Erectile dysfunction (ED) does not necessarily cause a low sperm count or mean a person is infertile. However, some conditions that cause ED may influence sperm count.

Several risk factors for ED and low sperm count overlap. These include hormonal disorders, age, certain medications, and anatomical differences.

Although a person can have both ED and low sperm count at once, it does not mean that treating one issue will cure the other. People seeking relief from ED and low sperm count need help from a healthcare professional for both issues.

Read on to learn more about how ED affects sperm count and conceiving with low sperm count.

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On its own, ED does not affect sperm count or cause a low sperm count. However, some medical conditions that cause low sperm count may also cause ED.

A 2020 study found that newly-married men with ED were also more likely to have low sperm counts. This may be because of common risk factors and medical conditions that can cause each health issue.

For example, about 6% of men with ED also have atypical thyroid function. Thyroid issues, especially hyperthyroidism, may also trigger low sperm count.

Some medical conditions linked to both ED and low sperm count include:

  • disorders affecting the endocrine system
  • structural abnormalities in the penis, testicles, or other portions of the reproductive tract
  • infections
  • medications and drugs such as opioids
  • advancing age

ED does not directly cause infertility. However, conditions that cause the former may increase the risk of infertility. For example, a person with anatomical differences may have low sperm count and difficulty getting or sustaining an erection.

Additionally, people with severe ED may be unable to have sexual intercourse or to reliably time intercourse to coincide with their partner’s fertile window. For some individuals, the stress of ED can make the condition progressively worse with time. Those dealing with low sperm count may feel even more stress and pressure.

Treatment depends on the underlying cause of a person’s low sperm count.

Just 1 in 5 cases of male infertility is treatable with medication or surgery. However, in some cases, treatment may entirely reverse the issue. For example, an obstruction in the sperm duct may lower sperm count. Additionally, surgical techniques may resolve it.

Treating ED starts with identifying the cause.

Cardiovascular causes, such as high blood pressure, are very common, with up to 50% of men with cardiovascular disease experiencing ED. Exercise, diet changes, weight loss, and other heart-healthy lifestyle choices can help.

A healthcare professional may also be able to treat structural or hormonal issues or prescribe alternatives to medications that cause ED. When a cause is not treatable, or a doctor does not identify a cause, medication can help.

For some individuals, depression, anxiety, stress, relationship problems, and other mental health concerns can also interfere with intimate feelings. In this situation, counseling and other behavioral therapies may improve sexual performance.

Learn more about ways to increase sperm count.

Infertility is different from sterility. Health experts define infertility as the inability to achieve pregnancy after 12 months of regular sex without contraception. In contrast, sterility means that a person produces no semen or does not ovulate. If one partner is sterile, then pregnancy cannot occur.

People with low sperm count still produce some sperm. They can still impregnate a partner, but the likelihood is lower.

The main ways to get pregnant with infertility and low sperm count are intrauterine insemination (IUI) and in vitro fertilization (IVF). Both options join the sperm and the egg together, making it easier for someone with a low sperm count to impregnate their partner.

IVF fertilizes the egg outside the body, while IUI fertilizes the egg inside the body of the individual with the uterus.

A 2020 study found no correlation between measures of semen quality and pregnancy rates in people using IUI. This suggests that artificial reproductive technologies may be a successful option for individuals with infertility.

People with sterility — a condition that means they produce no sperm — cannot impregnate a partner unless the underlying condition causing sterility is treatable. They may need to try other options, such as sperm donation.

Learn more about assistive reproductive technologies like IUI and IVF.

Individuals can contact a doctor if:

  • A couple has tried for longer than 1 year to get pregnant without a pregnancy occurring.
  • A male has a known medical condition that can affect fertility or erectile function.
  • A person develops ED.
  • Treatment for ED does not work or causes significant side effects.

Dealing with erectile dysfunction and low sperm count can cause concerns among individuals, because no single treatment works for everyone. However, the fact that a person has one condition does not mean they will have the other.

People who plan to try for a pregnancy should consult a doctor if they have concerns about ED or other medical issues, since early intervention may help improve their chances of a pregnancy.