Lifestyle management in ED with concomitant risk factors

Lifestyle management in ED with concomitant risk factors

The basic work-up must identify reversible risk factors for ED. Lifestyle changes and risk factor modification
must precede or accompany ED treatment. These guidelines include lifestyle modification (e.g. weight loss,
exercise) for ED, but also address psychosocial issues, adverse side-effects of prescription or non-prescription
drugs and the presence of hypogonadism as a modifiable aetiology or comorbidity of ED. 
The potential benefits of lifestyle changes may be of special relevance in individuals with ED and
specific comorbid cardiovascular or metabolic diseases, such as diabetes or hypertension (9,29,30). For these
men, the positive consequences of aggressive lifestyle changes may be of special benefit not only for
improving erectile function, but also for improving overall cardiovascular and metabolic health. Recent studies
support the potential value of lifestyle intervention, for both ED and overall health benefits (10).
Clearly, further studies are needed to expand and clarify the role of lifestyle changes in the manage-
ment of ED and related cardiovascular disease (CVD). Lifestyle changes may be recommended independently
or in combination with PDE5 therapy. Some studies have suggested that the therapeutic effects of PDE5
inhibitors may be enhanced if other co-morbidities or risk factors are aggressively managed (31). Although
suggestive, these results have yet to be confirmed in well-controlled, long-term studies. Given the success of
pharmacological therapy for ED, clinicians in the future will need to provide specific evidence for the potential
benefits of lifestyle change. Hopefully, further evidence for these benefits will become available in the future.