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Erectile dysfunction and lifestyle

Clinical bottom line

The only modifiable risk factor for erectile dysfunction is having a BMI over 30.


R Shiri et al. Effect of life-style factors on incidence of erectile dysfunction. International Journal of Impotence Research 2004 16: 389-394.


Erectile dysfunction is common, affecting a significant proportion of older men, and it increases with older age. There is little known about lifestyle factors and erectile dysfunction, although losing weight helps about a quarter of younger men with a mean weight of 100 kg or more.


The population for this study was 3,152 men born in 1924, 1934, or 1944 living ain Tampere, Finland, in 1994. They were asked a series of questions in 1994, and five years later, by means of a mailed questionnaire, which had questions about erectile function. Erectile dysfunction had predetermined criteria, basically the inability to achieve or maintain an erection sufficient for satisfactory sexual function. Incidence was calculated by dividing the number of new cases between surveys by the number of person years of follow up.


There were 1130 men free of erectile dysfunction in 1994, half 50 years old, 37% 60 years old, and 13% 70 years old. Most were married or living with a partner. A fifth were current smokers, and 17% had a body mass index of 30 or more.

The incidence of erectile dysfunction increased with age, and doubled for each decade (Figure 1). Erectile dysfunction was not related to marital status, smoking alcohol, or coffee intake, but was related to being overweight with a BMI of above 30 (Figure 2).

Figure 1: Annual incidence of erectile dysfunction according to age

Figure 2: Annual incidence of erectile dysfunction according to BMI


Age is something we can do nothing about. Not getting overweight is controllable, ands this observational study is in accord with a randomised trial showing that losing weight improves erectile function.

There is relatively little known about risk factors for erectile dysfunction. One other study from Boston [1], which as well as finding that obesity was a risk factor, confirming the results from Finland, also found that sedentary behavious was also a risk factor.