Until the 1970s, psychologists, physicians, and the public regarded erectile dysfunction (ED) as a sure sign of deep psychological disturbances. But oddly, psychological interventions—psychotherapy, psychoanalysis—did not provide much relief.
Since the 1970s, a mountain of research has shown that ED’s main cause is not psychological turmoil, but cardiovascular disease (CVD), the cause of heart attack and stroke. CVD narrows the arteries that carry blood throughout the body, including into the penis. Erection depends on increased blood flow into the spongy erectile tissues of the central penis. Anything that inhibits this blood flow, notably CVD, hurts erections, while anything that promotes it firms them.
The link between cardiovascular disease and ED is compelling. A recent review of dozens of studies concluded that ED “has aptly been called the ‘canary in the coal mine’ for heart attack and stroke” because it often develops before either of those cardiovascular emergencies strikes.
Ironically, while most ED is not psychological in origin, psychological interventions offer powerful ways to help prevent and treat it.
Mindfulness Meditation Tames Stress
Emotional stress plays a key role in ED. Stress releases the hormone cortisol, which narrows the arteries, including those in the penis. To reopen them, reduce stress. Psychological interventions help, notably mindfulness meditation, which involves deep breathing and nonjudgmental focus on the present moment. Canadian researchers asked 141 couples to keep sex and lifestyle diaries for 28 days. Those who practiced the most present-moment awareness in their sexual interactions had better sexual function, and the men reported firmer erections.
Regular, Moderate Exercise Reduces Stress and More
Exercise supports erections in two ways. It reduces emotional stress and it improves cardiovascular health, allowing more blood to flow into the penis.
Scandinavian scientists investigated the effects of exercise on erections by analyzing the results of 10 studies. As time spent exercising increased, the risk of ED steadily decreased. Forty minutes of moderate exercise at least four times a week produced the greatest risk reduction.
Austrian researchers analyzed exercise and partner sex in 7,049 men. As their time spent exercising increased, so did their ability to function well sexually.
The Internet abounds with recommendations about the “best” exercise. But obsession with the “best” obscures a greater truth. Just move your body for at least 30 minutes a day, ideally 60 minutes. Do anything you enjoy, or used to enjoy. Take walks, bike, dance, swim, garden, join a gym—anything you can stick to that works up a sweat. Many Americans believe that strenuous aerobic exercise is “best.” Aerobic workouts give college, Olympic, and professional athletes a competitive edge. If your main goal is not glory, but health, fitness, and firm erections, aerobic workouts are not necessary. Just move your body for at least 30 minutes a day in ways you enjoy.
Eat More Plants
Meats contain animal (saturated) fats, notorious for narrowing the arteries. Plant foods help keep the arteries open and healthy.
University of California researchers analyzed data from the ongoing Health Professionals Follow-Up Study, which has tracked the health and lifestyles of more than 20,000 male doctors and dentists since 1986. As adherence to a Mediterranean diet increased, their risk of ED decreased. A Mediterranean diet involves eating less meat and considerably more fruits and vegetables than the typical American diet does. Compared with the men eating Mediterranean diets, those who ate like typical Americans were significantly more likely to develop ED.
But it’s psychologically challenging to change one’s diet. Don’t make major changes all at once. Instead, make small changes you can live with. First, keep a daily food diary for a week or two. See how many servings of meats, whole-milk dairy, and fruits and vegetables you eat. Make just one small change that reduces your consumption of animal fat and increases your intake of fruits and vegetables. If you love pizza, top it with less meat and more vegetables. If you love bacon cheeseburgers, consider deleting the bacon or cheese, or adding more lettuce and tomato. Have some fruit with breakfast. Include a salad with lunch. Eat a salad and vegetables at dinner. Snack on fruits.
If you’re seriously overweight, ask your doctor about the new weight-loss drugs.
Make one small change you can live with long-term every four months. Over two years, that’s six changes, not many really, but probably enough to help your arteries—and your erections.
Smoking and Obesity Kill Erections
Smoking narrows the arteries. Smokers are at high risk for heart attack, stroke, and ED. Obesity raises blood pressure, which also increases the risk of ED.
German scientists surveyed 10,135 German men, all aged 45, about their lifestyle and sexual function. One-quarter (25 percent) reported some ED. Key lifestyle contributors included obesity and smoking.
If you smoke, ask your doctor for help quitting.
If you’re overweight, exercise more, evolve toward a Mediterranean diet, and consider drug therapy.
In addition to aiding erections and reducing the risk of heart attack, stroke, and many cancers, a healthy lifestyle also offers significant psychological benefits. It improves mood, concentration, memory, and sleep.
If you embrace a healthy lifestyle, you’ll add years to your life, and life—including improved sex and mental health—to your years.
