Exercising for at least 30 minutes three times a week can be just as effective as Viagra and similar medications at improving erectile function, according to a new analysis of the best research on aerobic exercise and erectile function.
The study, published in The Journal of Sexual Medicine in October, found that aerobic activities – such as walking or cycling – improved erectile function in all men with erectile dysfunction, regardless of body weight, overall health, or medication use. Men with the most severe erectile dysfunction saw the greatest benefit.
“This study provides physicians and patients the proof needed to definitively recommend aerobic activity as part of erectile dysfunction management,” said study author, Larry E. Miller, PhD.
Doctors have long known that erectile function is linked to cardiovascular health, but there is limited high-quality evidence on the impact of exercise on the disorder.
The researchers scoured the scientific literature and found 11 randomised, controlled trials – a gold-standard study design where participants are randomly assigned to receive an intervention or not.
Of the 1,100 men involved in the studies, 600 were assigned to ‘experimental’ groups that typically exercised for 30 to 60 minutes, three to five times a week, while 500 were assigned to ‘control’ groups with no exercise plan.
The worse the erectile dysfunction was, the more exercise helped, the researchers found.
On a standardised scale of six to 30, men with severe erectile dysfunction who exercised reported a five-point improvement in erectile function. Those with mild and moderate erectile dysfunction saw improvements of two and three points, respectively.
By comparison, phosphodiesterase-five inhibitors — like sildenafil (Viagra) or tadalafil (Cialis) – can lead to improvements of four to eight points, the study authors note. Testosterone replacement therapy can lead to an improvement of two points.
“We were particularly impressed by the finding that men with more severe erectile dysfunction saw greater improvements with exercise, and these improvements were similar to those seen in men taking drugs like Viagra,” Miller said.
Erectile dysfunction can often be traced to the same causes as cardiovascular disease, including inflammation, a narrowing of the arteries, or a hardening of the arteries.
“It’s important to recognise that erectile dysfunction can often serve as an indicator or barometer of underlying cardiovascular health,” said Amy Pearlman, MD, a urologist specialising in male sexual health at Prime Institute in Miami.
Pearlman was not involved in the study but thinks the results make sense, noting that, “It stands to reason that any intervention aimed at enhancing cardiovascular health may also have a positive impact on erectile health.”
But what was surprising was that aerobic exercise reduced symptoms on par with medications like Viagra, said urologist Rahul Mehan, MD, founder of East Valley Urology Center, in Mesa, AZ. (Mehan was also not involved in the study.)
While erectile dysfunction medications are generally affordable and accessible, some patients don’t want to take them or can’t tolerate the side effects.
These can include “headache, heartburn, nausea, flushing, and pain in muscles, back, arms, or legs,” said Mehan. He adds, “Everyone can exercise.”
Some doctors, including Mehan, already recommend exercise to their patients with erectile dysfunction.
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