Healthier Lifestyle Improves Erectile Dysfunction

September 15, 2011

September 15, 2011 (Rochester, Minnesota)Healthier eating habits and increased physical activity lead to an improvement in erectile dysfunction, a new meta-analysis suggests [1].

The analysis, which included six trials in a total of 740 patients, was published online on September 12, 2011 in the Archives of Internal Medicine.

Coauthor of the paper Dr Stephen Kopecky (Mayo Clinic, Rochester, MN) commented to heartwire : "Basic lifestyle changes seem to help with [erectile dysfunction]. These include losing 10% of body weight, eating your five a day of fruits and vegetables, and stopping smoking." He said that exercising in particular was associated with improvement in erectile dysfunction. "Exercising for 20 to 30 minutes five times a week has a huge effect, but just 10 minutes of vigorous exercise three times a week will also be of benefit."

An Early Marker of Heart Disease

The researchers note that erectile dysfunction is an early marker of coronary artery disease, with an average lead time between manifestation of erectile dysfunction and CAD presentation of two to five years. So increased awareness that erectile dysfunction is associated with coronary risk factors may provide an opportunity for early identification of risk factors modifiable with lifestyle interventions. And men with erectile dysfunction represent a specific population that may be motivated to adapt a healthy lifestyle to improve sexual health.

Men don't sit around worrying about heart disease, but they do worry about not being able to have sex and getting Alzheimer's.

Kopecky said: "If you start lecturing a man about his risk of heart disease, his eyes start to glaze over. Everyone knows someone who's had a heart attack, has had a stent, and is back on the golf course in a week or two. But when you tell them the risk factors for heart disease are the same as those for erectile dysfunction and dementia, they are immediately interested. Men don't sit around worrying about heart disease, but they do worry about not being able to have sex and getting Alzheimer's."

He says GPs need to make the link between erectile dysfunction and heart disease and refer patients with erectile dysfunction to the cardiologist, especially younger men with the problem. "If a 60-year-old man has [erectile dysfunction], his risk of heart disease is raised by about 1.3. But if a 40-year-old has [erectile dysfunction], he has a 50 times greater risk of heart disease and needs to start preventive action."

Results of the meta-analysis show that positive lifestyle changes were associated with an improvement in the erectile-dysfunction International Index of Erectile Function 5 (IIEF-5) score of 2.7 points, which the authors say would qualify as a clinically important difference for patients with mild erectile dysfunction but might not translate into clinically important differences for moderate and severe erectile dysfunction.

In comparison, oral phosphodiesterase-5 (PDE-5) inhibitor therapies such as sildenafil (Viagra, Pfizer) can produce IIEF-5 score improvements of 7 to 10 points. But some men do not respond to these medications, and in the current study, CV risk-factor reduction improved erectile dysfunction even in men who were not responsive to PDE-5 inhibitors. "And lifestyle changes will enhance the effect of Viagra," Kopecky added.

When the clinical trials evaluating cardiovascular drugs (such as statins) were excluded, the improvement in sexual function with lifestyle changes alone was also statistically significant (improvement of 2.4 points).

A Strong Argument to Make Changes

In an accompanying editorial [2], Drs Militza Moreno and Thomas Pearson (University of Rochester School of Medicine and Dentistry, NY) report that erectile dysfunction is one of the main causes of impaired quality of life in the US, affecting millions of men. "The ability of a healthier lifestyle to reduce [erectile-dysfunction] severity (or prevent its occurrence) should be a strong and persuasive argument for many to make such changes."

They conclude: "Both clinicians and public-health practitioners should be reassured that the benefits of their lifestyle-modification efforts are overwhelmingly positive and continue to grow, and we should renew our efforts to help patients add life to the years, as well as years to life."

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