Exercise and Erectile Dysfunction: What Actually Works, and How Much

Last updated: August 27, 2026

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Every man with erectile dysfunction is told to exercise regularly, and almost none is told what that means. This page gives the numbers — and starts with something more important that the earlier version of this article did not mention at all.

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Why this is not really a sex problem

The arteries supplying the penis are narrow — considerably narrower than the coronary arteries. When arterial disease begins anywhere in the body, those small vessels are affected first, which is why erectile dysfunction frequently appears years before a heart attack or stroke, and why it is treated in this clinic as a warning sign rather than only as a sexual complaint.

The practical consequence: a man presenting with ED, particularly under about 60 or with diabetes, high blood pressure, raised cholesterol or a smoking history, should have his blood pressure, blood sugar and lipids checked. That is not padding the consultation — it is the most valuable thing that can come out of it.

Which also reframes what follows. Exercise is not only about erections; it is about the arteries that produce them.

What the evidence supports

From the pooled analysis of trials, the regimen associated with improvement is specific enough to be useful:

1. Moderate to vigorous aerobic exercise — running, brisk walking, jogging, cycling, swimming.
2. 40 minutes per session.
3. 4 times per week — 160 minutes in total. More, in the range of 200 to 300 minutes weekly, appears to do more.
4. For at least 6 months. The shortest training period showing benefit was around two months, so something may be noticeable by then — but the fuller effect takes half a year, and men who stop at six weeks because nothing has happened have stopped too early.

Two qualifications on the type. Weight training alone has not been shown to improve erectile function — it is worth doing for other reasons and should be added to aerobic work rather than replace it. And on cycling: it is on the list, but very long hours on a narrow saddle can compress the nerves and vessels of the perineum and contribute to the problem. A wider saddle, a proper fit and breaks on long rides deal with that; it is not a reason to stop cycling.

On pelvic floor exercises

The earlier version of this article said the literature firmly says no to any benefit from pelvic floor exercise. That is stronger than the evidence warrants and has been softened. Aerobic training is where the good evidence sits; pelvic floor muscle training has smaller and more mixed trial support for erectile function, and a clearer role in recovering continence and erectile function after prostate surgery. It is not the main answer, and it is not nothing.

A correction that matters: heart disease is not a reason to stop exercising

The earlier version of this article stated that everyone benefits from exercise except men with a history of invasively treated ischaemic heart disease, and captioned a photograph with the words that such a patient is not suitable to exercise.

That has been removed, because it inverts standard cardiac care. Supervised exercise after a stent or bypass — cardiac rehabilitation — is one of the best-established treatments in cardiology and reduces the risk of dying. Telling a man who has had a stent that exercise is unsuitable for him is the opposite of the advice his cardiologist gives, and it is the group with the most to gain.

Where that statement came from is a study exclusion. Trials of exercise for erectile dysfunction often exclude men with treated ischaemic heart disease, for good methodological reasons — their medication affects erections independently, and their exercise capacity is limited, both of which muddy the result. A criterion for keeping someone out of a study is not a reason to keep them off a treadmill.

What is true for this group is narrower and worth saying plainly: exercise should be started under cardiology guidance rather than independently, the intensity is set for the individual, and improvement in erections may be limited by the medication regardless of how much training is done.

The rest of what helps

• Stopping smoking, which damages exactly the vessels involved.
• Losing weight, which improves erections and raises testosterone.
• Reviewing your medicines. Several common drugs contribute to ED and there are often alternatives — worth asking rather than assuming.
• Treating sleep apnoea, if you snore heavily and wake unrefreshed.
• Reducing alcohol.

And exercise works alongside treatment rather than instead of it — the combination performs better than either alone. See the medical treatment options for ED.

Symptoms that need attention before starting

In an emergency in Thailand, call 1669.

• Chest pain, tightness or unusual breathlessness on exertion — get this assessed before beginning vigorous exercise, not after.
• Blackouts or palpitations during or after activity.
• Erectile dysfunction that came on abruptly in a younger man, or alongside pain and curvature — different problems needing different assessment.
• An erection lasting more than four hours, which needs treatment the same day.
• Never having been assessed for blood pressure, blood sugar and cholesterol despite having ED. That is the appointment to make.

Frequently Asked Questions About Exercise and Erectile Dysfunction

What type of exercise helps?

Moderate to vigorous aerobic exercise — running, brisk walking, jogging, cycling, swimming. Weight training alone has not been shown to improve erectile function and should be added to aerobic work rather than replace it. Pelvic floor training has smaller and more mixed evidence, with a clearer role after prostate surgery.

How much, and how long before I notice anything?

Forty minutes, four times a week — 160 minutes in total, with 200 to 300 minutes weekly doing more. Something may be noticeable by two months, with the fuller effect at around six. Stopping at six weeks because nothing has changed is stopping too early.

I have had a stent. Should I avoid exercise?

No — and an earlier version of this article wrongly said so. Supervised exercise after a stent or bypass is standard cardiac care and reduces mortality. What is true is that it should be started under cardiology guidance with the intensity set individually, and that cardiac medication may limit how much erections improve.

Can I use exercise instead of medication?

The two work better together than either alone. Exercise addresses the underlying vascular problem, which medication does not; medication produces results sooner, which exercise does not. Choosing between them is unnecessary.

Should ED make me worry about my heart?

It should make you check. The penile arteries are narrower than the coronary arteries and are affected earlier by the same disease, so ED often precedes a cardiac event by years. Blood pressure, blood sugar and cholesterol are worth measuring in any man presenting with erectile dysfunction — particularly under about 60 or with existing risk factors.

Arranging a consultation

Dr. Soarawee Weerasopone completed an andrology fellowship at Chang Gung Memorial Hospital Kaohsiung, Taiwan, and sees men’s health patients at Bangkok Hospital Headquarters and at Samitivej Sriracha Hospital in Chonburi on 088-022-1445. Bring a list of your medicines and any recent blood pressure, blood sugar or cholesterol results.

Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients — arrange it in advance by email to the Urology department at bhquro@bdms.co.th. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital, not by this website.

Disclaimer: This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters, and is intended for education only. It is not medical advice, diagnosis or a prescription for any individual, and no advice, diagnosis or prescription is given through personal messaging channels or social media. Dr. Soarawee operates no public social media account; any account offering private consultation in his name is fraudulent. In an emergency in Thailand, call 1669.