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Erectile and Clitoral Dysfunction as Harbingers of Cardiovascular Disease: A Perspective
Fernanda Priviero1,2,3, Fiona Hollis4,5, Susan K Wood4,5
1Cardiovascular Translational Research Center, University of South Carolina, Columbia, SC 29208, USA.
Insights
Sexual dysfunction, including erectile dysfunction (ED) in men and female sexual arousal disorder (FSAD) in women, signals underlying cardiovascular disease (CVD). Clinicians should consider these conditions in cardiovascular risk assessments.
Area of Science:
- Cardiovascular Medicine
- Sexual Health
- Preventive Cardiology
Background:
- Sexual dysfunction (SD), specifically vasculogenic erectile dysfunction (ED) in men and female sexual arousal disorder (FSAD) in women, is increasingly recognized as a significant indicator of cardiovascular disease (CVD).
- While ED's role as an early warning sign for coronary artery disease (CAD) is well-documented, analogous evidence for FSAD in women is still developing.
- This highlights a critical gap in understanding the cardiovascular implications of sexual health in both sexes.
Purpose of the Study:
- To explore the epidemiologic associations between genital vasculogenic sexual dysfunction and cardiovascular disease.
- To investigate shared pathophysiologic mechanisms underlying sexual dysfunction and atherosclerosis.
- To propose clinical implications and screening paradigms for incorporating sexual dysfunction into cardiovascular risk stratification.
Main Methods:
- This perspective synthesizes existing literature on sexual dysfunction and cardiovascular disease.
- It examines epidemiological data linking ED and FSAD to various cardiovascular conditions.
- The review discusses shared mechanisms, such as endothelial dysfunction, and proposes clinical screening strategies.
Main Results:
- Genital vasculogenic sexual dysfunction, in both men and women, is a valuable marker for underlying cardiovascular risk.
- Shared pathophysiologic pathways, including endothelial dysfunction and atherosclerosis, link sexual dysfunction to systemic cardiovascular disease.
- Emerging evidence supports FSAD as a potential cardiovascular risk indicator in women, mirroring ED in men.
Conclusions:
- Clinicians should integrate the assessment of genital vasculogenic sexual dysfunction into routine cardiovascular risk stratification protocols.
- A multidisciplinary approach involving primary care, cardiology, and urology/gynecology is essential for comprehensive patient management.
- Recognizing sexual dysfunction as a cardiovascular risk-enhancing condition can lead to earlier diagnosis and intervention for cardiovascular disease.
Abstract:
Sexual dysfunction (SD), more specifically vasculogenic erectile dysfunction (ED) in men and female sexual arousal disorder (FSAD) in women, is increasingly recognized as a marker of cardiovascular disease (CVD). While extensive literature documents vasculogenic ED as an early warning sign of coronary artery disease (CAD) and other atherosclerotic manifestations, the evidence for analogous phenomena in women is emerging but less mature. This perspective explores epidemiologic associations, shared pathophysiologic mechanisms, clinical implications, and screening paradigms for ED and FSAD as cardiovascular (CV) risk-enhancing conditions. This perspective endorses that clinicians should incorporate genital vasculogenic SD into CV risk stratification and that multidisciplinary care (primary care, cardiology, urology/gynecology) is warranted. A summary table outlines key features and actionable steps.
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