A reader recently asked if high cholesterol can directly affect your sex life. The answer to this question is yes, but the effect may not be immediate. Studies have shown that some of the traditional risk factors for heart disease, such as high cholesterol, are also significant risk factors for male erectile dysfunction. An intact arterial blood supply is required for normal male erection, and it is thought that high cholesterol can impair normal artery blood flow. There are two ways that this might happen. Just like one can develop a blockage in the heart arteries, blockages from atherosclerosis can develop in the arteries responsible for erection. This could then diminish blood flow.
High cholesterol also can adversely affect arteries without developing blockages. Arteries not only need to be open, but they also must be able to respond to local hormones that regulate blood flow. One important artery relaxing hormone is nitric oxide. High cholesterol can reduce an artery’s response to this hormone and thereby decrease blood flow as well. Testosterone is not a major hormone involved in this blood flow.
As with the development of heart disease, high LDL and low HDL are both contributors to erectile dysfunction. Although the amount of time needed for high cholesterol to directly cause erectile dysfunction is not known, most studies have looked at this effect of high cholesterol over decades. However, there is evidence that arteries can develop abnormal responses in other parts of the body within hours of a high fatty meal.
One bit of good news is that treatment of high cholesterol with diet, exercise, and medication can reverse some of this erectile dysfunction. On the flip side, erectile dysfunction may be an early warning sign for future risk of heart attack and stroke. Men who develop erectile dysfunction without an obvious cause, such as from medication or physical injury, may have a 25% increased risk of cardiovascular disease over the next 5 years. Therefore, men with erectile dysfunction should be screened for traditional heart disease risk factors like high cholesterol. With regard to women and sexual dysfunction, unfortunately little is known the impact of high cholesterol as data is virtually non-existent.