Erectile Dysfunction Went With Higher Death Rates in U.S. Men

CATEGORY: MEN’S HEALTH

Men who reported erectile dysfunction—ongoing difficulty getting or keeping an erection firm enough for sex—were more likely to die over the following years than men without it, including from heart disease, a long-term study of U.S. men found. Because the study followed men as they were rather than assigning any treatment, it points to an association, not proof that erectile dysfunction causes earlier death.¹

4,110 Men Followed a Median 16 Years

Researchers drew on the National Health and Nutrition Examination Survey (NHANES), a long-running U.S. health survey, using data from 4,110 men aged 20 and older who answered a standard question about erectile function in 2001–2004. They then linked those records to national death records and tracked who died over a median of about 16 years—meaning half the men were followed longer than that. During follow-up, 1,226 men died, 419 of them from cardiovascular (heart and blood vessel) causes. The team adjusted for factors such as age, diabetes, high blood pressure and smoking to help separate erectile dysfunction from other explanations.

45% Higher Death Risk and 57% From Cardiovascular Causes

After those adjustments, men with erectile dysfunction had about a 45% higher risk of dying from any cause and about a 57% higher risk of dying from cardiovascular disease than men without it. The researchers noted that this added risk was in the same range as well-known heart risk factors such as diabetes, high blood pressure and prior stroke.¹

Small Arteries May Show Vessel Trouble Earlier

Erections depend on healthy blood flow, so the small arteries involved can be affected by the same vessel problems—such as stiffening or narrowing—that later show up in the heart. Because those smaller vessels can show trouble earlier, erectile difficulties are sometimes described as a possible early signal of wider cardiovascular disease. This kind of study can’t confirm that chain of events, and erectile dysfunction has many causes, including medications, stress, and hormonal or nerve conditions.

This Study Cannot Show Treatment Changes Survival

This was an observational study—it watched what happened rather than testing a treatment—so it can’t show that treating erectile dysfunction changes survival. What it adds is evidence that erectile dysfunction may be worth treating as a prompt to check overall heart health, not just as a stand-alone concern. It is a signal worth noticing, not a diagnosis on its own.

Pooled 111,440 Men Showed a Smaller 24% Increase

A meta-analysis combining seven cohort studies of 111,440 men found erectile dysfunction linked to a 24% higher risk of death from any cause—less than in this study—and no clear increase in cardiovascular death when the studies were pooled.² The mortality link was strongest for severe erectile dysfunction, a pattern also reported in an Australian study of 95,038 men.³

Key Takeaways

• In a U.S. study following men for about 16 years, those with erectile dysfunction had roughly 45% higher odds of dying from any cause and 57% higher odds of dying from heart disease, on average, than men without it.
• Erectile dysfunction may reflect early problems in blood vessels, which is why some researchers view it as a possible warning sign for the heart—though this study shows an association, not cause and effect.
• Erectile dysfunction has many everyday causes and does not by itself mean heart disease is present.

References

1. Bhattacharyya S, Miller LE, Rojanasarot S, Patel DP. Association of erectile dysfunction with all-cause and cardiovascular mortality in US men: findings from NHANES 2001–2004 with 16-year follow-up. International Journal of Impotence Research. 2025 Nov 24. doi:10.1038/s41443-025-01218-z. link
2. Fan Y, Hu B, Man C, et al. Erectile dysfunction and risk of cardiovascular and all-cause mortality in the general population: a meta-analysis of cohort studies. World Journal of Urology. 2018;36(10):1681–1689. link.
3. Banks E, Joshy G, Abhayaratna WP, et al. Erectile dysfunction severity as a risk marker for cardiovascular disease hospitalisation and all-cause mortality: a prospective cohort study. PLoS Medicine. 2013;10(1):e1001372. link.