Self-Treatment for ED | Effects and Limits of Foods, Strength Training, and Lifestyle Improvements Explained by a Doctor

ED (Erectile Dysfunction) refers to a persistent state in which a man cannot obtain or maintain an erection sufficient for satisfactory sexual intercourse. It includes not only the case of “no erection at all” but also “insufficient hardness” and “losing the erection mid-intercourse (mid-intercourse softening).”

The causes of ED can be broadly classified into 3 categories. Whether self-treatment is possible greatly depends on the type of cause.

According to Japanese epidemiological studies, the prevalence of ED is approximately 20% in those in their 40s, approximately 40% in those in their 50s, and approximately 60% in those in their 60s (Japanese Society for Sexual Medicine). However, in recent years, juvenile ED in those in their 20s and 30s has also been on the rise, with cases caused by psychogenic factors and pornography dependence becoming increasingly noticeable.

Exercise is the method with the most evidence for self-improvement of ED. A 2018 meta-analysis (Gerbild et al., Sexual Medicine) reported that moderate aerobic exercise of more than 150 minutes per week showed a significant effect on ED improvement.

There are multiple mechanisms by which exercise works for ED.

• Improvement of vascular endothelial function: Exercise promotes the production of nitric oxide (NO) and improves vasodilatory capacity
• Increase in testosterone: In particular, resistance training (strength training) promotes testosterone secretion
• Reduction of body fat percentage: Obesity causes excess estrogen and decreased testosterone, increasing ED risk
• Improvement of mental health: Endorphin release from exercise reduces stress and anxiety

“Foods that work for ED” is a topic many people search for, but just eating specific foods does not cure ED. However, by improving the overall diet, vascular function and hormonal balance can be regulated, which may lead to ED improvement.

In particular, the Mediterranean diet has been shown in multiple studies to be associated with ED improvement.

Smoking is one of the largest risk factors for ED. Nicotine and carbon monoxide contained in tobacco damage vascular endothelium and accelerate atherosclerosis of the penile arteries.

• The ED risk for smokers is approximately twice that of non-smokers (meta-analysis: Cao et al., 2013)
• ED improvement after smoking cessation: Vascular endothelial function begins to recover within several months to a year after smoking cessation, and improvement in erectile function has been reported
• Heated tobacco products and e-cigarettes: The risk may be lower than conventional tobacco, but products containing nicotine still have vasoconstrictive effects, and complete smoking cessation is ideal for ED improvement

Regarding alcohol, small amounts (1-2 drinks per day) have no negative effect on ED due to vasodilatory and relaxation effects, but excessive drinking suppresses the central nervous system and reduces erectile function. Chronic heavy drinking also negatively affects testosterone metabolism via liver dysfunction.

In particular, in juvenile ED in those in their 20s and 30s, psychogenic factors account for a large proportion. Stress management and sufficient sleep are the basics of psychogenic ED improvement.

• Performance anxiety: The pressure of “can I do it well” makes the sympathetic nervous system dominant, creating a vicious cycle that hinders erection
• Stress from work and relationships: Chronic stress raises cortisol and lowers testosterone
• Lack of sleep: Approximately 70% of testosterone is secreted during sleep. There are reports that men who sleep less than 5 hours have testosterone levels 10-15% lower

Specific countermeasures that are effective include the following.

• Ensure 7-8 hours of quality sleep
• Mindfulness meditation: 10 minutes of meditation per day is effective for reducing anxiety
• Open communication with partner
• Limiting pornography viewing: Excessive pornography dependence may dull sexual responses with actual partners

Many people try supplements and virility products because they “do not want to rely on medication.” However, there is limited evidence that over-the-counter supplements and virility products have the same effect as ED medications.

The biggest risk is overseas-made “powerful virility products.” Surveys by the Ministry of Health, Labour and Welfare have reported cases in which some overseas-made virility-enhancing supplements purchased online illegally contained unapproved pharmaceutical ingredients (sildenafil or tadalafil-like substances). These products carry a risk of health damage and should never be used.

Lifestyle improvements are important as a foundation for ED measures, but relying solely on self-treatment also carries risks.

• It takes time for effects to appear: The effects of lifestyle improvements often take several weeks to several months, with no immediate effect
• Insufficient for moderate to severe ED: In the case of organic ED, lifestyle improvements alone often cannot achieve sufficient improvement
• Possibility that ED is a sign of serious disease: ED can appear as an early symptom of atherosclerosis and may be a precursor to cardiovascular disease or diabetes
• Worsening from neglect: Leaving ED untreated tends to fall into a vicious cycle of accumulated failure experiences leading to coexisting psychogenic ED and further worsening

We strongly recommend seeing a medical institution early in the following cases.

• ED symptoms have continued for more than 3 months
• Morning erections (nocturnal penile tumescence) have disappeared
• You have a chronic illness such as diabetes, hypertension, or dyslipidemia
• Accompanied by depressive symptoms or strong anxiety
• It is affecting your relationship with your partner

While trying self-improvement for ED, combining the use of PDE5 inhibitors (ED medications) can lead to more reliable and earlier improvement.

The 3 ED medications approved in Japan:

The most effective approach is to combine ED medications with self-improvement. Supporting erectile function with medication while improving lifestyle and gradually reducing the dosage of medication – this is the basic strategy of modern ED treatment.

At Mens Care Clinic, we prescribe all 3 types of ED medications: Viagra, Levitra, and Cialis.

• Initial consultation and follow-up: Free
• Online consultation available: Can be received from anywhere nationwide
• Same-day shipping at the earliest: Prescription immediately after consultation
• Privacy considerations: Shipping without product name listed
• Lifestyle advice: Our medical team provides comprehensive ED improvement support including diet and exercise

If you have tried self-improvement but have not seen results, or want to improve quickly and reliably, please feel free to consult us via online consultation.