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
Factor | Effects on male sexuality | Effects on female sexuality |
|---|---|---|
Obesity | Loss 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] |
Loss of weightand Diet | 10% 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 Activity | Protective 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] |
Smoking | Quit 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] |
Alcohol abuse | Lower 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] |
Marijuana | Physiological decline of testosterone levels [81] | It gives major facilitatory effects [81] |
Cocaine | Depressive 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] |
Amphetamine | Decrease in sexual desire, inhibition of orgasm and a reduction of sexual satisfaction [87] | Â |
Heroin | At 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] |
Ecstasy | At 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 stress | PDE5i 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] |