Can nicotine cause erectile dysfunction?

Maybe you’ve already heard that weed and alcohol can cause softer erections — or erections that don’t last long enough for satisfying sex. But what about nicotine? Can nicotine cause erectile dysfunction (ED), in particular?  

Yes, nicotine may cause ED — especially indirectly. Though nicotine may not directly cause erection problems, it can cause other issues that can lead to ED. 

Whether you use cigarettes, vapes, dip, or another nicotine product (e.g. ZYN), here’s what you need to know about the connection between nicotine and erectile dysfunction.

Nicotine may not directly cause ED. But nicotine use can significantly increase your risk of developing ED by causing other health issues that are known to cause ED. 

In general, nicotine users are twice to three times as likely to develop ED compared to non-users, especially once blood vessels are damaged. But percentages vary across studies. 

Here are several reasons why nicotine can contribute to ED:

• Nicotine is a vasoconstrictor. It narrows blood vessels, reducing blood supply to the penis during sexual arousal. This can make it more difficult to get and stay hard. 

• Nicotine raises blood pressure. And high blood pressure is a well-known cause of ED over time.

• Nicotine may decrease testosterone. More research is needed, but small studies on e-cigarettes and nicotine gum suggest that nicotine may lower T levels. And lower T levels can lead to reduced libido and contribute to ED.  

• Nicotine may contract penile tissue. Limited data indicate that nicotine might cause the spongy tissue in the penis (the corpus cavernosum) to contract. This can impede erectile function.

• Nicotine may reduce nitric oxide production. Nitric oxide (NO) plays a vital role in erection formation. Older research suggested that nicotine reduces NO production. But a newer study linked impaired NO to cigarettes alone — not other nicotine products. Either way, reduced nitric oxide can limit blood flow to the penis, making it harder to get or keep an erection. 

• Long-term nicotine use reduces blood flow to the penis. Hypertension (high blood pressure) from nicotine increases your risk of atherosclerosis, a type of blood vessel damage that impedes blood flow all over the body — including the penis. 

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Nicotine pouches can contribute to erection problems — just like any other nicotine product.

Oral nicotine pouches like ZYN and VELO contain powdered nicotine, flavorings, and other ingredients. Nicotine content may vary by brand. But no matter how much is in the pouch, nicotine can reduce blood flow to the penis and raise blood pressure. It may also lower testosterone. All of these factors make it more challenging to get and keep hard, strong erections.

The nicotine in electronic cigarettes can increase your risk of developing ED — again, just like any other nicotine product. 

Research shows that people who use e-cigarettes daily are more than twice as likely to have ED than those who don’t vape. Even occasional vaping can increase your risk of ED by 28%.

Research on non-nicotine e-cigarettes is slim but ongoing. Notably, one study found that even nicotine-free vapes can negatively impact blood vessel function. 

In theory, this suggests that non-nicotine vapes might also contribute to ED by restricting healthy blood supply to the penis.

Nicotine patches and gum can also increase your risk of ED. After all, they contain nicotine, which is the main culprit here. 

One small study found that nicotine gum users were less likely to maintain hard erections while watching erotic films than individuals who were given a placebo gum in healthy young men who don’t normally smoke.

Nicotine gum and patches are indeed designed to help you stop smoking. They contain small amounts of immediate-release nicotine to help you deal with cravings during the discontinuation process. 

But a little bit of nicotine is still nicotine. 

That said, nicotine replacement therapies are meant to be temporary tools to help you quit smoking, not long-term solutions. Used as directed, they’re a smart step toward better overall — and sexual — health, not a setback.

Yes, your nicotine product of choice can change how deeply it impacts your sexual function and your chances of developing ED.

There are no studies comparing the effects of different nicotine products on sexual function. But we know the connection between nicotine and erectile dysfunction is dose-dependent. Meaning, the more nicotine consumed, the higher the ED risk. 

Different nicotine products contain different amounts of nicotine.  So, in theory, using a high-nicotine product like cigarettes can impact your erections more than using a low-nicotine product like gum.

But wait, there’s more! How much nicotine you consume in a day or week doesn’t just depend on the nicotine product. It can also change based on how many individual products you consume, and how often. Absorption matters, too. While cigarettes contain much more nicotine on paper, only about 1–1.5 mg is absorbed per cigarette. Nicotine gum delivers a similar amount per piece, but more slowly and with lower peak levels — which is why total daily use and absorption speed both matter.

If your nicotine use is making it harder to get or maintain erections firm enough for sex, the best thing you can do is quit the substance altogether. And even if nicotine is not the primary cause of your ED, quitting may offer other sexual benefits, including a bump in libido and even a slight bump in erectile function. 

Of course, quitting nicotine isn’t easy. Here are some tips to get you started:

• Set a quit date. Then start preparing mentally and physically. You’re more likely to succeed if you prep by pinpointing your reason for quitting and building mental confidence that you can do it.

• Share your plan. Loop supportive friends and family into your plan to quit nicotine. Strong support systems can make any big lifestyle change easier.

• Ask the pros for help. Your healthcare provider can tackle questions about nicotine addiction and potential withdrawal symptoms. A trained therapist can offer evidence-based strategies and personalized advice on quitting nicotine use. 

• Remove the nicotine from your living space. If you’re serious about quitting nicotine, get rid of it. That includes removing accessories like lighters, ashtrays, vape holders, and Zyn visor clips.

• Identify your triggers. Some people break up the workday with smoke breaks. Others reach for nicotine when they’re angry, bored, or hanging out in specific social settings. Knowing your triggers can help you prepare for them before they happen. 

• Find nicotine alternatives. If you vape to get a break from work, consider taking a walk or grabbing a cup of coffee or tea instead. If you reach for nicotine when you’re bored, ask yourself what else you can do to occupy your mind. This could be the perfect time to take up a new hobby.

• Celebrate the wins. Quitting forever sounds like a long, long time. Don’t forget to acknowledge and celebrate milestones, whether that’s a day, week, or month without nicotine. 

Still experiencing ED after quitting nicotine? Help is out there — and it starts with consulting a healthcare provider. 

ED treatment often requires an individualized approach based on your health history, health conditions, and current medications. Your provider might recommend one or more of these science-backed strategies or ED treatments:

• A healthier diet. Eating a heart-healthy diet full of vegetables, lean protein, and fiber-rich whole grains can support healthy blood flow — a key component of hard, lasting erections.

• Cutting back on alcohol. Heavy alcohol use can contribute to ED. Reducing your weekly drink count or abstaining entirely might improve erectile function.

• Losing excess weight. Obesity and ED can go hand-in-hand. If you have a body mass index (BMI) of 30 or higher, weight loss may also improve your sexual function.  

• Stress management. ED can be caused by both physical and psychological factors. Improve your odds of recovery by tackling stress and prioritizing your mental health. 

• ED medications. PDE5 inhibitors, such as Viagra (sildenafil) and Cialis (tadalafil), are approved by the US Food and Drug Administration (FDA) to treat ED in many people. They’re known to be very effective and safe, which is why they’re often considered first-line treatment for the condition. If you’re not a fan of pills, certain PDE5 inhibitors can be found in other formulations. Examples include Ro Sparks, a dissolvable lozenge containing tadalafil and sildenafil, and Daily Rise Gummies, fruit-flavored gummies made with tadalafil. Though these last two formulations aren’t specifically FDA-approved for the treatment of ED, their active ingredients have been individually FDA-approved for ED treatment. Speak with your healthcare provider if you have more questions.

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Does nicotine cause erectile dysfunction? Not in every case, but it certainly contributes to the reduced blood flow and other health issues that cause ED.

Here’s the recap on nicotine and ED:

• Nicotine is linked to ED. Using a nicotine product increases your chance of developing erectile dysfunction.

• Nicotine can contribute to ED in several ways. Nicotine narrows blood vessels and raises blood pressure, reducing blood supply to the penis. Nicotine has also been linked to decreased testosterone and lower nitric oxide production. 

• Quitting nicotine can improve ED symptoms. The more nicotine you use — and the longer you use it — the higher your risk of ED. So quitting nicotine as soon as possible might increase your chance of recovery from nicotine-induced ED (and, if you don’t have ED, contribute to your long-term erectile health).

• ED is usually treatable. Cutting back on nicotine should help, but there are also other lifestyle changes and prescription medications to treat ED. Don’t hesitate to ask your healthcare provider for personalized suggestions tailored to your health condition and lifestyle.