[Medical Q&A] Does smoking cause erectile dysfunction?

Planner: Chinese Medical Association

Reviewer: Xiao Dan, Researcher, China-Japan Friendship Hospital

Smoking can cause erectile dysfunction, and the more smokers smoke and the longer they smoke, the higher the risk of erectile dysfunction.

There are two main mechanisms by which smoking induces erectile dysfunction. The first mechanism is acute damage. Nicotine in smoke can directly stimulate the human sympathetic nerves and promote the production of adrenaline and norepinephrine. These two substances will cause the smooth muscles in the penis cavernous body to contract, resulting in the penis being unable to be filled with blood, and erectile dysfunction will ensue. The second mechanism is chronic damage. After long-term smoking, the arteries that supply blood to the penis (especially the internal pudendal artery and the penis cavernous body artery) will harden and narrow, thereby reducing the blood supply to the penis. After the blood supply is reduced, it is difficult for the penis to erect. Penile erection requires neurotransmitters released by nerve endings to play a role, among which nitric oxide transmitters have the greatest effect. After long-term smoking, the content of nitric oxide in the penis cavernous body will be significantly reduced, leading to erectile dysfunction. In addition, toxic substances in tobacco will destroy the interstitial cells that specialize in producing testosterone, causing the testosterone level in men to decrease, and testosterone deficiency will also make the penis weak in erection. In order to maintain good erectile function for a long time, male smokers should quit smoking as soon as possible.