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Lifestyle Medicine Erectile Dysfunction

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 sexual activity and it affects approximately 50% of men during their lifetime. ED used to be considered a problem of older age but it affects all age groups and is increasingly common in younger men.

Known causes

ED is often a symptom of other health issues and is commonly experienced by people who have some underlying health problems, the most common being heart disease, type 2 diabetes, high blood pressure, high cholesterol, depression and hormonal imbalances. Men who smoke are at higher risk than non-smokers of experiencing erectile problems. The main underlying physical factor is reduced flexibility and blood flow in the arteries.

ED lifestyle advice

Alcohol

Research surrounding the effects of drinking alcohol on erectile function suggests that moderate alcohol consumption (14 units a week) does not have a negative impact. Higher alcohol intakes, and/or increased frequency of alcohol drinking are thought to increase the risk of experiencing ED, and findings suggest that the more alcohol you drink the bigger the impact on ED.

Lose weight

ED is more common in men who are overweight, obese or have a high waist measurement. Losing weight and/or reducing your waist size has been found to help reduce ED.

Recommended eating guides for weight loss

One small study found that weight loss may help to preserve erectile function and prevent the worsening of ED. Another found that introducing lifestyle changes including a combination of losing weight and increasing physical activity led to an improvement in erectile function.

Weight loss for erectile dysfunction

The best weight loss diet to follow to improve erectile function if you are overweight is the Mediterranean diet. Eating a Mediterranean diet has been linked with having more flexible arteries and heart health and can support healthy weight loss and has been found to reduce erectile dysfunction. The most important factor though is to find a dietary pattern that you are happy to follow that can help you lose weight.

Recommended eating guides for weight loss

Eat Arginine rich foods to boost nitric oxide

Boosting intake of arginine (an amino acid found in many protein-rich foods) may help to improve circulation, a factor in ED - a Mediterranean diet is naturally rich in arginine. Nitric oxide helps you get an erection by increasing blood flow to your penis.

Healthy sources of arginine

  • Turkey

- Choose breast meat

  • Chicken

- Choose breast or leg meat

  • Pumpkin seeds

- Eat a small handful as a snack - sprinkle on salads / add to a smoothie

  • Sesame Seeds

- Add to smoothies/ sprinkle on porridge or salads / Tahini is made from sesame seeds and can be used as a dressing or dip

  • Soya Beans

- Great to add to soups/ salads or enjoyed as a snack/ enjoy as miso, tofu, or tempeh in curries/ soups or a stir-fry

  • Chickpeas

- Add to soups/ stews and salads - can be baked in the oven to enjoy as a tasty snack

  • Lentils

- Add to soups/ stews / curries and salads

  • Almonds

- Great as a snack or chop and add to breakfast or salads - Almond flour can be used in place of flour to make a protein-rich cake

Boost your intake of vegetables

Include colour in your diet from a variety of vegetables and fruit - aiming to eat the rainbow across the week - when you shop head to the vegetable aisle and see how many different colours you can add to your basket. All of these foods are rich in antioxidants which have been shown to improve blood flow and erectile function. Dark chocolate is rich in antioxidants so we would recommend you enjoy a couple of squares every day.

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.

How to measure your waist

Diet has a profound impact on the type of bacteria that live in our guts and the type of bacteria that populates each person's gut is very much influenced by what they regularly eat and drink. Many other factors including stress and low-grade inflammation have also been found to influence the gut microbiome.

Man measures his 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

Get active

Research suggests that being physically active is a vital part of preventing ED. Studies into physical activity and ED have found that all activities including walking, running, swimming, and cycling are beneficial and that the more active a person is the lower their risk of experiencing ED and increased activity may help to reverse it.

Pelvic floor exercises

Having strong pelvic floor muscles may help you to achieve an erection. The pelvic floor is a muscular band that stretches from the tailbone to the pubic bone. Several factors can lead to a weakened pelvic floor including:

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

To improve a weakened pelvic floor aim to make doing pelvic floor exercises part of your daily routine.

An easy way to work out where your pelvic floor is - is to stop your flow of urine when peeing, or to stop yourself when passing wind.

Simple Pelvic Floor Exercises

Now you have found your pelvic floor, aim to tighten these muscles on and off throughout the day, the great news is you can do these exercises anywhere. Aim to tighten and hold your pelvic floor muscles for a count of three and then relax these muscles slowly - aim to build up to three sets across the day - aiming for about 10 sets once your muscles start to strengthen.

Stop smoking

Smoking worsens ED by affecting blood vessels. The more exposure to smoking, the more cigarettes smoked and the number of years as a smoker affects how severely blood vessels are impacted - Some research showed that stopping smoking can improve erectile function and the sooner you stop smoking the better the outcome.

Talk to your partner (emotional and relational component)

Talking to your partner is an important step in reducing the emotional impact of ED, this may also help to alleviate any worry that you are experiencing. Open communication can help to build trust and understanding in a relationship which can, in turn, support you to overcome ED.

Manage your Stress

There are two separate types of stress that can be a factor in erectile dysfunction.

  • Emotional stress

Blood flow to the penis that helps to create an erection can be affected by emotional stress and anxiety - this can become a vicious cycle as experiencing ED may increase feelings of emotional stress and anxiety. Identifying and managing your stressors can be helpful.

  • Physiological Stress

Oxidative stress is a natural part of the ageing process. Some lifestyle factors can increase the likelihood of this being a factor in ED. These include being overweight or obese, smoking, and high alcohol intake. Increasing dietary sources of antioxidants (naturally bright or dark coloured foods) and addressing the triggering factors can help to reduce oxidative stress.

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Page last reviewed by: Dr. Christina Hennessey 23/08/2021