This is an archived article that was published on sltrib.com in 2007, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

Posted: 3:01 AM- Men, take heed: Exercising regularly and preventing heart disease and diabetes can safeguard your sex life.

A study published in today's issue of the American Journal of Medicine calculates that more than 18 million American men over age 20 are affected by erectile dysfunction, the inability to maintain or achieve an erection.

Almost 90 percent of the studied men with dysfunction had at least one risk factor for heart disease, such as diabetes, hypertension, poor cholesterol levels or smoking. They also were less likely to have had strenuous exercise within the month prior to the study.

With such a strong link between sexual problems and lifestyle, health providers are hoping men will make changes.

"This may be a powerful motivator for male patients who may be at risk for cardiovascular disease or who have diabetes," said Elizabeth Selvin, lead author and a faculty member in the Johns Hopkins Bloomberg School of Public Health's Department of Epidemiology. "It's another reason to get off the couch and exercise and eat well."

Researchers culled data from 2,126 participants in the National Health and Nutrition Examination Survey. Men who reported being "sometimes able" or "never able" to get and keep an erection were labeled as having erectile dysfunction, while men who reported being "always or almost always able" or "usually able" were not.

The prevalence of erectile dysfunction was 18 percent. Men 70 and older were more likely to suffer from erectile dysfunction, compared to 5 percent of men between ages 20 and 40.

Almost half of all men in the study with diabetes also had erectile dysfunction.

Steven N. Gange, a urologist at Western Urological Clinic in Salt Lake City, said he believes from other studies that the number of men with the condition is much higher.

"This is actually a much lower number than I'm comfortable with," Gange said.

The diabetes findings make sense to him. "Diabetes ultimately does become a vascular disease, and smoking and aging are also risk factors," he said.

Erectile dysfunction can be the first sign of a vascular disease in otherwise seemingly healthy males. Recently, Gange saw a 33-year-old smoker who wasn't responding to Viagra, Cialis or Levitra, popular drug treatments that increase blood flow to the penis. Gange recommended he see a cardiologist.

Blake Hamilton, a urologist with University Health Care in Salt Lake City, said men may seek medical help for sexual problems before other health issues because it affects their lives so negatively.

"Men often put things off," he said. "But a lot will go to the doctor for erectile dysfunction. It's important to make the connection between" erectile dysfunction and cardiovascular disease.

Brent Muhlestein, director of cardiology research at LDS Hospital in Salt Lake City, says cardiologists should ask their patients about erectile dysfunction.

They also need to be very careful when prescribing the three treatment drugs, because they can be dangerous for patients on nitroglycerin. Since both types of drugs can cause blood pressure to drop, when coupled, they can lead to plummeting blood pressure, heart attacks and even death.

"We have to learn when it's safe and not safe to let patients with heart disease use Viagra or other similar medications," Muhlestein said. "A lot of men ask for it because it's very distressing to them."

He also thinks more men might be willing to become healthier if they understand all the ways it can improve their lives.

"One thing I have done is tell patients not only can you prevent yourself from having a heart attack or stroke in the future, but it will also probably help your sex life to last longer," he said. "Sometimes that catches their attention."

chamilton@sltrib.com" Target="_BLANK">chamilton@sltrib.com