Can Dehydration Affect Erection or Size?

The 2025 European Association of Urology (EAU) Guidelines on Sexual and Reproductive Health define erectile dysfunction as “the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance.”¹ While the guidelines do not specifically mention dehydration as a direct cause of erectile dysfunction or reduced penile size, they do emphasize that erectile function depends on proper vascular health, which could theoretically be affected by hydration status.² Erectile dysfunction is a complex medical condition with several known causes, including vascular, hormonal, neurologic, and psychological factors.³ The guidelines identify numerous risk factors including age, diabetes mellitus, cardiovascular disease, and lifestyle factors, though dehydration is not specifically listed among them.⁴ For men with persistent erectile dysfunction that does not respond to first-line treatments, penile implants represent a highly effective solution with satisfaction rates of 92-100% in patients and 91-95% in partners when appropriate counseling is provided.⁵ According to the EAU Guidelines, there are two main classes of penile implants available: inflatable (two- and three-piece) and semi-rigid devices (malleable, mechanical, and soft flexible).⁶ The three-piece inflatable devices are often preferred by patients due to the more natural erections they provide, though there are no prospective randomized controlled trials comparing satisfaction rates between different types of implants.⁷ Regardless of the type chosen, penile prosthesis implantation has one of the highest satisfaction rates among all treatment options for erectile dysfunction.⁸