• Posted June 2, 2023

Erectile Troubles in Middle Age a Bad Sign for Men's Brains

Erectile dysfunction (ED) has been tied to an increased risk of diabetes, high blood pressure and heart disease. Now, research suggests that erectile woes during late middle age may also be linked to a man's chances of developing memory issues later on.

"Because subtle changes in erectile function were related to memory decline, our results suggest that neglecting this aspect of sexual health may contribute to cases of cognitive impairment and dementia in men,"said study author Tyler Reed Bell. He's a post-doctoral scholar at the University of California, San Diego.

"An ounce of erectile function treatment may be worth pounds in the number of years lived without cognitive impairment or dementia," Bell reasoned.

Researchers don't know precisely how the two conditions are linked, but they have a theory. "It is likely related to microvascular changes [in the walls of the small blood vessels] that are important to both penile and cognitive health,"Bell suggested.

For the study, the researchers tracked associations between erectile function, sexual satisfaction, and memory and thinking skills ("cognition") in more than 800 men, about age 56 on average at the study's start.

The men underwent tests of their memory and processing speed and completed questionnaires about erectile function and sexual satisfaction when they were 56, 61 and 68.

Those men who had reduced erectile function at age 56 were more likely to have lower scores on the memory and processing speed tests at the same age. In addition, men with lower erectile function when the study started showed greater and faster declines in memory over time, the findings showed.

"Maybe we should start thinking about ED as a canary in the coal mine," said study lead author Carol Franz, a professor psychiatry at UCSD. "From our and other research ED appears to be an early sensitive indicator of multiple aspects of poor cognitive, physical, and mental health in men -- prior to overt manifestation of other diseases."

So the message from both researchers is: Don't wait. If you notice problems in erectile function, even slight changes, talk to your doctor.

A doctor can help rule out many possible reasons for erectile function problems and develop a plan involving medication and lifestyle changes to improve erectile function, Bell said.

"Sixty is the new 30, and there should be no reason to consider ED an inevitable health symptom just as we would not accept ED as a normal symptom when someone is in their early adult years,"Bell said.

The study, recently published in The Gerontologist, can't prove a cause-and-effect relationship.

Still, "we know that ED can be a marker of health issues and can be a predictor of overall cardiac health as well, and now that it has been linked to cognitive function, it is even more important to prevent vascular disease from getting worse,"agreed Dr. Raevti Bole, a urologist at the Glickman Urological & Kidney Institute at Cleveland Clinic in Ohio.

Men should see their primary care doctor when they first notice problems achieving or maintaining an erection. "ED may be the first issue that many men notice and should be the one that makes them pick up their phone to call the doctor,"said Bole, who had no ties to the new study.

"If there are any health issues that are leading to the ED, such as high blood pressure, cardiac disease or diabetes, it's important to get them diagnosed and treated,"Bole said.

This proactive approach can stave off further damage. "If the underlying conditions continue to go untreated and they get worse, this can lead to worsening vascular disease and worsening problems all over the body, not just the erections,"Bole added.

Franz agreed, but noted that "few people understand that ED is a red flag. How many physicians incorporate such questions into annual checkups so that they have a sense of when changes occur or help men to feel more comfortable talking about their sexual health?"

"Hopefully this research will help educate men, their partners, and the medical community about ED and reduce the stigma associated with talking about this condition," she said.

More information

Learn more about how ED is diagnosed and treated at the Cleveland Clinic.

SOURCES: Tyler Reed Bell, PhD, post-doctoral scholar, University of California, San Diego; Carol Franz, PhD, professor of psychiatry, University of California, San Diego; Raevti Bole, MD, urologist, Glickman Urological & Kidney Institute, Cleveland Clinic, Ohio; The Gerontologist, March 2023