Trying to Conceive and Erectile Dysfunction

Are you struggling with erectile dysfunction and worried about how it might impact your chances of conceiving? Whilst we usually focus on male fertility and sperm health, erectile dysfunction is an issue that impacts more men than you might realise – and needs to be talked about.

What is erectile dysfunction?

Erectile dysfunction is a condition where the penis struggles to achieve or maintain an erection. The condition, often known as ED, is more common than you may think. Research indicates that around 43% of men between 18 and 60 struggle with ED – and that number increases when you look at men aged specifically over 40.
The severity of erectile dysfunction can range dramatically. For some guys, it’s a short-term problem that rears its head (or fails to rear in this case!) now and again, and for some, it’s a debilitating problem that means they can never get an erection. Whilst there’s no need to panic if you occasionally struggle to rise to the occasion, if it’s impacting your sex life, it’s always worth talking to your doctor about it.
What causes erectile dysfunction?
Just as there are many reasons that a man might get an erection, there are also many reasons why he might struggle to get or maintain one.

Physical reasons for erectile dysfunction

There are physical issues that might cause problems with erections. These can range from restricted blood flow to the penis, connected to blocked arteries or high blood pressure, to obesity. Research indicates that 79% of men experiencing ED had a dangerously high BMI. Erectile dysfunction is also a common symptom of people with low testosterone, or with conditions like Parkinson’s disease, diabetes, or multiple sclerosis. Then there are substance issues – there are strong links between smoking and issues with erections and many men cite alcohol as the culprit when struggling to get it up.

Psychological reasons for erectile dysfunction

Your mental well-being can also play a role in erectile dysfunction. Studies have indicated that high levels of the stress hormone cortisol can inhibit testosterone production which can have a negative impact on your sex life and ability to get and maintain an erection. Depression and anxiety have also been linked to ED. As well as the conditions themselves, medication like antidepressants can also cause issues with erections.

How can you treat erectile dysfunction?

There are many treatment routes for ED – but the one that will be most effective depends on the root cause.

If you go and speak to your doctor about ED, they will first likely try and address lifestyle factors. They may talk to you about your stress levels, diet, exercise habits and other things that could be putting pressure on your mind and body.

If things can’t be improved by lifestyle changes, there are a few things doctors can do to help.

There are medications you can take, including Viagra, or herbal supplements containing fenugreek and ashwagandha, that can improve blood flow to the penis. Some doctors also prescribe Alprostadil self-injections, where a medication that increases blood flow is injected directly into the penis.

In extreme cases of ED, you may decide to go down the root of a penis pump or penile implant to help pull blood into the penis and help it to maintain an erection,

Can erectile dysfunction be a sign of infertility?

In many cases, erectile dysfunction is not linked to low sperm quality. However, for some people, it can be a sign of a hormonal imbalance, which could also impact the production of sperm.

Testosterone is a big one when it comes to male fertility, and erectile dysfunction can be a sign of low T. Whilst, low testosterone does not always mean you will struggle to conceive, it can affect some sperm parameters.

However, it’s not just testosterone that’s linked to erectile dysfunction, there are other male reproductive hormones that could be behind the issue. Follicle-stimulating hormone (FSH) is responsible for the production of sperm in your testes, so if your FSH is low, it could cause issues with fertility. A 2020 study indicated that men with low FSH levels were more likely to encounter issues with their libido and be more prone to erectile dysfunction.

Another hormone that plays a key role in male fertility is the Luteinizing hormone (LH). LH helps to stimulate the production of testosterone and if you have too much LH in your system, studies have shown that it could cause issues in the testicles and, ultimately infertility. Researchers have also found a correlation between high LH levels and erectile dysfunction.

It’s also worth remembering that the issues spanning both ED and male subfertility are not purely hormonal. Having a high BMI, stress and lack of sleep have all been shown to impact sperm production as well as erectile function.

Can I still conceive if I’m struggling with erectile dysfunction?

If you are concerned about erectile dysfunction impacting your chances of conceiving, we’d first recommend getting your sperm tested – so you can understand whether the condition is affecting your sperm health.

If your sperm health is low, we would recommend speaking to your doctor and being completely transparent about your situation – as this will help them find the best treatment route for you.

Even if your sperm health is good, you may be concerned about conceiving if you struggle with erectile dysfunction. Your fertility is one part of the issue, but being able to have sex is another.

Again, we’d recommend first looking at your lifestyle factors, your mental well-being and your relationship. If you have never struggled with ED before but have started to notice it whilst trying to conceive, this could be linked to the pressure you and your partner are putting on sex right now. Try to take the stress out of sex, try to nurture your relationships and remember why you are trying to have a baby together.

Whilst date nights, romantic dinners or a holiday won’t solve deep-rooted fertility issues, this quality time could help reduce your stress levels and reduce the risk of ED.

However, if you have been living with ED for a while, and are struggling to have regular sex, or if your sperm health is below normal, it might be worth considering assisted fertility treatments.

What treatments can help?

Many assisted fertility treatments can help you overcome the hurdle of erectile dysfunction. If your sperm quality is good but you struggle to have sex, IVF could be a good option – or ICSI if you are struggling with low sperm count.

However, both ICSI and IVF will require you to produce a sample. If you struggle to ejaculate, which is not uncommon for people with ED, then you could investigate testicular sperm extraction (TESE) – where doctors surgically remove sperm cells from your testicles. These sperm cells can then be used in ICSI treatments.

If you’re struggling with erectile dysfunction, the most important thing to remember is there is nothing to be ashamed of. You will only be able to get the support and treatment you need if you open up to people – from your partner to your healthcare provider – so don’t be afraid to get honest and talk about what you’re dealing with!