The Effect of Lifestyle Modification and Cardiovascular Risk Factor Reduction on Erectile Dysfunction: A Systematic Review and Meta-Analysis

Study Questions:

What is the effect of lifestyle interventions and pharmacotherapy for cardiovascular (CV) risk factors on the severity of erectile dysfunction (ED)?


A comprehensive search of multiple electronic databases through August 2010 was conducted using predefined criteria. The authors included randomized controlled clinical trials with follow-up of at least 6 weeks of lifestyle modification intervention or pharmacotherapy for CV risk factor reduction. Studies were selected by two independent reviewers. The main outcome measure of the study was the weighted mean differences in the International Index of Erectile Dysfunction (IIEF-5) score with 95% confidence intervals (CIs) using a random-effects model.


A total of 740 participants from six clinical trials in four countries were identified. Lifestyle modifications and pharmacotherapy for CV risk factors were associated with statistically significant improvement in sexual function (IIEF-5 score): weighted mean difference, 2.66 (95% CI, 1.86-3.47). If the trials with statin intervention (n = 143) are excluded, the remaining four trials of lifestyle modification interventions (n = 597) demonstrate statistically significant improvement in sexual function: weighted mean difference, 2.40 (95% CI, 1.19-3.61).


The authors concluded that results of this study further strengthen the evidence that lifestyle modification and pharmacotherapy for CV risk factors are effective in improving sexual function in men with ED.


This systematic review and meta-analysis that included six clinical trials demonstrates the beneficial effect of lifestyle intervention along with CV risk factor reduction in ED, and further strengthens the evidence of improvement in maintenance of sexual function with these strategies. Men with ED may provide an opportunity to identify CV risk factors and initiate appropriate lifestyle changes. Lifestyle interventions focused on modifiable health behaviors appear to be a safe and effective strategy to improve ED and reduce CV risk factors.

Clinical Topics: Dyslipidemia, Heart Failure and Cardiomyopathies, Nonstatins, Novel Agents, Statins, Heart Failure and Cardiac Biomarkers

Keywords: Life Style, Erectile Dysfunction, Risk Reduction Behavior, Cardiology, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiovascular Diseases, Risk Factors, L-Selectin, Confidence Intervals, Databases, Factual

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