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Top Tips and Advice for Erectile Dysfunction From the Lifestyle Medicine Team

Sanam Hussain

Medically reviewed on

Written by Sanam Hussain

Sanam is a pharmacist independent prescriber. She graduated from University College London in 2003, following which she worked in both community and clinical pharmacy.

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What is Erectile Dysfunction

Erectile dysfunction (ED) is a term used to describe persistently being unable to get or maintain an erection to achieve satisfactory sex. It affects around 50% of men during their lifetime (1). ED can affect all age groups and is increasingly common in younger men.

Healthy waist measurement for men

Measuring and reducing your waist if your waist is bigger than the recommended size is a simple way of monitoring your health. Reducing your waist circumference through following a healthy diet and increasing physical activity may help with erectile function (13).

How to measure your waist

In the above image - the tape measure is sitting in a great position but is being pulled a little tighter than recommended

  1. Place the tape measure around your tummy level with your tummy button
  2. Inhale and then exhale - take the measurement on your exhale

*make sure not to hold the measure too tight - it should fit snugly on your skin but not be digging in **Your waist is not where your trousers sit

Ethnicity Waist Size
Europid 94cm or less
Sub-Saharan African 94cm or less
Eastern Mediterranean 94cm or less
Middle Eastern (Arab) 94cm or less
South Asian 90cm or less
Chinese 90cm or less
Japanese 90cm or less
Indigenous South American 90cm or less
Indigenous Central American 90cm or less

Tone Up Your Pelvic Floor

What is the pelvic floor?

The pelvic floor is a muscular band that stretches from the tailbone to the pubic bone. It is often referred to as “the core”. If you’re suffering from a weak pelvic floor, don’t worry you are not alone! Lots of men suffer from weak pelvic floor

Several factors can lead to a weakened pelvic floor (15) including:

  • a lack of exercise
  • sitting too much
  • constipation
  • straining to open the bowels (constipation)
  • having a chronic cough
  • being overweight
  • pelvic surgery

Exercising the pelvic floor regularly can improve its strength, particularly the strength of the bulbocavernosus muscle. This muscle allows blood to engorge the tissue around the penis, maintaining an erection and sexual performance.

How do pelvic floor exercises help ED?

Having strong pelvic floor muscles may help you to achieve an erection (16). When this muscle is weak, it can’t stop blood from flowing out of the erect penis. The pelvic floor muscles are key in sustaining blood flow to the penis and maintaining erections. The muscles do this by stopping blood from leaving the penis, making an erection possible.

How do I find my Pelvic floor?

An easy way to work out where your pelvic floor is, is to stop your flow of urine when peeing and at the same the trying to stop yourself from passing wind. It should feel like you’re squeezing, pulling the back passage up and in.

How do I strengthen the pelvic floor?

Find a comfortable position, sitting, standing or lying down with knees slightly apart.

It takes time to build up pelvic floor strength. Aim to repeat these exercises 5-10 times, 3 times a day (16) The strength of your pelvic floor will build over 3 - 4 months.

References

References
NHS inform: Erectile Dysfunction and Impotence
Jackson G. Erectile dysfunction and cardiovascular disease. Arab J Urol. 2013 Sep;11(3):212-6. doi: 10.1016/j.aju.2013.03.003. Epub 2013 May 3. PMID: 26558084; PMCID: PMC4442980.
Kovac JR, Labbate C, Ramasamy R, Tang D, Lipshultz LI. Effects of cigarette smoking on erectile dysfunction. Andrologia. 2015 Dec;47(10):1087-92. doi: 10.1111/and.12393. Epub 2014 Dec 29. PMID: 25557907; PMCID: PMC4485976.
Arackal BS, Benegal V. Prevalence of sexual dysfunction in male subjects with alcohol dependence. Indian J Psychiatry. 2007 Apr;49(2):109-12. doi: 10.4103/0019-5545.33257. PMID: 20711392; PMCID: PMC2917074.
Evans MF. Lose weight to lose erectile dysfunction. Can Fam Physician. 2005 Jan;51(1):47-9. PMID: 15732221; PMCID: PMC1479584.
Kelly DM, Jones TH. Testosterone and obesity. Obes Rev. 2015 Jul;16(7):581-606. doi: 10.1111/obr.12282. Epub 2015 May 15. PMID: 25982085.
Di Francesco S, Tenaglia RL. Mediterranean diet and erectile dysfunction: a current perspective. Cent European J Urol. 2017 Jun 30;70(2):185-187. doi: 10.5173/ceju.2017.1356. Epub 2017 Jun 11. PMID: 28721287; PMCID: PMC5510347.
Gerbild H, Larsen CM, Graugaard C, Areskoug Josefsson K. Physical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies. Sex Med. 2018 Jun;6(2):75-89. doi: 10.1016/j.esxm.2018.02.001. Epub 2018 Apr 13. PMID: 29661646; PMCID: PMC5960035.
Stanislavov R, Nikolova V. Treatment of erectile dysfunction with pycnogenol and L-arginine. J Sex Marital Ther. 2003 May-Jun;29(3):207-13. doi: 10.1080/00926230390155104. PMID: 12851125.
Zhang Q, Radisavljevic ZM, Siroky MB, Azadzoi KM. Dietary antioxidants improve arteriogenic erectile dysfunction. Int J Androl. 2011 Jun;34(3):225-35. doi: 10.1111/j.1365-2605.2010.01083.x. PMID: 20584092.
Velurajah R, Brunckhorst O, Waqar M, McMullen I, Ahmed K. Erectile dysfunction in patients with anxiety disorders: a systematic review. Int J Impot Res. 2022 Mar;34(2):177-186. doi: 10.1038/s41443-020-00405-4. Epub 2021 Feb 18. PMID: 33603242; PMCID: PMC8964411.
Kalaitzidou I, Venetikou MS, Konstadinidis K, Artemiadis AK, Chrousos G, Darviri C. Stress management and erectile dysfunction: a pilot comparative study. Andrologia. 2014 Aug;46(6):698-702. doi: 10.1111/and.12129. Epub 2013 Jul 3. PMID: 23822751.
Pizzol D, Smith L, Fontana L, Caruso MG, Bertoldo A, Demurtas J, McDermott D, Garolla A, Grabovac I, Veronese N. Associations between body mass index, waist circumference and erectile dysfunction: a systematic review and META-analysis. Rev Endocr Metab Disord. 2020 Dec;21(4):657-666. doi: 10.1007/s11154-020-09541-0. PMID: 32002782.
Katzmarzyk PT, Bray GA, Greenway FL, Johnson WD, Newton RL Jr, Ravussin E, Ryan DH, Bouchard C. Ethnic-specific BMI and waist circumference thresholds. Obesity (Silver Spring). 2011 Jun;19(6):1272-8. doi: 10.1038/oby.2010.319. Epub 2011 Jan 6. PMID: 21212770; PMCID: PMC3933952.
Grimes WR, Stratton M. Pelvic Floor Dysfunction. [Updated 2022 Jun 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559246/
Dorey G, Speakman M, Feneley R, Swinkels A, Dunn C, Ewings P. Randomised controlled trial of pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction. Br J Gen Pract. 2004 Nov;54(508):819-25. PMID: 15527607; PMCID: PMC1324914.