- When blood can’t flow freely to the penis, you’ll find it difficult—or impossible—to get an erection.
- Cardiovascular disease and other health conditions can impede circulation, and make getting erections more difficult.
- In many cases, adopting healthy habits or taking medications that improve blood flow can help treat erectile dysfunction.
When getting or maintaining an erection becomes, well, hard, the prevailaing narrative (and countless movie tropes) say you’ve failed as a man. But erectile dysfunction (ED) is incredibly normal—and almost always a circulation issue, not virility. Erectile dysfunction is “a blood flow problem for over 90 percent of people who experience it,” says Petar Bajic, M.D., a urologist at Cleveland Clinic’s Glickman Urological and Kidney Institute.
When ED is caused by blood flow issues (and again for the people in the back: that’s almost always the case), it’s usually fixable, says Bajic. Here’s what you need to know about the connection between circulation and erections, plus science-backed tips and strategies to improve blood flow to your penis.
Blood Flow and Erectile Dysfunction
Before we talk about how to fix ED, it’s worth a refresher on how you get an erection in the first place.
When you get aroused, neurotransmitters in the brain tell the two small cavernosal arteries in your penis to dilate so that more blood can enter the corpora cavernosa—two spongy cylinders of tissue that form the bulk of your penis. When these arteries, which are each less than a millimeter in diameter each, fill with blood, your penis gets erect, explains Bajic.
These arteries are often the first to be affected—and therefore narrowed—by cardiovascular disease. That’s why Bajic jokingly refers to the penis as “the divining rod of vascular health.”
Penises are very sensitive to blood flow changes, says Bajic. Any condition that affects your vascular system can potentially affect your ability to get an erection by limiting blood flow to your penis.
Conditions that reduce blood flow to the penis
Almost all causes of ED—both psychological and physiological—can diminish blood flow to your penis, says Bajic.
Atherosclerosis is the hardening and narrowing of the arteries in the body, explains Bajic. “This occurs due to cardiovascular disease related to high blood pressure, cholesterol, and diabetes,” he adds. “It also affects the cavernosal arteries”
2. High blood pressure
Men with high blood pressure are nearly twice as likely to have erectile dysfunction and impaired penile blood flow compared to men with normal blood pressure (1). Here’s why: When your BP is high, your heart has to work harder and less efficiently to pump blood throughout the body—including to your penis.
Taking certain medications to lower your blood pressure can ironically, make the problem worse (2). This is particularly the case with diuretics, or water pills, because they decrease forceful blood flow to the penis and can deplete the body of zinc, a mineral necessary for testosterone production. Beta-blocker drugs are also known to have sex-related side effects.
3. High cholesterol
If you have high cholesterol, which is often caused by high salt intake, an overall unhealthy diet, or smoking, fatty plaque builds up in your arteries and restricts blood flow. That includes—you guessed it—the arteries that supply blood to your penis.
Research shows that more than half of men with diabetes are affected by ED (3). And men with diabetes may develop ED 10 to 15 years earlier than men without the disease (4). Diabetes can cause nerve damage that can make getting an erection difficult, but high blood sugar can also damage your blood vessels, hampering blood flow and inhbiting sexual function.
5. Low testosterone
Low testosterone and other endocrine disorders like hypothyroidism (an underactive thyroid) rarely causes ED on its own, says Bajic. But low T is often linked to health conditions like cardiovascular disease (5), as well as diabetes, and obesity—both of which increase the likelihood of vascular diseases and subsequently, ED.
6. Stress and anxiety
It can be a struggle to get in the mood when your mind is in a dark place. “Many men, particularly younger men, have ED due to performance anxiety or generalized anxiety,” explains Bajic. How is that related to blood flow to the penis? “Anxiety causes a ‘fight or flight’ response which constricts the penile arteries and prevents filling.”
How Common is Erectile Dysfunction?
Most men experience ED to some degree at some point in their life, but it’s largely underreported, says urologist Joshua Calvert, M.D. “I tell my patients as a general rule of thumb that their decade of life is a predictor of how likely ED is for them,” he explains. For example, 30-year-olds have about a 30 percent chance of developing ED, he says, adding that about half of men over 50 have it.
Research in the American Journal of Medicine found that only 20 percent of men between the ages of 40 and 59 said they could get a healthy enough erection for sex most of the time (6).
10 Ways to Increase Blood Flow To Your Penis
The better your overall vascular health is, the more easily you can avoid ED. Here are some ways to keep your circulation flowing throughout your body—and to your most prized appendage.
1. Stay Hydrated
Water makes up 60 percent of your body weight, and drinking as much of it as you can helps your heart efficiently pump blood through the body. Research shows a lack of water impairs cardiovascular function (7), because when you’re dehydrated, your blood retains more sodium, which makes it thicker. Your heart has to beat faster to pump thicker blood throughout your body, which raises your heart rate and blood pressure.
Aim for 3.7 liters (just under 16 cups) per day.
2. Quit Smoking
Puffing away causes inflammation and, over time, creates plaque build-up in the arteries, limiting blood flow. In serious cases, smokers may develop peripheral artery disease, a narrowing or blockage of the vessels that carry blood from the heart to the limbs and other extremities, including the penis. “As long as you smoke, things are going to continue to get worse,” says Bajic.
3. Manage Your Blood Pressure
A healthy blood pressure rate helps curb your risk for ED because it keeps your heart from going into overdrive, giving it the ability to efficiently pump blood to the penis. Three ways to keep it down: eat a balanced, low-sodium diet, exercise regularly, and manage stress (8).
4. Manage Your Blood Sugar
High blood sugar can lead to diabetes, which is a big contributor to atherosclerosis. “Maintaining good blood sugar control is all about diet,” Bajic says.
Carbs in particular have a big impact because they break down into glucose (blood sugar), raising insulin levels. While it’s OK to have some carbs, focus on eating those with a low glycemic load (meaning they’re least likely to spike blood sugar) to best decrease high blood sugar risk. Bran cereals, apples, oranges, kidney beans, black beans, lentils, carrots, peanuts, and skim milk are good bets. Fiber-rich foods like vegetables, fruits, and whole grains can also slow carb absorption (9).
Throw in some regular exercise, which inhibits insulin secretion, and of course, “work with your primary care doctor or endocrinologist to keep your blood sugars under control,” says Bajic.
5. Drink Green Tea
Flavonoids known as catechins in green tea are thought to reduce inflammation (10), which can prevent plaque build-up in the arteries, preventing heart disease and improving blood flow.
6. Limit Alcohol
Excessive, prolonged drinking can foster alcohol cardiomyopathy, a condition where your heart changes shape and becomes weakened, affecting its ability to pump blood. Drinking too much booze can also cause your veins to tighten and constrict (11), which increases blood pressure and—you guessed it—negatively impacts circulation.
7. Get Regular Check-Ups
If you have an underlying health condition that is causing ED or restricting blood flow, your doctor may uncover it during your annual physical. If he or she prescribes medications to treat a health condition, take them as instructed. Likewise follow any suggested behavioral tweaks.
8. Hit the Gym
It’s called cardio for a reason. Get the heart pumping and blood flowing by working out for 45 minutes at least three times a week. Bonus points if you find yourself out of breath. “We’re talking about getting your heart rate up into the 75 percent max or higher for a sustained period of time,” says Bajic. “When that’s done regularly for a period of several months, it has been shown to improve the erections in a measurable way.”
He’s not wrong: A 2018 systematic review of 10 studies conducted between 2006 and 2016 found that when participants with ED exercised at such a rate, ED was improved by anywhere from 14% to 86% (12).
9. Eat a Balanced Diet
Eating well helps maintain a healthy weight, which makes it easier for the heart to do its blood-pumping job. Avoid sugar and ultra-fatty foods, which contribute to plaque build-up in the arteries and instead load your plate with nitrate-rich veggies (think: leafy greens, beets, carrots, and broccoli). Your body uses these eats to create nitric oxide (13), a compound that boosts blood flow by relaxing blood vessels.
10. Consider Meds
A class of medications called PDE5 inhibitors can increase blood flow to your penis. These drugs “basically increase the diameter of the arteries that are bringing blood into the penis,” Bajic explains.
If your doctor suggests a PDE5 inhibitor like tadalafil (sold under the brand name Cialis) or sildenafil (Viagra), make sure he knows if you are on any nitrate-based heart medications like nitroglycerin (commonly prescribed after heart attacks) because “the combination can lead to a life threatening drop in blood pressure,” Bajic says.
Help For Erectile Dysfunction
If the above tactics don’t help with your ability to get and keep an erection, the issue may not be with circulation. Other strategies can still help improve ED:
Don’t Ignore Your Mental Health
If you experience ED, “what was once a part of your body that gave you pride and confidence is now a source of stress,” says Calvert.
Many patients with ED find sex therapy or couple therapy beneficial, says Bajic. Certain antidepressants can also boost your mood, although some meds, including selective serotonin reuptake inhibitors (SSRIs)—can actually exacerbate erection issues downstairs.
Get Better Sleep
“Testosterone is produced during the deepest stages of sleep, specifically REM sleep,” says Bajic. Men who struggle with insomnia or other sleep disorders may not clock enough high quality Z’s for the restorative bodily functions that happen overnight, including testosterone production. Plus, you’re less likely to get turned on when you’re cranky and overtired.
Check Your T Levels
If you experience sluggishness, depression, weight gain, and weakness along with ED, you may have low testosterone and could benefit from testosterone replacement therapy (TRT). Thankfully, it’s never been easier to check your levels and get help.
Hone’s comprehensive at-home test that, via a simple mail-in process, measures not just your testosterone, but various other biological markers related to T production including luteinizing hormone (LH), estradiol, sex hormone binding globulin (SHBG), albumin, and more. Hone’s test comes with everything you need to safely collect a blood sample and get accurate results.
The Bottom Line