title: The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis.
abstract: BACKGROUND
  Erectile dysfunction (ED) shares similar modifiable risks factors with coronary artery disease (CAD). Lifestyle modification that targets CAD risk factors may also lead to improvement in ED. We conducted a systematic review and meta-analysis of randomized controlled trials evaluating the effect of lifestyle interventions and pharmacotherapy for cardiovascular (CV) risk factors on the severity of ED.
  
  
  METHODS
  A comprehensive search of multiple electronic databases through August 2010 was conducted using predefined criteria. We included randomized controlled clinical trials with follow-up of at least 6 weeks of lifestyle modification intervention or pharmacotherapy for CV risk factor reduction. Studies were selected by 2 independent reviewers. The main outcome measure of the study is the weighted mean differences in the International Index of Erectile Dysfunction (IIEF-5) score with 95% confidence intervals (CIs) using a random effects model.
  
  
  RESULTS
  A total of 740 participants from 6 clinical trials in 4 countries were identified. Lifestyle modifications and pharmacotherapy for CV risk factors were associated with statistically significant improvement in sexual function (IIEF-5 score): weighted mean difference, 2.66 (95% CI, 1.86-3.47). If the trials with statin intervention (n = 143) are excluded, the remaining 4 trials of lifestyle modification interventions (n = 597) demonstrate statistically significant improvement in sexual function: weighted mean difference, 2.40 (95% CI, 1.19-3.61).
  
  
  CONCLUSIONS
  The results of our study further strengthen the evidence that lifestyle modification and pharmacotherapy for CV risk factors are effective in improving sexual function in men with ED.
authors.affiliation: Division of Cardiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. gupta.bhanu@mayo.edu
authors.forename: Bhanu P
authors.initials: BP
authors.lastname: Gupta
authors.forename: M Hassan
authors.initials: MH
authors.lastname: Murad
authors.forename: Marisa M
authors.initials: MM
authors.lastname: Clifton
authors.forename: Larry
authors.initials: L
authors.lastname: Prokop
authors.forename: Ajay
authors.initials: A
authors.lastname: Nehra
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Kopecky
mesh_terms: D001294:Attitude to Health; D001521:Behavior Therapy; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000150:complications / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D016208:Databases, Factual; D007172:Erectile Dysfunction / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D014943:Global Health; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D040242:Risk Reduction Behavior
chemical_list: D002317:Cardiovascular Agents; D058986:Phosphodiesterase 5 Inhibitors