Can a hernia cause erectile dysfunction?

Hernias happen when your insides — an organ, intestines, or fat — bulge through a weak spot in the muscle wall. Even when a hernia isn't painful, the pressure, swelling, or visible bulge can make sex uncomfortable. 

So, can a hernia cause erectile dysfunction (ED)? Not exactly. But having a hernia can indirectly cause sexual problems that make it difficult to get or stay hard — including ED (even temporary!).

Before we dive into how hernias impact your sex life, it’s essential to understand that there are different types of hernias: inguinal (in the groin), hiatal (upper abdominal), umbilical (around the belly button), and more.  In this article, we’ll be talking about inguinal hernias, which are located near the scrotum and affect 27% of men at some point in their lives. 

Hernias don’t directly cause ED. But pain, pressure, or stress from a hernia can interfere with your ability to get and maintain an erection hard enough for satisfying sex. So, a hernia can indirectly contribute to ED.

• Inguinal hernias can make sex painful.

• Hernias can trigger sexual performance anxiety.

• Untreated hernias don’t usually cause issues with testicular blood flow.  However, a large or trapped hernia can compress structures in the spermatic cord and, in rare cases, reduce blood flow to the testicles.

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Pain

Like an enlarged prostate, hernias can also be a real pain in the pelvic region. 

In one study, 23% of men with inguinal hernias reported pain during sexual activity. Other research has established a link between pain and sexual dysfunction — specifically, pain has been linked with low libido (sex drive) and decreased sexual satisfaction. 

Think about it: If sex hurts, the prospect of physical intimacy might be more stressful than stimulating. And stress can cause ED by interrupting the signals between the brain and body needed to get an erection. 

Anxiety

An inguinal hernia can cause a palpable lump in your groin. Sometimes, it can also cause a bulging or enlarged scrotum. For some men, these visible symptoms might cause performance anxiety, which can lead to psychological ED. 

So, is the hernia itself preventing an erection from developing? No — and a clue might be that erections still occur normally at night, in the morning, and during masturbation.

But research is clear that self-consciousness about a hernia (or anything, for that matter) can mess with sexual performance and contribute to ED, especially during partnered sex.  

Impaired blood flow to the testicles

In rare but severe cases, an untreated hernia can become incarcerated or strangulated. This means tissue (such as fat or intestines) can get trapped in the hernia and lose its blood supply. When this happens, nearby structures in the spermatic cord can be compressed. If blood flow to a testicle is blocked, this can cause the death of testicular tissue.

Signs of impacted testicular blood flow include:

• Sudden and severe one-sided testicular pain

• Swelling of the scrotum

• Abdominal pain (especially in the lower abdominal region)

Compromised blood flow to the testicles is a medical emergency. Blood flow to the testicle must be restored quickly to prevent permanent damage to sexual function. While hernias are a possible cause of impaired testicular blood flow, there are other potential causes as well including testicular torsion. 

To get to the bottom of your symptoms and, most importantly, restore testicular blood flow as soon as possible, seek emergency medical attention if you are suspecting issues with testicular blood supply.

Temporarily, maybe — but it might also improve sexual function. 

Some research shows that some men report temporary sexual dysfunction or pain after hernia repair surgery. But other research has found that surgery can end up reducing pain and swelling from the hernia itself, which often improves sexual function after healing takes place. 

One study even found that erectile function and orgasm satisfaction significantly improved from the first to the sixth month after surgery. This suggests that any post-procedure pain (and any erectile issues it may have caused) may continue to get better as the body heals. 

Bottom line: Some patients experience increased groin pain during sex after hernia surgery, but this is usually related to the healing process and isn’t a long-term issue. Most research suggests that surgically repairing a hernia can actually improve sexual function and satisfaction as healing progresses. 

In general, most people can get back to daily activities (including having sex) within a week after hernia surgery. 

However, the exact timing depends on:

• Type of procedure. Open inguinal hernia repairs tend to cause more groin pain than laparoscopic surgery. This pain could postpone your ability to enjoy sex while healing.

• Whether you experience complications. Though they are uncommon, possible hernia repair complications include urinary retention and infection. If you experience complications, your provider may recommend abstaining from sex until these issues are resolved.

• Personal comfort. Every body is different, but mild pain and swelling may persist for two weeks after surgery (and longer in some cases). If these symptoms make sex uncomfortable, there’s no need to rush into it.

Only a healthcare provider familiar with your medical history and procedure can tell you when it’s safe to have sex again after hernia surgery. Don’t hesitate to reach out to your provider if you have questions or concerns as your body heals.

Whether a hernia (or hernia surgery) triggered your ED symptoms, the good news is that erection problems are typically treatable. 

Here are some science-backed ED treatments:

Practice healthy lifestyle habits

That means following a healthy diet and exercising regularly. Both obesity and a sedentary lifestyle are associated with ED, so tackling these issues can be a great first step toward stronger erections. 

If your healthcare provider tells you that you need to lose weight, improving your diet and exercise can help you with weight loss. And no matter what weight you are, research shows that regular physical movement can help prevent ED or improve existing symptoms. 

Don’t forget mental health

Remember, stress and anxiety can contribute to ED. Managing your mental health with mindfulness exercises or therapy can help improve your self-image and overall stress level, which can help with ED symptoms. 

Your ED may be related to mental health or relationship dynamics if you’re experiencing difficulty with erections during partnered sex but still experience firm erections overnight, in the morning, and during masturbation.

Screen for underlying health conditions

Hernias don’t usually cause ED, but many health conditions are well known to be associated with ED. High blood pressure, high cholesterol, diabetes, and other diseases can contribute to erectile dysfunction by damaging blood vessels. 

If you haven’t seen a healthcare provider or had blood work done recently, it’s a good idea to schedule an appointment to check for underlying health conditions. Treating underlying health conditions could go a long way toward maintaining your erectile health and potentially solving sexual performance issues.

Try prescription medications

First-line ED medications like Viagra (sildenafil) and Cialis (tadalafil) belong to a class of drugs called phosphodiesterase type-5 inhibitors (PDE5 inhibitors). PDE5 inhibitors don’t trigger erections on their own. Instead, they promote blood flow to the penis for harder, longer-lasting erections when you’re aroused.

Sildenafil and tadalafil are also available in different forms, like Ro’s Daily Rise Gummies and dissolvable Ro Sparks. These options contain active  ingredients that are individually FDA-approved for ED but their specific formulations are not FDA-approved themselves.

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So, can a hernia cause erectile dysfunction? And if not, can you have sex with a hernia? By now, we hope you understand that though hernias don’t directly mess with your erections, they can impact sexual function. Here’s the recap:

• Hernias can make sex painful or uncomfortable. And if sex doesn’t feel good, you might be less interested — or feel less satisfied when you do engage in sexual activity. (But just because you have a hernia doesn’t mean sex is off the table. It’s possible to have sex safely even if you have a hernia! Speak with your healthcare provider for more information.)

• Hernias can trigger self-consciousness. Stress and anxiety are common causes of ED in your twenties. Regardless of age, feeling embarrassed about your body can trigger a sort of temporary, situational ED.

• Hernia repair surgery might improve sexual function. Can you have sex even if you have a hernia? Yes. But fixing an inguinal hernia can make sex more pleasant and improve erectile function, especially if you experience bulging or pain due to the hernia.

• Regardless of cause, most ED is treatable. Prescription PDE5 inhibitors like Viagra and Cialis are first-line treatments for ED. Lifestyle changes, like a healthy diet and exercise, along with caring for your mental health, can also help with erectile health. 

• Don’t hesitate to talk to a healthcare provider. If you’re experiencing symptoms of a hernia (hello, pressure and swelling), dealing with ED symptoms, or both, tell your healthcare provider. They can help you determine the best course of action for your overall (and sexual) health.