Erectile dysfunction (ED) is one of the common erotic disorders which decreases the quality of life in men. It has been estimated that the worldwide prevalence of ED will be 322 million cases by the year 2025. Risk factor categories associated with ED include cardiovascular diseases, the presence of diabetes mellitus, the concurrence of other genitourinary diseases, psychiatric/psychological disorders, and the general health status of the individual. Several studies showed a relation between ED and most of the cardiovascular risk factors, such as diabetes, smoking, hypertension, hyperlipidemia, metabolic syndrome.
Cardiovascular diseases are the main cause of mortality in both gender worldwide: behavioral modifications that occurred in the last decades have led to the spreading of unhealthy lifestyles, which are believed to be one main cause of ED. The increasing prevalence of obesity has brought about the rising prevalence of metabolic syndrome, a cluster of risk factors for Cardiovascular Diseases, and type 2 diabetes mellitus.
All these metabolic conditions are strongly associated with a pro-inflammatory state that results in endothelial dysfunction and a decrease in the activity of nitric oxide (NO). As NO is the driving force of the genital blood flow, it has been known that most cardiovascular risk factors are associated with ED in men. Testosterone modulates nearly every process of erectile function and also modulates the timing of the erectile process, which works to improve femininity desire, coordinating penile erection with s*x.
Lifestyle and medicines like Cenforce, Vidalista, Fildena, Tadalista, Vilitra were identified as primary factors influencing vascular Nitric Oxide production and erectile function. Both fundamental and scientific research has proven that focusing on lifestyle factors typically related to ED, along with smoking, alcohol consumption, obesity, and lack of physical activity could have tremendous outcomes on the development of the erectile feature. Therefore, there can be a place for lifestyle measures to prevent progression or even enhance the regression in erectile function.
Effects of Lifestyle Changes on Erectile Dysfunction
As Nitric Oxide is a key factor for vascular health and ED is strongly associated with Cardiovascular Diseases, maximum attention should have to be paid to measures known to increase vascular NO production.
Physical Activity
Several ambitious investigations have indicated that physical activity has a beneficial effect on the prevention and improvements of ED. In hypertensive patients with ED, an 8-week exercise activity for 45–60 min a day, improved conditions of ED compared with men who remained sedentary during the same period.
The mechanisms by which physical activity improves ED include cardiovascular fitness, increase in endothelial-derived Nitric Oxide, decrease in oxidative stress, and increase in regenerative EPCs. Moreover, the physical exercise showed positive effects on self-esteem and mental health, with a beneficial impact on psychological issues associated with erectile dysfunction.
Weight Loss
Prospective epidemiologic studies suggest that overweight, obesity, and metabolic syndrome are associated with an increased risk of ED. Health professionals’ follow-up study, reported that overweight or obese men are at 40% increased risk of developing ED compared with normal-weight men.
Moreover, bodyweight loss, obtained either by lifestyle or bariatric intervention, is associated with a decline in estrogen levels and a rise in gonadotropins and testosterone, which is greater in those who lose more bodyweight.
Dietary Factors
Dietary patterns with high content of whole-grain foods and legumes and vegetables and fruits, and limit the consumption of red meat, beverages with added sugar, and full-fat dairy products are known to reduce the risk of Erectile Dysfunction. The Mediterranean-style diet, in particular, has been known to lower the prevalence of ED in both diabetic and non-diabetic men.
Thorough studies show that abundant consumption of vegetables, fruit, and whole-grain, produced a markedly lower risk of coronary disease. The benefits of the Mediterranean diet on ED can be mediated through multiple biological pathways, including a reduction of oxidative stress and subclinical inflammation, insulin sensitivity, and amelioration of endothelial dysfunction which may increase the production of Nitric Acid in the penis arteries.
Overall Lifestyle Changes
Lifestyle changes, such as reduced caloric intake, increased physical activity, and a healthy diet, have been associated with the improvement of erectile function in the general male population.
Physical exercise, weight loss, and a healthy diet help in insulin resistance, and low-grade inflammatory state which are associated with diabetes and metabolic diseases, all of which are risk factors for ED.
Smoking
Smoking tobacco is considered a high-risk factor for ED. Quitting smoking enhances both physiological and physical indication of erotic health in long-term male smokers, irrespective of baseline erectile impairment.
Alcohol
Limited consumption of alcohol may provide a positive effect on ED in both the general male population and in diabetic men. However, excessive consumption can directly affect penile function. The overall findings are suggestive of alcohol consumption of a moderate quantity conferring the highest protection. Moderate alcohol consumption has long-term benefits on high-density lipoprotein cholesterol and other variables that increase the bio-availability of NO.
Which Role For Lifestyle Changes In Erectile Dysfunction?
Risks of erectile dysfunction are associated with smoking, lack of physical activity, abdominal obesity, excessive alcohol intake, hypertension, metabolic syndrome, diabetes, and decreased antioxidant defenses, all of which reduce NO production. Moreover, physiological causes of ED are coming into view and of the benefits of therapy to improve patient’s quality of life, self-esteem, and ability to maintain intimate relationships.
It has been known that lifestyle-based strategies and psychological therapy can improve endothelial function, NO bioavailability, and testosterone levels, producing benefits on erectile function. The European Association of Urology recently stated that lifestyle changes and risk factors modification help in the treatment of ED.
Though there are many ED drugs available in the market such as Cenforce 200, Vidalista 20, Fildena 150, Super Kamagra, and more, none of the many available treatment options offers a complete response in all patients. Thus, as with many other medical diseases, prevention may be the most effective approach to eliminate the consequences of ED.
Despite the increasing evidence that unhealthy lifestyles lead to metabolic diseases, including erectile dysfunction, the majority of adults fail to meet physical activity and nutritional guidelines. Weight loss, physical activity, and a healthy diet in overweight or obese men can result in effective improvement in erectile function in a short period.
Mediterranean diet has been proposed as a healthy dietary pattern based on evidence that greater adherence to this diet is associated with lower all-cause and disease-specific survival. In clinical trials, the Mediterranean diet was more effective than a control diet in treating ED or restoring erectile function in men with obesity or metabolic syndrome.
To conclude, the promotion of healthful lifestyles for primary prevention among individuals of all ages would yield healthy life and improve erectile dysfunction.
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