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Table 1 Risky and protective lifestyles and their effects on male and female sexuality

From: Lifestyles and sexuality in men and women: the gender perspective in sexual medicine

FactorEffects on male sexualityEffects on female sexuality
ObesityLoss of libido [8]
Risk of ED > 30% with BMI > 28.7 [13]
Arousal problems, Coital pain and Sexual dissatisfaction [8]
More sexual complaints in women seeking bariatric surgery [22]
Higher risk for postmenopausal breast cancer [27, 28]
Loss of weightand Diet10% weight loss related with increased insulin sensitivity, plasma testosterone levels, erectile function and desire both in diabetics and non-diabetics [52]
Weight loss induced by bariatric surgery improve erectile functions and testosterone levels [53]
Mediterranean diet improves IIEF scores after 2-years [54]
Adherence to Mediterranean diet improve BMI, waist circumference, waist-to-hip ratio, mood symptoms, weight and metabolic syndrome [55]
Higher frequency of sexual intercourses in women who better comply to Mediterranean diet [55]
Physical ActivityProtective effects against ED in men with diabetes [34]
Increase of NO production and decrease of oxidative stress [14]
Benefits on self-esteem and mental health [36, 41]
Improvement of IIEF-5 score after 3 months of physical exercise [38]
Augmented improvement of ED symptoms in association with PDE5i treatment [39]
Sedentary life increase PE symptoms [41]
Protective effects against sexual dysfunction in women with diabetes [35]
Benefits on self-esteem and mental health [36, 52]
Improvement of menopause symptoms, mood, anxiety and musculoskeletal problems [47,48,49]
Keeping good sexual quality of life in postmenopausal women who do regular physical activity [48]
Regual physical exercises prevent the development of sexual dysfunction [51]
SmokingQuit with smoking improve erectile function by 25% after 1 year [61]
>  50% odds to develop ED in smokers and 30% in ex-smokers [60]
30% decrease of genital stimulation due to nicotine acute intake [62]
Delayed orgasm and low vaginal lubrication [10, 64, 65]
Alcohol abuseLower likelihood of developing ED between non-habitual drinkers compared to binge-drinkers [68, 71]Low sexual desire, inability to reach orgasm or unsatisfactory orgasm in women with an alcohol dependence [68, 73]
MarijuanaPhysiological decline of testosterone levels [81]It gives major facilitatory effects [81]
CocaineDepressive effect on sexual activity and progressive inability to reach orgasm in the long term [82, 83]
Loss of sexual desire, ED symptoms, inhibition of ejaculation and reduction in sexual performance [83, 85]
Loss of sexual activity [84]
AmphetamineDecrease in sexual desire, inhibition of orgasm and a reduction of sexual satisfaction [87] 
HeroinAt early stages, it improves sexual inadequacy, sexual performance and ejaculatory control [88]
Heroin dependence produces loss of libido and ED [90]
Heroin dependence produces delayed ejaculation or inability to reach it [91]
At early stages, it reduces anxiety and coital pain, due to a relaxation of pelvic floor muscles and higher lubrication [88]
EcstasyAt early stages, it reduces sexual inhibition [92]
Long-term use reduces sexual desire and penile erection [93]
At early stages, it maximized sexual experience and orgasm [77]
Long-term use reduces vaginal lubrication and ability to reach satisfying orgasm [93]
Chronic stressPDE5i treatment combined with stress management techniques reduces cortisol levels and improves IIEF scores [113]Chronic stress is related to lower levels of sexual arousal both in hormonal factors (cortisol) and psychological factors (attention to visual sexual stimuli) [114]