There is now increasing evidence of a strong association between diseases of the male reproductive system and chronic diseases such as diabetes and heart disease.

Our new awareness of the relationship between reproductive health and general health in men provides windows of opportunity for doctors to perform a few simple laboratory tests to investigate male patients who consult them about, for example, conditions such as Erectile Dysfunction or Male Infertility. This will allow serious conditions such as Diabetes, Heart disease and Testicular Cancer to be tested for – and diagnosed at an early stage.

Several research studies have clearly shown that Erectile Dysfunction (difficulty in getting and maintaining an erection) is a significant early warning sign of disease in the circulatory system). The risk of a man suffering a heart attack or stroke after developing ED is as serious as that of a man who is a smoker or a man who has a parent or sibling who suffered a premature heart attack. A research study published in 2005 demonstrated that 2% of men will suffer a major heart attack or stroke within a year of their first significant episode of Erectile Dysfunction – and within five years of such an episode, this risk rises to 5% in such men.

Several studies have also shown that erectile dysfunction (sometimes termed Impotence and better known by the acronym ED) can be an early warning sign of Diabetes. Between 30 and 90 per cent of diabetic men are known to experience erectile problems. Since the early diagnosis of diabetes is only made on the results of a blood test which shows elevated levels of glucose in the blood, many men with diabetes do not realise that they have the disease for the simple reason that they seldom visit a doctor and have no reason to undergo a blood test!

Diabetes is associated with ED because blood vessels in the penis are damaged by diabetes. This impedes blood flow to the penis, which makes it difficult for a man to get and maintain a hard erection. Moreover, since diabetes can be responsible for damage to nerves as well, interference with the nerves supplying the penis can also contribute to ED in diabetics.

In about 50% of couples who seek assisted reproductive therapy (commonly known as IVF or artificial insemination), infertility of the male partner is the sole or contributing factor. With modern techniques such as ICSI, all that is needed these days is a single motile sperm that can be drawn from the testis itself – so doctors may neglect to utilise the opportunity of investigating the male partner for other serious conditions.

It has been shown that one in eight men presenting for infertility treatment has evidence of testosterone deficiency. Furthermore, there is an increased risk of testicular cancer in these sub-fertile men, especially those who were born with an undescended testis (irrespective of whether the testis was surgically brought down after birth into its correct place within the scrotum).

It is important therefore that men (and their partners!) are made aware of the links between sexual health conditions and chronic diseases – so that they speak to their doctors early and use the opportunity to get themselves examined and tested for these serious diseases.