Do sit ups help erectile dysfunction? Many men wonder whether abdominal exercises can improve erectile function. Whilst sit ups strengthen core muscles and support general fitness, there is no good evidence that they specifically improve erectile dysfunction. Erectile function depends primarily on adequate blood flow, neurological signalling, and pelvic floor muscle coordination—mechanisms not directly targeted by conventional abdominal exercises. However, targeted pelvic floor exercises and aerobic conditioning have demonstrated significant benefits for erectile dysfunction. Understanding which exercise approaches are evidence-based can help men make informed decisions about managing this common condition affecting up to 50% of UK men aged 40-70 years.

Understanding Erectile Dysfunction and Physical Exercise

Erectile dysfunction (ED) affects a significant proportion of men in the UK, with prevalence increasing with age—up to 50% of men aged 40-70 years experience some degree of erectile difficulties. The condition is characterised by the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Whilst many men seek quick solutions, understanding the underlying mechanisms is essential for effective management.

Physical exercise has emerged as an important non-pharmacological intervention for erectile dysfunction. The relationship between exercise and erectile function is multifaceted, involving improvements in cardiovascular health, endothelial function, hormonal balance, and psychological wellbeing. Regular physical activity enhances blood flow throughout the body, including to the penile arteries, which is fundamental to achieving erections. Additionally, exercise helps address common risk factors for ED, including obesity, diabetes, hypertension, and metabolic syndrome.

The mechanism by which exercise improves erectile function primarily involves the vascular system. Erections depend on adequate blood flow to the corpus cavernosum, the erectile tissue of the penis. Exercise promotes endothelial health by increasing nitric oxide production, a crucial vasodilator that facilitates penile blood flow. Furthermore, regular physical activity may reduce systemic inflammation and improve insulin sensitivity—factors that contribute to healthy erectile function. Some studies suggest modest improvements in testosterone levels with certain exercise regimens, though these effects vary between individuals.

However, not all forms of exercise provide equal benefits for erectile dysfunction. Whilst general cardiovascular fitness is beneficial, specific exercise modalities may offer more targeted improvements. It's also worth noting that ED can sometimes result from medication side effects (such as certain antihypertensives or antidepressants) or psychological factors, which may require additional management approaches.

Do Sit Ups Help Erectile Dysfunction?

Sit ups, or abdominal crunches, are primarily designed to strengthen the rectus abdominis and oblique muscles of the anterior abdominal wall. Whilst they contribute to core strength and general fitness, there is no good evidence that sit ups specifically improve erectile dysfunction. The muscles targeted by sit ups are not directly involved in the physiological mechanisms of achieving or maintaining an erection.

Erectile function relies predominantly on adequate blood flow, neurological signalling, and the coordinated relaxation and contraction of specific pelvic floor muscles. Conventional sit ups do not significantly engage the pelvic floor musculature, which plays a more direct role in erectile function. The bulbocavernosus and ischiocavernosus muscles, located in the pelvic floor, are responsible for maintaining penile rigidity and are not effectively trained through conventional abdominal exercises.

That said, sit ups may offer indirect benefits as part of a comprehensive exercise programme. Core strengthening exercises can improve overall fitness, enhance body confidence, and contribute to weight management—all factors that may positively influence sexual function. Obesity is a significant risk factor for erectile dysfunction, and exercises that contribute to weight loss and improved metabolic health can indirectly support erectile function.

For men seeking exercise-based interventions specifically for erectile dysfunction, the evidence suggests that targeted pelvic floor exercises and aerobic conditioning provide more direct benefits than sit ups alone. Whilst incorporating sit ups into a broader fitness routine is not harmful and may support general health, they should not be relied upon as a primary treatment for ED. Men experiencing erectile difficulties should consider evidence-based exercise approaches that directly address the vascular and muscular components of erectile function.

Pelvic Floor Exercises vs Sit Ups for Erectile Function

Pelvic floor exercises (also known as Kegel exercises) represent a more targeted approach to improving erectile dysfunction compared to sit ups. These exercises specifically strengthen the bulbocavernosus, ischiocavernosus, and other pelvic floor muscles that play a direct role in erectile rigidity and ejaculatory control. Research has demonstrated that pelvic floor muscle training can significantly improve erectile function, particularly in men with venous leakage or weak pelvic floor musculature.

The mechanism by which pelvic floor exercises improve erectile function differs fundamentally from abdominal exercises. During an erection, the ischiocavernosus muscles compress the base of the corpora cavernosa, restricting venous outflow and maintaining penile rigidity. Strengthening these muscles through targeted exercises enhances this compressive function, leading to firmer, more sustainable erections. A randomised controlled trial by Dorey et al. (BJU International) found that after six months of pelvic floor exercises, approximately 40% of men regained normal erectile function, with an additional 35% showing improvement.

To perform pelvic floor exercises correctly, men should:

• Identify the correct muscles by stopping urination midstream (though this should only be done to locate the muscles, not as a regular exercise)

• Contract these muscles for 5-10 seconds (slow holds), then relax for an equal duration

• Perform quick contractions by rapidly tightening and releasing the muscles 5-10 times

• Complete 10-15 repetitions of each type, three times daily

• Avoid tensing the abdominal, buttock, or thigh muscles during the exercise

In contrast, sit ups engage the superficial abdominal muscles and do not provide this targeted pelvic floor strengthening. Whilst core stability may support overall physical function, it does not directly address the specific muscular mechanisms involved in erectile rigidity. For men seeking exercise-based treatment for ED, pelvic floor exercises should be prioritised over sit ups, ideally under the guidance of a physiotherapist specialising in pelvic health.

Evidence-Based Exercise Approaches for Erectile Dysfunction

Aerobic exercise has the strongest evidence base for improving erectile dysfunction, with multiple systematic reviews demonstrating significant benefits. NICE Clinical Knowledge Summaries recommend lifestyle measures, including regular physical activity, as part of the management approach for all men with ED. The UK Chief Medical Officers' Physical Activity Guidelines recommend at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity weekly (or a combination of both), which has been shown to improve erectile function scores, particularly in men with cardiovascular risk factors.

The types of aerobic exercise most studied include:

• Brisk walking or jogging: 30-40 minutes, 4-5 times weekly

• Cycling: Benefits cardiovascular health, though proper saddle fit and position are important to avoid excessive perineal pressure; regular breaks from seated position are advised

• Swimming: Provides cardiovascular benefits without joint stress

• Rowing: Combines cardiovascular and resistance training elements

A meta-analysis published in the Journal of Sexual Medicine found that aerobic exercise improved International Index of Erectile Function (IIEF) scores by an average of 3-5 points, a clinically meaningful improvement. The benefits were most pronounced in men with baseline cardiovascular disease, obesity, or metabolic syndrome. Exercise intensity appears important, with moderate to vigorous activity showing greater benefits than light activity.

Resistance training also offers benefits, though the evidence is less robust than for aerobic exercise. Resistance exercises may improve body composition and insulin sensitivity—factors that influence erectile function. A balanced programme incorporating both aerobic and resistance training may provide optimal results.

Combination approaches appear most effective. A comprehensive programme might include:

• Aerobic exercise (150 minutes moderate or 75 minutes vigorous weekly)

• Pelvic floor muscle training (daily)

• Resistance training (2-3 sessions weekly)

• Flexibility and stress-reduction activities such as yoga

Men should begin gradually, particularly if previously sedentary, and consider consultation with a physiotherapist or exercise specialist. Those with cardiovascular disease should obtain medical clearance before commencing vigorous exercise programmes. The benefits of exercise for erectile dysfunction typically become apparent after 8-12 weeks of consistent activity.

When to Seek Medical Advice for Erectile Dysfunction

Whilst exercise represents an important self-management strategy, men should consult their GP if erectile difficulties persist for more than a few weeks or cause significant distress. Erectile dysfunction can be an early warning sign of cardiovascular disease, diabetes, or other serious health conditions. The NHS recommends medical evaluation for ED, as it may indicate underlying pathology requiring investigation and treatment.

Urgent medical attention is warranted if:

• Erectile dysfunction is accompanied by chest pain, shortness of breath, or other cardiovascular symptoms

• Priapism occurs (painful erection lasting more than 2 hours)

• There are acute neurological symptoms or recent pelvic/penile trauma

• Sudden complete loss of erectile function occurs, particularly in younger men

Routine GP consultation is appropriate for:

• Gradual onset erectile difficulties

• ED accompanied by urinary symptoms

• Penile curvature or deformity (Peyronie's disease)

• Loss of morning erections or reduced sexual desire

Your GP will typically conduct a comprehensive assessment including medical history, physical examination, and relevant investigations. Blood tests may include HbA1c/glucose, lipid profile, and blood pressure measurement. Morning testosterone may be checked if there are symptoms of testosterone deficiency (low libido, fatigue). NICE recommends cardiovascular risk assessment (QRISK3) for all men presenting with ED, as the condition shares risk factors with coronary artery disease.

Treatment options your GP may discuss include:

• Phosphodiesterase-5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil) – these should not be taken with nitrate medications (e.g., GTN spray/tablets) and require caution with certain other medicines

• Addressing underlying conditions (diabetes management, blood pressure control)

• Psychological or relationship counselling

• Referral to urology/andrology specialists or psychosexual therapy services for complex cases

It is important to note that exercise and lifestyle modifications can be used alongside medical treatments and often enhance their effectiveness. Men should not discontinue prescribed medications without medical advice. Additionally, avoid purchasing medications from unregulated online sources, as these may be counterfeit or unsafe. Only use GPhC-registered UK pharmacies. If you experience side effects from any medication, report them through the MHRA Yellow Card scheme. Early intervention typically leads to better outcomes, so men should not delay seeking help due to embarrassment—erectile dysfunction is a common medical condition that healthcare professionals are well-equipped to address.

Frequently Asked Questions