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Cited by 137Sexual function and dysfunction studiesSexuality, Behavior, and TechnologyHealth and Lifestyle Studies

Health-Related Lifestyle Factors and Sexual Dysfunction: A Meta-Analysis of Population-Based Research

Allen, Mark S., Walter, Emma E.·2018·The Journal of Sexual Medicine
DOI 10.1016/j.jsxm.2018.02.008
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Abstract

Background: Sexual dysfunction is a common problem among men and women and is associated with negative individual functioning, relationship difficulties, and lower quality of life. Aim: To determine the magnitude of associations between 6 health-related lifestyle factors (cigarette smoking, alcohol intake, physical activity, diet, caffeine, and cannabis use) and 3 common sexual dysfunctions (erectile dysfunction, premature ejaculation, and female sexual dysfunction). Methods: A comprehensive literature search of 10 electronic databases identified 89 studies that met the inclusion criteria (452 effect sizes; N = 348,865). Pooled mean effects (for univariate, age-adjusted, and multivariable-adjusted estimates) were computed using inverse-variance weighted random-effects meta-analysis and moderation by study and population characteristics were tested using random-effects meta-regression. Results: Mean effect sizes from 92 separate meta-analyses provided evidence that health-related lifestyle factors are important for sexual dysfunction. Cigarette smoking (past and current), alcohol intake, and physical activity had dose-dependent associations with erectile dysfunction. Risk of erectile dysfunction increased with greater cigarette smoking and decreased with greater physical activity. Alcohol had a curvilinear association such that moderate intake was associated with a lower risk of erectile dysfunction. Participation in physical activity was associated with a lower risk of female sexual dysfunction. There was some evidence that a healthy diet was related to a lower risk of erectile dysfunction and female sexual dysfunction, and caffeine intake was unrelated to erectile dysfunction. Publication bias appeared minimal and findings were similar for clinical and non-clinical samples. Clinical Translation: Modification of lifestyle factors would appear to be a useful low-risk approach to decreasing the risk of erectile dysfunction and female sexual dysfunction. Strengths and Limitations: Strengths include the testing of age-adjusted and multivariable-adjusted models and tests of potential moderators using meta-regression. Limitations include low statistical power in models testing diet, caffeine, and cannabis use as risk factors. Conclusion: Results provide compelling evidence that cigarette smoking, alcohol, and physical activity are important for sexual dysfunction. Insufficient research was available to draw conclusions regarding risk factors for premature ejaculation or for cannabis use as a risk factor. These findings should be of interest to clinicians treating men and women with complaints relating to symptoms of sexual dysfunction.

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  • Cigarette smoking, high alcohol intake, and lack of physical activity all have deleterious effects on erectile function.

    “Cigarette smoking, high alcohol intake, and lack of physical activity all have deleterious effects on erectile function [58].”

    From Treatment of Functional Hypogonadism Besides Pharmacological Substitution (2020) · cites this paper as [58]

  • The effect of regular physical activity on erectile dysfunction was apparent in almost all individual studies scrutinized.

    “In addition, this effect was apparent in almost all the individual studies scrutinized [58].”

    From Treatment of Functional Hypogonadism Besides Pharmacological Substitution (2020) · cites this paper as [58]

  • A recent meta-analysis indicates that consistent aerobic endurance exercise is the most effective strategy for preventing erectile dysfunction, besides increasing testosterone levels.

    “In particular, a recent meta-analysis indicates that consistent aerobic endurance exercise is the most effective strategy for preventing ED [58], beside increasing T levels.”

    From Treatment of Functional Hypogonadism Besides Pharmacological Substitution (2020) · cites this paper as [58]

  • Regular physical activity reduced the odds ratio for erectile dysfunction by 50%.

    “However, the most impressive results were observed for regular physical activity, which reduced the odds ratio for ED by 50% [58].”

    From Treatment of Functional Hypogonadism Besides Pharmacological Substitution (2020) · cites this paper as [58]

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Authors
Allen, M. S., & Walter, E. E.
Affiliations
University of Wollongong (AU)
Corresponding author
Allen, Mark S.
ORCID
Venue
The Journal of Sexual Medicine
Publisher
Oxford University Press (OUP)
Published
2018-03-06
Volume
15
Issue
4
Pages
458-475
ISSN
  • 1743-6095 (ISSN-L)
  • 1743-6109
DOI
10.1016/j.jsxm.2018.02.008
OpenAlex
W2790969590
Cited by
137
References
62
Citations by year
2026: 9 · 2025: 18 · 2024: 17 · 2023: 15 · 2022: 18 · 2021: 28 · 2020: 14 · 2019: 13 · 2018: 3
FWCI
2.21
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The Journal of Sexual Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Research Online (University of Wollongong) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
  • Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
  • Health Sciences › Health Professions › General Health Professions › Health and Lifestyle Studies
Keywords
sexual dysfunction, erectile dysfunction, female sexual dysfunction, premature ejaculation, lifestyle factors, cigarette smoking, alcohol consumption, physical activity, diet, caffeine, cannabis use, risk factors, dose-response relationship
MeSH terms
Female, Humans, Life Style, Male, Risk Factors, Sexual Dysfunction, Physiological, Health Behavior

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