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Ask Dr. Doug: The Link Between Smoking and ED

Published: June 3, 2010

I was surprised that per researchers the cause of ED in smokers is still so unclear. There is speculation about plaques in the blood vessels and/or hormones, but I think of a third possibility. Smoking causes vaso-constriction. This is why some plastic surgeons often won’t do face-lifts in smokers. The results tend to be lousy if the blood supply is dicey – and with smokers it is. It seems to me this is the most likely reason why the plumbing has more trouble in those addicted to nicotine.

This invites two digressions.

First – that cigarettes ARE addicting, much more than other forms of tobacco. Why? Well exactly like crack cocaine nicotine hits the blood stream FAST if it comes in the form of a cigarette. It has to do with how tobacco gets cured. Around the turn of the 19th century somebody learned that drying tobacco in ovens changed the chemistry of the leaf. Apparently cigarette smoke allows the drug to hit the bloodstream rapidly. This contributes to the “rush” that makes one drug more addicting than another. Ever see a cigar smoker jonesing? A pipe smoker? Me neither. They are NOT hooked like the cigarette smoker. And he/she IS hooked, make no mistake about it.

Second – other vaso-constrictors work against normal erectile functioning. Why should cigarette smoke be different? Standard item #1 to treat someone who is overreacting to an ED medicine is… are you ready… Sudafed. That’s right, the little red pill that clears you up when a cold or allergy has your nasal passages stuffed up. Dilating your blood vessels is necessary for an erection. Constricting your blood vessels…well…it works against that. Something to think about if you have a mission failure while on cold meds.

So my theory is that the vaso-constrictor effect of cigarettes is at the root of the problem. Then again, as is so often the case in medicine the EXACT why is not critical.

Any time I see a patient who smokes I’ll write a Rx to help them stop. Quitting smoking is THE #1 health intervention known to medical science. In this odd way a smoker has a more powerful health intervention available to him than any non-smoker. I guess that’s the silver lining in that cloud of gray smoke.

If you smoke cigarettes QUIT. Odds are you’ll live longer and better – and have a more co-operative tool at your disposal. THAT is important to just about everyone, even folks in denial about emphysema, cancer and heart disease.