Do squats help with erectile dysfunction? Whilst squats offer general fitness benefits, there is no established evidence linking them directly to improved erectile function. Erectile dysfunction (ED) affects millions of UK men and often relates to cardiovascular health and blood flow. Regular physical activity, including resistance exercises like squats, contributes to overall cardiovascular fitness, weight management, and metabolic health—all factors that may indirectly support erectile function. However, squats should be viewed as one component of a broader lifestyle approach rather than a standalone treatment. Dedicated pelvic floor exercises have stronger evidence for improving ED, and medical assessment remains essential for persistent symptoms.

Understanding Erectile Dysfunction and Physical Exercise

Erectile dysfunction (ED) is the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity. It is a common condition that affects millions of men in the UK, with prevalence increasing with age. While ED can result from psychological factors, many cases have an underlying physical cause or mixed aetiology, particularly involving vascular health and blood flow to the penis.

The relationship between physical exercise and erectile function is increasingly recognised in clinical practice. Regular physical activity improves cardiovascular health, enhances endothelial function (the lining of blood vessels), and promotes healthy blood flow throughout the body—including to the erectile tissues. Exercise also helps regulate hormones, reduces inflammation, and improves psychological wellbeing, all of which contribute to sexual health.

Squats, as a compound resistance exercise, engage large muscle groups including the quadriceps, gluteals, hamstrings, and core musculature. Whilst no exercise specifically targets erectile function, squats may contribute to overall physical fitness. It's important to note that while squats engage the lower body, they should not be confused with dedicated pelvic floor exercises, which have stronger evidence for improving erectile function. The pelvic floor muscles play a crucial role in erectile rigidity and ejaculatory control.

It is important to understand that whilst exercise forms part of a comprehensive approach to managing ED, there is no established evidence linking squats alone as a treatment for erectile dysfunction. Rather, they should be considered as one component of a broader lifestyle modification strategy, alongside other evidence-based interventions recommended by NICE and supported by cardiovascular health principles.

How Squats May Improve Erectile Function

The potential benefits of squats for erectile function relate primarily to their effects on overall physical fitness, cardiovascular health, and body composition. Cardiovascular improvements are particularly relevant, as ED and cardiovascular disease share common risk factors and pathophysiology. Squats, when performed as part of a resistance training programme, can contribute to cardiovascular fitness—though it's worth noting that aerobic exercise has the strongest evidence base for improving erectile function.

Resistance exercises like squats may also influence testosterone levels. Testosterone plays a vital role in libido and erectile function, and compound movements that recruit large muscle groups have been associated with acute, transient increases in circulating testosterone. However, the clinical significance of these exercise-induced hormonal changes in men with normal baseline levels remains uncertain, and resistance training should not be viewed as a replacement for medical assessment of hypogonadism.

Regarding pelvic floor engagement, while proper squat technique requires core stabilisation, squats are not a substitute for targeted pelvic floor muscle training. Dedicated pelvic floor exercises specifically target the bulbocavernosus and ischiocavernosus muscles, which are essential for maintaining erectile rigidity by compressing veins and trapping blood within the corpora cavernosa.

Additionally, regular exercise including squats contributes to weight management and reduces visceral adiposity. Obesity is strongly associated with ED through multiple mechanisms including endothelial dysfunction, reduced testosterone, and increased inflammatory markers. By supporting healthy body composition, squats form part of a strategy to address modifiable risk factors for erectile dysfunction.

The UK Chief Medical Officers' Physical Activity Guidelines recommend both aerobic and muscle-strengthening activities for overall health, which may indirectly benefit erectile function through improved cardiovascular and metabolic health.

Evidence for Exercise-Based Approaches to Erectile Dysfunction

Clinical evidence supports the role of physical activity in managing erectile dysfunction, though research specifically examining squats is limited. A systematic review and meta-analysis published in the British Journal of Sports Medicine found that aerobic exercise of moderate to vigorous intensity significantly improved erectile function, particularly in men with ED related to cardiovascular disease, obesity, or sedentary lifestyle.

NICE Clinical Knowledge Summary on erectile dysfunction recommends discussing lifestyle factors including physical activity as part of initial management. The guidance emphasises that regular physical exercise can improve erectile function and should be encouraged, particularly in men with cardiovascular risk factors. Whilst specific exercise modalities are not prescribed, the principle of increasing overall physical activity is well-established.

Pelvic floor muscle training has the strongest evidence base for exercise-based ED management. A randomised controlled trial by Dorey et al. published in BJU International demonstrated that pelvic floor exercises were superior to lifestyle advice alone, with significant improvements in erectile function after three months. These exercises specifically target the muscles involved in erectile rigidity, unlike squats which provide more generalised benefits.

Resistance training, including exercises like squats, has been less extensively studied than aerobic exercise in the context of ED. However, research indicates that combined aerobic and resistance training programmes produce beneficial effects on endothelial function, body composition, and metabolic health—all relevant to erectile function. The UK Chief Medical Officers recommend muscle-strengthening activities on at least two days a week as part of a comprehensive exercise programme.

It is important to note that whilst exercise shows promise, there is no direct evidence establishing squats as a standalone treatment for ED. Exercise should be viewed as an adjunct to, not a replacement for, medical assessment and evidence-based treatments such as phosphodiesterase-5 inhibitors when clinically appropriate.

Other Lifestyle Changes That Support Erectile Health

Beyond exercise, multiple lifestyle modifications can improve erectile function and should be considered as part of a holistic approach to sexual health. Dietary changes play a significant role, with evidence supporting Mediterranean-style diets rich in fruits, vegetables, whole grains, legumes, nuts, and olive oil. This dietary pattern improves endothelial function and reduces cardiovascular risk, thereby supporting erectile health. Conversely, diets high in processed foods, saturated fats, and refined sugars are associated with increased ED risk.

Smoking cessation is crucial, as tobacco use damages blood vessels and impairs nitric oxide production—essential for penile vasodilation. Men who smoke have a significantly higher risk of developing ED compared to non-smokers, and stopping smoking can lead to improvements in erectile function, particularly in younger men without established vascular disease. The NHS offers support services to help with smoking cessation.

Alcohol moderation is advisable, as excessive consumption can impair erectile function both acutely and chronically. The NHS recommends limiting alcohol intake to no more than 14 units per week, spread over three or more days. Chronic heavy drinking can cause hormonal changes, liver damage, and neuropathy, all of which may contribute to ED.

Weight management through caloric balance and regular physical activity addresses a major modifiable risk factor. Research shows that men who lose significant body weight through lifestyle intervention experience improvements in erectile function scores. Weight loss improves endothelial function, reduces inflammation, and can increase testosterone levels in obese men.

Stress reduction and sleep hygiene should not be overlooked. Chronic stress elevates cortisol and can suppress testosterone production, whilst poor sleep quality is associated with reduced sexual function. Techniques such as mindfulness, cognitive behavioural approaches, and ensuring adequate sleep duration (7-9 hours) support overall sexual health and wellbeing.

When to Seek Medical Advice for Erectile Dysfunction

Men experiencing persistent erectile difficulties should seek medical advice rather than relying solely on lifestyle modifications. ED can be an early warning sign of cardiovascular disease, as the penile arteries are smaller than coronary arteries and may show dysfunction earlier. NICE guidance recommends cardiovascular risk assessment for all men presenting with ED, as it may precede myocardial infarction or stroke by several years.

You should contact your GP if:

• Erectile difficulties persist for more than a few weeks

• ED is causing significant distress or affecting your relationship

• You experience other symptoms such as reduced libido, fatigue, or mood changes (which may indicate hormonal issues)

• You have cardiovascular risk factors including hypertension, diabetes, high cholesterol, or a family history of heart disease

• ED developed following new medication (never stop prescribed medication without medical advice)

• You notice penile deformity or curvature (which may indicate Peyronie's disease)

Urgent medical attention is required if you experience chest pain, breathlessness, or other cardiac symptoms in association with sexual activity, or if you develop a painful erection lasting more than 4 hours (priapism)—a rare but serious condition requiring emergency treatment.

Your GP will conduct a thorough assessment including medical history, physical examination, and relevant investigations such as blood pressure, BMI measurement, cardiovascular risk assessment (QRISK), blood tests to check glucose, lipids, morning testosterone, and thyroid function if indicated. They can discuss evidence-based treatments including phosphodiesterase-5 (PDE5) inhibitors such as sildenafil, which are effective for most men and commonly prescribed in primary care. Sildenafil 50mg is also available over-the-counter as Viagra Connect following pharmacist assessment. PDE5 inhibitors must not be used with nitrate medications or riociguat due to dangerous blood pressure drops, and caution is needed with alpha-blockers.

Psychological factors should also be addressed. If anxiety, depression, or relationship difficulties contribute to ED, your GP can arrange appropriate support including counselling or psychosexual therapy. Many cases of ED have mixed physical and psychological components, and a comprehensive approach addressing both aspects typically yields the best outcomes. Remember that ED is a common medical condition, and healthcare professionals are experienced in providing sensitive, confidential support.

If you experience side effects from any medication, report them through the MHRA Yellow Card scheme.

Frequently Asked Questions