- Strongest evidence: regular aerobic exercise, losing excess weight, quitting smoking.
- Good evidence: pelvic floor exercises, a Mediterranean-style diet.
- Worth doing: drinking less, sleeping better, treating sleep apnoea.
1. Aerobic exercise
A review of exercise trials found that about 160 minutes a week of moderate-to-vigorous aerobic activity (for example, four 40-minute sessions of brisk walking, cycling, running or swimming) for around six months improved erectile function. The men who benefited most were inactive, overweight, or had high blood pressure or heart disease.
2. Losing excess weight
In a well-known trial of men with obesity and ED, those who lost weight through diet and exercise over two years improved erectile function significantly, and around a third regained normal function. Losing even a moderate amount of weight helps blood vessels and testosterone levels.
3. Quitting smoking
Smoking damages the lining of blood vessels. Studies show erections can improve after quitting, especially in younger men and those who smoked less. It's one of the best things you can do for your sexual and overall health.
4. Pelvic floor exercises
The pelvic floor muscles help keep blood in the penis during an erection. In a UK trial, men with ED who did daily pelvic floor exercises for three months (with some biofeedback) improved markedly, and about 40% regained normal erectile function.
How to find the muscles: they're the ones you'd use to stop peeing midstream or to hold in gas. (Don't practise by actually stopping your urine flow regularly.) Squeeze and lift, hold for a few seconds, relax fully, and build up to several sets a day, lying, sitting and standing.
5. A Mediterranean-style diet
Diets rich in vegetables, fruit, whole grains, legumes, nuts, olive oil and fish are linked to lower ED risk in observational studies, likely through better blood-vessel health. No single "erection food" is a substitute for the overall pattern.
6. Drinking less
Heavy drinking, both in the moment and over time, makes erections less reliable. Staying within recommended limits is a sensible target.
7. Sleep
Short or poor sleep lowers testosterone and raises stress hormones. If you snore loudly, stop breathing during sleep or wake up exhausted, ask a doctor about sleep apnoea, which is linked to ED and is treatable.
What doesn't have good evidence
Most "testosterone boosters" and herbal erection supplements have little reliable evidence behind them, and some are contaminated with hidden prescription drugs. Your money is better spent on running shoes.
Lifestyle and medication aren't either/or
Lifestyle changes take weeks to months. Many men use ED medication in the meantime, and some find they need it less as their health improves.
Sources
- Gerbild H. et al. "Physical activity to improve erectile function: a systematic review of intervention studies." Sexual Medicine, 2018.
- Esposito K. et al. "Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial." JAMA, 2004.
- Dorey G. et al. "Randomised controlled trial of pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction." British Journal of General Practice, 2004.
- Pourmand G. et al. "Do cigarette smokers with erectile dysfunction benefit from stopping?" BJU International, 2004.
- American Urological Association: Erectile Dysfunction Guideline (2018, amended 2023).