Pre-workout and erectile dysfunction: What’s really going on behind the pump?

Getting down to the gym for a heavy weightlifting session or a burst of cardio is something everyone should be doing to keep their bodies in good physical condition. Today, around four million Aussie adults are involved in some sort of organised sport or physical activity, including the gym [1].

You’ve probably already heard of pre-workout supplements, but have you heard the rumours that they cause erectile dysfunction? It’s one of the most common forms of sexual dysfunction, with an estimated 23.3% of Aussie blokes between 35 and 80 suffering from some form of it [2].

In this guide, we address this rumour directly to understand whether your pre-workout drink could be causing erectile dysfunction and, if so, what you can do about it.

What are pre-workout supplements?

Adding dietary supplements to your day isn’t uncommon. Around one in every three people above the age of two is taking some form of supplement today, including pre-workout [3]. 

Pre-workout is formally known as a type of Multi-Ingredient Pre-Workout Supplement (MIPS), and it covers an entire class of supplements designed to be taken before exercise. Most contain ingredients like creatine, amino acids, beta-alanine, and caffeine [4]. Approximately 30% of participants in one study used pre-workout, making it by far the most common supplement you’ll find in any gym [5].

Some of the purported benefits of pre-workout include [6]:

• Enhance focus
• More energy
• Boost performance

And it’s no surprise to see that gym rats and newbies alike swear by these supplements as the key to hitting their fitness goals in the gym.

How do pre-workouts work?

Can pre-workout supplements enhance your athletic performance at the gym? The truth is, yes, because pre-workout ingredients combine to delay muscle fatigue, stimulate the nervous system, and improve blood flow. That’s why you feel energised, focused, and ready to go hard whenever you take them.

For example, caffeine will offer that physical and mental energy boost, whereas beta-alanine mitigates muscle burn during strenuous workouts. Other ingredients, including nitrates, creatine, and amino acids, focus more on oxygen delivery, muscle strength, and increased blood flow. 

Side effects of pre-workouts

Pre-workouts aren’t for everyone, and they do come with some side effects due to the various stimulants and other ingredients inside. Let’s go through the side effects of the major ingredients:

• Caffeine – Fast heart rate, insomnia, nausea, restlessness, and an irregular heartbeat.
• Beta-alanine – Potential for itchy skin and a tingling in the upper torso, face, neck, and hands [7].
• Branched-chain amino acids (BCAAs) – Ineffective in endurance exercise, but may improve muscle mass and strength, with no reported side effects [8].
• Citrulline – The primary reported side effect is gastrointestinal (GI) discomfort.
• Creatine – Diarrhea, muscle cramps, weight gain, and nausea.

Who should avoid pre-workout supplements?

Generally, children should avoid using them, as they can result in adverse reactions with certain medications. A study from the American Academy of Pediatrics (AAP) also found that these types of performance-enhancing supplements don’t create results that can’t be gained through following a proper diet and reaching your proper hydration threshold [9].

Additionally, if you’re already sensitive to certain stimulants, including caffeine, then either avoid pre-workout or read through the ingredients to ensure your pre-workout is free of products that could cause unpleasant side effects.

Does pre-workout cause ED?

There is currently no strong evidence to suggest a direct link between pre-workout and erectile dysfunction. The short answer is that if you’re suffering from this type of sexual dysfunction, it’s unlikely to be the pre-workout you’re taking.

Likewise, the same goes for studies focusing on the most common ingredients found in these products. Granted, there have been casual or indirect links in the past, such as claims that sugar can increase the risk of getting erectile dysfunction, but there’s nothing that comprehensively proves that your pre-workout concoction of choice is the reason, or even a contributor.

In fact, some studies have found that some ingredients inside pre-workout may actually be beneficial for your sex life.

How pre-workouts may affect your sexual health

Pre-workouts already make you feel energised, focused, and ready to perform. You might also feel more confident in yourself after guzzling down your shake. It’s not the placebo effect, either, as the ingredients within genuinely do affect your body's sexual performance, positive and negative.

Caffeine is the primary culprit, but in terms of your erectile function, studies have shown that consuming between 170 mg and 375 mg of caffeine daily could lower your overall erectile dysfunction risk [10].

Meanwhile, you have ingredients in pre-workout like nitric oxide, which leads to enhanced blood flow by causing your blood vessels to relax, which is essential for obtaining and maintaining an erection [1]. Plus, high nitric oxide levels even control how your body burns fat and sugar, and with obesity being a major risk factor for erectile dysfunction, this compound could lower your risk [12].

Overall, some blokes may find that pre-workout actually enhances their sex life. But do remember that the evidence is relatively thin on the ground, and your experience won’t necessarily resemble your mate’s.

Factors that may worsen ED when taking pre-workout supplements

Pre-workouts aren’t going to cause erectile dysfunction directly. But there are side effects that could make it difficult for you to perform when the moment is right. These include:

• Overusing them – Consuming too much of any stimulant can overstimulate your central nervous system, leading to mood changes and an elevated heart rate. Stimulants like caffeine could make it harder for you to relax during sexual activity.
• Underlying health Conditions – There’s a reason you're advised not to take pre-workouts if you’ve got certain underlying health conditions. These supplements can aggravate these conditions, which is a risk factor for erectile dysfunction.
• Dehydration – Combine an intensive gym session with pre-workout, and you’re risking dehydration. Staying hydrated is essential for optimal sexual health because of its impact on your circulatory system.
• Poor sleep – It’s hard to feel your best when you’re not getting enough sleep, which is why how long you sleep is one issue a GP will focus on when assessing sexual function. Too much of any stimulant disrupts the sleep cycle, so if you’re taking too much pre-workout, you could be risking erectile dysfunction and a whole other host of problems.

Again, it’s not that this supplement causes problems directly. It’s what it does for other risk factors for sexual dysfunction. It’s not raising the problems themselves but worsening those that are already there.

Can pre-workout decrease testosterone? 

Pre-workouts don’t directly reduce your testosterone. Some ingredients may actually increase your testosterone, which is why you feel stronger and faster when taking them just before your workout.

For example, a study found that creatine increases the concentrations of growth hormones and testosterone during exercise [13]. Of course, that’s not the same for every ingredient. We already know that excessive amounts of caffeine increase cortisol levels (the body’s stress hormone), which is a risk factor for decreased testosterone [14].

Can pre-workout improve sex?

With all this in mind, you might be wondering whether pre-workouts could be beneficial for your bedroom time. This is where your experience will vary.

In theory, most pre-workout supplements could improve sex by increasing your energy levels and blood flow, thus helping you to get and maintain an erection. If we look at the other side of the coin, ingredients like caffeine and nitric oxide boosters could lead to mood changes and an increased heart rate.

Some people might report the sexual benefits of pre-workout, but this isn’t the case for everybody, so we can’t say this is any sort of sexual supplement.

Can you prevent ED while training hard?

Lifestyle factors are part of the erectile dysfunction story. Common risk factors for erectile dysfunction include issues like:

• Heart health
• Hypertension
• Inactivity
• Obesity
• Metabolic syndrome

All of these issues can benefit from regular exercise. If we look at a study, we find that just 160 minutes a week of moderate to vigorous exercise for six months can result in a major decrease in erectile dysfunction [15]. 

That doesn’t make it a cure-all for erectile dysfunction, but it does mean that pre-workout could impact sexual health positively if your erectile dysfunction is primarily due to a sedentary lifestyle.

When to talk to a doctor about ED

Talking to a doctor about erectile dysfunction can help you tackle the problem head-on and reclaim your confidence in the bedroom. Generally, if it’s been a persistent issue for several weeks or months, it’s time to approach a healthcare professional. Likewise, if it’s causing you to feel anxious or worried, reaching out to your GP is the right move.

Your healthcare provider can assess your medical history and lifestyle to understand why you might be having issues. They might also point you in the direction of treatments like sex therapy, mental health counselling, or programs like Pilot’s ED treatment.

So, if you’re worried about erectile dysfunction or the potential role of pre-workout, contact your GP for an appointment immediately. 

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