Cardiologists are not single organ specialists . They are supposed to be sincere guardians of the the entire vascular system .Sexual dysfunction in males is almost synonymous with erectile dysfunction(ED) .The male sex organ is equally dynamic organ like the heart . It demands a sudden gush of blood to the tune of 500 ml during complete erection .This conveys an important message . The penile macro and micro vasculature is as important as coronary mIcrovascular bed. Atherosclerois of LAD can be as common as atherosclerosis of pudendal artery .It can precede or follow the coronary lesion. Penile insufficiency is a early marker of endothelial dysfunction. All patients with CAD should be screened for ED and vice versa.
This is not a sexual intrusion in academics , but I am sure , a sustained erection that completes a normal sexual act may very well rule out a proximal LAD lesion 99 % of times .
Do you know , > 7 Mets on a tread mill will rule out a significant left main disease with high degree of accuracy ! Sexual acts require more than that (One may do a study on this !)
There has been some interesting guidelines for managing issue of sexual dysfunction in CAD. .Princeton consensus conference is the famous one.
References
Dr.S.Venkatesan MD 
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