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Review Article

Penile erection and cardiovascular function: effects and pathophysiology

, &
Article: 2336627 | Received 11 Dec 2023, Accepted 26 Mar 2024, Published online: 03 Apr 2024

References

  • Andersson KE, Wagner G. Physiology of penile erection. Physiol Rev. 1997;75:191–236.
  • Adeyemi DH, Odetayo AF, Hamed MA, et al. Impact of COVID 19 on erectile function. Aging Male. 2022;25(1):202–216. doi: 10.1080/13685538.2022.2104833.
  • Driel MFv. Physiology of penile erection—a brief history of the scientific understanding up till the eighties of the 20th century. Sex Med. 2015;3(4):349–357. doi: 10.1002/sm2.89.
  • Ajayi AF, Akhigbe RE. Assessment of sexual behaviour and fertility indices in male rabbits following chronic codeine use. Andrology. 2020;8(2):509–515. doi: 10.1111/andr.12717.
  • Besong EE, Akhigbe TM, Ashonibare PJ, et al. Zinc improves sexual performance and erectile function by preventing penile oxidative injury and upregulating circulating testosterone in lead-exposed rats. Redox Rep. 2023;28(1):2225675. doi: 10.1080/13510002.2023.2225675.
  • Besong EE, Ashonibare PJ, Akhigbe TM, et al. Sodium acetate abates lead-induced sexual dysfunction by upregulating testosterone-dependent eNOS/NO/cGMP signaling and activating Nrf2/HO-1 in male wistar rat. Naunyn Schmiedebergs Arch Pharmacol. 2023;397(2):1233–1243. doi: 10.1007/s00210-023-02696-y.
  • Kalsi J, Muneer A. Erectile dysfunction – an update of current practice and future strategies. J Clin Urol. 2013;6(4):210–219. doi: 10.1177/2051415813491862.
  • Panchatsharam PK, Durland J, Zito PM. Physiology, erection. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. http://www.ncbi.nlm.nih.gov/books/NBK513278/.
  • Kałka D, Biernikiewicz M, Gebala J, et al. Diagnosis of hypogonadism in patients treated with low energy shock wave therapy for erectile dysfunction: a narrative review. Transl Androl Urol. 2020;9(6):2786–2796. doi: 10.21037/tau-20-796.
  • Jung J, Jo HW, Kwon H, et al. Clinical neuroanatomy and neurotransmitter-mediated regulation of penile erection. Int Neurourol J. 2014;18(2):58–62. doi: 10.5213/inj.2014.18.2.58.
  • El-Sakka AI, Lue TF. Physiology of penile erection. ScientificWorldJournal. 2004;4(Suppl 1):128–134. doi: 10.1100/tsw.2004.58.
  • Lue TF, Takamura T, Schmidt RA, et al. Hemodynamics of erection in the monkey. J Urol. 1983;130(6):1237–1241. doi: 10.1016/s0022-5347(17)51768-1.
  • Akhigbe RE, Hamed MA, Odetayo AF, et al. Zinc improves sexual and erectile function in HAART-treated rats via the upregulation of erectogenic enzymes and maintenance of redox balance. Aging Male. 2023;26(1):2205517. doi: 10.1080/13685538.2023.2205517.
  • Akhigbe RE, Dutta S, Sengupta P, et al. Adropin in immune and energy balance: ‘a molecule of interest’ in male reproduction. Chem Biol Lett. 2021;8(4):213–223.
  • Oyedokun PA, Akhigbe RE, Ajayi LO, et al. Impact of hypoxia on male reproductive functions. Mol Cell Biochem. 2023;478(4):875–885. doi: 10.1007/s11010-022-04559-1.
  • Qiu X, Villalta J, Lin G, et al. Role of hydrogen sulfide in the physiology of penile erection. J Androl. 2012;33(4):529–535. doi: 10.2164/jandrol.111.014936.
  • Patel DV, Halls J, Patel U. Investigation of erectile dysfunction. Br J Radiol. 2012;85(Spec Iss 1):S69–S78. doi: 10.1259/bjr/20361140.
  • Rampin O, Giuliano F. Central control of the cardiovascular and erection systems: possible mechanisms and interactions. Am J Cardiol. 2000;86(2A):19F–22F. doi: 10.1016/s0002-9149(00)00886-9.
  • Andersson K-E, Stief C. Penile erection and cardiac risk: pathophysiologic and pharmacologic mechanisms. Am J Cardiol. 2000;86(2A):23F–26F. Supplement 1 doi: 10.1016/s0002-9149(00)00887-0.
  • Russell ST, Khandheria BK, Nehra A. Erectile dysfunction and cardiovascular disease. Mayo Clin Proc. 2004;79(6):782–794. doi: 10.1016/S0025-6196(11)62632-3.
  • Jensen J, Lendorf A, Stimpel H, et al. The prevalence and etiology of impotence in 101 male hypertensive outpatients. Am J Hypertens. 1999;12(3):271–275. doi: 10.1016/s0895-7061(98)00225-8.
  • Wei M, Macera CA, Davis DR, et al. Total cholesterol and high density lipoprotein cholesterol as important predictors of erectile dysfunction. Am J Epidemiol. 1994;140(10):930–937. doi: 10.1093/oxfordjournals.aje.a117181.
  • Bacon CG, Mittleman MA, Kawachi I, et al. Sexual function in men older than 50 years of age: results from the health professionals follow-up study. Ann Intern Med. 2003;139(3):161–168. doi: 10.7326/0003-4819-139-3-200308050-00005.
  • Moulik PK, Hardy KJ. Hypertension, anti-hypertensive drug therapy and erectile dysfunction in diabetes. Diabet Med. 2003;20(4):290–293. doi: 10.1046/j.1464-5491.2003.00911.x.
  • Derby CA, Mohr BA, Goldstein I, et al. Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk? Urology. 2000;56(2):302–306. doi: 10.1016/s0090-4295(00)00614-2.
  • Buranakitjaroen P, Phoojaroenchanachai M, Saravich S. Prevalence of erectile dysfunction among treated hypertensive males. J Med Assoc Thai. 2006;89(Suppl 5):S28–S36.
  • Akhigbe R, Ajayi A. The impact of reactive oxygen species in the development of cardiometabolic disorders: a review. Lipids Health Dis. 2021; Dec20(1):23. doi: 10.1186/s12944-021-01435-7.
  • Böhm M, Baumhäkel M, Probstfield JL, et al. Sexual function, satisfaction, and association of erectile dysfunction with cardiovascular disease and risk factors in cardiovascular high-risk patients: substudy of the ONgoing telmisartan alone and in combination with ramipril global endpoint trial/telmisartan randomized AssessmeNT study in ACE-INtolerant subjects with cardiovascular disease (ONTARGET/TRANSCEND). Am Heart J. 2007;154(1):94–101. doi: 10.1016/j.ahj.2007.03.024.
  • Shiri R, Koskimäki J, Häkkinen J, et al. Cardiovascular drug use and the incidence of erectile dysfunction. Int J Impot Res. 2007;19(2):208–212. doi: 10.1038/sj.ijir.3901516.
  • Opadijo OG, Akande AA, Jimoh AK. Prevalence of coronary heart disease risk factors in Nigerians with systemic hypertension. Afr J Med Med Sci. 2004;33(2):121–125.
  • Peter LW, James HFR. Atherosclerotic biology and epidemiology of disease. In: Topol EJ, Califf RM, Isner J, Prystowsky EN, Swain J, editors. Textbook of cardiovascular medicine. 2nd ed. Philadelphia (PA): Lippincott Williams & Wilkins; 2002. p. 1–20.
  • Ayodele OE, Alebiosu CO, Salako BL, et al. Target organ damage and associated clinical conditions among nigerians with treated hypertension: cardiovascular topic. Cardiovasc J South Afr. 2005;16(2):89–93.
  • Fasanmade OA, Okubadejo NU. Magnitude and gender distribution of obesity and abdominal adiiposity in Nigerians with type 2 diabetes mellitus. Niger J Clin Pract. 2007;10(1):52–57.
  • Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts male aging study. J Urol. 1994;151(1):54–61. doi: 10.1016/s0022-5347(17)34871-1.
  • Filippo CD, Verza M, Coppola L, et al. Insulin resistance and postprandial hyperglycemia the bad companions in natural history of diabetes: effects on health of vascular tree. Curr Diabetes Rev. 2007;3(4):268–273. doi: 10.2174/157339907782330012.
  • Ajayi AF, Akhigbe RE. The physiology of male reproduction: impact of drugs and their abuse on male fertility. Andrologia. 2020;52(9):e13672. doi: 10.1111/and.13672.
  • Rastogi S, Rodriguez JJ, Kapur V, et al. Why do patients with heart failure suffer from erectile dysfunction? A critical review and suggestions on how to approach this problem. Int J Impot Res. 2005;17 Suppl 1(S1):S25–S36. Dec doi: 10.1038/sj.ijir.3901426.
  • Schwarz ER, Rastogi S, Kapur V, et al. Erectile dysfunction in heart failure patients. J Am Coll Cardiol. 2006;48(6):1111–1119. Sep 19 doi: 10.1016/j.jacc.2006.05.052.
  • Guay A, Jacobson J. The relationship between testosterone levels, the metabolic syndrome (by two criteria), and insulin resistance in a population of men with organic erectile dysfunction. J Sex Med. 2007;4(4 Pt 1):1046–1055. doi: 10.1111/j.1743-6109.2007.00530.x.
  • Vlachopoulos C, Ioakeimidis N, Rokkas K, et al. Cardiovascular effects of phosphodiesterase type 5 inhibitors. J Sex Med. 2009;6(3):658–674. doi: 10.1111/j.1743-6109.2008.01107.x.
  • Wallis RM, Corbin JD, Francis SH, et al. Tissue distribution of phosphodiesterase families and the effect of sildenafil on tissue cyclic nucleotides, platelet function, and the contractile responses of trabeculae carneae and aortic rings in vitro. Am J Cardiol. 1999;83(5A):3C–12C. doi: 10.1016/s0002-9149(99)00042-9.
  • Dhaliwal A, Gupta M. PDE5 inhibitors. In: StatPearls [Internet] 2023 Apr 10. StatPearls Publishing, 2023.
  • Mónica FZ, De Nucci G. Tadalafil for the treatment of benign prostatic hyperplasia. Expert Opin Pharmacother. 2019;20(8):929–937. doi: 10.1080/14656566.2019.1589452.
  • Mostafa T. Oral phosphodiesterase type 5 inhibitors: nonerectogenic beneficial uses. J Sex Med. 2008;5(11):2502–2518. doi: 10.1111/j.1743-6109.2008.00983.x.
  • Ghiadoni L, Versari D, Taddei S. Phosphodiesterase 5 inhibition in essential hypertension. Curr Hypertens Rep. 2008;10(1):52–57. doi: 10.1007/s11906-008-0011-4.
  • Nagendran J, Archer SL, Soliman D, et al. Phosphodiesteras type 5 (PDE5) is highly expressed in the hypertrophied human right ventricle and acute inhibition of PDE5 improves contractility. Circulation. 2007;116(3):238–248. doi: 10.1161/CIRCULATIONAHA.106.655266.
  • Takimoto E, Belardi D, Tocchetti CG, et al. Compartmentalization of cardiac beta-adrenergic inotropy modulation by phosphodiesterase type 5. Circulation. 2007;115(16):2159–2167. doi: 10.1161/CIRCULATIONAHA.106.643536.
  • Takimoto E, Champion HC, Li M, et al. Chronic inhibition of cyclic GMP phosphodiesterase 5A prevents and reverses cardiac hypertrophy. Nat Med. 2005;11(2):214–222. doi: 10.1038/nm1175.
  • Kloner RA, Mitchell M, Emmick JT. Cardiovascular effects of tadalafil in patients on common antihypertensive therapies. Am J Cardiol. 2003;92(9A):47M–57M. doi: 10.1016/s0002-9149(03)00075-4.
  • Santos RC, de Faria AP, Barbaro NR, et al. Tadalafil-induced improvement in left ventricular diastolic function in resistant hypertension. Eur J Clin Pharmacol. 2014;70(2):147–154. doi: 10.1007/s00228-013-1611-8.
  • Jain A, Iqbal OA. Alprostadil. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022.
  • Neves-Zaph SR. Phosphodiesterase diversity and signal processing within cAMP signaling networks. Adv Neurobiol. 2017;17:3–14. doi: 10.1007/978-3-319-58811-7_1.
  • Lea AP, Bryson HM, Balfour JA. Intracavernous alprostadil. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in erectile dysfunction. Drugs Aging. 1996;8(1):56–74. doi: 10.2165/00002512-199608010-00009.
  • Wu JD, Tao S, Jin X, et al. PGE1 improves diabetic peripheral neuropathy in patients with type 2 diabetes. Prostaglandins Other Lipid Mediat. 2016;126:24–28. doi: 10.1016/j.prostaglandins.2016.07.006.
  • Guay AT. Testosterone and erectile physiology. Aging Male. 2006;9(4):201–206. doi: 10.1080/13685530601051155.
  • Akhigbe RE, Afolabi OA, Ajayi AF. L-Arginine reverses maternal and pre-pubertal codeine exposure-induced sexual dysfunction via upregulation of androgen receptor gene and NO/cGMP signaling. PLoS One. 2022;17(9):e0274411. doi: 10.1371/journal.pone.0274411.
  • Morales A, Lunenfeld B. Androgen replacement therapy in aging men with secondary hypogonadism. Aging Male. 2001;4(3):151–162. doi: 10.1080/tam.4.3.151.162.
  • Matsumoto AM. Andropause: clinical implications of the decline in serum testosterone levels with aging in men. J Gerontol A Biol Sci Med Sci. 2002;57(2):M76–M99. doi: 10.1093/gerona/57.2.m76.
  • Gagliano-Jucá T, Basaria S. Testosterone replacement therapy and cardiovascular risk. Nat Rev Cardiol. 2019;16(9):555–574. doi: 10.1038/s41569-019-0211-4.
  • Bassil N, Alkaade S, Morley JE. The benefits and risks of testosterone replacement therapy: a review. Ther Clin Risk Manag. 2009;5(3):427–448. doi: 10.2147/tcrm.s3025.
  • Goodale T, Sadhu A, Petak S, et al. Testosterone and the heart. Methodist Debakey Cardiovasc J. 2017;13(2):68–72. doi: 10.14797/mdcj-13-2-68.
  • English KM, Steeds RP, Jones TH, et al. Low-dose transdermal testosterone therapy improves angina threshold in men with chronic stable angina: a randomized, double-blind, placebo-controlled study. Circulation. 2000;102(16):1906–1911. October 17; doi: 10.1161/01.CIR.102.16.1906.
  • Rosano GM, Leonardo F, Pagnotta P, et al. Acute anti-ischemic effect of testosterone in men with coronary artery disease. Circulation. 1999;99(13):1666–1670. doi: 10.1161/01.cir.99.13.1666.
  • Webb CM, Adamson DL, de Zeigler D, et al. Effect of acute testosterone on myocardial ischemia in men with coronary artery disease. Am J Cardiol. 1999;83(3):437–439, A9. doi: 10.1016/s0002-9149(98)00880-7.
  • Persu C, Cauni V, Gutue S, et al. Diagnosis and treatment of erectile dysfunction – a practical update. J Med Life. 2009;2(4):394–400.
  • Lin H, Wang G, Wang R. Application of the vacuum erectile device in penile rehabilitation for erectile dysfunction after radical prostatectomy. Zhonghua Nan Ke Xue. 2015;21(3):195–199.
  • Yuan J, Hoang AN, Romero CA, et al. Vacuum therapy in erectile dysfunction-science and clinical evidence. Int J Impot Res. 2010;22(4):211–219. doi: 10.1038/ijir.2010.4.
  • Jackson G, Montorsi P, Adams MA, et al. Cardiovascular aspects of sexual medicine. J Sex Med. 2010;7(4 Pt 2):1608–1626. doi: 10.1111/j.1743-6109.2010.01779.x.
  • Thompson IM, Tangen CM, Goodman PJ, et al. Erectile dysfunction and subsequent cardiovascular disease. JAMA. 2005;294(23):2996–3002. doi: 10.1001/jama.294.23.2996.
  • Vlachopoulos C, Jackson G, Stefanadis C, et al. Erectile dysfunction in the cardiovascular patient. Eur Heart J. 2013;34(27):2034–2046. doi: 10.1093/eurheartj/eht112.
  • Gandaglia G, Briganti A, Jackson G, et al. A systematic review of the association between erectile dysfunction and cardiovascular disease. Eur Urol. 2014;65(5):968–978. doi: 10.1016/j.eururo.2013.08.023.
  • Doumas M, Tsakiris A, Douma S, et al. Beneficial effects of switching from beta-blockers to nebivolol on the erectile function of hypertensive patients. Asian J Androl. 2006;8(2):177–182. doi: 10.1111/j.1745-7262.2006.00076.x.
  • Baumhäkel M, Schlimmer N, Kratz M, et al. Cardiovascular risk, drugs and erectile function - a systematic analysis: CV-DrugED. Int J Clin Pract. 2011;65(3):289–298. doi: 10.1111/j.1742-1241.2010.02563.x.
  • Baumhäkel M, Werner N, Böhm M, et al. Circulating endothelial progenitor cells correlate with erectile function in patients with coronary heart disease. Eur Heart J. 2006;27(18):2184–2188. doi: 10.1093/eurheartj/ehl202.
  • Böhm M, Baumhäkel M, Teo K, et al. Erectile dysfunction predicts cardiovascular events in high-risk patients receiving telmisartan, ramipril, or both: the ONgoing telmisartan alone and in combination with ramipril global endpoint trial/telmisartan randomized AssessmeNt study in ACE iNtolerant subjects with cardiovascular disease (ONTARGET/TRANSCEND) trials. Circulation. 2010;121(12):1439–1446. doi: 10.1161/CIRCULATIONAHA.109.864199.
  • Toblli JE, Stella I, Mazza ON, et al. Different effect of losartan and amlodipine on penile structures in male spontaneously hypertensive rats. Am J Nephrol. 2004;24(6):614–623. doi: 10.1159/000082598.
  • Düsing R. Effect of the angiotensin II antagonist valsartan on sexual function in hypertensive men. Blood Press Suppl. 2003;2(sup2):29–34. doi: 10.1080/08038020310021967.
  • Baumhäkel M, Schlimmer N, Böhm M. Effect of irbesartan on erectile function in patients with hypertension and metabolic syndrome. Int J Impot Res. 2008;20(5):493–500. doi: 10.1038/ijir.2008.28.
  • Cordero A, Bertomeu-Martínez V, Mazón P, et al. Erectile dysfunction in high-risk hypertensive patients treated with beta-blockade agents. Cardiovasc Ther. 2010;28(1):15–22. doi: 10.1111/j.1755-5922.2009.00123.x.
  • Terentes-Printzios D, Ioakeimidis N, Rokkas K, et al. Interactions between erectile dysfunction, cardiovascular disease and cardiovascular drugs. Nat Rev Cardiol. 2022;19(1):59–74. doi: 10.1038/s41569-021-00593-6.
  • Becker AJ, Uckert S, Stief CG, et al. Plasma levels of angiotensin II during different penile conditions in the cavernous and systemic blood of healthy men and patients with erectile dysfunction. Urology. 2001;58(5):805–810. doi: 10.1016/s0090-4295(01)01312-7.
  • Imprialos KP, Stavropoulos K, Doumas M, et al. Sexual dysfunction, cardiovascular risk and effects of pharmacotherapy. Curr Vasc Pharmacol. 2018;16(2):130–142. doi: 10.2174/1570161115666170609101502.
  • Llisterri JL, Lozano Vidal JV, Aznar Vicente J, et al. Sexual dysfunction in hypertensive patients treated with losartan. Am J Med Sci. 2001;321(5):336–341. doi: 10.1097/00000441-200105000-00006.