Smoking and Erectile Dysfunction - Why Smoking Causes Impotence
By Bob Sherman
Smokers can expect to suffer from a number of smoking related ailments, including erectile dysfunction.
The most significant health risks of smoking involve respiratory cancers and chronic obstructive pulmonary disease. Most people affected by smoking related disease suffer from respiratory and cardiovascular diseases.
Smokers also have higher risks of experiencing many other diseases, including osteoporosis, periodontal disease, impotence, male infertility, and cataracts. Various studies have shown that the risk of impotence to smokers is 1.3 to 1.7 times the risk to non-smokers. In fact, though smokers make up less than a quarter of the population, 40% of those with impotence are current smokers.
Why Erectile Disfunction Affects Smokers
An erection occurs when incoming arteries are dilated (widened) causing increased blood flow to the penis; expanding venous cavities trap incoming blood; venous outflow is reduced by compression of outgoing veins; further venous obstruction is caused by stretching of the veins and surrounding tissue; contraction of the ischiocavernosus muscles (at the base of the penis) further reduces venous flow. As a result, increasing blood pressure within the penis causes it to become erect.
Smokers have increased difficulty achieving an erection, most likely because of smoking-related damage to the vascular system. This damage, producing erectile dysfunction, seems to persist after quitting. Some believe that smoking increases oxidative stress that causes dysfunction of the thin layer of cells that line the interior of blood vessels.
Nicotine may both decrease arterial flow to the penis as well as block corporeal smooth muscle relaxation which prevents venous occlusion. Arterial occlusive disease can decrease the pressure and arterial flow to the sinusoidal spaces (small blood vessels). This increases the time to an erection and reduces the rigidity of the erect penis, causing erectile dysfunction.
Smoking also harms lipid metabolism, causing higher triglyceride and lower HDL circulation. These changes contribute to development of atherogenic processes that cause vascular damage in penile arteries.
Ultrasound, coupled with Doppler technology, can measure blood flow velocities to and from the ultrasound probe. Smokers and past smokers show lower peak systolic blood velocity within the penis. The magnitude of these effects are strongly related to the length of smoking history.
Stopping smoking, even for 24 hours, appears to rapidly improves the blood flow to the penis and improves the tumescence (swelling) and rigidity of erections.
So, if you want to have good erections, quit smoking.
Resources
- Robert C Dean & Tom F Lue, Physiology of Penile Erection and Pathophysiology of Erectile Dysfunction, Urology Clinics of North America, 32(4), 397-v.
- Richard Edwards, ABC of smoking cessation: The problem of tobacco smoking, BMJ 328, 24 January 2004, 217-219.
- G Corona, E Mannucci, L Petrone, V Ricca, R Mansani, A Cilotti, G Balercia, V Chiarini, R Giommi, G Forti & M Maggi, Psychobiological correlates of smoking in patients with erectile dysfunction, International Journal of Impotence Research v 17, 527-534.
- M C Sighinolfi, A Mofferdin, S DeStefani, S Micali, A F G Cicero & G Bianchi, Immediate Improvement in Penile Hemodynamics after Cessation of Smoking: Previous Results, Journal of Urology, v 69, 163-165.
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