By Marc Braman, MD, MPH

MB (Marc Braman, MD, MPH):

Any chemical that impairs or interferes with the bodies systems involved in sexual function can be a cause of ED. It is a type of mild poisoning that doesn’t kill you immediately.

What are chemicals that we put into our bodies?

Smoking is a whole slew of chemicals. Not only is nicotine a neurotransmitter and one of the most addictive substances we know of, but all the chemicals of combustion in the smoke are a huge hit to the health of the blood vessels – which are critical and the primary actor in an erection. Sure enough, smoking is directly proportional to ED. Studies show that the more one smokes, the worse the ED. “Stopping cigarette smoking can improve ED in a considerable proportion of smokers.” How much benefit you are likely to get from quitting? It is relative to how old you are and how bad the ED was before you quit. How much capacity does the body have to heal from how much injury?

Another top chemical we pure down our gullets is alcohol. Now alcohol and sex seem to have been associated with each other for a very long time. Human history portrays “drunken orgies” as the classic association between booze and uninhibited sex. Sex is used to sell alcohol day in and day out, all over the world, today. Alcohol, for many people, produces a chemically-induced, artificial relaxation. People think they are more “sexy.” What is really happening is that it anesthetizes the “command and control” center, or the moral pilot in the brain, and the sexual urges are less inhibited. People are not really more sexy – just less in control.

This is likely the case with other mind-altering drugs also. You may feel more sexy for a little bit but it’s just not really true.

What about prescription medications? Of course, these are artificial chemicals too. Do they have an effect?

It is estimated that 25% of ED is due to medications. That’s right! We are creating 1 out of every 4 cased of ED with the medications we prescribe — typically for lifestyle-caused problems — which is also the primary cause of most ED.

Eight of the 12 most commonly prescribed medications list ED as a side effect. Medications for high blood pressure, depression and other mental health issues, hormones, some antacids, etc.

And lets not forget about nutritional supplements — you hear about those “all natural male performance enhancers” that seem to be everywhere today. Some studies have found that 1/3 to 1/2 of these “natural” products actually have synthetic Viagra-like medications or compounds in them, leading to serious safety concerns.

Whatever you are going to do, do it with reality and based on tangible evidence. As a general rule, where there is a lot of hype and puffery about a product, there is someone wanting to make a lot of money but usually not a lot of reality.

One of the first things to do if you have ED, is to figure out if you are directly causing it by the chemicals you are putting into your body — legal or illegal, medical or otherwise.

Often the best treatment is to simply stop causing the problem.

Emotional changes in men treated with sildenafil citrate for erectile dysfunction: a double-blind, placebo-controlled clinical trial. Moncada I, Martínez-Jabaloyas JM, Rodriguez-Vela L, et al. J Sex Med 2009; 6:3469.

Impotence in medical clinic outpatients. Slag MF, Morley JE, Elson MK, Trence DL, Nelson CJ, Nelson AE, Kinlaw WB, Beyer HS, Nuttall FQ, Shafer RB. JAMA. 1983 Apr 1;249(13):1736-40.

“Medication Health Fraud – Tainted Sexual Enhancement Products.” FDA. U S Food and Drug Administration Home Page, Center for Biologics Evaluation and Research, 2018,

“Herbal Viagra Should Be Shunned.” O’Mathuna, Donal P. AHC Media – Continuing Medical Education Publishing, 2010,

Marc Braman, MD, MPH

Dr. Braman is board certified in preventive medicine/public health and occupational/environmental medicine. He is founding member, second President and first Executive Director of American College of Lifestyle Medicine and founder and current president of the Lifestyle Medicine Foundation which created He provides lifestyle medicine care in a wide variety of settings as well as initiating efforts to establish professional standards for the field of lifestyle medicine and planning and conducting national professional conferences in lifestyle medicine.

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