Can Smoking Cause Impotence? The Science Behind How Cigarettes Affect Erections
It’s well known that smoking harms the heart and lungs — but few men realise how deeply tobacco damages the vascular system that makes erections possible.
Clinical research shows that men who smoke are twice as likely to experience erectile dysfunction (ED) compared with non-smokers.
At Androhaus, we view ED as a vascular condition, meaning anything that restricts blood flow to the penis can impair erection strength — and smoking is one of the strongest modifiable risk factors.
How an Erection Works
An erection is a neurovascular process involving both nerve signals and blood vessels.
When aroused, the brain releases nitric oxide (NO) — a chemical messenger that relaxes penile arteries, allowing blood to surge into the corpora cavernosa.
As these chambers expand, veins are compressed, trapping blood and producing rigidity.
If blood inflow weakens or venous trapping fails, the erection won’t be as hard or may fade quickly.
What Smoking Does Inside the Body
1. Endothelial Dysfunction
The endothelium — the inner lining of blood vessels — regulates nitric oxide.
Nicotine and carbon monoxide damage these cells, reducing NO production.
Result: less vasodilation, weaker erections, and increased risk of atherosclerosis — narrowing of arteries that also affects the penis.
2. Reduced Penile Blood Flow
Doppler studies show that smokers have lower peak systolic velocity in penile arteries.
Even young smokers exhibit early arterial insufficiency, relying on adrenaline rather than smooth-muscle relaxation to achieve erections.
3. Venous Leak and Tissue Damage
Chronic smoking degrades collagen and elastin in penile tissue.
The tunica albuginea becomes less elastic, causing a venous leak, where blood escapes too fast.
Many men describe this as: “I can get an erection, but it won’t stay hard.”
4. Testosterone Suppression
Nicotine interferes with testosterone production in the testes, weakening libido and spontaneous erections.
Research Evidence
A BJU International study found that quitting smoking for eight weeks improved penile blood flow by 25%.
The Massachusetts Male Aging Study linked heavy smoking with a 50% higher risk of moderate to severe ED.
Even vaping and e-cigarettes release chemicals that harm endothelial function, though to a lesser extent.
Because penile arteries are smaller than coronary arteries, erectile issues often appear years before heart problems, making ED an early cardiovascular warning sign.
Why Some Men Notice a Rapid Decline
Men who smoke and also have hypertension, diabetes, or high cholesterol face a triple threat: restricted arteries, slower nerve signals, and poor oxygen delivery.
Once fibrosis sets in, blood cannot fill the erectile chambers fully — and the erection won’t be as firm even with medication.
Treatment Pathways at Androhaus
1. Smoking Cessation Support
Quitting smoking improves erection strength within weeks, as endothelial cells begin to regenerate.
2. Vascular Assessment
We use penile Doppler ultrasound to measure arterial inflow and check for venous leakage.
3. Hormonal Testing
Smoking can mask low testosterone — addressing both factors helps restore energy and libido.
4. Shockwave Therapy (LI-ESWT)
Low-intensity shockwaves stimulate new blood vessel growth, restoring natural erections without drugs.
5. Lifestyle and Medication Support
PDE-5 inhibitors (sildenafil, tadalafil) enhance nitric oxide signalling.
Pelvic-floor training strengthens veins that maintain rigidity.
Cardiometabolic care — optimising diet, exercise, sleep, and stress — preserves long-term vascular elasticity.
Prevention: The Best Medicine
The ideal approach is to quit smoking before ED develops.
Within:
24 hours – carbon monoxide levels drop
Weeks – nitric oxide improves
Months – vascular tone returns to normal
Men who quit regain not only erectile strength but also reduce risks of heart attack, stroke, and infertility.
Key Takeaway
Smoking damages arteries, nerves, and testosterone — attacking every pathway that produces an erection.
When an erection isn’t as hard, it’s often a vascular warning sign, not just a bedroom issue.
Through smoking cessation, medical assessment, and Shockwave Therapy, Androhaus helps men restore natural performance — safely, discreetly, and effectively.
