Male Sexual Function and Smoking.

INTRODUCTION: Erectile dysfunction (ED) is a common disorder that has many potential etiologies, including hormonal imbalances, psychogenic factors, neurologic disorders, vascular insufficiency, and other risk factors. Cigarette smoking has been well established as a risk factor for cardiovascular disease and stroke, but the relation between smoking and ED is less frequently considered.

AIM: To review the current literature that analyzes the association between cigarette smoking and ED.

METHODS: The PubMed database was searched using the terms erectile dysfunction and smoking and erectile dysfunction and tobacco through December 2015.

MAIN OUTCOME MEASURES: Main outcome measures were significant changes in erectile function in relation to smoking status.

RESULTS: Eighty-three studies and articles were reviewed. Multiple human studies, animal studies, case series, cross-sectional, and cohort studies analyzed the relation between smoking or nicotine and ED.

CONCLUSION: There is substantial evidence showing that cigarette smoking is a risk factor for ED. Multiple human, animal, case series, cross-sectional, and cohort studies support this conclusion. A positive dose-response relation also is suggested such that increased quantity and duration of smoking correlate with a higher risk of ED. Smoking cessation can lead to recovery of erectile function, but only if limited lifetime smoking exposure exists. Smoking contributes to ED in different ways, especially by causing penile vasospasm and increased sympathetic nervous system tone.