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Erections: Use It or Lose It?

What the research says about whether sex and masturbation help prevent erectile dysfunction.
By David Freeman
WebMD Feature
Reviewed by Laura J. Martin, MD

Men who have trouble getting erections have sex less often than men with normal sexual function, several studies have shown.

But can a long sexual dry spell actually cause erectile dysfunction (ED)? And can men cut their risk for ED by having sex (or masturbating) on a regular basis?

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What the Research Says

European scientists caused a stir in 2008 when they published results of a study -- believed to be the only one of its kind -- purporting to show that infrequent sex can lead to erectile dysfunction.

But many urologists remain skeptical.

The study, published in the July 2008 issue of the American Journal of Medicine, tracked 989 men in their 50s, 60s, and 70s for five years. It showed that men who reported having sexual intercourse less than once a week were twice as likely to develop ED. The less frequent the sex, the greater the risk for ED.

“The result indicated that regular sexual activity preserves potency in a similar fashion as physical exercise maintains functional capacity,” the scientists concluded.

The study didn’t address the question of whether masturbation helps preserve male sexual function. But it probably does help, says Juha Koskimaki, MD, PhD, a urologist at Tampere University Hospital in Tampere, Finland, and one of the authors of the study.

Both forms of sexual activity seem to protect nerve fibers and blood vessels responsible for erectile function and prevent scarring of the chambers inside the penis that fill with blood to form an erection, Koskimaki says.

Not So Fast

Other urologists tell WebMD that that while infrequent sex is clearly associated with ED, it’s unclear that it causes ED. And it’s premature to conclude that frequent sex or masturbation can help men stave off ED, they say.

“Having sex is good, masturbating is good, but the concept that men have to go out and have sex to preserve erectile function is bogus,” says Irwin Goldstein, MD, director of sexual medicine at Alvarado Hospital in San Diego. 

Ira D. Sharlip, MD, clinical professor of urology at the University of California at San Francisco School of Medicine and a spokesman for the American Urological Association, says that infrequent sex is more likely to be a consequence of ED than a cause.

Among men in the study, those who reported frequent sex might simply have had “good genes” that protected them from ED, whereas the men who developed ED might have had sex less frequently simply because they were having erection trouble, Sharlip tells WebMD in an email.

Erections to the Rescue

Erections seem to be the key, whether or not they're accompanied by sex.

Anecdotal reports and expert opinion in sexual medicine indicate that having erections -- with or without sex -- helps preserve male sexual function. And of course, there's no downside to having sex; it certainly won't hurt a man's chances of avoiding ED.

And with few exceptions, every man has several spontaneous erections each night while sleeping. So even in the absence of sexual activity, most men have a measure of built-in protection against erectile dysfunction, just by having erections at night.

The bottom line? Given the many benefits of sexual activity, and the possibility that the Finns are right about sex helping to prevent ED, urologists say there’s every reason to stay in the game.

Reviewed on April 13, 2010

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