einstein (São Paulo). 24/jun/2026;24:eAO1905.

Association between self-initiated changes in physical activity patterns and erectile dysfunction: a longitudinal follow-up study

Rafael Mathias

Pitta

, Oskar Grau

Kaufmann

, Eduardo Rossato de

Victo

, Gabriel Grizzo

Cucato

, Raphael Mendes

Ritti-Dias

, Luana de Lima

Queiroga

, Nelson

Wolosker

DOI: 10.31744/einstein_journal/2026AO1905

Highlights

■ Becoming physically active was associated with low odds  of erectile dysfunction.
■ Remaining physically active was associated with low odds  of erectile dysfunction.

ABSTRACT

Objective:

The effect of self-initiated changes in physical activity patterns over time on erectile dysfunction remains unclear. We aimed to analyze the relationship between self-initiated changes in physical activity over time and erectile dysfunction in a large sample of men.

Methods:

This study included 925 adults and older men with erectile dysfunction who underwent routine health screening. Erectile dysfunction was determined using the 5-item version of the International Index of Erectile Function questionnaire, with a score of <21 indicating the condition. The participant’s physical activity levels, body mass index, blood pressure, blood samples, alcohol consumption, tobacco use, perceived stress, depressive symptoms, and lower urinary tract symptoms were measured at baseline and follow-up (531,9±149,7 days). The participants were grouped into four categories based on their physical activity levels at baseline and follow-up: i) persistently physically inactive, ii) became physically inactive, iii) became physically active, and iv) persistently physically active.

Results:

Hierarchical regression analysis revealed that individuals who became physically active and those who remained physically active were independently associated with decreased odds of erectile dysfunction (odds ratio [OR], 0.656; 95%CI=0.432-0.980 and OR=0.717; 95%CI=0.508 0.992, respectively).

Conclusion:

Self-initiated changes in physical activity patterns were longitudinally associated with erectile dysfunction in adults and older individuals. These data suggest that initiating and maintaining physical activity can reduce the risk of erectile dysfunction.

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