Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual activity. As men get older, their erectile functioning may naturally decline due to changes in testosterone levels, cardiovascular functioning, and the potential development of other chronic medical conditions that become more common with age.
Despite the recognized benefits of aerobic exercise in multiple areas of life, there is still a need for more high-quality evidence on its impact on erectile function. To address this gap, researchers conducted a systematic review and meta-analysis of randomized controlled trials, aiming to determine the effect of aerobic exercise on erectile function in men and identify influencing factors. The authors of the study hypothesized that regular aerobic exercise would lead to improved erectile functioning.
To accomplish their objective, the authors systematically searched several databases for randomized controlled trials that compared the erectile function of men who engage in regular aerobic exercise with that of non-exercising men in a control group. Two very experienced researchers independently reviewed all the studies to determine which ones met the criteria for being included in this review.
The main outcome was the change in the men’s Erectile Function domain scores on the International Index of Erectile Function (IIEF-EF), a validated questionnaire used to assess erectile functioning. IIEF-EF scores range from 5 to 25 (IIEF-EF-5) or 6 to 30 (IIEF-EF-6), with higher scores indicating better erectile functioning.
In the end, 11 randomized controlled trials involving 1,147 men were included in this study to assess the impact of aerobic exercise on erectile function. Participants varied in comorbidities (coexisting health issues), though the reporting of health issues was inconsistent across the 11 trials.
The exercise interventions, lasting from 2 to 24 months, included supervised workout sessions or resources for unsupervised aerobic activity. Though the activities varied across the studies, some examples of aerobic exercises were cycling 3x per week for 45-60 minutes per session, moderate exercise 5x per week for at least 30 minutes a day, and walking 5x per week for 30-45 minutes per session. Men in the control groups received “usual care” or health improvement support, but they were not involved in the supervised or unsupervised exercise sessions.
As predicted by the authors, aerobic exercise significantly improved the erectile function (IIEF-EF) scores of the intervention groups compared to the control groups, especially in men who had lower baseline scores. Factors like exercise supervision, age, and medication use did not significantly influence the benefit of the treatment.
These findings show that regular aerobic exercise can improve erectile function, especially for men with lower initial scores and mild erectile difficulties. This suggests that aerobic exercise could be a low-risk therapy for ED, especially because the improvement in erectile function was not only statistically significant but also clinically meaningful (meaning it could make a noticeable difference for people in a real-world setting).
What’s more, exercise positively impacted cardiovascular health, body weight, blood pressure, glycemic control, and testosterone levels. Therefore, men struggling with mild ED may find that regular aerobic exercise is helpful not only for improving their condition, but also for improving other aspects of their health. Still, this study has some limitations such as possible complications in data analysis due to the diversity of the trials included, and further research is needed to establish optimal exercise regimens for ED management.
For more information on this topic, please read these publications from the ISSM Journals: The Journal of Sexual Medicine, Sexual Medicine Reviews, and Sexual Medicine Open Access:
Systematic Review and Meta-Analysis of Cycling and Erectile Dysfunction
References:
Khera, M., Bhattacharyya, S., & Miller, L. E. (2023). Effect of aerobic exercise on erectile function: systematic review and meta-analysis of randomized controlled trials. The Journal of Sexual Medicine, 20(12), 1369-1375. https://doi.org/10.1093/jsxmed/qdad130
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