Exercise and Impotence: What Actually Works

Exercise improves impotence for most of the men it has been tested on, and the evidence is better than you might expect. Impotence is the older word for erectile dysfunction (ED), and the training approach is the same whatever you call it. Cardio improves the blood vessels that fill the penis, and pelvic floor training builds the muscles that keep the blood there. Together they attack both halves of an erection.

If you want the terminology first, our explainer on what impotent means covers it. This guide is about the exercise.

What the Research Shows

The best single source is a systematic review and meta-analysis by Silva and colleagues in the British Journal of Sports Medicine (2017). It pooled seven randomized trials with 478 men who had diagnosed ED, using aerobic, pelvic floor, or combined programs, with follow-up from 8 weeks to 2 years.

The result: a statistically significant improvement in erectile function scores, a mean gain of 3.85 points on the International Index of Erectile Function (95% CI 2.33 to 5.37). The benefit held in a sensitivity analysis, and the authors concluded that exercise helps, particularly moderate-to-vigorous aerobic exercise.

Two honest caveats. The authors rated the trials as moderate to high risk of bias, partly because you cannot blind someone to whether they are exercising. And the review is about men with ED, not a promise that exercise prevents it. The NHS notes that regular exercise and a healthy weight are part of the standard advice for ED.

Why Exercise Works on Erections

An erection needs healthy arteries, a functioning lining in those arteries, and muscles that hold blood in. Exercise touches each:

• Aerobic training improves circulation and blood vessel function and helps with weight, blood pressure, and blood sugar, which are all ED risk factors.
• Strength training helps body composition and insulin sensitivity, which feed into the same risk factors.
• Pelvic floor training strengthens the ischiocavernosus and bulbocavernosus muscles that compress the base of the penis during an erection.

The Pelvic Floor Piece

Most men skip this one. In a randomized controlled trial of 55 men with ED, Dorey and colleagues reported in BJU International (2005) that after six months of pelvic floor exercises with biofeedback and lifestyle changes, 40% of men had regained normal erectile function and 35.5% had improved; 24.5% did not improve. The men were taught by a physiotherapist, so supervised technique matters.

A Weekly Plan

This is a practical starting point, not a medical prescription.

1. Aerobic, 3 to 5 days a week: 30 minutes of brisk walking, cycling, swimming, or jogging, at a pace where talking is possible but singing is not. Work toward about 150 minutes weekly.
2. Strength, 2 days a week: squats, deadlifts or hip hinges, rows, and presses. Large muscle groups give the biggest payoff.
3. Pelvic floor, daily: a short set of kegels. Learn to find the right muscle in our kegels for men guide, then follow a structure like the pelvic floor exercises for men routine.
4. Sleep and alcohol: both undercut everything above. See does alcohol cause ED.

Who Should Check With a Doctor First

Most men can start walking and light kegels today. Get checked before ramping up if you have chest pain or breathlessness on effort, known heart disease, uncontrolled blood pressure, or diabetes. ED sometimes shows up before those conditions are diagnosed, which is why a general check-up is worth booking even if you plan to fix this with training.

If you take prescription ED medication, keep taking it as directed. Exercise does not conflict with it, and many men find the two work better together because the medication helps when blood vessels are the bottleneck and training improves the underlying health. Never stop a prescription on your own.

It also helps to think about what kind of ED you have. When the cause is mostly vascular, aerobic work addresses it directly. When it is mostly muscular or related to pelvic floor tension, targeted pelvic floor training matters more. When it is driven by worry, exercise still helps through lower stress and better sleep. Most real cases are a mix, which is the case for training broadly rather than relying on a single exercise.

Tracking Progress

Pick two or three numbers and write them down: weekly minutes of cardio, days you completed pelvic floor sessions, and how often erections feel firm enough for sex. A simple monthly note works better than daily scrutiny, which tends to feed anxiety. If you want a formal score, your doctor can give you the IIEF questionnaire used in the studies above.

Mistakes to Avoid

• Squeezing the glutes and abs instead of the pelvic floor. If your buttocks move, you are not isolating it.
• Holding your breath. Breathe through every rep.
• Only doing kegels. They help, but they do not replace the cardiovascular work.
• Long rides on a hard saddle. Prolonged perineal pressure can cause numbness, so use a well-fitted saddle and stand up periodically.

How Long Until You Notice Something

Trials in the meta-analysis ran from 8 weeks upward, and the pelvic floor trial measured at 3 and 6 months. Plan on at least 8 to 12 weeks of consistent training before judging, and keep going to six months for the full picture. If nothing improves, there is a large menu of treatments; see ED treatment options and therapy for impotence. Exercise works well alongside them.

Common Questions

The questions below cover the best exercise type, frequency, and when to involve a doctor. For more on how Defy approaches training, see about us or browse the blog.