Mechanisms of dyslipidemia-induced erectile dysfunction: a narrative review

Background: Dyslipidemia is strongly associated with obesity, metabolic syndrome, and atherosclerosis, and is increasingly recognized as an independent risk factor for erectile dysfunction (ED). Emerging evidence suggests lipid-specific mechanisms that may directly impair erectile function, beyond the effects of obesity. Objective: To summarize the pathophysiological mechanisms linking dyslipidemia to the development and progression of ED. Methods: A narrative review of studies published between 2000 and 2025 was conducted using PubMed, Web of Science, Scopus, and Google Scholar, including experimental, clinical, observational, and review studies. Results and conclusion: Dyslipidemia contributes to ED through multiple interconnected pathways, including vascular dysfunction, neural impairment, oxidative stress, inflammation, and endocrine alterations. These mechanisms may increase susceptibility to ED in affected patients. However, direct evidence remains limited, and confounding by coexisting metabolic, cardiovascular and neural conditions complicates interpretation. Further research is needed to clarify the independent effects of dyslipidemia and to identify potential therapeutic strategies.