While e-cigarette advertising has historically used sexy looking men, a new study published in the American Journal of Preventive Medicine concludes that "The use of [e-cigarettes] seems to be associated with erectile dysfunction, independent of age, cardiovascular disease, and other risk factors."

Oxford Languages defines erectile dysfunction as the "inability of a man to maintain an erection sufficient for satisfying sexual activity."

Within the study, 2,128 of 13,711surveyed men self-reported erectile dysfunction by responding to the following question.

"Many men experience problems with sexual intercourse. How would you describe your ability to get and keep an erection adequate for satisfactory intercourse?" Men selected one of five possible answers: (1) always (2) almost always (3) usually (4) sometimes or (5) never.

Those who responded sometimes or never were defined as having moderate-to-severe erectile dysfunction.

Among the 2,128 with erectile dysfunction, researchers excluded 1,096 who were older than 65 or who had a history of cardiovascular disease, factors known to result in a higher prevalence of erectile dysfunction.

After excluding all smokers and dual users (cigarettes + e-cigs), researchers found that current daily e-cigarette users were 2.3 times as likely to report moderate to severe erectile dysfunction.

But why?

A common complaint heard from nicotine-dependent men and women is that their hands and feet are always cold.

According to the study's authors, "Abundant evidence suggests that nicotine prevents vasodilatation of blood vessels and reduces blood flow, which impairs normal erectile function and negatively affects male sexual performance."

The authors note that "Another plausible mechanism for the e-cigarette's association with erectile dysfunction is that exposure to e-cigarette refill liquids with or without nicotine reduces circulating testosterone levels (by 50% and 30%, respectively) owing to a decrease in the messenger RNA expression of 2 key steroidogenesis enzymes, cytochrome P450scc and 17b-hydroxysteroid dehydrogenases, at least in rodent models."

"Moreover," according to the study's authors, human studies have shown a dose−response association between the nicotine concentration in cigarettes and erectile dysfunction, with high-nicotine cigarettes being associated with higher rates of erectile dysfunction than low-nicotine cigarettes."

So, the next time you see some super sexy-looking hunk bellowing e-cig vapor, remind youself, looks can be deceiving.

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