The association between cardiorespiratory endurance and erectile dysfunction severity in older men

Background Erectile dysfunction (ED) is prevalent among older men and negatively associated with lower physical fitness and cardiovascular health. While previous studies often rely on self-reported activity levels, this study uses objective measures of cardiorespiratory endurance (CRE), specifically peak oxygen uptake (VO₂peak), to investigate its relationship with ED severity.

Objective To assess the association between objectively measured CRE (VO₂peak) and ED severity in healthy men aged 55–75 years and evaluate the influence of age, BMI, and depressive symptoms as potential confounders.

Methods This cross-sectional analysis included 329 men from the AMCOHF*cohort. VO₂peak was measured via maximal cardiopulmonary exercise testing. ED severity was assessed with the IIEF-5 questionnaire. Correlation and multiple regression analyses were conducted, and group differences between men with and without ED were compared using t-tests.

Results ED prevalence was 18%. VO₂peak was positively correlated with IIEF-5 scores (ρ=0.36, p=.003), indicating that higher CRE was associated with lower ED severity. A 1.0 L/min increase in VO₂peak predicted a clinically meaningful 4.73-point increase in IIEF-5 scores. VO₂peak alone explained 13.2% of the variance in ED severity; this increased to 16% when adjusted for age, BMI, and depressive symptoms. Men with ED had significantly lower VO₂peak and were older than those without ED (both p<.05), while BMI and depressive symptoms showed no significant group differences.

Conclusion Cardiorespiratory endurance is a clinically relevant and modifiable predictor of erectile dysfunction severity. Given the association and clinical impact of VO₂peak, combinig endurance training with pelvic floor physiotherapy may enhance outcomes for older men with ED. These findings highlight the need for further longitudinal and interventional research to support the role of physiotherapy in sexual health.

Publikationsverlauf

Artikel online veröffentlicht:
23. Oktober 2025