Research has shown that men who smoke are 60% more likely to experience erection problems such as impotence, which is why smoking is considered to one of the prime lifestyle causes of impotence. Not only is smoking a singular cause of impotence, but it can also amplify the effects of some of the other causes of impotence such as diabetes, high blood pressure, depression and certain medications. Doctors will usually recommend that a man make lifestyle adjustments, such as giving up smoking, when they first experience erection difficulties.

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How does smoking cause impotence?

The connection between smoking and impotence

An erection occurs when a man is sexually stimulated. Chemical signals from the brain increase the amount of blood flow to the corpora cavernosa chambers located in the penis that are usually empty. If these chambers do not fill sufficiently then an erection can't occur.

Smoking has a direct effect on erectile dysfunction due to the nicotine and chemicals contained in a cigarette. This damages blood vessels and constricts the arteries to the extent that blood supply to the penis is reduced. This occurs in two ways:

  • Atherosclerosis – The chemicals that damage blood vessels and lead to atherosclerosis, narrow your arteries and make it much harder for blood to flow to the penis.
  • Nicotine also reduces blood flow by temporarily constricting the arteries.
relationship between impotence and smoking

How nicotine causes erectile dysfunction

The nicotine in cigarettes can cause blood vessels and penile tissues to spasm and narrow by stimulating receptors in the brain. Therefore, nicotine has an effect on the way in which blood is able to circulate around the penile tissues. This in particular affects how effectively blood pressure is able to rise to reach a point where an erection is sufficient for sex, without the risk of blood pressure falling.

How atherosclerosis causes erectile dysfunction

Smoking is a major risk factor for atherosclerosis, which in turn can lead to cardiovascular disease. Atherosclerosis is the medical term used for a condition where arteries start to harden as a result of a build-up of plaque and fatty deposits in artery walls, often leading to serious circulatory problems. Most people don't know they have atherosclerosis until they experience erectile dysfunction or have a heart attack.

Atherosclerosis as a Result of Smoking'

Adequate blood supply and blood pressure in the penis is vital for normal erections. Men who quit smoking may see an immediate improvement in their erectile health.

The effect smoking has on sperm

Along with the possible decrease in erections, smoking can have an effect on the quality of sperm. One study found that smoking damaged the necessary proteins needed to create healthy sperm. Smoking can affect the accessory glands and the testis causing them to become inflamed.

Research has shown that the severity of impotence experienced by a man is related to how heavy a smoker he is. This means that there is a chance of sexual health improving by giving up smoking. However, it can be difficult to reverse the effects of atherosclerosis if the condition has already had substantial time to spread.

Chemicals that cause erectile dysfunction

There are 41,000 chemicals in cigarette smoke and a high number of these can cause various health issues. Some of the most common ones include:

  • Carbon monoxide
  • Lead
  • Acetone
  • Ammonia
  • Arsenic
  • Tar

These chemicals harm your brain, kidneys, heart, lungs, appearance and body tissues as well as causing erectile dysfunction. They lead to cancer, lung diseases, fertility problems, eye disease, gum disease and osteoporosis. Smoking is likely to shorten your life by 15 years.

A study by the John Hopkins university in America found that you were more likely to be diagnosed with impotence if you were a current smoker in your forties to seventies than if you were a non-smoker. Whilst erectile dysfunction is more common with age, the correlation between smoking and erectile dysfunction is clear.

Another study from onlinelibrary.wiley.com monitored ex-smokers and current smokers that complained of erectile dysfunction and found that the severity of the condition was linked to the exposure of smoke.

If you stopped smoking for one year, the level of impotence had lessened for at least 25% of participants. Current smokers experienced no change whatsoever.

Findings published on webmd.com found that men who heavily smoked more 20 cigarettes per day were 60% more likely to get erectile dysfunction than their non-smoking counterparts. For ex-smokers, this likelihood halves to 30%. In comparison to men that have never smoked (12%), this is significantly higher.

Lastly, the link between young men who smoke that also develop erectile dysfunction is higher than those who don't smoke. In mature men, this can be more difficult to analyse due to other factors.

Is erectile dysfunction caused by smoking reversible?

In most cases giving up smoking can have an immediate positive effect on your erections. Nicotine levels will begin to fall as soon as you stop, and your body will start to process the chemicals out of your system. This means a boost to your blood flow. Within one day of giving up smoking you will experience these effects:

  • After 8 hours your nicotine and carbon dioxide levels will fall by more than 50% and your oxygen levels will increase.
  • After 48 hours there will be no nicotine left in your body and you will start to regain your ability to smell and taste.
  • After 72 hours your breathing will become easier as your lungs and tubes relax.
  • After 2 weeks to 3 months your circulation will improve and your body will begin to repair the damage caused by smoking.

If you are a heavy smoker who has smoked cigarettes for a long time some damage can be irreversible, however it is never too late to give up smoking. The benefits of being nicotine and chemical free are numerous and it will improve your quality of life.

Doctors will usually recommend that a man make lifestyle adjustments, such as quitting smoking, when they first experience erection difficulties. This could improve or completely stop erectile dysfunction altogether.

As mentioned under the studies related to how common smoking-related impotence, cutting down can begin to reduce the severity of the condition already. This means you can develop a strong programme to quit for good.

If the damage caused by smoking is irreversible, or you have continued to develop erectile dysfunction naturally or based on another condition that isn't directly smoking, there are other options.

Firstly, you must be diagnosed by a doctor, who can also help clarify the causes behind the condition for you personally. This could be smoking or a combination of various factors. Once this has been established, you can explore treatment options.

One option is prescription impotence treatments, however, if you smoke it's unlikely that an NHS doctor will prescribe ED tablets such as Levitra, Cialis or Viagra as the cause is a lifestyle choice that can be altered. It is likely that a patient will be advised to give up smoking, after which a doctor will prescribe a treatment if it's still required.

For more information on quitting smoking, including curbing the cravings, treatments and self-help techniques, you can visit our stop smoking page.

Dr Hilary Jones Independent Medical Adviser

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