported feeling their masculinity was diminished, and that they had lost a vital part of their identity, Zaider said.

A better understanding of how men respond to their sense of a change in their identity could help researchers find better ways to help men recover, the researchers wrote in their study, published online Sept. 18 in the Journal of Sexual Medicine.

About 242,000 men in the U.S. will be diagnosed with prostate cancer in 2012, and 28,000 will die of the disease this year, according to estimates from the National Cancer Institute. More than 9 in 10 prostate cancers are diagnosed in early stages, and these men are likely to live for a long time after treatment.

This optimistic outlook on survival means that researchers are looking closely at factors affecting men's quality of life after the treatment, Zaider said.

Treatments can affect men's sexual, urinary and bowel functioning, but i mpaired sexual functioning is the most common long-term complaint of men after treatment, according to the study.

Zaider and colleagues interviewed 75 men, whose average age was 60, who had received prostate cancer treatment in the previous year.

The men answered questions about their level of erectile function, how happy they were with their sex lives, the degree to which they felt a loss of masculinity, and the amount of "marital affection" they felt in their relationship (all men in the study were living with a spouse or partner). The men's spouses were also interviewed.

"Men who felt they'd lost their masculine identity were very likely to be stressed by their ED. The two seemed to go closely together," Zaider said. "That link was there whether they had severe or mild ED."

The researchers also found that among men who felt a lost of their masculinity, those in relationships with a high degree of affection were less likely to feel distress over their ED.

But women don't always understand their husbands' feelings. "I've worked with couples, and when the man talks about how upset he is about his loss of erectile function, the wife says, 'but you're alive, and we're OK,'" Zaider said. "For men, it's not just about their function — it signifies a loss of who they are. There are feelings of incompleteness."

The findings make a case for involving men's partners in interventions aimed at helping men cope with their distress, she said. The researchers have begun a trial to test the effectiveness of such an intervention.

"Perhaps in the context of a strong, affectionate and communicative relationship, men can revise their ideas about what makes them a man and, in turn, adjust better to ED," Zaider said.

More from MyHealthNewsDaily:

• 7 Surprising Reasons for Erectile Dysfunction
• 5 Ways Relationships Are Good for Your Health
• 5 Things You Should Know About Prostate Cancer 

Koshy Johnson / Getty Images

The mask-and-hose contraption known as a CPAP machine may not look alluring, but the relief it provides for sleep apnea can help improve erectile dysfunction and boost users' sex lives.

A CPAP device, the Darth Vader-like mask used to ease breathing in sleep apnea sufferers, might be the least attractive thing a man can wear at night, but it could wind up improving his sex life, according to a new study released today at an annual meeting of sleep experts.

In yet another example of how the human penis can serve as an important health indicator, a team of doctors from the Sleep Disorders Center of the Walter Reed National Military Medical Center has found that erectile dysfunction is common in younger men with sleep apnea, but that E.D. -- and libido -- improves in men who use the CPAP, or continuous positive airway pressure machine.

They presented their results today at the meeting of the Associated Professional Sleep Societies in Boston.

Over the past few years, medical science has repeatedly shown that how a man’s penis is working can reflect how the rest of his body is working. E.D. can be an early sign of diabetes, cardiovascular disease, high blood pressure and poor fitness, among other ailments.

So when army captain Dr. Joseph Dombrowsky looked at a small handful of studies that had linked apnea to E.D., he realized that he had access to a pool of possible test subjects -- military beneficiaries newly diagnosed with the sleep disorder -- that he could use to explore the link.

Dombrowsky and his colleagues recruited 92 men with an average age of nearly 46 who had both a new diagnosis of obstructive sleep apnea, or OSA, and who were starting therapy with CPAP machines.

The CPAP is a mask-and-tube contraption that few might call sexy. Worn during sleep, it sends a steady flow of air through the mask into breathing passages to keep airways open and restore depleted oxygen levels. It’s the most common and effective treatment for OSA, which occurs when tissue in the back of the throat collapses during sleep, blocking air, disrupting sleep and boosting the risk of health problems such as heart disease and stroke.

The men in the study averaged 38 apnea events per hour, Dombrowsky found. That’s pretty bad. Severe apnea is defined as 30 or more such events per hour.

Using a well-established sexual function survey, 43.5 percent of the men reported erectile dysfunction. Unlike previous studies, the E.D. was broken down into three varieties: mild, moderate and severe. The men were reassessed at one-, three- and six-months of CPAP therapy. 

Dombrowksy was looking for what he called “minimal clinically important differences” of CPAP use.

“That’s not just a change in a score, a statistic,” he explained in an interview, “but a difference patients really notice and will appreciate.” 

More than half of patients with mild E.D., or some 54 percent, noticed an improvement after CPAP use. Nearly 29 percent of those with moderate E.D. improved, and more than 27 percent of those with severe E.D. saw a boost. Sexual desire also tended to improve, Dombrowsky found.

Drugs like Viagra have been shown to work more powerfully to improve E.D. than CPAP therapy, but  Dombrowsky speculates that by starting CPAP before the condition gets worse, some men might be able to skip the pills. 

While stressing that he was speaking for himself, not for his research team, the army, or the U.S. government, Dombrowsky said he believes that CPAP therapy might be a good early therapy for E.D., particularly in younger men.

“What the results say to me is that E.D. is a progressive disease, as is sleep apnea. So if we were to intervene earlier, we might be able to stave off the progression of erectile dysfunction.”

His study raises the issue of why apnea might lead to E.D. in the first place. The most obvious explanation is that the link is related to the way apnea creates low oxygen levels in the blood. But that may or may not be correct. Dombrowsky pointed out that during REM sleep, men get erections in something like a nocturnal workout of penis plumbing. Because apnea interferes with REM sleep, fragmenting sleep patterns, penises may not be getting this workout, leading to dysfunction.

Dombrowksy said he plans to continue the work with larger numbers of men in hopes of answering some of these questions.         

Brian Alexander (www.BrianRAlexander.com) is co-author, with Larry Young PhD., of "The Chemistry Between Us: Love Sex and the Science of Attraction," (www.TheChemistryBetweenUs.com)  to be published Sept. 13.

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