Smoking affects your sex life, your ability to have children and your intimate health. The encouraging part is that many of these effects improve after you quit, often sooner than people expect.
By Jean-François Etter, professor of public health.
Why smoking affects sexual arousal
Sexual arousal depends on healthy blood flow. Cigarette smoke contains thousands of chemicals that injure the lining of blood vessels, make them narrower and stiffer, and over time contribute to atherosclerosis (hardening and blockage of the arteries). Nicotine also causes blood vessels to constrict with every cigarette.
For men, an erection requires a rapid increase in blood flow. Studies consistently find that smokers are around 1.5 times more likely to develop erectile dysfunction (ED) than non-smokers, and the risk rises with the number of cigarettes smoked and the number of years of smoking. ED in smokers also tends to appear at a younger age.
A warning : because the arteries supplying the penis are small, ED can be one of the first signs of wider blood-vessel disease. If you smoke and notice erection problems, see a doctor. It may be an early signal about your heart health, and it is a good reason to quit.
For women, reduced blood flow to the genital area can mean weaker arousal, less natural lubrication and more difficulty reaching orgasm. This can make sex less enjoyable or uncomfortable. Research in this area is less extensive than for ED, but the underlying mechanism is the same, and the size of the effect is also the same : the risk of female sexual dysfunction is increased 1.5 times in smokers.
Smoking and your intimate health
Smoking weakens several of the body’s defences. One well-established example is HPV, the virus behind most cervical cancers. Smokers are more likely to be infected than non-smokers, and smokers who are infected are more likely to have the infection persist and to develop precancerous changes in the cervix and carcinoma of the cervix. Smoking is also a risk factor for bacterial vaginosis.Smoking can also slow healing, which may matter after infections or surgical procedures.
HPV vaccination, regular screening and quitting smoking together offer the best protection.
Smoking and fertility
Smoking can make it harder to conceive, for men and women alike.
- Sperm: Smoking is linked to lower sperm concentration, poorer movement (motility) and more abnormally shaped sperm, reducing the chances of fertilisation.
- Eggs and hormones: In women, smoking can disrupt the menstrual cycle, damage eggs and bring on menopause one to four years earlier on average.
- Conception and pregnancy: Smokers generally take longer to conceive and have a higher risk of miscarriage and ectopic pregnancy. See our article on smoking and pregnancy for more.
- Fertility treatment: Smoking lowers the success rates of IVF and other assisted reproduction.
- Secondhand smoke: A non-smoking partner exposed to smoke is also affected, and exposure during pregnancy harms the baby.
If you use hormonal contraception, note that combining it with smoking carries specific risks, especially blood clots. Read more about smoking and the contraceptive pill.
Other effects on intimacy
Smoking can reduce stamina and cause breathlessness, which affects physical activity of every kind. The smell of smoke on breath, hair and clothes, along with skin ageing and stained teeth, can also affect how comfortable people feel about their bodies and closeness with others. These effects vary from person to person, and many people notice them more in themselves than their partners do.
What happens when you quit?
The body begins to repair itself sooner than most people think.
- Within weeks: circulation starts to improve and breathing becomes easier.
- Within about three months: sperm quality can begin to recover.
- Within months: many former smokers, especially younger men and those with milder problems, notice improvement in erectile function.
- Over the longer term: fertility, pregnancy outcomes and cardiovascular risk improve, with the benefits growing the longer you stay smoke-free.
Recovery is not guaranteed for everyone, particularly after many years of smoking, but quitting offers the best chance of improvement. It also helps any other treatment work better.
The next steps
- Speak with a doctor about any sexual or fertility concerns. Several causes are possible, and effective treatments exist.
- If you are trying to conceive, quitting smoking now, for both partners, improves your chances.
- Support makes quitting much more likely to succeed. Nicotine replacement therapy and prescription medications can double your chances compared with going it alone, and your doctor or pharmacist can support you and help you choose the best treatment. Or you can call a helpline.
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References:
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