Do Nicotine Pouches Cause ED or Affect Testosterone and Sperm?

By PouchGuide Editorial Team · Published September 25, 2026

“Can ZYN cause erectile dysfunction?”, “do nicotine pouches lower testosterone?” and “do pouches affect sperm count?” come up a lot among men who use pouches. Smoking is a well-established risk factor for erection problems. But pouches don’t involve smoke, so does the same apply?

The honest answer: there are no studies on nicotine pouches and sexual health specifically. But there’s relevant research on smoking, on nicotine, and on Swedish snus, a smokeless oral product, which gives a reasonable picture. This is general information, not medical advice.

Erections: blood flow is the key

An erection depends on healthy blood flow and blood vessels. That’s why cardiovascular problems and erectile dysfunction (ED) so often go together.

• Tobacco use is a recognized risk factor for ED. A 2016 review in the World Journal of Men’s Health lists tobacco use alongside cardiovascular disease, high blood pressure and diabetes as risk factors, and notes that quitting smoking improves erectile function in many men.
• Cutting down helps. A 2013 study followed 62 men who smoked through a quit attempt that used nicotine patches. The more they reduced smoking, the better their measured erectile response became four weeks after they stopped the patch. The authors linked this partly to improvements in how the nervous system regulates the heart.

What about nicotine on its own? Nicotine constricts blood vessels and raises heart rate and blood pressure. A 2024 risk assessment concluded that a clinically relevant rise in heart rate is very likely even from a single pouch. Those are the same mechanisms that make smoking harmful for erections, so it’s plausible that heavy nicotine use could contribute to erection problems. It just hasn’t been directly studied in pouch users, and pouches avoid the smoke that does most of the damage to blood vessels.

If you notice erection problems, cutting down on nicotine is a reasonable step. But see a doctor too. ED can be an early warning sign of heart disease, diabetes or low testosterone, and it deserves a proper check.

Testosterone: not the drop people expect

This one surprises people. In a 2022 study of 613 Swedish men published in Andrology, men who used snus had 14% higher testosterone than non-users, after adjusting for smoking. Higher levels of cotinine, the marker of nicotine exposure, were also linked to higher testosterone and estradiol.

So the evidence doesn’t support the idea that oral nicotine “kills testosterone”. Higher hormone levels aren’t necessarily a good thing either, though. The study found changes in several reproductive hormones, which fits with nicotine affecting the hormone system rather than leaving it untouched.

Sperm count: a real concern

The same Swedish study found that total sperm count was 24% lower in snus users than in non-users. That was after adjusting for cigarette smoking, so the effect isn’t explained by smoking. The amount of snus used was linked to hormone levels.

Snus contains tobacco, while pouches don’t, so the result can’t be applied directly to ZYN or other pouches. But the study measured nicotine exposure directly, and it’s the best evidence available on smoke-free oral nicotine and male fertility. The authors noted the findings are relevant to other smoke-free nicotine products too.

If you’re trying to conceive, it’s reasonable to cut down or stop nicotine, and to mention it to your doctor or fertility clinic. Sperm take around two to three months to develop, so any benefit from stopping won’t show up immediately.

What you can do

• Use less nicotine. Fewer, lower-strength pouches mean less strain on your blood vessels (see our strength guide).
• Look after your heart. Exercise, blood pressure control and not smoking do more for erections than almost anything else (see pouches and blood pressure).
• Watch alcohol, which affects both erections and sperm (see nicotine and alcohol).
• See a doctor about persistent erection problems, low libido, or fertility concerns. Don’t assume it’s “just the pouches”.
• Consider quitting. Our quitting guide covers how to taper.

Bottom line

There’s no direct research on nicotine pouches and sexual health yet. Smoking is a clear risk factor for ED, and nicotine affects the same blood-vessel mechanisms, so heavy nicotine use could plausibly contribute. A large Swedish study of snus users found higher, not lower, testosterone, but a 24% lower sperm count. If you have erection or fertility concerns, cutting down on nicotine makes sense, and so does seeing a doctor.