madman
Super Moderator
Abstract
Erectile dysfunction could be an early sign of endothelial dysfunction and, therefore, of cardiovascular disease, with which it shares many risk factors. Among reversible risk factors, physical inactivity is one of the most important. Regular physical exercise has been shown to improve erectile function through different mechanisms involving glucose and lipid metabolism, regulation of arterial pressure, production of nitric oxide and hormonal modulation. Furthermore, exercise shows a synergistic effect with the drugs commonly used in the treatment of impotence. Since many patients with erectile dysfunction may have underlying cardiovascular disease, the evaluation of individual cardiovascular risk is mandatory before prescribing physical exercise. When exercise is not contraindicated, the most appropriate protocol must be chosen, considering the individual characteristics of the patient. Both aerobic and anaerobic/ resistance protocols have proven effective. However, meta‐analytic studies show that aerobic exercise with moderate‐to‐vigorous intensity is the most effective in improving erection. Testosterone is an important modulator of physical performance, and its blood levels must always be evaluated in patients with erectile dysfunction.
7 | CONCLUSIONS
Meta‐analyses have shown that physical inactivity is the most important risk factor for ED (Allen & Walter, 2018) and that PA and PE are effective in improving erection (Silva et al., 2017). The protocol mostly prescribed consists in 150–160 min/week of aerobic PA of moderate intensity. Vigorous intensity PA and resistance exercise could represent a valid supplement, as well as pelvic floor muscle‐ specific exercise (Gerbild et al., 2018; Siegel, 2014). PA is more effective if prescribed together with PDE5i (Silva et al., 2017), drugs that exert little effect on physical performance (Guidetti et al., 2007). Blood testosterone levels are essential for achieving a good physical fitness. In hypogonadal patients, in absence of contraindications, testosterone replacement therapy should be prescribed to maximise individual well‐being and performance (Page et al., 2005). Before resuming physical and sexual activity, it is mandatory to evaluate cardiovascular risk: patients with high cardiovascular risk, according to the Princeton Consensus classification, must be first stabilized with appropriate pharmacological treatment (Nehra et al., 2012).
Erectile dysfunction could be an early sign of endothelial dysfunction and, therefore, of cardiovascular disease, with which it shares many risk factors. Among reversible risk factors, physical inactivity is one of the most important. Regular physical exercise has been shown to improve erectile function through different mechanisms involving glucose and lipid metabolism, regulation of arterial pressure, production of nitric oxide and hormonal modulation. Furthermore, exercise shows a synergistic effect with the drugs commonly used in the treatment of impotence. Since many patients with erectile dysfunction may have underlying cardiovascular disease, the evaluation of individual cardiovascular risk is mandatory before prescribing physical exercise. When exercise is not contraindicated, the most appropriate protocol must be chosen, considering the individual characteristics of the patient. Both aerobic and anaerobic/ resistance protocols have proven effective. However, meta‐analytic studies show that aerobic exercise with moderate‐to‐vigorous intensity is the most effective in improving erection. Testosterone is an important modulator of physical performance, and its blood levels must always be evaluated in patients with erectile dysfunction.
7 | CONCLUSIONS
Meta‐analyses have shown that physical inactivity is the most important risk factor for ED (Allen & Walter, 2018) and that PA and PE are effective in improving erection (Silva et al., 2017). The protocol mostly prescribed consists in 150–160 min/week of aerobic PA of moderate intensity. Vigorous intensity PA and resistance exercise could represent a valid supplement, as well as pelvic floor muscle‐ specific exercise (Gerbild et al., 2018; Siegel, 2014). PA is more effective if prescribed together with PDE5i (Silva et al., 2017), drugs that exert little effect on physical performance (Guidetti et al., 2007). Blood testosterone levels are essential for achieving a good physical fitness. In hypogonadal patients, in absence of contraindications, testosterone replacement therapy should be prescribed to maximise individual well‐being and performance (Page et al., 2005). Before resuming physical and sexual activity, it is mandatory to evaluate cardiovascular risk: patients with high cardiovascular risk, according to the Princeton Consensus classification, must be first stabilized with appropriate pharmacological treatment (Nehra et al., 2012).
