title: The association of exercise with both erectile and sexual function in black and white men.
abstract: BACKGROUND
  There is growing interest in using exercise to treat. Although many studies have highlighted the relationship between better erectile function and exercise, black men have been underrepresented in the literature.
  
  
  OBJECTIVE
  This study aims to determine whether or not exercise is associated with better erectile as well as sexual function in black men and define a minimum exercise threshold for which better erectile/sexual function is seen in a cross-sectional study.
  
  
  METHODS
  Our study population consisted of 295 healthy controls from a case-control study assessing risk factors for prostate cancer conducted at the Durham Veterans Affairs Medical Center, which contained a substantial proportion of black men (n = 93; 32%). Exercise and erectile/sexual function were both determined from self-reported questionnaires. Subjects were stratified into four exercise groups: <3 (sedentary), 3-8.9 (mildly active), 9-17.9 (moderately active), and ≥18 (highly active) metabolic equivalents (MET) hours/week. The association between exercise and erectile/sexual function was addressed utilizing multivariable linear regression analyses.
  
  
  METHODS
  Erectile/sexual function was defined by the validated Expanded Prostate Cancer Index Composite sexual assessment, which was analyzed as a continuous variable (sexual function score). Clinically significant better function was defined as half a standard deviation (SD) (16.5 points).
  
  
  RESULTS
  Median sexual function score was 53 (SD = 33). Higher exercise was associated with a better sexual function score (P < 0.001). Importantly, there was no interaction between black race and exercise (P-interaction = 0.772), meaning more exercise was linked with better erectile/sexual function regardless of race. Overall, exercise ≥18 MET hours/week predicted better erectile/sexual function (P < 0.001) with a clinically significant 17.3-point higher function. Exercise at lower levels was not statistically (P > 0.147) or clinically (≤8.14 points higher function) associated with erectile/sexual function.
  
  
  CONCLUSIONS
  In a racially diverse population, exercise ≥18 MET hours/week is highly associated with better erectile/sexual function regardless of race.
authors: Duke Prostate Center, Division of Urology, Department of Surgery and Pathology, Duke University School of Medicine, Durham, NC, USA.|Urology Section, Veterans Affairs Medical Center, Durham, NC, USA.
authors: Ross M
authors: RM
authors: Simon
authors: Duke Prostate Center, Division of Urology, Department of Surgery and Pathology, Duke University School of Medicine, Durham, NC, USA.|Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
authors: Lauren
authors: L
authors: Howard
authors: Duke Prostate Center, Division of Urology, Department of Surgery and Pathology, Duke University School of Medicine, Durham, NC, USA.|Urology Section, Veterans Affairs Medical Center, Durham, NC, USA.
authors: Daniel
authors: D
authors: Zapata
authors: Duke Prostate Center, Division of Urology, Department of Surgery and Pathology, Duke University School of Medicine, Durham, NC, USA.|Urology Section, Veterans Affairs Medical Center, Durham, NC, USA.
authors: Jennifer
authors: J
authors: Frank
authors: Department of Surgery, Division of Urology and Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Stephen J
authors: SJ
authors: Freedland
authors: Department of Surgery, Division of Urology and Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Adriana C
authors: AC
authors: Vidal
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D005081:Exercise Therapy; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D011471:Prostatic Neoplasms / Q000453:epidemiology; D012044:Regression Analysis; D012307:Risk Factors; D057566:Self Report; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D044465:White People / Q000706:statistics & numerical data*
keywords: Erectile Dysfunction; Exercise; Exercise Therapy; Impotence; Penile Erection