How Smoking Can Lead to Erectile Dysfunction

Smoking increases risk of heart and lung disease as well as many types of cancer. But did you know that smoking can affect sexual function? 

Here’s how smoking can lead to erectile dysfunction (ED). 

Does smoking cause erectile dysfunction?

Yes, there’s clear evidence that smoking cigarettes can cause ED. In one study, men who smoked had double the risk of developing ED in middle age than men who didn’t smoke. This study only included men who didn’t have other conditions that increased their risk for developing ED, like diabetes and heart disease.

This appears to be a dose-dependent relationship. That means the more you smoke and the longer you smoke, the more likely you are to develop ED. In one study, people who smoked more than 20 cigarettes per day were twice as likely to develop ED than those who smoked less than 20 cigarettes each day. 

Can smoking weed cause erectile dysfunction?

Maybe. One study found that rates of ED were twice as high in people who smoked cannabis compared to people who didn’t smoke. But the reasons why aren’t well understood. 

Why does smoking affect your sexual health?

Here’s how smoking can affect your sexual health.

Smoking increases your risk of developing erectile dysfunction

Achieving and maintaining an erection starts when the nervous system directs more blood toward the penis. 

The extra blood goes into the corpus cavernosum, two columns of spongy tissue that run through the shaft of the penis. When the corpus cavernosum fills with blood, it becomes rigid and creates an erection.

Smoking affects your ability to achieve and maintain an erection two ways:

• Smoking lowers the amount of nitric oxide your body makes. Nitric oxide is the chemical that tells smooth muscle in the penis to relax. This muscle relaxation is what allows the spongy tissue in the penis to fill with blood and become erect. 

• Smoking also makes it easier for fatty deposits to form inside blood vessels over time. This hardens your blood vessels, so they can’t open up as easily to receive extra blood. This is called atherosclerosis. Atherosclerosis is a major cause of ED. 

EXPERT PICKS: WHAT TO READ NEXT

• What about alcohol? Here’s why drinking can make it more difficult to get an erection. 

• All about nicotine replacement therapy (NRT): Quitting cold turkey is hard. NRT can help. Learn about the different NRT options.

• Can you cure erectile dysfunction (ED)? Some causes of ED are treatable, while others aren’t. Here’s what to know.

Smoking can increase your risk of infertility 

People who smoke are more likely to have trouble with getting or staying pregnant. Studies suggest that smoking can lower your sperm count. It does this by interfering with your body’s hormone production. 

Smoking can also affect sperm’s mobility. So, even if you make enough sperm, that sperm may not be healthy enough to swim to an egg and create an embryo. Smoking can also affect the DNA inside sperm. Damaged DNA isn’t able to create a viable embryo. This can increase the risk of a miscarriage. 

Will quitting smoking reverse erectile dysfunction?

Yes, quitting smoking can sometimes help reverse ED. But it’s important to stop smoking as soon as possible. 

People who smoked for many years and then quit are less likely to see their ED get better than people who only smoked for a few years. This is likely because the longer you smoke, the more likely you are to develop atherosclerosis. Atherosclerosis won’t go away when you quit smoking. But it won’t stop getting worse. 

Cutting back on how much you smoke can also help. People who smoke more cigarettes each day are more likely to develop ED than people who smoke fewer cigarettes. So consider cutting back if you’re not ready to stop smoking completely. 

How do you treat erectile dysfunction from smoking?

Smoking cessation is the best treatment for ED from smoking. There are many tools you can use to help you quit smoking. 

Nicotine replacement therapy (NRT) can make it easier to cut back and stop smoking altogether. Prescription treatments — like Wellbutrin and Chantix — can also help you quit smoking. 

You may see improvement in your ED symptoms if you quit smoking. But this can take time. While you wait for the effects, you can also try medications like Viagra (sildenafil) and Cialis (tadalafil). These medications work by relaxing smooth muscle in the blood vessels of the penis, which help it fill with blood more easily. These medications are FDA approved to treat ED — but they can’t cure ED.

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Written by:

Christine Giordano, MD

Christine Giordano, MD, is board-certified in general internal medicine. She received her medical degree from Rutgers New Jersey Medical School and completed residency at Thomas Jefferson University.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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