Exercise as a Solution to Erectile Dysfunction

Erectile dysfunction or ED affects 3-76.5% of all men based on a global study.

The same study also found that when compared with men with no ED, men with ED have an increased risk of dying from all causes, including:

  • Cardiovascular disease like heart attacks, hypertension, heart failure, hyperlipidemia, peripheral vascular disease, strokes
  • Dementia
  • Prostate enlargement causing difficulty in urination

Why is that?

The risk factors for developing erectile dysfunction are the same risk factors for developing obesity, diabetes, and metabolic syndrome. They are

  • Sedentary lifestyle
  • Obesity
  • Diabetes
  • Smoking and
  • Excessive use of alcohol

Penile erection depends on psychological factors but also on properly functioning blood vessels. For that to happen, a healthy inner lining of the blood vessels is essential.

The endothelium is the blood vessels’ inner lining that ensures a smooth surface and proper contraction and distention when needed.

Read: The Magical Endothelium

If the endothelium gets damaged in diabetes, obesity, hypertension, and atherosclerosis, then ED happens.

Erectile dysfunction is an early sign of cardiovascular disease like coronary artery disease.

Prescription drugs can control cardiovascular diseases and diabetes; however, they may not necessarily treat erectile dysfunction.

Medicines and Erectile Dysfunction

Common medicines for hypertension like beta-blockers (atenolol, betaxolol, bisoprolol, esmolol, acebutolol, metoprolol, and nebivolol) thiazide diuretics like hydrochlorothiazide or and metolazone can increase insulin resistance and type 2 diabetes.

Niacin is used to lower cholesterol, but it can also increase the risk of diabetes.

Rosiglitazone, a drug for diabetes, can increase total cholesterol and LDL.

Drugs that can cause Metabolic Syndrome Part 1

Moreover, sulfonylureas like Glyburide, Glibenclamide, and Glipizide worsen outcomes in people with diabetes who develop heart attacks.

Prescriptions that Promote and Pharmaceuticals that Prevent Ischemic Preconditioning

The problem with well-known medicines promoted on mass media like sildenafil (Viagra) and Tadalafil (Cialis) is that they:

  • They do not correct the cause of the problem.
  • They don’t work for all men.
  • They have many drug and food interactions. Example: Sildenafil and Cialis are contraindicated in people who take nitrate medications since they can lower blood pressure to dangerously low levels. They are not recommended for symptomatic heart failure.

So the question arises, Is there anything out there that can address the underlying cause of ED?

The blood vessels of the Human Penis

Exercise and Erectile Dysfunction

Yes, there is. An effective way is moderate to vigorous aerobic exercise.

That is the conclusion of 4 metanalyses that looked at 25 studies from Europe, Asia, Africa, and the US, including 1,959 subjects.

A meta-analysis is a study that puts together similar investigations to draw more robust conclusions.

The four meta-analyses conclude that moderate to vigorous exercise works on men with:

  • Coronary artery disease, including those with previous heart attack, heart disease treated with angioplasty or coronary artery bypass graft
  • Class 3 heart failure – improvement in ejection fraction
  • Obesity
  • Those who underwent radical prostatectomy.

How does exercise works?

During exercise, there are changes in the endothelium that induce acute and long-term blood vessel relaxation.

The repeated efforts of aerobic exercise have a prolonged effect by reducing inflammation in the blood vessels.

Physical activity also increases the tone of the pelvic floor muscles. These muscles are essential to prevent the return of venous blood from the penis. The result is an increase in the pressure inside the penis.

Exercise’s protective effects extend beyond erectile dysfunction and improve metabolic syndrome, atherosclerosis, and blood sugar control.

Examples of exercise performed

  • 40 minutes of aerobic exercise of moderate to vigorous intensity 4 times per week for 6 months
  • In one study, a stationary bicycle was used 3x/week for 8 weeks. Each session has a total duration of each session had an entire duration of one hour divided into:
    • 15 minutes of initial stretching 
    • 40 minutes on a stationary bike
    • five minutes of recovery

Another study used a treadmill for 3x/week for 12 weeks with 50-minute sessions divided into:

  • 5 minutes of stretching
  • 40 minutes of aerobic exercise in the target training zone and
  • 5 minutes of stretching exercise.

Other lifestyle changes to improve ED

  • Intermittent fasting
  • Avoid alcohol consumption
  • Stop cigarette smoking

Precautions:

  1. Talk to your doctor before starting an exercise program.
  2. It is crucial to start to begin gradually and allow the body to adapt to exercise.
  3. Monitor your blood sugar and blood pressure as dosage adjustments may need to be done as you continue to exercise. Don’t stop any medicines on your own.

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Don’t Get Sick!

Kessler, A., Sollie, S., Challacombe, B., Briggs, K., and Van Hemelrijck, M. (2019). The global prevalence of erectile dysfunction: a review. BJU Int, 124: 587-599. doi:10.1111/bju.14813

Gerbild H, Larsen CM, Graugaard C, Areskoug Josefsson K. Physical Activity to Improve Erectile Function: A Systematic Review of Intervention StudiesSex Med. 2018;6(2):75-89. doi:10.1016/j.esxm.2018.02.001

Gonzales et al. Physical Exercise in the Management of Erectile Dysfunction in Patients with Heart Failure. International Journal of Cardiovascular Sciences. 2019;32(4):418-427

Lamina S, Agbanusi E, Nwacha RC. Effects of aerobic exercise in the management of erectile dysfunction: a meta-analysis study on randomized controlled trialsEthiop J Health Sci. 2011;21(3):195-201.

Silva, André & Sousa, Nelson & Azevedo, Luís & Martins, Carlos. (2016). Physical activity and exercise for erectile dysfunction: Systematic review and meta-analysis. British Journal of Sports Medicine. 51. 10.1136/bjsports-2016-096418.

Image Credit: PD-US-expired, https://en.wikipedia.org/w/index.php?curid=62444575

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