J Clin Psychiatry. 2024 Jul 29;85(3):24f15480. doi: 10.4088/JCP.24f15480.
Erectile dysfunction (ED) refers to the difficulty in achieving and maintaining a degree of penile erection that suffices for satisfactory sexual activity. ED is multifactorial in origin; its prevalence therefore varies with the population studied. In the general population, ED is present in 18-52% of men in younger to older age groups and in 43-76% of men with different medical conditions. Phosphodiesterase-5 inhibitor drugs are gold standard treatments for ED. However, because many lifestyle disorders predispose to ED and because aerobic exercise is beneficial for these lifestyle disorders, aerobic exercise may be a possible intervention for ED. In this context, a recent systematic review and meta-analysis identified 11 randomized controlled trials (RCTs; pooled N = 1,147) of aerobic exercise vs nonexercising control conditions for the treatment of ED. These RCTs had been conducted in men with different medical and surgical conditions, commonly obesity, metabolic syndrome, diabetes mellitus, and cardiovascular disease. The exercise interventions were varied but mostly involved 30-60 minutes sessions of activity, 3-5 times a week, for a median duration of 6 months. Advice for diet and weight loss was also commonly provided. The meta analysis found that aerobic exercise was significantly superior to nonexercising control conditions, with greater improvement in erectile functioning observed in subjects with greater baseline impairment. Limitations of the findings were that subjects could not be blinded to the nature of the intervention and that the magnitude of benefit with exercise, although statistically significant, fell below thresholds suggested for clinical significance. Aerobic exercise might therefore be more useful for the primary prevention of ED, for which preliminary evidence already exists. Exercise can also be recommended, along with other lifestyle guidance, to improve sexual functioning in both men and women and to improve health across a range of domains.
勃起功能障碍（ED）是指在获得和维持足以进行满意的性活动的阴茎勃起程度方面存在困难。ED 的起源是多因素的；因此，其患病率因所研究的人群而异。在一般人群中，ED 在年轻到老年的男性中占 18-52%，在患有不同医学疾病的男性中占 43-76%。磷酸二酯酶-5 抑制剂药物是 ED 的金标准治疗方法。然而，由于许多生活方式障碍会导致 ED，并且有氧运动对这些生活方式障碍有益，因此有氧运动可能是 ED 的一种可能干预措施。在这种情况下，最近的一项系统评价和荟萃分析确定了 11 项随机对照试验（RCT；汇总 N = 1,147），比较了有氧运动与不运动对照组治疗 ED 的效果。这些 RCT 是在患有不同医学和手术条件的男性中进行的，常见的医学和手术条件有肥胖、代谢综合征、糖尿病和心血管疾病。运动干预措施各不相同，但大多涉及 30-60 分钟的活动，每周 3-5 次，中位数持续时间为 6 个月。还通常提供关于饮食和减肥的建议。荟萃分析发现，有氧运动明显优于不运动对照组，在基线损伤程度较大的受试者中观察到勃起功能的改善更大。研究结果的局限性在于，受试者无法对干预措施的性质进行盲法，并且运动带来的益处虽然具有统计学意义，但低于临床意义的建议阈值。因此，有氧运动可能更有助于 ED 的一级预防，因为已经有初步的证据表明这一点。运动可以与其他生活方式指导一起推荐，以改善男性和女性的性功能，并改善一系列领域的健康状况。
