Increased risk of dying from cardiovascular disease for men with erectile dysfunction and low testosterone

April 2011

Nearly 1700 men attending an andrology clinic for erectile dysfunction were monitored for an average of 4.3 years to find out whether those with low testosterone levels were more likely to suffer a major cardiovascular disease event, such as a heart attack or stroke.

Key findings

  • At the start of the study, over 22% of the men had testosterone levels in the blood that were lower than the widely accepted lower limit for normal testosterone levels (the medical term for low testosterone is hypogonadism)
  • Over the course of the study, 139 men had a major cardiovascular event, such as heart attack, stroke, sudden cardiac death or other major cardiac events
  • For 15 of these men, the major cardiovascular event was fatal
  • Although having a low testosterone level did not make men more likely to have a cardiovascular event, men with lower levels of testosterone who had a major cardiovascular event were seven times more likely to die than those with higher testosterone levels.

Source: Low testosterone is associated with an increased risk of MACE lethality in subjects with erectile dysfunction. Corona G, Monami M, Boddi V, et al. J Sex Med 2010;7(4 Pt 1):1557-1564.

Background information

There is increasing evidence that erectile dysfunction may be a warning sign of a number of disease conditions, such as high blood pressure, metabolic syndromediabetes mellitus, depression and coronary heart disease.

  • This study is important as it is the first to show that low testosterone increases the risk of men with erectile dysfunction dying from cardiovascular events
  • Low testosterone is often a contributing factor to erectile dysfunction
  • Seeking advice or treatment for symptoms of erectile dysfunction gives an opportunity for both the patient and his doctor, as a check-up may uncover other health issues that would benefit from early treatment or lifestyle changes
  • It is known that testosterone therapy benefits sexual function and improves the effectiveness of common treatments for erectile dysfunction in men with low testosterone
  • Testosterone therapy may also have benefits in preventing or slowing the development of atherosclerosis
  • Screening for low testosterone may also be a worthwhile way of discovering those men most at risk from heart disease
  • However, more study is needed to find out if testosterone therapy can help prevent unnecessary deaths from cardiovascular disease in men with erectile dysfunction.