Q. Could smoking (20 cigarettes per day) affect erection and ejaculation during intercourse?

A. Smoking has many effects on the body. One of them is certainly decreased erectile function. The loss in erections is due both to decrease in blood flow to the penis and to loss in elasticity of the penis.

As you know, for a man to have an erection, the small muscles in the penis must relax so that the arteries to the penis can allow blood to enter it. Once the penis is full of blood, it is hard and erect. Unfortunately, smoking can lead to clogging of those arteries in the penis. The decrease in blood flow means less blood in the penis, which equals a weaker erection.

In addition, the smooth muscle relaxation in the penis depends on nitric oxide metabolism. Smoking interferes with the body’s production of nitric oxide, and therefore interferes with muscle relaxation in the penis. This translates into less filling of the penis, and again a weaker erection.

In my practice, I insist patients stop smoking before I treat them with any medicines to improve erections.

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