Men, and those in intimate partnerships with men, may become more concerned about erectile dysfunction as they age. While the condition is known for impacting quality of life and relationships, new research shows that erectile dysfunction may also be an early sign that you’re suffering from cognitive decline and may experience worse decline than those without erectile dysfunction. 

How are these two seemingly unconnected conditions related? We now believe that both may have underlying vascular causes which contribute to both sexual health and cognitive health issues. 

Vascular conditions are those that affect your heart and the flow of blood through your body. While it’s obvious that the penis relies on blood for function, it is sometimes harder to remember that the brain also has micro-vasculature that delivers the nutrients and oxygen it needs to function properly. When you have reduced blood flow, both areas of the body can be impacted. 

How Erectile Dysfunction and Cognitive Decline are Connected

Research has helped us to better understand how these vascular conditions may link erectile dysfunction and your brain health. `

The US military conducted one such study during the Vietnam War. Researchers compared twins who were serving in the military and compared their levels of erectile dysfunction and cognitive impairment. They found that those men who suffered from erectile dysfunction were more likely to suffer from amnestic cognitive impairment, which is cognitive impairment that affects memory. Researchers also found that erectile dysfunction developed first, prior to cognitive impairment, and could potentially be a warning sign of cognitive impairment. 

More recent research has built on this study and explored how men with erectile dysfunction progress if they develop cognitive issues. A longitudinal study followed over five hundred men for five years to see how these two conditions interacted. Researchers measured the men’s cognitive ability with a mini-mental state examination (MMSE) and asked the men to self-report the frequency of their erectile dysfunction. 

Researchers gathered sufficient information from participants to control for other factors that might also affect the men’s erectile dysfunction or cognitive performance. These factors included age, smoking, BMI, medications, education, marital status, and reproductive hormones. This control led to some interesting results. 

Firstly, researchers found that declines in both erectile function and frequency of sexual activity were related to a decline in cognitive performance over time. Unlike previous research, this study found that more than memory was impacted. Men who had erectile dysfunction had worse ability, over time, in important brain functions like number sequencing, recall, fluency, and visuospatial ability. 

When the researchers controlled for sex hormones, they did not see a significant difference in cognitive function. That means that there was no discernible pattern between men’s cognitive ability and their sexual hormones. Although sex hormones may have a role to play in erectile disfunction, it seems that it does not connect the condition to cognitive performance. 

Lastly, this study found that the men who started the study with erectile dysfunction were more likely to see a greater cognitive decline over the five-year period of the study. 

This study raises an important question: If those who suffer from erectile dysfunction are more likely to develop cognitive decline (and more quickly) does treating erectile dysfunction have a protective effect on the brain? One group of researchers sought to understand this better. For their study, they asked for observed participants who had both erectile dysfunction and mild cognitive impairment. Researchers asked these participants to take Tadalfil once per day. 

Tadalafil is a medication used to treat erectile dysfunction and benign prostatic hypertrophy. It does so by releasing tension from the muscles that control the blood vessels, which allows blood to travel more freely in the body. In animal models, treatment with Tadalafil has increased cognitive performance. 

This study found that the men who took Tadalafil had significantly increased cognitive performance. In fact, they found that blood flow had increased to a few specific parts of the brain, including the postcentral gyrus, precuneus and brainstem! 

How to Protect Yourself from Erectile Dysfunction and Cognitive Decline 

Diet and exercise can help you prevent the underlying vascular issues that cause or worsen erectile dysfunction and cognitive decline. There is evidence to suggest that with some simple changes you can make to your diet you will be able to support your vascular health and thereby limit your chances of developing erectile dysfunction and cognitive problems.

Exercise is, of course, also deeply linked to vascular health. Regular exercise, of the right intensity, can improve your blood flow in the short and long term, preventing vascular disease and other vascular conditions. In our comprehensive review, which was published in the prestigious Journal of Lifestyle medicine, we elaborated on how a comprehensive approach to lifestyle can significantly reduce one’s risk for vascular disease, and cognitive decline. 

Those who are already suffering from erectile dysfunction should keep in mind that they may also suffer from some cognitive impairment, and if so, decline may occur more swiftly than in those who do not have erectile dysfunction. It is important to be even more proactive about protecting your brain and preventing further vascular problems through regular exercise and a healthy diet. Your doctor can help you develop a plan to tackle this, and it may include dietary and exercise changes. 

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