Can high cholesterol cause erectile dysfunction?

Erectile dysfunction (ED) has many causes, including mental health factors, medication side effects, and underlying health conditions. If your latest bloodwork showed high cholesterol levels, you might be wondering, “Can high cholesterol cause erectile dysfunction?” In a way, yes. 

Before we dive into the connection between high cholesterol and ED, it’s essential to understand that there are two main types of cholesterol: 

• Low-density lipoprotein (LDL), often called “bad” cholesterol

• High-density lipoprotein (HDL), often called “good” cholesterol 

If your healthcare provider says you have high cholesterol, they’re likely saying you have too much LDL in your bloodstream. This can build up and create plaques in your arteries.

Read on to learn more about the link between high cholesterol and erectile dysfunction, including what you can do to treat it.

Research doesn’t indicate that high cholesterol directly causes ED. But men with high cholesterol are more likely to experience ED than those with healthy cholesterol levels. In fact, about 42% of men with ED also have high cholesterol.

There are a few ways high cholesterol contributes to ED:

• High cholesterol reduces blood flow

• High cholesterol impedes nitric oxide production

• High cholesterol may decrease testosterone

Let’s dive into the science.

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Reduces blood flow to the penis

High cholesterol increases your risk of developing atherosclerosis,which is associated with ED.

Atherosclerosis develops when fatty plaques (hello, LDL!) build up inside your blood vessel walls. Over time, this damages the blood vessels; it makes them stiff and narrow, impeding blood flow. Low blood flow to the penis means you may struggle to get or keep hard erections.

Impedes nitric oxide production

Too much cholesterol in the bloodstream reduces production of nitric oxide — one of the many key players in getting and maintaining an erection hard enough for sex. 

Nitric oxide is a chemical that activates the muscle cells of blood vessels, telling them to relax and widen, allowing blood to enter the penis more easily. This supports the steady blood flow needed for healthy, lasting erections.

Decreases testosterone levels

A recent study of data from 2,859 adult males found a “significant association” between high LDL cholesterol and an increased risk of testosterone deficiency (low T). And while low T alone typically doesn’t cause ED, it is a known contributor to the condition. 

Low testosterone can also impact your sex life in other ways, like weakening libido. And the less interested you are in having sex, the less likely you are to achieve and maintain a hard-on. 

Yes, lowering cholesterol can improve ED symptoms — but probably only if high cholesterol was a key contributor to your erection problems in the first place. 

The reason is simple: If something other than high cholesterol is causing your ED, addressing the underlying cause is more likely to improve your ED than addressing an unrelated issue.

Still, if you have high LDL cholesterol, lowering your levels can help lower your risk of atherosclerosis. And since atherosclerosis can cause ED, lower cholesterol levels may prevent the development or worsening of ED, too. 

Not sure whether you have high cholesterol? You can find out with a simple blood test ordered by your healthcare provider. This test is known as a lipid profile, which measures total blood cholesterol, plus how much LDL cholesterol, HDL cholesterol, and triglycerides are in your blood. 

If you’re experiencing ED symptoms and haven’t had a recent lipid profile, call your provider to schedule one. 

Remember, not all sexual performance issues are caused by unhealthy cholesterol. Lowering cholesterol levels may improve your ED symptoms, sure. But your best bet is to work with a provider to pinpoint, then treat, the underlying cause, whether that’s cholesterol or something else. 

Treating ED caused by high cholesterol may require reducing your cholesterol, treating the ED directly, or both. 

The good news is that it’s not too late to make changes that improve your cholesterol and your sexual performance.

Eat a heart-healthy diet

Healthy blood flow is essential for the formation of an erection. Eating a heart-healthy diet can help lower cholesterol and support the blood flow necessary for strong, long-lasting erections. 

A “heart-healthy diet” means:

• Cutting back on processed foods, super salty foods, and foods high in saturated fat

• Adding in more fruits, veggies, and fiber-rich whole grains  

Exercise regularly 

Yes, regular physical exercise can help both high cholesterol and erectile dysfunction. 

Research shows that high-intensity exercise, such as running, cycling, or bursts of bodyweight exercises (push-ups, squats, etc.), can improve lipid profiles. There’s also strong evidence that regular exercise can improve ED symptoms — and even boost the effects of ED medications. 

Consider cholesterol-lowering medication

If a healthcare professional has diagnosed you with high cholesterol, chances are, they’ve also floated the possibility of cholesterol-lowering medication. And, in theory, if your ED is caused solely by high cholesterol, reducing your LDL levels should help with your sexual performance issues, too.

There are several types of cholesterol meds to discuss with your provider, including:

• Statins. These first-line cholesterol-lowering drugs prevent the liver from creating additional cholesterol. This lowers your levels over time. Examples of statins include atorvastatin (Lipitor) and rosuvastatin (Crestor).

• PCSK9 inhibitors.Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are newer medications that lower cholesterol by helping the body break down and eliminate LDL particles. PCSK9 inhibitors like alirocumab (Praluent) and evolocumab (Repatha) are injected rather than taken by mouth.

• Ezetimibe. This cholesterol-lowering medication prevents your body from absorbing dietary cholesterol. It’s also sold under the brand name Zetia. 

Try prescription ED medication

In some cases, your provider might recommend treating ED directly in addition to tackling your high cholesterol. 

The most common oral ED treatments belong to a group of medications called PDE5 inhibitors. They work by relaxing and widening the blood vessels in your penis so that blood can flow in easily. This helps cause strong, hard erections whenever you feel sexually aroused. 

Common PDE5 inhibitors include:

• Viagra (sildenafil)

• Cialis (tadalafil)

• Stendra (avanafil)

• Vardenafil 

There’s no single best Viagra for men with ED, but it’s helpful to know that there are non-pill options. These included compounded ED products, such as:

• Ro Sparks (tadalafil and sildenafil), a lozenge that melts under your tongue and kicks in after 15 minutes

• Daily Rise Gummies (tadalafil), fruit-flavored daily gummies that work continuously so you can feel ready wherever, whenever

An important note: The last two products are not FDA-approved, but their ingredients are. They are still medications and require a prescription from a healthcare professional.

Ultimately, there is no one-size-fits-all best treatment for ED. Every situation is unique. The most important thing is to tell a healthcare professional about your symptoms so they can work with you to find the best treatment plan for your health and lifestyle.

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Can high cholesterol cause ED? Over time, yes. Here’s the recap on high cholesterol and erectile dysfunction.

• High cholesterol and ED are closely connected. Men with high cholesterol are more likely to develop ED than men with healthy cholesterol levels. 

• High cholesterol contributes to ED in several ways. Elevated LDL levels can reduce blood flow, decrease production of nitric oxide (which helps widen blood vessels in the penis), and decrease testosterone. All of these can make it challenging to get and maintain a firm erection for sex. 

• There are ways to treat high cholesterol and ED. Your healthcare provider may recommend a cholesterol-lowering medication, prescription ED treatment, or both. Lifestyle changes, such as a healthy diet and exercise, can also help support healthy cholesterol levels and the healthy blood flow for strong, lasting erections. 

• Don’t hesitate to tell your provider what you’re experiencing. Sexual performance issues can be embarrassing. But if you’ve just been diagnosed with high cholesterol, it’s the perfect time to let your provider know you’re experiencing sexual symptoms too. They can help recommend a treatment plan that tackles both issues.