Erectile dysfunction: Exercise or Sildenafil? Exercise can be as good as Sildenafil.
For more than a decade, we have found publications demonstrating the importance of physical exercise in improving sexual activity, including contributing to reducing cases of erectile dysfunction.
Research carried out in the USA showed that 43% of women and 31% of men had some sexual dysfunction; obesity and lack of physical activity were among the causes of the problem. A study published in the medical journal “The Journal of Sexual Medicine” revealed that men with high waist circumference or BMI were 50% more likely to have erectile dysfunction. At the same time, obese women reported sexual difficulties and lack of desire. This study also showed that participants who exercised six hours a week had better sexual performance and satisfaction than those who did not exercise.
Short periods of exercise, such as regular brisk walks, can help with sexual well-being.
Many experts have studied the importance and impact of sex on mental health and quality of life, and how exercising can help.
What seems clear is that when a person exercises, an internal revolution takes place. With the practice of aerobic activity, there is an increase in blood flow and, in other words, circulation works better. In men, this is a preponderant factor for erections, and in women, it contributed, at least, to vaginal lubrication.
It is possible to maintain sexual performance at an optimal level by adopting healthier practices. Ending a sedentary lifestyle is essential, that is, exercising regularly. You don’t have to be an athlete or go to sophisticated gyms to improve your health and, consequently, your sexual performance. A simple daily walk already provides improvement.
Practicing physical exercise leads to the release of serotonin, a substance present in the brain that acts as a neurotransmitter, and which allows communication between the brain’s nerve cells, and neurons. Serotonin plays an important role in the nervous system, such as the release of some hormones, regulation of sleep, appetite, motor activity, and cognitive functions. Serotonin also helps improve mood, providing a feeling of well-being.
Thus, practicing physical exercise makes people more willing to have sexual intercourse. There is an improvement in self-esteem, and a reduction in the level of stress and anxiety, in addition to other benefits. Regular exercise, such as cycling or walking, improves the efficiency of the heart, lungs, and circulatory system, and, as a result, a “healthier” body.
Important: Sedentary people should not practice physical exercise without first consulting a doctor for a clinical evaluation.
Erectile dysfunction (previously, it was described as sexual impotence) has many factors involved, but we will talk about that later.
Exercising for at least 30 minutes three times a week may be as effective as Viagra and similar medications in improving erectile function, according to a new analysis of the best research to date on aerobic exercise and erectile function.
The study, published this month in The Journal of Sexual Medicine, showed that aerobic activities — such as walking or cycling — improved erectile function in all men with erectile dysfunction, regardless of body weight, general health, or drug use. medicines. Men with the most severe erectile dysfunction saw the greatest benefits.
Larry E. Miller, Ph. D., commented that “this study provides clinicians and patients with the evidence needed to definitively recommend aerobic activity as part of the treatment of erectile dysfunction (ED).”
Doctors have long known that erectile function is linked to cardiovascular health, but there was limited high-quality evidence on the impact of exercise on this disorder.
The researchers of this recent publication analyzed the scientific literature and 11 randomized controlled trials were identified. These studies featured a gold-standard study design in which participants were randomly assigned to receive or not receive an intervention. A total of 1,100 men were involved in these studies, 600 of them were assigned to “experimental” groups (those included in this group exercised for 30 to 60 minutes, three to five times a week), while the remaining 500 were assigned to control groups (where those included here did not have an exercise plan).
The significant finding identified by the researchers was that “the worse the ED was, the more exercise helped”. These studies used a standardized scale of 6 to 30 to classify ED, and the lower the point count, the more severe the ED.
And what was identified? Men with severe erectile dysfunction who exercised reported a 5-point improvement in erectile function. Those with mild and moderate ED saw improvements of 2 and 3 points, respectively.
The study authors noted that phosphodiesterase-5 inhibitors — such as sildenafil (Viagra) or tadalafil (Cialis) — can lead to improvements of 4 to 8 points. And testosterone replacement therapy can lead to a 2-point improvement.
Dr. Miller commented, “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 medications like Viagra.”
Erectile dysfunction can often be attributed to the same causes as cardiovascular disease, including inflammation, narrowing of the arteries (endothelial dysfunction), or hardening of the arteries (atherosclerosis).
“It’s important to recognize that erectile dysfunction can often serve as an indicator or barometer of underlying cardiovascular health,” says Amy Pearlman, MD, a urologist specializing in men’s sexual health at Prime Institute in Miami.
Pearlman wasn’t involved in the study but thinks the results make sense. “It stands to reason that any intervention aimed at improving cardiovascular health can also have a positive impact on erectile health.”
But what was surprising?
Aerobic exercise reduced symptoms in the same way as medications like Viagra, commented urologist Rahul Mehan, MD, founder of East Valley Urology Center in Mesa, AZ. (Mehan was also not involved in the study.)
Although erectile dysfunction medications are generally cheap and accessible, some patients do not want to take them or cannot tolerate the side effects. This can include “headache, heartburn, nausea, flushing and pain in the muscles, back, arms or legs,” Mehan said.
However, “everyone can exercise”, added Dr. Mehan.
Some doctors, including Mehan, already recommend exercise for their ED patients.
But now everyone can tell patients that habitual exercise is “a proven approach, supported by high-quality data from randomized trials.”
This doctor added, “Exercise is low-risk and accessible, which makes it an ideal first-line treatment option for erection difficulties, especially for patients who are unwilling or unable to use medications.”
There is no doubt that exercise is essential for general health, however, erectile dysfunction can be related to many factors, such as emotional, psychological, and other factors.
Research carried out over 2 decades ago, with the main purpose of observing the safety of sildenafil in hypertensive patients with erectile dysfunction, also showed that ED was exclusively related to emotional or psychological factors.
What happened then?
In this research, patients were distributed into two groups, in a study model called double-blind (when the doctor and patient do not know whether the medicine used, in that phase, is the active medicine — in this case, sildenafil — medicine A or an inert “medicine” with no activity, called a placebo — medicine B). These patients took the medication for a few weeks. As the study model was also crossover, patients in each group, in a second phase, received the second medication for a few more weeks, that is, the second medication was different from that in the first phase, so the patient who received the medication A, in the first phase, received medicine B, in the second phase and, on the contrary, whoever received medicine B, in the first phase, received medicine A, in the second phase. The order in which medications A or B were taken was determined randomly, as is usual in randomized studies. At the end of the study, it was observed that some patients who received drug B (placebo) reported improvement in ED, in the first phase, and, on the other hand, some patients who showed improvement with drug A, in the first phase, continued with improvement in ED, in the second phase, now with the use of placebo. Another interesting fact is that after the research ended, some of these patients, following treatment for high blood pressure, no longer reported ED.
What can be concluded from these data?
The data from this research demonstrate that ED deserves a multidisciplinary approach and, there are cases, that do not require medications with a specific indication for ED.
If you have ED, see your doctor. Your doctor will be able to recommend the best course of action for your case. Do not practice self-medication.
References
- KHERA M et al — Journal of Sexual Medicine — 2023 October 16
- SOUTHWICK C — Medscape — 2023 October 23
