Exercise guide
Erectile dysfunction (ED) means not being able to get or keep an erection firm enough for sex. It's very common, especially after 40, and regular exercise helps, though modestly. In trials, aerobic exercise such as brisk walking, jogging or cycling improved erections a little, losing weight and getting more active restored normal erections in about 1 in 3 men with obesity, and pelvic floor exercises helped in one small trial.
Start with a GP, though, not the gym. Erection problems that keep happening can be an early sign of heart disease, high blood pressure, high cholesterol or diabetes, often years before other symptoms, and erection tablets are the main treatment. Exercise works alongside them.
This guide gives the amount of exercise used in the trials and a week that matches it, how to do pelvic floor exercises, what the evidence says about cycling, sex and your heart, and the warning signs that need urgent help.
Most men sometimes fail to get or keep an erection, usually because of stress, tiredness or alcohol. If it keeps happening, see a GP or a sexual health clinic: it can be a sign of a treatable condition such as high blood pressure, high cholesterol or diabetes. Across 12 studies following 36,744 men, those with erection problems had about 1.5 times the risk of heart disease, and the problems often start 2 to 5 years before heart symptoms.
In 11 trials, aerobic exercise raised scores on a standard erection questionnaire (scored from 6 to 30) by 2.8 points on average, and by more in men whose problems were worse to start with. Reviews that also included pelvic floor or diet programmes found average gains of about 2.4 to 3.9 points, but they pooled different versions of the questionnaire, so the numbers aren't directly comparable. It helps, but it isn't a cure.
A review of 10 studies recommends about 40 minutes of moderate to vigorous aerobic exercise 4 times a week, roughly 160 minutes a week, for 6 months. That's a little more than the NHS minimum of 150 minutes of moderate activity a week, plus strength exercises on 2 days.
In a 2-year trial of 110 men with obesity, losing weight and getting more active gave normal erections to 17 of the 55 men in the programme, against 3 of 55 given general advice. Pelvic floor (Kegel) exercises improved erections in one UK trial of 55 men, and a review of small trials was encouraging, though the evidence is low to moderate quality.
European urologists recommend starting lifestyle changes before or alongside treatment, and erection tablets such as sildenafil (Viagra) as the first treatment to try. In a small trial, men who added at least 3 hours a week of aerobic exercise to their tablets regained normal erections more often after 3 months (78% against 39%). Never take these tablets with nitrates such as a glyceryl trinitrate (GTN) spray, or with poppers.
In a survey of 3,932 men, cyclists' sexual function was no worse than swimmers' or runners', but a review of 6 studies found higher odds of erection problems in cyclists once age and illness were allowed for. Standing up on the pedals from time to time and a saddle that takes pressure off the area between your legs are sensible, and if numbness or erection problems start, see a GP (our suggestion).
Across 12 cohort studies following 36,744 men, those with erection problems had 1.48 times the risk of heart and circulation disease, 1.46 times the risk of coronary heart disease and 1.35 times the risk of stroke, and the link held after allowing for the usual risk factors. An expert panel (the Princeton III consensus) puts the gap between erection problems starting and a heart attack or similar event at 2 to 5 years. The NHS lists high blood pressure, high cholesterol, diabetes, depression or anxiety, and hormone problems among the causes when it happens often.
Furring of the arteries happens throughout the body, but the arteries to the penis are narrower than those to the heart, so the same build-up causes symptoms sooner. In 300 men with chest pain and narrowed heart arteries seen on an X-ray of the heart (an angiogram), 49% had erection problems, and in 67% of those the problems had started first, on average 38.8 months earlier.
Erection problems aren't only an older man's problem: in one study of men seeking help for new erection problems, 1 in 4 was under 40, and almost half of them had severe problems. In a study from Western Australia cited by the Princeton III panel, heart and circulation events were more than 7 times as common in men under 40 with erection problems as in men generally.
Across 145 studies of 88,577 men with diabetes, 52.5% had erection problems (37.5% with type 1 and 66.3% with type 2), about 3.5 times the odds of men without diabetes. See a GP if you also feel very tired, pee more than usual, feel thirsty all the time, lose weight without trying, or have itching around your penis or repeated thrush.
The GP or nurse may ask about your lifestyle and relationships, check your blood pressure and examine your genitals, and your prostate if you have urinary symptoms such as needing to pee more often. Blood tests usually check your blood sugar, cholesterol and hormones, including a morning testosterone level. An expert panel (the Princeton IV consensus) advises treating men with erection problems as at risk of heart problems until proven otherwise.
If you're 40 to 74 and haven't been diagnosed with heart disease, diabetes, kidney disease, high blood pressure or a similar condition, you should be invited for a free NHS Health Check every 5 years. It checks your risk of heart disease, diabetes, kidney disease and stroke. If you haven't been invited, contact your GP practice.
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Erectile dysfunction is being unable to get an erection, or to keep one long enough to have sex. Depending on the cause, you may still get erections at other times, such as when you wake up, and you may also have a low sex drive. Failing to get or keep an erection now and then is common and usually nothing to worry about.
The NHS calls it very common, particularly in men over 40. In a US study of men aged 40 to 70, 52% had some degree of it (17.2% minimal, 25.2% moderate and 9.6% complete), and in a German study of men aged 30 to 80 it rose from 2.3% of the youngest to 53.4% of the oldest. The British Association of Urological Surgeons (BAUS) puts it at 50% to 55% of men aged 40 to 70.
Usually more than one thing. Causes include narrowed blood vessels (linked with smoking, inactivity, obesity, diabetes, high blood pressure and high cholesterol), nerve damage, hormone problems such as low testosterone, some medicines, heavy drinking, recreational drugs and anabolic steroids, and stress, anxiety or relationship worries. BAUS says 9 in 10 men have at least one physical cause, though a psychological part, such as performance anxiety, is common. Weak or tight pelvic floor muscles can play a part too.
If you think a medicine is the cause, don't stop it: talk to your GP, who may be able to switch it.
An erection depends on blood flow: the arteries to the penis widen and fill its spongy tissue, helped by nitric oxide released by the lining of the blood vessels. Regular aerobic exercise improves how that lining works, which is one reason it's the most studied type of exercise for erections. Small pelvic floor muscles at the base of the penis help too: the bulbocavernosus presses on a vein to keep blood in the penis, and the ischiocavernosus muscles support it like guy ropes.
In 11 randomised trials, aerobic exercise raised scores on the erectile function part of a standard questionnaire (scored from 6 to 30) by 2.8 points on average compared with no exercise. Men whose erections were worse to start with gained more: 2.3 points with mild, 3.3 with moderate and 4.9 with severe erectile dysfunction. In another review of 7 trials with 478 men, exercise, mostly aerobic, raised scores by 3.85 points, though the trials were at moderate to high risk of bias, mainly because the men knew which group they were in. European urologists say regular exercise and a lower body mass index (BMI) can improve erections.
Across 16 randomised trials with 1,477 men, programmes of diet, exercise or both raised erectile function scores by 2.35 points on average, and the reviewers rated the evidence moderate certainty. Diet alone, exercise alone and both together all helped, with no clear winner. An older review of 4 lifestyle trials (597 men) found a similar gain of 2.4 points on a shorter, 5-question version of the questionnaire. The trials used different versions, so treat these averages as a rough guide rather than exact figures.
In 60 men taking erection tablets, adding at least 3 hours a week of aerobic exercise (they averaged 3.4 hours) restored normal erections in 77.8% after 3 months, against 39.3% on tablets alone. The trial was small and the men knew which group they were in. A review of 7 trials found exercise helped whether it was done alone or on top of usual care.
In 110 men aged 35 to 55 with obesity and erection problems but no diabetes, high blood pressure or high cholesterol, a 2-year programme of eating less and moving more brought BMI down from 36.9 to 31.2 and raised activity from 48 to 195 minutes a week. Their erection questionnaire scores rose from 13.9 to 17, and 17 men reached normal function, against 3 in the comparison group. In 306 overweight men with type 2 diabetes in the Look AHEAD trial, losing about 10% of their weight helped a little: fewer men's erections got worse over a year (8% against 20%).
In 31,742 US men aged 53 to 90, the most active had about 30% lower risk of erection problems than the least active, and obesity raised the risk. In 593 men followed for about 9 years, those who stayed inactive had the highest risk of developing erection problems, and those who stayed active or became active in midlife the lowest. These studies show links, not proof that activity prevents it.
No trial has tested strength training on its own for erection problems. In 4 of the 10 studies in one review, strength work was added to aerobic exercise, and in another review the aerobic-plus-strength group showed no clear effect, from few trials. Strength training is still recommended for everyone on at least 2 days a week.
A review of 10 small studies reported benefits for erection problems and especially premature ejaculation, but called for proper trials. Yoga counts as activity; brisk aerobic exercise has far more evidence.
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Erection tablets have much stronger evidence than exercise: European urologists rate them the first treatment to try (a strong recommendation), with no difference in effect between the types. Exercise and weight loss work more slowly and their average effect is modest, but they also lower the heart and circulation risks behind many cases. Lifestyle changes and tablets are partners, not rivals.
A review of 10 studies (7 of them randomised) in men aged 41 to 62 with erection problems and inactivity, obesity, high blood pressure, metabolic syndrome or heart disease found that every programme was aerobic and at least moderate in intensity, and half added harder intervals. Sessions lasted 30 to 60 minutes (40 on average), 3 to 7 times a week (4 on average), for 1 to 24 months (about 6 on average), and almost all were supervised. The authors recommend 40 minutes of moderate to vigorous aerobic exercise 4 times a week, about 160 minutes a week, for 6 months.
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Moderate activity raises your heart rate and breathing so you can still talk, but not sing. Vigorous activity means you can't say more than a few words without pausing for breath. The NHS minimum for adults is 150 minutes of moderate or 75 minutes of vigorous activity a week, spread over 4 to 5 days or more, plus strength exercises on at least 2 days. The trial dose is a little more than that.
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Built on the trial dose and the NHS guidelines:
Programmes in the trials ran for 1 to 24 months, most for about 6, and the trial of tablets plus exercise saw a difference at 3 months. For pelvic floor exercises, Pelvic, Obstetric and Gynaecological Physiotherapy (POGP), the UK's pelvic health physiotherapists, says to expect an improvement in 3 to 6 months: they aren't a quick fix. Give regular exercise 3 to 6 months, and keep seeing your GP and using any treatment they offer meanwhile (our suggestion).
Speak to your GP before starting if you haven't exercised for some time or have a medical condition. The Princeton III panel puts men whose heart disease is stable and well treated in a low-risk group who can generally manage exercise of modest intensity without symptoms. Follow your cardiac team's advice on harder efforts, and see our heart disease guide.
Build towards about 40 minutes, 4 times a week, at a talk-but-not-sing pace, adding harder efforts once you're fitter (the trial dose). A recumbent bike takes pressure off the area between your legs.
3D demoTreadmill walkingBeginner · Cardio machine
3D demoTreadmill joggingIntermediate · Cardio machine
3D demoStationary cyclingBeginner · Cardio machine
3D demoRecumbent exercise bikeBeginner · Cardio machine
3D demoIndoor Rowing (Rowing Machine)Beginner · Cardio machine
3D demoElliptical trainerBeginner · Cardio machine
3D demoStair climbingIntermediate · A step
3D demoStep jack (low-impact jumping jack)Beginner · No equipment
3D demoAir bike intervalsAdvanced · Cardio machineStart with the easy cardio workout, about 40 minutes like the trial sessions, 3 or 4 times a week. Once it feels comfortable, swap one session for intervals. If you have heart disease, start with the cardiac rehab-style workout and follow your cardiac team's advice on harder efforts.
A steady 30 to 45 minute cardio session at talk-but-not-sing pace: walk, cycle, row or cross-train, counting toward weekly activity guidelines.
40 minBeginner3 movesCardio machine, A wallA 25-minute interval session on a bike or rower: one-minute hard efforts with two minutes easy, building from 4 to 8 rounds.
25 minIntermediate1 movesCardio machineA 25-minute walk with short faster bouts: notice your heart and breathing speed up, then settle. A gentle way to get used to the feelings of effort.
25 minBeginner5 movesCardio machine, A wallThe Norwegian 4x4, a well-studied interval session for raising VO2 max: four 4-minute hard efforts with 3 easy minutes between, on a bike, rower or treadmill.
40 minIntermediate3 movesCardio machine, A wallA 25-minute standing cardio circuit with no jumping: marching, step jacks, sit-to-stands, punches, step-ups and wall push-ups, with a seated option for most moves.
25 minBeginner9 movesA bench or box, A stepA 45-minute home session built like a UK cardiac rehab class: a 15-minute warm-up, 20 minutes of cardio mixed with light strength, and a 10-minute cool-down.
45 minBeginner14 movesA wall, A bench or boxIn a UK trial, 55 men who had had erection problems for at least 6 months had five weekly sessions with a physiotherapist, using biofeedback (a sensor that shows how hard the muscles squeeze), plus daily exercises at home. At 3 months their erection scores had risen 6.7 points more than in men given lifestyle advice only. The comparison group then did the exercises too, so the 6-month figures aren't a controlled comparison: by then, 40.0% of all the men had normal erections, 34.5% had improved and 25.5% hadn't. 22 men (40%) left the trial early, 13 of them because their erections had improved.
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A review of 10 trials found pelvic floor training improved erections in all of them, with no best routine, but the trials were small and of low to moderate quality. A meta-analysis of men not taking tablets found no clear effect from pelvic floor training, from few trials. So it's a reasonable, low-risk extra rather than a cure.
POGP says pelvic floor exercises are evidenced to help erection problems with no obvious physical cause, and that good pelvic floor muscles help maintain an erection. The NHS erectile dysfunction page doesn't mention them, and the European urology guideline mentions pelvic floor training only for erections after prostate surgery.
On top of their daily squeezes, men in the trial did 3 strong squeezes lying, 3 sitting and 3 standing, morning and evening; lifted the pelvic floor to about half strength while walking; squeezed strongly after peeing to stop the after-dribble; and tightened the muscles rhythmically during sex to help keep the erection firm. POGP gives the same advice for sex: tighten your pelvic floor muscles during intercourse to maintain the quality of your erection.
POGP lists tight pelvic floor muscles, as well as weak ones, among the causes, and says physiotherapy for tight muscles aims to help them relax instead. If you have pain in your penis, testicles or bottom, or pain when you pee or ejaculate, see a GP: it can be prostatitis. Meanwhile, don't add more squeezes; the pelvic floor relaxation routine may help (our suggestion).
Erection problems are common after the prostate is removed, and erection tablets are the first treatment after surgery that spares the nerves, started as early as possible. Pelvic floor training for erections after surgery has mixed results: in 12 trials, 4 found a benefit and 7 found no difference, and another review found mostly positive but weak studies. Prostate Cancer UK says some men find the exercises help. Our pelvic floor guide covers leaking after surgery.
A men's health (pelvic health) physiotherapist can check you're squeezing the right muscles and tailor the exercises. Ask your GP for a referral; in some areas you can refer yourself.
From POGP's booklet for men and Prostate Cancer UK. The figure shows the sitting position only; it can't show the squeeze.
See the movement on the 3D figure: Pelvic floor exercise (Kegel)
Squeezes every day. The relaxation and slow breathing are for a tight or painful pelvic floor, or for stress. The figures show positions only.
The daily workout covers the squeezes; add the trial's extras above if you like. Use the relaxation routine instead if your pelvic floor feels tight or painful, and see a GP or physiotherapist.
A 5-minute daily pelvic floor workout for women and men: slow holds and quick squeezes, three times a day, with how to find the right muscles.
5 minBeginner2 movesNo equipmentAn 8-minute routine for a tight pelvic floor: slow breathing and comfortable positions to help the muscles let go, with no strengthening squeezes.
8 minBeginner5 movesNo equipment2 to 3 sets of 8 to 12 of each, stopping a couple of reps before you couldn't do another (our editorial starting point). Breathe out as you lift rather than holding your breath.
3D demoDumbbell goblet squatIntermediate · A dumbbell
3D demoSit to stand from a chairBeginner · A bench or box
3D demoDumbbell Romanian deadliftIntermediate · A dumbbell
3D demoIncline push-upBeginner · A bench or box
3D demoBand rowBeginner · A band + An anchor point
3D demoGlute bridgeBeginner · No equipment
3D demoFarmer's carryBeginner · A dumbbell + A kettlebellAny of these on 2 days a week, with a day between.
A 20-minute full-body dumbbell workout: two supersets of squats, rows, Romanian deadlifts and push-ups. Twice a week covers the minimum dose.
20 minBeginner8 movesA dumbbell, A bench or boxA gentle 20-minute beginner home workout with a chair, a wall and a band: sit-to-stands, wall push-ups, band rows, step-ups and dead bugs.
20 minBeginner11 movesA bench or box, A wallA 35-minute full-body strength workout with dumbbells: goblet squats, presses, rows, Romanian deadlifts and carries.
35 minIntermediate9 movesA band, A dumbbellWeekly plans that mix cardio and strength. Add pelvic floor exercises every day.
A 3-day strength plan for men over 40 with power and bone work, two cardio days and mobility, built on research on ageing muscle.
3 training days45 minBeginner4 days a weekA 4-day gym workout routine for men: upper and lower days, each muscle trained twice a week, with sets, reps, progression and the evidence.
4 training days50 minIntermediate2 days a weekYour first four weeks: two, then three short strength sessions a week at home plus walks, building gently to a full routine.
2 training days20 minBeginner5 days a weekA 12-week workout plan for weight loss: three strength days, two cardio days and daily steps, building to 200 minutes a week, with honest results.
3 training days45 minBeginnerAn older US study suggested that men who rode for longer each week might be more likely to have erection problems, while shorter riding wasn't linked. Newer studies disagree. In a 2018 survey of 3,932 men, cyclists' sexual function was no worse than swimmers' or runners', though narrowing of the urethra was more common. A review of 6 studies found no difference at first, but about twice the odds of erection problems in cyclists once age and other illnesses were allowed for, and called the evidence limited.
No-nose saddles and recumbent bikes lowered pressure on the area between the legs (the perineum) in studies of healthy men, and standing up on the pedals every 10 minutes or so has indirect support. Men who stood for more than a fifth of their ride, and those with handlebars level with or above the saddle, had less genital numbness. POGP suggests tipping the nose of the saddle down slightly, lifting yourself off the saddle regularly, padded shorts, and a saddle designed to reduce pressure.
Cycling is good aerobic exercise, and the trial programmes that improved erections included it. Use a saddle that fits you and takes pressure off, stand up on the pedals from time to time, and if you notice numbness between your legs or erection problems, see a GP. A recumbent exercise bike avoids saddle pressure altogether. This is our editorial reading of mixed evidence; our cycling guide covers bike fit.
Sex between partners in a long-term relationship takes about as much effort as walking a mile on the flat in 20 minutes or briskly climbing two flights of stairs in 10 seconds. In a review cited by the Princeton III panel, the small rise in heart events during exertion or sex was smaller in people who were regularly active.
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Men whose heart disease is stable and well treated are usually at low risk during sex, but men with unstable or severe heart problems need treatment and assessment first. Ask your cardiac team when it's safe, and see our heart disease guide for cardiac rehabilitation.
No randomised or open-label study has shown more heart attacks in men taking erection tablets, and BAUS says there's no evidence they're dangerous with heart disease. The danger is mixing them with nitrates, such as GTN spray or isosorbide for angina, or with poppers: together they can cause a sudden, dangerous drop in blood pressure. The NHS says sildenafil may not be suitable if you've recently had a heart attack or stroke, or have low or uncontrolled high blood pressure.
Sildenafil (Viagra), tadalafil (Cialis), vardenafil and avanafil increase blood flow to the penis and work only with sexual stimulation; sildenafil is usually taken about an hour before sex. You can buy sildenafil from a pharmacy after speaking with a pharmacist. If you do, the NHS advises a check-up with your doctor within 6 months, because erection problems can be a sign of diabetes or heart problems.
Vacuum pumps work for most men. Injections into the penis, a small pellet placed in the tip of the penis, and implants are options when tablets don't work or aren't suitable. Treating a cause helps too: your doctor may switch a medicine that's causing the problem, or treat high blood pressure, high cholesterol or a hormone problem. Testosterone treatment is only for men whose levels are low.
Anxiety about performance is common, and depression and anxiety can cause erection problems. European urologists recommend cognitive behavioural therapy (CBT), including your partner, alongside medical treatment. The NHS lists counselling and sex therapy, through your GP or privately (look for the College of Sexual and Relationship Therapists, the Institute of Psychosexual Medicine or Relate). Our guides to exercise for depression and anxiety cover the exercise side.
European urologists give only a weak recommendation for L-arginine or ginseng, and only for men with mild erection problems who decline medicines, warning that any improvement may be mild. An expert panel has flagged dietary supplements spiked with the drugs in erection tablets, and the NHS warns that many websites sell fake medicines. If you buy online, use a pharmacy registered with the General Pharmaceutical Council.
Tablets act quickly and have the strongest evidence; exercise works over months and its average effect is modest. But exercise and weight loss also lower the heart and circulation risks behind many cases, and in one small trial the two worked better together. Never stop or change a medicine without talking to your doctor.
Call 999, and don't drive yourself to A&E, if, during exercise, sex or at any other time:
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Call 999 if you might be having a severe allergic reaction, a heart attack or a seizure. In an emergency, tell the call handler and the paramedics what you took and when (our advice): these tablets must not be combined with nitrates such as GTN. Call NHS 111 for other serious side effects, such as fainting, a fast or irregular heartbeat, or blistering skin with flu-like symptoms. If you feel dizzy or have blurred vision, don't drive or cycle.
An erection that lasts more than 3 to 4 hours, or a painful erection lasting more than 1 hour if you have sickle cell disease, needs hospital treatment as soon as possible to avoid permanent damage. Some treatments for erection problems can cause it. Don't drive yourself.
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Erection problems can go with low mood. If you might harm yourself, call 999 or go to A&E. For support now, call Samaritans free on 116 123, call NHS 111, or text SHOUT to 85258. In the US, call or text 988.
Speak to your GP first if you haven't exercised for some time, or you have a medical condition or concerns. With known heart disease, follow your cardiac team's advice.
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One small UK trial was positive and a review of 10 small trials was encouraging, but the evidence is low to moderate quality and one meta-analysis found no clear effect. The NHS's main treatments are lifestyle changes and tablets. Pelvic floor exercises are a low-risk extra; see a GP as well.
Erection problems can be the first sign of heart disease or diabetes, often 2 to 5 years before heart symptoms, and an expert panel advises treating men with erection problems as at risk of heart problems until proven otherwise. Exercise is part of the answer, not a reason to skip the check.
No randomised or open-label study has shown more heart attacks with them, and BAUS says there's no evidence they're dangerous with heart disease. The real danger is taking them with nitrates such as GTN, or with poppers.
The evidence linking cycling with erection problems is mixed: a large survey found cyclists' sexual function no worse than runners' or swimmers', while a review found higher odds once age and illness were allowed for. Better saddles and standing up regularly take pressure off. If you have numbness or erection problems, see a GP; a break from long rides while you're checked is reasonable (our suggestion).
No trial has tested strength training on its own for erection problems: the trials were aerobic, a few with strength work added. Strength training is still worth doing on 2 days a week for your health.
It's more common with age, but in one study a quarter of men seeking help for new erection problems were under 40, and almost half of them had severe problems. In younger men it's an even stronger warning sign for heart disease.
Anxiety often plays a part, but BAUS says only about 1 in 10 cases is purely psychological. Both sides deserve attention: a medical check and, where it helps, talking therapy alongside treatment.
European urologists give only a weak recommendation for L-arginine or ginseng in mild erection problems, warning the benefit may be mild. Some supplements have been found to contain hidden prescription drugs, and many websites sell fake medicines.
Yes, modestly. In trials of men with erectile dysfunction, regular aerobic exercise such as brisk walking, jogging or cycling raised scores on erection questionnaires by a few points on average, and by more in men whose problems were worse to start with. It works best alongside a check-up and any treatment your GP offers, not instead of them.
Aerobic exercise has the most evidence: brisk walking, jogging, cycling, rowing or swimming at a pace where you can talk but not sing, adding some harder efforts once you're fitter. Pelvic floor exercises may add a little. Strength training on 2 days a week is good for your health, though no trial has tested it on its own for erections.
The trials averaged about 40 minutes, 4 times a week, roughly 160 minutes a week, for about 6 months. That's a little more than the NHS minimum of 150 minutes of moderate activity a week. Expect months rather than weeks: in a trial that added exercise to tablets, the difference showed at 3 months.
They may. In a UK trial of 55 men, pelvic floor exercises taught by a physiotherapist improved erections more than lifestyle advice alone at 3 months. Reviews call the trials small and of low to moderate quality, and one found no clear effect, so treat them as a low-risk extra rather than a cure.
Sit comfortably and squeeze as if stopping yourself peeing and passing wind at the same time; in a mirror, the base of your penis should draw in and your testicles lift. Do slow holds and quick squeezes at least 3 times a day, building towards 10 holds of up to 10 seconds and 10 quick squeezes. Don't practise by stopping your pee mid-flow.
Pelvic health physiotherapists say to expect an improvement in 3 to 6 months, and to keep going even if they don't seem to help at first. In the UK trial, the difference showed at 3 months. After that, keep them up as part of your routine.
The evidence is mixed. A survey of nearly 4,000 men found cyclists' sexual function no worse than runners' or swimmers', while a review found higher odds of erection problems in cyclists once age and illness were allowed for. A saddle that takes pressure off, standing up on the pedals from time to time and higher handlebars may all help, and if you notice numbness or erection problems, see a GP.
It can be. The arteries to the penis are narrower than those to the heart, so narrowing often shows there first, usually 2 to 5 years before heart symptoms, and men with erection problems have about 1.5 times the risk of heart disease. That's why the NHS says to see a GP if erection problems keep happening: they may check your blood pressure, blood sugar and cholesterol.
Sex takes about as much effort as briskly climbing two flights of stairs, and men whose heart disease is stable and well treated are usually at low risk, but check with your cardiac team first. Stop and call 999 for chest pain that feels tight or spreads to your arms, neck or jaw, and tell the ambulance crew if you've taken an erection tablet.
Yes, and the two may work better together: in a small trial, men who added at least 3 hours a week of aerobic exercise to their tablets regained normal erections more often after 3 months (78% against 39%). European urologists recommend lifestyle changes before or alongside tablets. If you feel dizzy or have blurred vision after a tablet, don't drive or cycle, and never stop or change a medicine without talking to your doctor.
It can. In a 2-year trial of 110 men with obesity, losing weight and getting more active restored normal erections in about 1 in 3. In men with type 2 diabetes, losing weight helped a little, and fewer men's erections got worse. Our weight loss guide covers how.
Sometimes lifestyle changes are enough to improve erections: exercise, losing weight, stopping smoking, drinking less and managing stress can all help. But erection problems can also be a sign of a health problem that needs treating, and tablets are the treatment with the strongest evidence. See a GP rather than relying on supplements, which have weak evidence and can contain hidden drugs.
Exercise education, not a diagnosis or treatment plan, and clinical review of these guides is pending. Stop and get advice for chest pain, unusual breathlessness, dizziness or fainting, or new pain, and check with your doctor or midwife first if they have told you to limit activity. Health disclaimer.
