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

CATEGORY: MEN’S HEALTH

Erectile dysfunction, ongoing difficulty getting or keeping an erection firm enough for sex, is usually treated as a problem in its own right. A long-term study of U.S. men suggests it may also sit alongside something wider. Men who reported it were about 45% more likely to die of any cause over the years that followed than men who did not, and about 57% more likely to die of cardiovascular disease.¹ These men were followed as they were, with no treatment assigned, so what emerges is an association rather than proof that erectile dysfunction causes earlier death.

4,110 Men, One Survey Question, 16 Years of Death Records

The data came from the National Health and Nutrition Examination Survey, a long-running U.S. health survey. Specifically, from 4,110 men aged 20 and older who answered a standard question about erectile function in 2001 to 2004. Those records were then linked to national death records. The median stretch of follow-up was about 16 years, meaning half the men were tracked longer than that. In that time 1,226 men died, 419 of them from cardiovascular causes, meaning disease of the heart and the blood vessels. Age, diabetes, high blood pressure and smoking were adjusted for, to pull erectile dysfunction apart from the obvious alternative explanations.

Risk in the Same Range as Diabetes or a Prior Stroke

After those adjustments the gap came to about 45% higher risk of dying from any cause and about 57% higher risk of dying from cardiovascular disease. The researchers noted that the size of that added risk landed in the same range as well-known heart risk factors: diabetes, high blood pressure, prior stroke.¹ Erections depend on healthy blood flow, and the arteries involved are small. Stiffening or narrowing may register there before it registers in the heart, which is why erectile difficulties are sometimes described as an early signal of wider vessel disease. A study of this kind cannot confirm that chain of events. Erectile dysfunction also has many causes, medications, stress, and hormonal or nerve conditions among them.

A Larger Pooled Analysis Found a Smaller Gap

Seven cohort studies of 111,440 men, combined in a meta-analysis, linked erectile dysfunction to a 24% higher risk of death from any cause, well under the figure here, and turned up no clear increase in cardiovascular death once the studies were pooled.² Severity is where the link concentrates. It ran strongest in men whose erectile dysfunction was severe, and an Australian cohort of 95,038 men reported the same pattern.³ None of this tests whether treating erectile dysfunction changes survival. It is a signal, not a diagnosis.

Key Takeaways

• Men reporting erectile dysfunction had roughly 45% higher odds of dying from any cause and 57% higher odds of dying from heart disease, across about 16 years of follow-up.
• Erectile dysfunction has many everyday causes and does not by itself mean heart disease is present.
• The study watched men rather than testing a treatment, so what it shows is a link; a larger pooled analysis found a smaller increase in all-cause death and none in cardiovascular death.

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.