Weight loss, quitting smoking, and controlling blood pressure and blood sugar can improve erectile function

Cost: There is no cost involved; in fact, it may even save money. The real challenge is staying consistent over time — eating healthily, exercising regularly, and quitting smoking.
In plain terms: Managing cardiovascular risk factors naturally leads to better erectile function. When multiple randomized trials are combined, questionnaire scores improve by an average of 2 to 3 points. This questionnaire has a maximum score of 25, with scores above 22 considered normal.
Benefit: One meta-analysis evaluated six randomized controlled trials involving 740 men. Interventions included lifestyle changes or medication to control cardiovascular risk factors, with follow-ups lasting at least six weeks. Overall, erectile function scores on the IIEF-5 questionnaire rose by an average of 2.66 points (95% CI: 1.86–3.47). When two trials using statins (143 participants) were excluded, the remaining four trials relying solely on lifestyle changes still showed an average improvement of 2.40 points (95% CI: 1.19–3.61). A total of 597 men participated in these four trials. The IIEF-5 consists of five questions scored from 5 to 25; scores between 22 and 25 indicate no erectile dysfunction, while scores of 5–7 indicate severe impairment.
Evidence grade: A
Sources:Gupta BP, Murad MH, Clifton MM, Prokop L, Nehra A, Kopecky SL (2011). The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis. Archives of Internal Medicine, 171(20), 1797-1803. https://doi.org/10.1001/archinternmed.2011.440；Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM (1999). Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. International Journal of Impotence Research, 11(6), 319-326. https://doi.org/10.1038/sj.ijir.3900472
Notes: These six trials used different interventions — some combined weight loss and exercise, while others used medication to control blood pressure and lipids. With only 740 participants overall, the results confirm a positive trend, though the exact degree of improvement varies per individual. The benefit is rated as “minor” because the outcome measured was solely questionnaire scores, not actual reductions in disease incidence. However, similar lifestyle changes have been shown to produce measurable health benefits elsewhere: quitting smoking (see Section 2, Item 1), maintaining a BMI between 20–25 through weight control (Section 2, Item 33), and managing blood pressure with medication when necessary (Section 7). Prescription medications are acceptable when prescribed by a doctor; caution is advised with over-the-counter “health supplements,” which may contain unregulated amounts of active ingredients. For guidance on identifying safe products, see Section 28, Item 4.