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Individuals who are at risk for ED may benefit from nonpharmacological interventions that focus on lifestyle modifications. When it comes to ED, there are plenty of lifestyle changes that can be adopted to ensure better erectile health. Let us understand and review the important ones here.

What is Erectile Dysfunction?

Erectile dysfunction (ED) is the inability to consistently obtain and sustain an erection strong enough to engage in satisfying sexual activity (Salonia, et al. 2021). Erectile dysfunction affects 15% of men annually (Johannes, et al. 2000) and it is estimated to affect 350 million men worldwide by 2025 (Abolfotouh and Al Helali 2001). 

Causes of erectile dysfunction can vary, encompassing factors such as psychological (depression, deterioration of couple relationships due to conflicts, anxiety disorder), neurological (stroke, Alzheimer’s disease, any injury to the pelvic), hormonal (low testosterone), vascular (hypertension, diabetes mellitus, atherosclerosis, Peyronie’s disease), drug-induced (anti-androgens, neuropsychiatric, and some cardiac medication), improper lifestyle, and age. 

Major symptoms of erectile dysfunction include being unable to achieve or maintain an erection and reduced sexual desire (Viigimaa, et al. 2014). 

It should be known that there are available treatments and medications for ED, and it can be cured. The question “Can erectile dysfunction be cured?” often prompts individuals to explore various medical interventions and lifestyle changes in pursuit of a solution. Understanding the diverse range of erectile dysfunction causes is crucial for developing effective treatment plans tailored to individual needs. Prescribing medication for erectile dysfunction is a common approach, with phosphodiesterase type 5 (PDE5) inhibitors like sildenafil and tadalafil being widely used to enhance blood flow to the penis and facilitate improved sexual function. An issue with the diagnosis of ED arises from the patient’s (particularly in young men) discomfort in discussing sexual issues. If you want to know more about ED, you should read our already-published article titled “Unveiling the Truth: Erectile Dysfunction - Causes, Symptoms, Diagnosis, and Treatment”.

Lifestyle modifications and counseling can also be part of an effective ED treatment plan. In this article, we will learn about the lifestyle changes that can make a difference and help overcome ED. 

Lifestyle Changes That Make a Difference

Healthy living and nutrition play a crucial role in both the production of nitric oxide in blood vessels and erectile function. Additionally, adopting habits that reduce mild inflammation may help lessen the impact of ED. Let us understand some important lifestyle changes that could help in overcoming ED

• Walk Every Day: Engaging in regular walks can play a role in overcoming ED. Physical activities, such as walking, are linked to better blood circulation, heart health, and overall wellness. These elements can have a positive impact on erectile function by boosting blood flow to the pelvic region. A study has shown that progressive walking can help improve functional capacity in men, which has been linked to improvement in ED (Begot, et al. 2015). 

• Exercise: Enhancing physical activity has the potential to improve erectile function in men at risk. Exercise improves blood circulation, manages weight, improves hormonal balance, and reduces stress. There are several studies that have shown a positive link between exercise and ED (Esposito, et al. 2009). In a meta-analysis on exercise and ED, it was found that engaging in moderate and high levels of physical activity was linked to a reduced risk of experiencing ED (Cheng, et al. 2007). Engaging in aerobic physical activity enhances endothelial function (blood flow and the dilation and constriction of blood vessels) in middle-aged individuals experiencing ED (La Vignera, et al. 2011).

• Weight Management: Implementing lifestyle adjustments with the goal of achieving lasting and consistent weight loss, coupled with an increase in physical activity, has shown a positive impact on both erectile and endothelial functions (Esposito, et al. 2009). A meta-analysis on the effect of body weight loss on sex hormone levels showed that weight loss is associated with an increase in testosterone levels (Corona, et al. 2013).

• Strong Pelvic Floor: The muscles in the pelvic floor play a role in regular erectile function. If these muscles are not strong enough, it might be a reason for ED. An observational study that investigated the association between pelvic floor muscle strength and ED showed that patients with ED had lower pelvic floor muscle maximal strength (Kim, et al. 2021). Pelvic floor muscle exercise can be an effective treatment for ED (Dorey, et al. 2004).

• Eat a Healthy Diet : Inadequate nutrition and a sedentary lifestyle are connected to risk factor, like ED. Studies have shown that diets rich in whole grains, fruits, vegetables, legumes, walnuts, and olive oil are effective in managing ED (Esposito, et al. 2006). A prospective study on men without diabetes evaluated an association between adherence to healthy dietary patterns and ED. The study showed that a healthy dietary pattern, i.e. consumption of vegetables, fruits, nuts, legumes, and fish, as well as avoidance of red and processed meats, play a role in maintaining erectile function in men (Bauer 2020)

• Mild to Moderate Alcohol Intake – It’s a good thing: Patients with alcohol dependence commonly experience sexual dysfunction, and the likelihood of this issue rises in tandem with heavy drinking. A study that included patients diagnosed with alcohol dependence showed that 72% of patients experienced sexual dysfunction, like premature ejaculation, low sexual desire, and ED (Arackal and Benegal 2007). High levels of alcohol consumption in women can result in reduced sexual arousal, decreased vaginal lubrication, dyspareunia (pain during sexual intercourse), and challenges in achieving orgasm. A meta-analysis involving a sample size of approximately 50,000 women showed a significant correlation between alcohol consumption and an increased risk of sexual dysfunction in women (Salari, et al. 2023). A study has shown that drinking alcohol moderately could help protect against ED. The study concluded that alcohol in moderate quantities can show a dual effect of disinhibition and relaxation. A study conducted in diabetic patients showed that physical activity and consumption of small amounts of alcohol were found to be protective (Kalter-Leibovici, et al. 2005). 

• Stop Smoking: The nicotine, carbon monoxide, oxidant chemicals, and metals found in cigarette smoke can harm the endothelium and interfere with erectile function (Allen and Tostes 2023). There are a number of studies that have shown a strong association between smoking and ED (Wu, et al. 2012; Pourmand, et al. 2004). 

• Quality Sleep: Quality sleep is crucial for any individual for their overall health benefits. A poor sleep pattern can lead to many issues, like hormonal imbalances, that can affect normal erectile function. There have been studies that have connected poor-quality sleep with ED. A cross-sectional survey study that involved 381 students with a mean age of 23 years reported that 50% of students had poor sleep quality, of which 72% had mild ED (Gutierrez-Velarde, et al. 2023). A study on 72 healthy adult men showed a strong correlation between sleep factors and ED, suggesting that a decline in sleep quality might heighten the risk of experiencing ED (Wu, et al. 2022).

• Manage Diabetes and Control Blood Sugar : Diabetes mellitus is linked to ED, with an estimated prevalence of 52.5% within the diabetic population (Cayetano-Alcaraz 2023). Diabetes can damage the blood vessels that supply blood to the penis, and lead to nerve damage that disrupts the normal process of achieving an erection. Additionally, it can cause hormonal imbalances, contributing to ED. A cross-sectional observational study that included 357 diabetic men showed a high prevalence (59%) of ED (Parmar, et al. 2022). Another cross-sectional study involving 160 men with type 2 diabetes also showed a high prevalence (77%) of ED (Tamrakar, et al. 2021). Improved management of blood sugar levels has the potential to decrease sexual dysfunction in men with diabetes, enhancing overall quality of life.

• Manage Blood Pressure: Patients with high blood pressure (hypertension) often face ED, which significantly impacts the quality of life for both hypertensive individuals and their sexual partners. The incidence of ED is roughly twice as high in individuals with hypertension as compared to those with normal blood pressure (Viigimaa, et al. 2014). High blood pressure can lead to vascular damage, reduce nitric oxide production, and lead to atherosclerosis, which limits the blood flow in the arteries, thereby causing ED (Jensen, et al. 1999).

• Stay Sexually Active : An active sexual life can help improve blood flow to the genitals, maintain hormonal balance, and have a positive impact on psychological well-being. Studies have shown that engaging regularly in sexual activity can lower the likelihood of ED in males (Qin, et al. 2012; Koskimäki, et al. 2008). 

• Treat Depression : Depression is often accompanied by a depressive mood, loss of interest and pleasure, insomnia, and an imbalance in neurotransmitters like serotonin and norepinephrine (Huang, et al. 2013). These, individually or collectively, can be risk factors for ED. A meta-analysis including male subjects diagnosed with depression showed an association between depression and ED (Liu, et al. 2018). Feeling depressed or taking certain antidepressant medications can make it harder for males to get or keep an erection. On the flip side, struggling with ED by itself can lead to or make feelings of sadness even worse. It's like a two-way street between feeling low and having trouble in the bedroom (Shiri, et al. 2007). Sildenafil is a successful remedy for ED in men dealing with both erectile issues and depression at the same time. It is important to see ED as a complex issue that might need a team of different experts working together to find the best treatment, especially when depression is part of the picture (Seidman 2002).

Conclusion

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