Physical Activity and PDE5 Inhibitors in the Treatment of Erectile Dysfunction: Results of a Randomized Controlled Study


Giuseppe Maio, MD, Abano Terme Private Hospital, Operative Unit of Andrology, via Montegrande 28, Abano Terme 35031, Italy. Tel: (39) 348-2614920; Fax: (39) 049-667441; E-mail:


Introduction.  Physical activity (PhA) has proven to be a protective factor for normal erectile function in numerous epidemiological studies.

Aim.  The aim of this study was to establish if PhA could have a therapeutic role in the treatment of erectile dysfunction (ED).

Methods.  This was a randomized, open-label study. A total of 60 patients complaining of ED were studied. Patients were assessed at baseline and after 3 months of study treatment. At baseline, patients were randomized to receive phosphodiesterase type 5 inhibitor (PDE5i) alone (group A) or PDE5i plus regular (≥3 hours/week), aerobic, non-agonistic PhA (group B).

Main Outcome Measures.  All subjects completed the International Index of Erectile Function (IIEF-15) questionnaire and performed total testosterone (TT).

Results.  Mean PhA was 3.4 hours/week in group B vs. 0.43 in group A; mean energy expenditure in group B was 1,868 kcal/ week or 22.8 metabolic equivalent (MET)/week. IIEF restoration of ED occurred in 77.8% (intervention group) vs. 39.3% (control) (P < 0.004). The IIEF-15 score resulted in statistical improvement in intervention group in all the domains but one (orgasm): erectile function 24.7 vs. 26.8 (P = 0.003); confidence (Q15) 3.53 vs. 4.07 (P = 0.006); sexual desire 6.46 vs. 7.18 (P = 0.028); intercourse satisfaction 9.85 vs. 11.25 (P = 0.001); total satisfaction 7.17 vs. 8.07 (P = 0.009); total score 56.2 vs. 61.07 (P = 0.007). TT was statistically similar in the two groups; separate analysis in each group showed statistical increase in group B 4.24 vs. 4.55 (P = 0.012). At multivariate logistic regression analysis, PhA was the only independent variable for normal erection (P = 0.010) (95% confidence interval [CI] 0.036–0.643), higher sexual satisfaction (P = 0.022) (95% CI 0.084–0.821) and normal total IIEF-15 score (P = 0.023) (95% CI 0.85–0.837).

Conclusion.  In this randomized controlled pilot study, PDE5i plus PhA was more effective than PDE5i alone in the treatment of ED. Maio G, Saraeb S, and Marchiori A. Physical activity and PDE5 inhibitors in the treatment of erectile dysfunction: Results of a randomized controlled study. J Sex Med 2010;7:2201–2208.