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also like to thank Professor Jessica Smith for her knowledge

and insight during the preparation of our study.

Touro University - California College of Health Sciences

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Numerous studies have shown that physical activity is a protective factor for development of erectile dysfunction (ED).  Additionally, a recent intervention study demonstrated that improving physical activity significantly reduced the prevalence of ED.  However, yoga specifically has not been explored as an alternate treatment of ED. Recent community studies have shown yoga is effective in improving the physical fitness of older adults.  Given yoga’s multiple health benefits through increased physical activity and stress reduction there is justification to explore the effects of yoga on ED.  Therefore, the objective of this study is to determine whether the regular practice of yoga in a community setting is an effective intervention for older men with ED.

Yoga for Erectile Dysfunction in Aging MenJustin Davis, Nhi Duong, Erin Littmann, Mickey Lui, and Sarah Zitsman

Touro University Epidemiology Class- Spring 2010, Vallejo, California

At the beginning of the study all subject were between the ages of 55-70 and diagnosed with erectile dysfunction based on the IIEF score obtained during the pre-screening process (Table 1). At the conclusion of the study, the IIEF scores showed statistically significant improvement from a mean of 14.16 to 18.58 (p< .001) amongst case subjects (Graph 1). The incidence of reversal of erectile dysfunction amongst this group was 34% (p< .001) (Graph 2). Slight improvement was seen in the control group, though was not statistically significant (p= .3) (Graph 3). Overall there was not significant weight loss seen in either the case group or the control group. Those who smoked at the start of the study continued to smoke throughout, and after the study. Erectile dysfunction can be the result of hypertension; the authors of this study evaluated the results of yoga and pre-hypertension.  At the completion of the study there was an improvement in the case group, albeit not statistically significant, with a decrease from 42% to 30% of the subjects having pre-hypertension (p= .09) (Graph 2).  In the control group there was not a statistically relevant decrease from 44% to 40% (p= .57) (Graph 3). 

This study demonstrated that yoga via community intervention can effectively reduce the ED prevalence among older men, ages 55-70. The results may suggest that yoga has a place in helping older communities improve and maintain their sexual vitality during their 'golden years.'

Initial results after six months utilizing 100 male participants from two senior community centers in separate cites within the San Francisco Bay Area of similar ethnicity, race, marital status, and age, show promise that yoga is an effective treatment for ED, based on IIEF scores. This study individually determined that yoga therapy over a period of six months is effective in reducing ED. A reversal of ED in 34% of the case participants at Center A (p< .001) was observed. In contrast, the control Center B showed no statistically significant reversal in ED amongst participants.

As all other risk factors tracked (pre-hypertension, weight, obesity, and smoking status) remained virtually unchanged when compared between study start and end points, it can be inferred that yoga has an independent effect on reducing ED. It is not presently possible to determine if yoga would confer a greater change in ED reduction combined with smoking cessation, weight reduction, or decreased hypertension. It is also unknown whether a customized exercise system could be found to reduce ED more efficiently. As yoga programs are extremely customizable based on individual limits and targets, further studies can be done to assess which type of yoga is most effective in ED management. More research is also needed in order to generalize the results of this study’s findings to younger age groups, as this study included individuals of advanced age. In order to do this, further studies are needed to include broader populations of men with varied socio-economic status (SES), age, and culturally distinct backgrounds. Additional control of exercise quantity and intensity, as well as experiments that follow patients for a longer time range may be helpful in assessing how large the decrease in ED can be with yoga based interventions.

References1.Reffelmann, T., & Kloner, R.A. (2006) Sexual function in hypertensive patients receiving treatment. Vascular Health and Risk Management 2006:2(4) 447–455.2.Sivalingam, S., Hashim, H., & Schwaibold, H. (2006). An overview of the diagnosis and treatment of erectile dysfunction. Drugs , 66 (18), pp. 2339-55.3.Yang, Kyeongra. (2007) A Review of Yoga Programs for Four Leading Risk Factors of Chronic. Evidence Based Complementary and Alternative Med.v.4 (4).4.Esposito, K., Giugliano, F., Di Palo, C., Giugliano, G., Marfella, R., D'Andrea, F., et al. (2004, June 23). Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA , 291 (24), pp. 2978-84.

The focus of this study was to determine the impact of regular yoga practice in a community setting of older men with erectile dysfunction. Therefore, the study design consisted of a community trial utilizing two senior centers in different cities within the San Francisco Bay Area. Center A and Center B serve similar populations in terms of ethnicity, marital status, age and race. Each center enrolled 50 male participants between the ages of 55 and 70, adhering to strict inclusion and exclusion criteria outlined in our study design. The six month “Healthy Men” program at Center A consisted of 1-hour Integral Yoga classes 3 times per week, plus a take-home video, adapted for older adults. The control program at Center B consisted of weekly meetings to promote and discuss healthy lifestyles and included take-home pamphlets discussing the benefits of exercise. Participants took detailed health surveys at the start and conclusion of the program in order to confirm eligibility in the program, assess baseline information, and measure improvements. The surveys were administered by trained data collectors who were blinded to the

Erectile Dysfunction (ED) is diagnosed as “a consistent or recurrent inability of a man to attain and/or maintain penile erection sufficient for sexual activity” for a minimum of a three month period1.  ED has become a common phenomenon among the older male population, ages 40-70. Risk factors associated with ED include behavioral habits, psychosocial causes, and physical ailments2. Hypertension control is of particular interest not only because it is an important risk factor for many forms of cardiovascular diseases and ED, but also because most antihypertensive drugs, due to their mechanism, worsen ED. Lifestyle changes, such as physical activity, have the greatest association in potentially reducing ED2.Yoga is a system of physical exercise combined with breathing and psychological intention, with various health benefits including, but not limited to, decreased stress, weight loss, and improved physical fitness3. Given yoga’s multiple health benefits and its’ significance in reducing overall hypertension, there is justification that yoga be explored as a potential alternative to drug treatment of ED. Although there have been studies done regarding the use of physical activity as  treatment for ED, there is limited current research regarding the effectiveness of yoga in reducing ED. Hence this study is a primer study in the field of erectile dysfunction.

INTRODUCTION

METHODOLOGY

DISCUSSION

RESULTS

ABSTRACT

ACKNOWLEDGEMENT

intervention status of participants. Based on the information gathered, the prevalence of ED was assessed using the International Index of Erectile Function (IIEF). The IIEF consists of five questions, and the maximum score is 25; a score of less than 21 indicates erectile dysfunction4. Additional health factors were tracked, including overweight/obesity status and the presence of hypertension. Statistical analysis included T-tests and Chi Squared tests to evaluate the significance of change for continuous and discrete data respectively.

Table 1. Baseline Characteristics of Participants with Yoga and controls.     

CharacteristicsPatients with yoga n=50 Controls n=50

Mean age 61.42 61.34

Current smoker (%) 18 20

Overweight BMI>25 (%) 64 62

Obese BMI>30 (%) 32 32

Pre-hypertension (%) 42 44

Graph 1: Pre vs. Post IIEF Score Averages

Graph 2: Pre vs Post Case Group Graph 3: Pre vs. Post Control Group