How Exercise Benefits All Aspects of Men's Sexual Wellness

Exercise can have direct and indirect effects on sexual and reproductive health. Here's a breakdown of what it might help with and how.

Erections

About 40 percent of men in their 40s and 70 percent of guys in their 70s have some degree of ED, according to Cleveland Clinic (defined as persistent, consistent difficulties achieving or maintaining an erection).

Age and various conditions, such as diabetes and atherosclerosis, or "clogged arteries," can contribute to the problem.

"Erection issues are most often a vascular issue," said Michael Werner, M.D., the medical director and founder of Maze Sexual & Reproductive Health based in New York City and Purchase, New York. "So I always tell people whatever is good for your heart is good for your penis."

Exercise is one good example of Werner's advice. Physical activity doesn't just get your blood pumping in the moment. Over time, regular exercise can strengthen the heart, improve blood flow, reduce the amount of fat and cholesterol in the blood, and lower the risk of chronic illness. Some research suggests it may even shrink existing atherosclerosis plaques.

One Harvard study of more than 31,000 participants ages 50 and older found physically active men were less likely to have ED than their inactive counterparts. Another study, from Duke University, reported similar findings.

Exercise can also help alleviate mental health issues, such as stress, anxiety and depression, which are the primary sources of ED in men under age 40.

Libido

Testosterone, the primary sex hormone in men, plays a part in various functions and processes, such as libido, fat distribution, muscle building, and the production of red blood cells and sperm.

Low testosterone can produce multiple issues, including depression, fatigue, increased fat storage, diminished fertility and low libido.

Because testosterone is converted to estrogen in adipose tissue (body fat), according to experts, people with obesity tend to have imbalanced hormones, including low testosterone. If exercise can help a person lose weight, their testosterone levels may increase, and their libido along with it.

Working out can also improve libido by stimulating the production of endorphins, or "happy hormones," that can boost mood and confidence, said Jagan Kansal, M.D., a Chicago-based urologist and the founder of Down There Urology.

"There's a direct and indirect way where exercise can dramatically increase libido from a psychological perspective all the way down to a hormonal perspective and blood flow," Kansal said.

Fertility

Heightened testosterone levels, which can result from exercise and weight loss, may boost sperm production and fertility. Physical activity may also improve conditions such as metabolic syndrome, hypertension and diabetes, all of which can affect erections and sperm count, Werner said.

"In general, healthier men have better semen analyses," Werner said.

A study published in the British Journal of Sports Medicine seems to confirm this. Researchers found men who engaged in moderate or vigorous exercise for at least 15 hours each week had higher sperm counts than those who were inactive.

Exercise can strengthen the pelvic floor muscles, Kansal said, which may enhance erections and increase ejaculation volume.

BPH symptoms

Benign prostatic hyperplasia (BPH) is a common condition that affects about 50 percent of men between ages 51 and 60; 70 percent of those ages 60 to 69; and 80 percent of those over 70, according to Yale Medicine.

Not everyone has symptoms, but those who do may experience frequent urination, incontinence and a weak stream. Those with severe BPH may also have low libido, difficulty maintaining erections and less pleasurable sex.

BPH treatment frequently involves medications, dietary changes and pelvic floor physical therapy, which can help to diminish urinary tract issues and improve sex.

Physical therapy isn't the only form of exercise that could alleviate BPH symptoms, however. A study published in the Journal of General Internal Medicine suggests physical activity of any kind may reduce urinary tract symptom risk and severity.

Prostate cancer

About 13 percent of men will develop prostate cancer in their lifetime, according to the Centers for Disease Control and Prevention (CDC). That's 1 in 8.

Although its causes are unknown, research suggests leading a healthy lifestyle—including exercising regularly and maintaining a healthy weight—may help to reduce the risk.

"We don't have a clear understanding of why prostate cancer develops or why exercise would affect that. But we do know the unhealthier you are, the more inflammation you can have in your body," Kansal said.

Fit people develop cancer, too, but reducing systemic inflammation may diminish the likelihood of developing high-risk types.

Exercise may also benefit men who already have prostate cancer.

"Recent research also supports physical exercise programs as an effective means of improving sexual function in men with prostate cancer," said Amy Pearlman, M.D., a men's health specialist and co-founder of Prime Institute in Fort Lauderdale, Florida.

Pearlman cited a 2022 systematic review published in the World Journal of Men's Health, which indicated physical activity programs improved factors such as libido and erectile function in men undergoing prostate cancer treatment.

The Physical Activity Guidelines for Americans recommends engaging in moderate-intensity physical activity—such as brisk walking—for at least 150 minutes per week, plus two days of muscle training.

Although you can have too much of a good thing, generally the more exercise you can get, the better.

That said, according to the CDC, anything you can do to move more and sit less may be beneficial.

"At the end of the day, something (when it comes to exercise) is always better than nothing when it comes to improving overall health and genital, sexual and hormonal health," Pearlman said.

The best types of exercise for sexual health depend on the specific issues being addressed, Pearlman and Kansal said, but experts typically recommend a varied routine for best results. This can include the following:

• Kegels. Pelvic floor exercises such as Kegels are usually the go-to for improving urinary tract symptoms, such as incontinence and pelvic pain. Pelvic floor relaxation exercises often alleviate pelvic pain and enhance sexual function and pleasure, Pearlman and Werner said.
• Cardio. "Cardiovascular exercise can improve heart health and increase blood flow throughout the body, including the genitals," Pearlman said. These exercises can also burn calories and promote weight loss.
• Strength training. Calisthenics, weightlifting and other forms of strength training can improve body composition. They can also help with weight loss and maintenance, especially when combined with cardio. Research suggests resistance or weight-bearing exercise and high-intensity workouts are best for increasing testosterone production.
• Yoga. "Yoga and other types of physical activity that promote mind-body connection can reduce stress and improve overall well-being, which can indirectly benefit sexual health as well as help optimize pelvic floor function," Pearlman said.

With fertility specifically, most people can expect to see some improvement after three months, or the average time it takes the body to produce new sperm, Kansal said.

"I tell guys anything that they decide to do—whether it's starting a medication or living a healthier lifestyle—usually we'll recheck a semen analysis about three to six months later to get a sense if it's making a difference," he said.

However, one person's experience can vary substantially from another's based on factors such as their previous and current activity levels, age and overall health.

"There is no magic answer when it comes to the specific type of exercise or amount of time to engage in exercise. Finding activities that are enjoyable to the person, that are performed consistently, and that help that person not only feel good but also look good, will invariably help optimize one's overall and sexual/hormonal/genital health over the lifespan," Pearlman said.