Blood vessel damage blamed for smoking-related ED

NEW YORK (Reuters Health) - Smoking causes erectile dysfunction by harming the health of blood vessels, Finnish researchers report.

Among ex-smokers, erectile dysfunction could signal silent, pre-symptomatic blood vessel (vascular) disease, Dr. Rahman Shiri of the University of Tampere School of Public Health and colleagues conclude.

Cigarette smoking has been strongly linked with erectile dysfunction, with smokers at a 50 percent greater risk than non-smokers of having difficulty achieving an erection, the investigators note in a report in the journal Urology.

But the mechanism by which smoking contributes to erectile dysfunction isn't clear; it could impair penile blood flow, interfere with the nitric oxide activity essential for erection, or lead to atherosclerosis (hardening of the arteries), which is known to be involved in erectile dysfunction.

To investigate, the researchers looked at 1,368 men in their 50s, 60s and 70s who completed three questionnaires every five years from 1994 to 2004.

Men who were smokers in 1994 and developed vascular disease later on were three times more likely to report erectile dysfunction during the course of the study than men who weren't smokers at the study's outset, the researchers found. But smokers who didn't develop vascular disease were not at greater risk of erectile dysfunction.

Men who reported erectile dysfunction in 1994 and were ex-smokers were 50 percent more likely to develop vascular disease than those who had never smoked and didn't have erectile dysfuction at the beginning of the study.

"Our findings suggest that smoking may cause ED by causing vascular disease," the researchers write. "ED may also be regarded as a potential predictor of silent vascular disease in smokers without clinical signs of vascular disease."

SOURCE: Urology, December 2006.