High cholesterol and erectile dysfunction

If you’re living with high cholesterol, you might already know how it affects your heart health. But high cholesterol could also be affecting your sexual health—more specifically, your ability to get and maintain an erection.

Many people associate erectile dysfunction (ED) with ageing or psychological factors, but it often signals deeper health issues. Understanding the connection between high cholesterol and erectile dysfunction is key if you want to improve your sexual health and well-being. In this blog, we explain what you can do to tackle both high cholesterol and ED for a healthier, more satisfying life.

What is cholesterol?

Cholesterol is a type of fatty substance that circulates in the blood. Around 20% of this cholesterol comes from the food we eat, and our bodies produce the remaining 80% in the liver (1).

There are two main types of cholesterol:

• Low-density lipoprotein (LDL): This is often called “bad” cholesterol because it can build up in your arteries, making them narrower and less flexible.
• High-density lipoprotein (HDL): Known as “good” cholesterol, HDL helps carry cholesterol back to the liver, where it’s removed from the body.

We all need a small amount of cholesterol to function, as it helps our bodies create hormones, vitamin D, and cell membranes. But too much total cholesterol can lead to various health problems, such as high blood pressure, heart attacks, stroke—and erectile dysfunction.

What’s the link between high cholesterol and erectile dysfunction?

Research consistently shows that the higher your cholesterol levels, the bigger your risk for erectile dysfunction. One study found that men with total cholesterol levels above 6.21 mmol/L were almost twice as likely to experience ED than those with levels below 4.65 mmol/L (2).

The type of cholesterol in the bloodstream also alters the risk for erectile dysfunction. Men with ED have significantly higher LDL levels than healthy individuals (3). Another study found that men with higher HDL levels had a much lower chance of developing ED than those with lower levels, even if their total cholesterol was the same (2).

The bottom line? The higher your cholesterol, the higher your chance of having erection problems.

What causes the high cholesterol erectile dysfunction link?

The connection between cholesterol and ED primarily lies in how cholesterol affects blood flow. Because erections rely on good blood flow to the penis, anything that affects your blood vessels can also affect your ability to get and maintain an erection.

Anyone with high cholesterol has excess fat in the blood, which can start to clump together and form deposits on the lining of the blood vessels. Over time, this damage causes the vessels to narrow and restrict blood flow. In the case of ED, reduced blood flow to the penile arteries may impair the ability to achieve or maintain an erection.

High cholesterol can also interfere with the function of smooth muscles and peripheral nerves involved in the erection process (4). This can make it hard to get or maintain an erection, leading to erectile dysfunction.

Can lowering cholesterol improve erectile dysfunction?

As erectile dysfunction is closely linked to high cholesterol, managing your cholesterol levels may improve ED. Indeed, research shows that people with high cholesterol can experience stronger erections by lowering their cholesterol.

Cholesterol levels can be lowered through medications, lifestyle changes, or a combination:

Statins and erectile dysfunction

Statins are the most common medication prescribed to help lower cholesterol. These drugs reduce the amount of “bad” cholesterol produced by the liver, lowering both LDL and total cholesterol levels to improve blood flow.

There’s been some debate about whether statins worsen ED, as they can lower testosterone levels (5). Testosterone is the primary male sex hormone and plays a central role in regulating sex drive and erectile function. By potentially lowering testosterone, some argue that statins—while improving cholesterol—won’t improve erections.

However, other studies have found that statins improve the symptoms of ED (6). This is likely achieved by improving blood flow to the penis. And not only this—by lowering cholesterol, statins also help prevent heart disease and increase mortality rates. (7).

Lifestyle changes to lower cholesterol

Lowering cholesterol isn’t just about taking medication; lifestyle changes can make a big difference too. Here are a few steps you can take:

• Diet: Around 20% of the cholesterol in our bodies comes from our diets—specifically, from fats. To lower your cholesterol, try cutting down on the amount of fatty food you eat. Some fat consumption is fine (and healthy), but aim to eat healthier unsaturated fats and leave saturated fats out of your diet.
• Exercise: Regular physical activity can boost HDL cholesterol while lowering LDL cholesterol (8). While total cholesterol levels stay the same, higher “good” cholesterol and lower “bad” cholesterol result in better health outcomes and reduce the risk for certain diseases.
• Limit alcohol: When you drink alcohol, it’s broken down by the liver and converted into fats, including cholesterol. Moderate alcohol intake can increase the “good” HDL in the blood, but excessive drinking increases “bad” LDL and total cholesterol. Try to avoid drinking more than 14 units of alcohol per week and keep several days alcohol-free (9).

By lowering total cholesterol or increasing HDL, these lifestyle changes may improve erectile function.

What else can cause erectile dysfunction?

ED can have many causes beyond high cholesterol. Some other common risk factors include (10):

• Obesity and metabolic syndrome
• Type 2 diabetes
• High blood pressure
• Depression and anxiety
• Mental and emotional stress
• Chronic kidney disease
• Injuries to the penis
• Drinking alcohol and smoking cigarettes
• Hormonal imbalances
• Certain medications
• Other sexual dysfunction (premature ejaculation, sexual aversion, etc.)
• Neurological conditions or nerve disorders

It’s important to note that lowering cholesterol will only be effective if high cholesterol is the root cause of your ED. For example, one study found that when treated with atorvastatin erectile dysfunction was significantly improved—but only if high cholesterol was the only risk factor for ED (11).

Often, multiple risk factors are at play, and it may take addressing all these issues to see an improvement in symptoms. This is why understanding why you have erectile dysfunction is so important. Identifying the underlying causes can help you find the right treatment tailored to your needs.

Erectile dysfunction treatment options

Lowering cholesterol can help improve ED, but other options that might help include:

• Switching medications if you think they’re causing ED.
• Talk therapy to manage stress better, improve symptoms of depression and anxiety, and manage the psychological impact of erection problems.
• Testosterone replacement therapy (TRT) if you have low testosterone levels.
• Weight loss through diet and exercise changes if you’re overweight.
• Quitting smoking and limiting alcohol consumption.

There are also oral medications aimed directly at improving erectile function. The most well-known erectile dysfunction treatment is Viagra, which contains the active compound sildenafil. Other medications for ED include tadalafil (Cialis) and vardenafil (Levitra). These drugs work by increasing blood flow to the penis, making it easier to achieve and maintain an erection.

Vacuum erection devices are another route. These are external pumps that help draw blood into the penis, creating an erection. Once the erection is achieved, a ring is placed at the base of the penis to maintain it. For men who do not respond to other treatments, penile implants may be considered.

Can I take Viagra and high cholesterol drugs together?

If you have been diagnosed with high cholesterol and erectile dysfunction, you may wonder if it’s safe to take statins and Viagra together. Generally speaking, it’s okay to take erectile dysfunction drugs while on statin therapy, and there is no known interaction between statins and Viagra.

However, Viagra, Levitra, and Cialis are not safe to combine with all drugs. These erectile dysfunction treatments should be avoided if you’re currently on nitrates and alpha-blockers. By causing blood vessels to dilate and increasing blood flow, these drugs can also be dangerous in people with a history of heart disease or stroke.

Next steps: getting ED treatment delivered to your door

If you have both high cholesterol and erectile dysfunction, it’s vital to address these interconnected health issues. Managing your cholesterol levels can improve your erectile function, offering you better heart health, sexual health, and quality of life. However, you may also want to look at erectile dysfunction treatments.

At Oxford Online Pharmacy, we understand that seeking help for ED can feel overwhelming. That’s why we offer convenient, discreet services to help you access the necessary treatments without added stress. Learn more about your options on our erectile dysfunction page.

Citations

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7. Mangione CM, Barry MJ, Nicholson WK, Cabana M, Chelmow D, Coker TR, et al. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults. JAMA [Internet]. 2022 Aug 23;328(8):746.
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9. NHS. High Cholesterol - How to Lower Your Cholesterol [Internet]. nhs.uk. 2019.
10. Lowy M, Ramanathan V. Erectile Dysfunction: Causes, Assessment And Management Options. Australian Prescriber. 2022 Oct 4;45(5):159–61.
11. Saltzman EA, Guay AT, Jacobson J. Improvement In Erectile Function In Men With Organic Erectile Dysfunction By Correction Of Elevated Cholesterol Levels: A Clinical Observation. The Journal of Urology. 2004 Jul 1;172(1):255–8.