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Home / Smoking / Smoking and Impotence

Smoking and Impotence

Cigarettes contain up to 4000 harmful chemicals, which are passed directly into your body when you smoke. These chemicals and toxins have a highly negative effect on the body, its processes and your health, and have been identified as one of the possible causes of impotence in men, among other fertility and sexual problems.

Research has shown that men who are heavy smokers are twice as likely to experience problems gaining or maintaining an erection when compared to people who don't smoke.

Smoke inhalation has an immediate effect on the vascular systems of the body - the blood system. The poisonous chemicals inhaled all play different roles in damaging the vascular system and nicotine even affects the muscles in the walls of the veins and arteries, thus affecting the flow of blood through the body. However, it is thought that smoking is mostly responsible for causing erection problems because of the fact that it increases a person's likelihood of experiencing a build-up of plaque in the arteries. All of these factors play a role in the negative effect smoking has on how an erection works.

What happens during an erection?

To best understand how smoking affects penis health, it's a good idea to understand what exactly happens during an erection and how important a healthy vascular system is in this process.

1. The brain is sexually stimulated.

brain stimulation

2. This then triggers a signal to be emitted in the para-vetricular nucleus of the brain that is located in the hippocampus.

hippocampus of brain

3. These signals are then passed through the central nervous system with the help of autonomic nerves till it eventually reaches the prostate gland and corpora cavernosa.

Coropora cavernosa - Penis anatomy

4. When these signals reach the corpora cavernosa, it relaxes, which allows blood to fill the porous tissues.

corpus cavernosa flaccid and errect

5. As this happens, the muscle fibres in the arteries that carry blood to the penis expand to allow blood to flow more freely towards the penis, resulting in an erection.

Penis anatomy

6. After a man orgasms, the signals from the brain change, which causes an increase of noradrenaline by the nerves in the genitalia, causing the penis to become flaccid again.

Flaccid and erect penis

How does smoking influence how the penis functions?

In general, penile blood pressure is low in smokers, which is largely due to atherosclerosis (hardening of the arteries). This condition occurs when the fatty deposits that build up and harden along the walls of the arteries become so thick that they decrease the flow of blood through that artery. With a decrease in the flow of blood through the arteries in the body, not enough blood is able to travel into the penis to create an erection, leading to impotence.

Nicotine also has been directly related to the onset of impotence in men. When nicotine stimulates particular hormones in the brain, it also causes penile tissues to rapidly contract. When they contract, the blood flow through the arteries is restricted, which means that blood cannot flow into the penis. This is called acute vasospasm.


Nicotine inhaled through smoking has another effect on the penis, which is called venous dilatation. Basically the nicotine has a direct effect on the valve system that regulates the flow of blood out of the penis after an erection. Because the system does not work correctly, what often happens is that blood flows out of the penis faster than it should, which results in a brief erection.

Both acute vasospasm and venous dilatation are direct results of the effect of nicotine, which means that if you give up smoking, it could make a significant difference.

Need help quitting smoking?

Content reviewed on 08-04-21
Dr. Sarah Donald Clinical Lead MRCGP DFSRH DPD DRCOG (GMC Reg: 6099482)

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