Exercise Improves Self-Reported Sexual Function Among Physically Active Adults

Background: Sexual dysfunction is common among adults and takes a toll on quality of life for both men and women. Aim: To determine whether higher levels of weekly cardiovascular exercise are protective against self-reported sexual dysfunction among men and women. Methods: We conducted an international online, cross-sectional survey of physically active men and women between April and December 2016, assessing exercise activity categorized into sextiles of weekly metabolic equivalent-hours. Odds ratios (ORs) of sexual dysfunction for each activity sextile compared with the lowest sextile were calculated using multivariable logistic regression, controlling for age, body mass index, diabetes mellitus, tobacco/alcohol use, sport, and marital status. Main Outcome Measures: Female sexual dysfunction was defined as a score <= 26.55 on the Female Sexual Function Inventory and erectile dysfunction (ED) was defined as a score <= 21 on the Sexual Health Inventory for Men. Results: 3,906 men and 2,264 women (median age 41-45 and 31-35 years, respectively) met the inclusion criteria for the study. Men in sextiles 2-6 had reduced odds of ED compared with the reference sextile in adjusted analysis (P-trend=. 03), with an OR of 0.77 (95% CI = 0.61-0.97) for sextile 4 and 0.78 (95% CI = 0.62-0.99) for sextile 6, both statistically significant. Women in higher sextiles had a reduced adjusted OR of female sexual dysfunction (P-trend =. 02), which was significant in sextile 4 (OR = 0.70; 95% CI = 0.51-0.96). A similar pattern held true for orgasm dissatisfaction (P-trend <.01) and arousal difficulty (P-trend <.01) among women, with sextiles 4-6 reaching statistical significance in both. Clinical Implications: Men and women at risk for sexual dysfunction regardless of physical activity level may benefit by exercising more rigorously. Strengths & Limitations: Strengths include using a large international sample of participants with a wide range of physical activity levels. Limitations include the cross-sectional design, and results should be interpreted in context of the study population of physically active adults. Conclusion: Higher cardiovascular exercise levels in physically active adults are inversely associated with ED by self-report in men and protective against female sexual dysfunction in women. Copyright (C) 2019, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.