How are erectile dysfunction and heart problems linked?

In the past, the buildup of plaques in the arteries of your body (atherosclerosis) was believed to be the reason why erectile dysfunction often precedes heart problems. The idea was that plaque buildup reduces blood flow in the penis, making an erection difficult.

However, experts now believe that erectile dysfunction preceding heart problems is more often due to the dysfunction of the inner lining of the blood vessels (endothelium) and smooth muscle. Endothelial dysfunction causes inadequate blood supply to the heart and impaired blood flow to the penis, and aids in the development of atherosclerosis.