If heart disease, stroke, and certain cancers have not been reason enough for men to quit smoking, consider this: The habit also increases the risk of erectile dysfunction, according to a report in the journal Tobacco Control.
In fact, emerging research shows that men with a pack-a-day habit are almost 40 percent more likely to struggle with erectile dysfunction than men who do not smoke.
"Smoking delivers nicotine and other vasoconstrictors that close down the blood vessels" of the penis, explains Dr. Jack Mydlo, at Temple University School of Medicine and Hospital in Philadelphia.
Erectile dysfunction - also called ED or impotence - is the inability to achieve or sustain an erection on repeated occasions.
It is estimated that about two of every 100 American men have erectile dysfunction serious enough to warrant a physician's visit, according to the National Institute of Diabetes and Digestive and Kidney Disorders (NIDDK). The risk of erectile dysfunction increases as men age.
A recent study of more than 8,000 Australian men between the ages of 16 and 59 found that those who smoked less than a pack a day had a 24 percent increased risk of erectile problems.
And, as the number of cigarettes smoked went up, so, too, did the chances of erectile dysfunction. Those men who averaged more than 20 cigarettes a day increased their risk of erectile dysfunction by 39 percent.
Another study, published in the American Journal of Epidemiology, found that male smokers in their 40s were more likely to experience erectile difficulties than older nonsmoking males.
The risk of erectile dysfunction was nearly doubled for smoking men in their 40s compared to nonsmokers in their 50s.
"Smoking, because it causes blood vessel constriction, is a very big cause of erectile dysfunction," says Dr. Larry Lipshultz, chief of male reproductive medicine at Baylor College of Medicine in Houston.
Smoking is not the only cause of impotence problems - other lifestyle habits can have a big impact on men's sexual health.
Obesity, heavy alcohol consumption, and recreational drug use can all cause erectile dysfunction. And a sedentary lifestyle can also contribute to erectile problems, adds Dr. Lipshultz.
Other causes include diabetes; heart disease; cancer surgery of the prostate, bladder, colon or rectum; high blood pressure medications or antidepressants; a spinal injury; and a hormone imbalance, usually low testosterone, explains Dr. Lipshultz.
All of these conditions or lifestyle factors contribute to erectile difficulties in three major ways: by reducing blood flow, causing nerve damage, or changing the hormonal environment.
While there are medications that can help treat erectile dysfunction, both Drs. Mydlo and Lipshultz advocate a healthy lifestyle for maintaining good sexual health.
"Take better care of yourself,” advises Dr. Lipshultz. “Make sure you're not obese, eat well, exercise, and if you have diabetes or hypertension, make sure they're well-controlled."
He adds that by addressing lifestyle factors, you may not need medication to treat erectile dysfunction.
Dr. Mydlo echoes that advice, adding, "Stop smoking, drink in moderation, lose weight, and maintain good blood pressure."
Dr. Mydlo adds one more word of caution: "Don't use ED medications - Viagra, Cialis - if you don't need them. Erections that last longer than four hours - priapism - can cause permanent scar tissue and permanent impotence. It's not a good idea to use these drugs casually."
Always consult your physician for more information.
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According to the American Academy of Family Physicians (AAFP), physical causes of erectile dysfunction can include alcohol and tobacco use, fatigue, brain or spinal-cord injuries, hypogonadism (which leads to lower testosterone levels), liver or kidney failure, multiple sclerosis, Parkinson's disease, radiation therapy to the testicles, stroke, or some types of prostate or bladder surgery .
Many times, men will avoid sexual situations due to their emotional pain associated with ED, causing their partner to feel rejected or inadequate.
It is important to communicate openly with your partner. Some couples consider seeking treatment for ED together, while other men prefer to seek treatment without their partner's knowledge.
A lack of communication is the primary barrier for seeking treatment, and can prolong the suffering. The loss of erectile capacity can have a profound effect on a man.
The good news is that ED can usually be treated safely and effectively.
Feeling embarrassed about being impotent may prevent many men from seeking the medical attention they need, which can delay diagnosis and treatment for more serious underlying conditions.
Impotence itself is often related to an underlying problem, such as heart disease, diabetes, liver disease, or other medical conditions.
Since impotence can be a forewarning symptom of progressive coronary disease, men should tell their physicians about their symptoms of ED.
Physicians may ask directly about sexual function, through conversation or a questionnaire during a check-up, in order to detect more serious health conditions sooner.
The following medical problems can also cause erectile dysfunction including diabetes, hypertension, or atherosclerosis (hardening of the arteries).
If you cannot keep your blood sugar or your blood pressure under control, you may experience erectile dysfunction. It is important that you take your medicines for these problems just the way your physician tells you.
Sometimes your hormones get out of balance and this causes erectile dysfunction. Your physician will decide if you need blood tests to check your hormones.
Some medicines can cause erectile dysfunction. If this is true for you, your physician may take you off that medicine or give you a different one.
Drinking too much alcohol, smoking too much, and abusing drugs can also cause erectile dysfunction.
Problems in your relationship with your sexual partner can also cause erectile dysfunction.
Improving your relationship may help your sex life. If you decide to seek therapy, it will probably be most effective if your sex partner is included.
Couples can learn new ways to please one another and to show affection. This can reduce anxiety about having erections.
Always consult your physician for more information.