Can High Cholesterol Cause Erectile Dysfunction?
Key takeaways:
High cholesterol makes blood vessels stiffer and narrow. These changes can lead to erectile dysfunction (ED).
Cholesterol-lowering medications may help improve ED symptoms.
Prescription medications for ED can also help lessen symptoms.
Table of contents
Achieving and maintaining an erection is a complex process. It requires healthy nerves, hormones, and blood vessels. Problems with any of these can lead to erectile dysfunction (ED).
If you have high cholesterol, you may have been told that it can increase your risk of heart attack and stroke. But high cholesterol can affect blood vessels in every part of the body — including the penis.
Let’s look at how high cholesterol can contribute to ED.
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What’s the link between cholesterol and erectile dysfunction?
Having high cholesterol puts you at higher risk for ED in two main ways:
It reduces blood flow to the penis.
And it makes it more difficult for penis muscles to relax.
We’ll go into both in more detail below.
Lowers blood flow to the penis
Achieving an erection starts when the nervous system directs more blood flow into the penis. Blood fills the corpus cavernosum — two columns of tissue that run through the shaft of the penis. This makes the penis rigid.
High cholesterol increases your risk for developing atherosclerosis. Atherosclerosis is a medical condition in which fatty plaques build up on the sides of blood vessels.
Over time, atherosclerosis makes arteries stiffer and narrow. These changes make it more difficult for blood to pass through the blood vessels and reach your penis. You can develop ED when enough blood can’t easily reach your penis to produce an erection.
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Do all men get ED as they age? ED is more likely as you age. But men who have better physical health are also more likely to have better sexual health.
Makes it more difficult for penis muscles to relax
High cholesterol also impacts your body’s ability to make nitric oxide. Nitric oxide is a chemical that encourages smooth muscle in the penis to relax. Blood is able to enter your penis more easily when these muscles relax. This helps you maintain an erection.
Will lowering cholesterol levels improve erectile dysfunction?
Yes, there’s evidence that lowering cholesterol levels can help improve symptoms of ED. This is especially true if high cholesterol is the only thing causing your ED.
There are different types of cholesterol. LDL (low-density lipoprotein) is the “bad” cholesterol that can lead to atherosclerosis. People with high LDL levels in their blood are more likely to develop ED.
Lowering your LDL levels can help atherosclerosis from getting worse. And this can stop ED from getting worse too. In some situations, it may even help improve some ED symptoms.
How to treat erectile dysfunction caused by high cholesterol
There are two ways to treat ED caused by high cholesterol: lowering your levels of the “bad” cholesterol (LDL) and taking medications for ED.
1. Lower your LDL levels
Lowering your LDL levels can help your ED symptoms from getting worse. It may not completely reverse or cure your ED. But, in some cases, ED symptoms may get better when LDL levels are in a healthy range.
Statins are a class of medications that can help treat high cholesterol. Examples include:
Atorvastatin (Lipitor)
Rosuvastatin (Crestor)
Simvastatin (Zocor)
In a large review of studies, researchers found that men with high cholesterol and ED reported improvement of ED symptoms once they started statin therapy.
You can also keep blood vessels healthy by staying active, eating a plant-based diet, and maintaining a comfortable weight.
2. Try ED medications
There are safe and effective prescription medications to treat ED symptoms. They can’t cure ED, but they can make it easier to achieve and maintain an erection.
Phosphodiesterase-5 (PDE5) inhibitors are medications that relax smooth muscle in the blood vessels of the penis. This helps blood vessels fill more easily. Examples include Viagra (sildenafil) and Cialis (tadalafil).
It’s usually safe to take Viagra if you only have high cholesterol. But it’s important to discuss these medications with your healthcare team. They may not be safe choices if you have other medical conditions — or if you’re already taking certain medications.
Frequently asked questions
Medical conditions like diabetes and hypertension can contribute to ED. Other causes of ED include:
Medication side effects
Mental health issues
Low testosterone
Nerve problems
There are no visible signs of high cholesterol. People with extremely high levels of cholesterol may develop lumps or growths such as:
Xanthomas: small yellow nodules in the skin
Xanthelasma: yellow growths near the eyelids
There’s some evidence that high testosterone can lead to higher cholesterol levels. But testosterone seems to primarily drive up high-density lipoprotein (HDL), the “good” cholesterol.
Other studies show that the relationship between testosterone and cholesterol levels may be more complicated. Both very high and very low levels of LDL cholesterol were associated with low testosterone.
Maybe. You may feel better if you’re more active and eat a plant-based diet. But most people don’t notice when their cholesterol is high. And they won’t necessarily feel much different when it’s lower.
The bottom line
ED can happen when the penis receives less blood. High cholesterol damages blood vessels and makes them more stiff and narrow. High cholesterol also makes it more difficult for smooth muscle in the penis to relax. These changes make it harder for blood to get into the penis, which leads to ED.
Statins can help lower cholesterol, which can improve sexual function. Treatment for ED can also help improve symptoms.
Why trust our experts?
References
Dhaliwal, A., et al. (2023). PDE5 inhibitors. StatPearls.
Kostis, J. B., et al. (2014). The effect of statins on erectile dysfunction: A meta-analysis of randomized trials. The Journal of Sexual Medicine.
Lee, J. H., et al. (2023). Non-linear association between testosterone and LDL concentrations in men. Andrology.
Li, M., et al. (2020). Significance of blood lipid parameters as effective markers for arteriogenic erectile dysfunction. Andrology.
National Cancer Institute. (n.d.). Corpus cavernosum. National Institutes of Health.
Page, S. T., et al. (2009). Higher testosterone levels are associated with increased high-density lipoprotein cholesterol in men with cardiovascular disease: Results from the Massachusetts Male Aging Study. Asian Journal of Andrology.
Panchatsharam, P. K., et al. (2023). Physiology, erection. StatPearls.
Saltzman, E. A., et al. (2004). Improvement in erectile function in men with organic erectile dysfunction by correction of elevated cholesterol levels: A clinical observation. The Journal of Urology.
Wei, M., et al. (1994). Total cholesterol and high density lipoprotein cholesterol as important predictors of erectile dysfunction. American Journal of Epidemiology.
