Two recent reviews of studies looked at erectile dysfunction from different angles. The first review found that regular exercise or physical activity improves erectile function (especially if the person has heart disease or has had their prostate removed) - with improvements similar to what people see with a medication. Other studies have found similar results (see here and here). The other review found that having chronic periodontitis (gum disease) is linked to a higher incidence of erectile dysfunction, with one study finding that treating the periodontitis improves erectile dysfunction symptoms. Bottom line: get regular physical activity and exercise, and get regular dental care (and treat any periodontitis).
From Medscape: Erectile Dysfunction May Improve With Exercise
Men who have difficulty maintaining erections may benefit from exercise or physical activity, according to a new analysis. A growing body of evidence has suggested physical activity could improve erectile function, but the authors of the new report say that until now, no one had looked at all the studies together....The prevalence of erectile dysfunction ranges from 8 percent among men in their 20s and 30s, up to 37 percent among men in their early 70s.
For the new study, the researchers searched for randomized controlled trials testing exercise and physical activity as a therapy for erectile dysfunction. They found seven studies published between 2004 and 2013 that included a total of 505 men, who were tracked for anywhere from eight weeks to two years. Average ages ranged from 43 to 69 years. Altogether, 292 men were randomly assigned to complete aerobic exercises, pelvic floor muscle exercises or a combination of exercises. The other 213 men were not told to exercise.
Erectile function was measured using the International Index of Erectile Function. Scores range from 5 to 25; men with no erectile dysfunction have scores of 22 to 25, and those with the most severe dysfunction score between 5 and 7. Overall, men who exercised had their scores increase by an average of 3.85 points, compared to men who did not exercise. Exercises specific to pelvic floor muscles didn't seem to yield a benefit. Among men with an increased cardiovascular risk, coronary heart disease or prostate removal, however, any type of exercise led to improved erectile function scores.
A take-home message from this analysis is that exercise should have a role in the treatment of erectile dysfunction, said Dr. Landon Trost, who is head of andrology and male infertility at the Mayo Clinic in Rochester, Minnesota....He told Reuters Health that the average increase in erectile function score would likely be similar to what people see with a medication.
From Medscape: Periodontitis Tied to Risk of Erectile Dysfunction
Erectile dysfunction is more common in men with chronic gum disease, according to a new review of existing studies. Periodontitis has been tied to a higher risk of cardiovascular disease and general inflammation, which in turn have been tied stroke and atherosclerosis, which are associated with erectile dysfunction (ED).
The reviewers analyzed data from five studies published between 2009 and 2014, including one randomized controlled trial. In total, the studies covered 213,000 participants aged 20 to 80. Each study found erectile dysfunction was more common among men being treated for chronic periodontitis, particularly for those younger than 40 and older than 59. After accounting for diabetes, which can influence both gum disease and sexual function, erectile dysfunction was 2.28 times more common for men with periodontitis than for men without it, according to the report in the International Journal of Impotence Research....One study in 2013 found that treating periodontitis improves erectile dysfunction symptoms.
The new review did have limitations, including the fact that erectile dysfunction and chronic periodontitis are caused by similar risk factors, such as aging, smoking, diabetes mellitus and coronary artery disease. While some studies did account for diabetes, most did not account for smoking or alcohol consumption, which can also affect oral health and sexual function, the authors write. Even after an exhaustive search, the evidence linking periodontitis and ED is limited, they write.