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When it comes to erectile dysfunction, the first concern that usually arises is does this impact your chance to have children in the future. An understandable concern, but is this just over-worrying about a common problem or is there some merit to this?

Erectile dysfunction is a common condition in society affecting males over the age of 60 but is no longer a disease restricted to elderly[1]. Several different etiologies can cause inability to achieve and maintain an erection. Systemic illnesses like hypertension, diabetes and heart failure can lead to vascular blockades to prevent blood from pooling in the penis. Excessive stress or depression can be psychological factors that manifest as erectile dysfunction as well [2]. Viagra can represent a quick solution to this underlying problem but can fail and patients turn to many different vitamins and dietary supplements for ED. As we have seen in previous articles, some of the natural supplements for erectile dysfunction can benefit like how DHEA increases libido and L-arginine offers help for erectile dysfunction and they can be used to help improve erections, but they are not entirely reliable. In this article, we will explore the link between erectile dysfunction and infertility. The question is, does erectile dysfunction mean a man is infertile? 

What is Infertility? 

Infertility is a common disease in society and is traditionally a term used to describe couples who are routinely having unprotected sexual intercourse without the ability to conceive a child after a one year period. If a woman is over 35, this threshold is protracted to a limit of 6 months before it becomes problematic. When looking at reasons for infertility, they are often multi-factorial and can be due to both female and male anomalies that can prevent adequate fertilization and implantation of the egg. Infertility is an issue for 1 in every six couples and is usually due to one of the following four categories:

  • advanced age, 
  • low semen quality or count; 
  • changes in sexual behavior 
  • and elimination of taboos [3].  

Infertility is not a problem that is dependent exclusive on female partners, and around 50 percent of overt infertility cases are due to issues stemming from males. It is premature just to generalize the problem and say this is due to low sperm counts because that is only a factor in about 2 percent of cases. Infertility from a male perspective is through a combination of low sperm concentrations, poor sperm motility and abnormal morphology of the sperm. The most common for this worldwide is due to infectious diseases that are more likely to be seen in third-world countries. Nevertheless, even 10 percent of couples in the United States are infertile meaning about 5 percent of men in the US are currently infertile. Thankfully, due to a better understanding of health and prevention of infectious diseases through contraception, the global rate of male infertility has decreased by 15 percent in the last decade. [4]

The Link Between Infertility and Erectile Dysfunction 

When a patient is diagnosed with erectile dysfunction, there is also a good chance that he may be infertile. The critical point to remember, however, is what is the cause of this erectile dysfunction and whether it is something that is reversible. 

In one study examining the link between hypothyroidism, erectile dysfunction and infertility, 24 patients suffering from hypothyroidism were compared against 66 patients who didn't have problems with underactive thyroid. At the conclusion of the study, researchers determined that patients suffering from hypothyroidism were over two times more likely to experience erectile dysfunction and had seminal parameters that were significantly weaker compared to patients in the control group. This conclusion indicates that erectile dysfunction and infertility are co-morbidities and are often coexisting hand in hand. However, if a patient takes medications to correct his thyroid dysfunction, his sperm counts, sperm motility and erectile dysfunction will be corrected too. [5]

Another common parameter worth exploring would be the link between diabetes, erectile dysfunction, and infertility. Unlike hypothyroidism, a simple antidote of medication will not work when a patient has long-standing diabetes due to the different mechanism that is occurring. Oftentimes, patients suffering from diabetes ignore physician warnings and continue to eat diets high in sugars to the point of causing significant vascular damage. Sugar is a substance that is fine in small concentrations. However, sugar has the potential to have a toxic effect on blood vessels when it is consumed in high quantities. In standard Western diets, children aged 5 to 12 are able to consume up to 280 grams of sugar in a single day due to the foods that make up a regular diet. What may be shocking to most is that sweets are not the main contributor to the high amounts of sugar. Instead, the main foods are milk, cheese, and bread[6]. This can account for over 1,000 calories of energy per day yet current recommendations in the medical world call for only 5 percent of calories coming from sugar products [7]. 

With such explosive levels of sugar consumption, it should come as no surprise as the number of cases of diabetes occurring in males of reproductive age has mushroomed by nearly a factor of 5 in the last two decades. Side effects of long-term diabetes often entail cardiac and neurological problems and this will impact erection potentials from two different mechanisms. Even treatment options with Viagra to offset this impotence has been proven in recent studies to depress sperm counts and lead to more cases of infertility. [8]

Unfortunately, it is hard to draw a silver lining in this problem if there is an irreversible root to what is causing the erectile dysfunction. Even strict dietary control and insulin use make never return the blood flow, and neurological input to the penile shaft and sperm counts may be depressed for the rest of the patient's life. No matter what natural treatment for erectile dysfunction you take, no vitamin or dietary supplement for ED will make a difference. 

If erectile dysfunction has a more reversible cause without vascular implications like hypothyroidism or stress disorders, patients suffering from ED without any obvious damage to their sperm quality should be able to become fertile again. As you can see, when asked "does erectile dysfunction mean a man is infertile," the answer is not as simple as "yes" or "no" but depends on the reason for the erectile dysfunction. If the answer to this burning question is yes, we should add that is also something that can be reversible. 

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