Minimize ED risk

Erectile dysfunction (ED) is a complex and often misunderstood disorder, and here we explain the factors that increase your ED risk, and how to minimize it.

Doctors and experts define ED as the recurrent or persistent inability to achieve and/or sustain an erection for sexual intercourse and satisfactory activity. The prevalence rate of ED in the general population varies from 20-50%, depending on age.

ED is a significant cause of decreased quality of life for Australian men, with an estimated 1 million affected. Approximately 12% of men younger than 59 years have moderate-to-severe erectile dysfunction, and around 25% of men 60 years and older experience ED.

Lifestyle factors, such as weight and physical activity status are key issues for erectile function, with the prevalence of overweight or obese men having ED being about 75% (Grover, et al., 2006).

What causes ED?

To minimize your ED risk, you should know what causes this complex and misunderstood disorder.

Originally thought to be psychogenic, scientists now recognize ED as a multifactorial condition. More than 75% of cases are physical, with organic ED being associated with cardiovascular causes (veno-occlusive dysfunction and arterial insufficiency), neurological causes (compromised neural pathways, Alzheimer’s and Parkinson’s diseases), endocrine causes (diabetes and thyroid dysfunction), and androgen depletion resulting in low testosterone levels.

Many medications, such as anti-anxiety agents and anti-hypertensive drugs, can also cause ED (Walczak, Lokhandwala, Hodge, & Guay, 2002).

Lose weight and eat healthy

Researchers Dr. Esposito and colleagues (2004) maintain there is an association between a healthy lifestyle and being able to maintain an erection. Therefore to lower your ED risk, you should eat healthily and lose weight.

To evaluate the effect of weight loss and increased physical activity on erectile function in overweight and obese men, the researchers studied 110 obese men aged between 35 and 55 years. The participants didn’t have diabetes, high cholesterol, or high blood pressure, but had ED according to the International Index of Erectile Function (IIEF).

The study showed lifestyle alterations, such as a reduced-calorie diet and increased exercise, improved erectile function in overweight men. Approximately one-third of the men with ED regained sexual function afterwards.

In one controlled trial of obese men with ED, researchers (Grover et al., 2006) found the participants had abnormal penile endothelial function, indicating reduced responses to nitric oxide activity. Nitric oxide is a molecule linked to adequate filling of the corpus cavernosal tissue, a process necessary to maintain an erection.

Of the many men treated, those who lost weight reduced their erection difficulties. About 33% of participants regained sexual function two years after adopting a healthy lifestyle involving regular exercise.


Grover and associates (2006) surveyed 3,921 men aged between 40 and 88 years to identify independent factors associated with ED. The participants answered questions from the IIEF, achieving a low score that indicated erectile function problems. The researchers found the overall prevalence of ED was 50%, with diabetes and heart disease increasing ED risk. Future coronary risk and increasing fasting glucose levels were also independently associated with ED.

Heart disease risk factors such as high cholesterol, high blood pressure, obesity and cigarette smoking were also directly connected to developing ED. Doctors recommend men with ED exercise on a regular basis, as it also helps lower cholesterol and stablize blood pressure.

Heart disease and diabetes screening

If you have ED, you should ask your doctor to screen you for heart disease and diabetes. Dr. Montorsi and associates (2003) studied the predictive role of ED as a marker of coronary artery disease by evaluating patients who came to emergency departments with acute coronary syndromes. These researchers found the prevalence of ED was higher in patients with heart conditions.

As experts now consider ED a vascular disorder, it is important your doctor assess you for risk factors associated with atherosclerosis and other vascular disorders.


  • Esposito, K. et al. (2004). Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA, 291(24): 2978 – 2984. doi:10.1001/jama.291.24.2978.
  • Grover, S.A. et al. (2006). The prevalence of erectile dysfunction in the primary care setting: importance of risk factors for diabetes and vascular disease. Archives of Internal Medicine, 166(2): 213 – 219. doi:10.1001/archinte.166.2.213.
  • Montorsi, F. et al. (2003). Erectile dysfunction prevalence, time of onset, and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. European Urology, 44: 360–365
  • Walczak, M.K., Lokhandwala, N., Hodge, M.B., & Guay, A.T. (2002). Prevalence of cardiovascular risk factors in erectile dysfunction . Journal of Gender Specific Medicine, 5(6): 19 – 24.

Last reviewed 24/Feb/2017


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