Cardio and strength training for sexual health
Erectile function in men and arousal in women both depend on the ability of blood vessels to dilate and deliver blood to the genitals. Cardio and strength training are the two main branches that improve vascular health and hormone balance.
Updated November 14, 2026Compiled by UK MASTER ACADEMYFor readers aged 18 and over
- The blood vessels supplying the penis are much smaller in diameter than the coronary arteries, so vascular dysfunction affects erection before causing chest pain.
- A 2018 systematic review of 10 studies concluded that 40 minutes of moderate-to-vigorous aerobic exercise, 4 times per week for 6 months, reduced erectile dysfunction in men with cardiovascular risk factors.
- The 2020 WHO global physical activity guidelines recommend 150 to 300 minutes of moderate-intensity aerobic activity per week for adults.
- Exercise does not replace treatment of underlying disease, but it is a supported add-on with the fewest side effects.
Blood vessels are the foundation of sexual response
Erection in men and arousal in women both begin with blood vessels dilating and delivering more blood to the genitals. The vascular endothelium, the layer of cells lining the inside of vessel walls, releases nitric oxide to trigger this process. When vessel walls stiffen or the endothelium functions poorly, blood flow is insufficient.
The blood vessels supplying the penis are smaller in diameter than the coronary arteries. This means that conditions affecting the vasculature, such as high blood pressure, type 2 diabetes, and atherosclerosis, often show up as sexual dysfunction before producing clear cardiovascular symptoms. For this reason, unexplained erectile dysfunction in a middle-aged person warrants cardiovascular evaluation.
What Western and Chinese medicine say
Western medicine
Aerobic exercise improves vascular endothelial function, reduces chronic inflammation, supports weight management, and increases insulin sensitivity. All of these factors are linked to sexual health.
A 2018 systematic review of 10 studies on aerobic exercise and erectile dysfunction concluded: 40 minutes of moderate-to-vigorous exercise, 4 times per week for 6 months, reduced erectile dysfunction in men with cardiovascular risk factors. The studies in this review were primarily in men with existing underlying conditions.
Chinese medicine
Traditional Chinese medicine views moderate exercise as a way to cultivate qi and open the meridians. Good circulation of qi and blood helps the organ systems function correctly, including the Kidney, which governs reproduction, and the Liver, which governs the free flow of qi.
Overexertion is also warned against in classical health cultivation texts, because it depletes qi and causes exhaustion. Moderate, regular exercise suited to one's constitution is recommended over high-intensity training without adequate rest.
This is the traditional Chinese medicine view, which has not been validated by clinical trial standards. See the Kidney page for more.
WHO physical activity guidelines
The 2020 World Health Organization global physical activity guidelines recommend for adults:
- Moderate-intensity aerobic activity: 150 to 300 minutes per week, for example brisk walking, light swimming, cycling.
- Vigorous-intensity aerobic activity: 75 to 150 minutes per week, for example running, vigorous swimming.
- Strength training: at least 2 sessions per week targeting the major muscle groups, using bodyweight exercises or weights.
This is the minimum to maintain cardiovascular health. The 2018 Gerbild et al. study on erectile dysfunction recommended a higher level: 160 minutes of aerobic activity per week over 6 months to see improvement in erectile function in those with risk factors.
Sample weekly exercise plan
The plan below is based on WHO guidelines and adapted so it can be done at home or nearby, with no special equipment.
| Day | Exercise type | Duration | Notes |
|---|---|---|---|
| Monday | Brisk walking or cycling | 40 minutes | Moderate intensity |
| Tuesday | Bodyweight strength training | 30 minutes | Squats, push-ups, plank |
| Wednesday | Rest or light walking | 20 minutes | Recovery |
| Thursday | Brisk walking or swimming | 40 minutes | Moderate intensity |
| Friday | Bodyweight strength training | 30 minutes | Deadlift, rows, pull-ups |
| Saturday | Cardio of choice | 45 minutes | Swimming, cycling, running |
| Sunday | Full rest | Muscle recovery |
How to start if you have not been active
People with low activity levels should begin at a low level and increase gradually over the first 4 to 6 weeks to avoid injury. Here is one approach:
- Weeks 1 to 2: walk 20 to 30 minutes per day, 4 days per week. No running or hard effort needed.
- Weeks 3 to 4: increase to 30 to 40 minutes, and add one simple strength session.
- From week 5: progress gradually toward the sample schedule above, or follow specific guidance from a doctor or personal trainer.
When to see a doctor
Exercise improves sexual health through vascular mechanisms, but it is not the only cause that may need to be addressed. See a doctor when:
- Erectile dysfunction persisting more than 3 months despite regular exercise, to rule out underlying cardiovascular disease, diabetes, or hormone deficiency.
- Chest pain, severe shortness of breath, or abnormal heart palpitations during or after exercise.
- Sexual dysfunction in a person under 40 with no clear cardiovascular risk factors.
See also the articles on erectile dysfunction and Kegel for men.
Questions and answers
Which cardio exercise is most suitable?
Swimming, cycling, brisk walking, and running are all suitable. What matters most is maintaining sufficient intensity and duration according to guidelines, not choosing a specific type.
Can people with existing heart disease exercise?
Ask a doctor before starting. Many people with heart disease are encouraged to exercise at a suitable intensity, but the safe threshold must be determined based on each individual's condition.
Is strength training necessary?
Strength training helps maintain hormone balance, reduce visceral fat, and improve overall endurance. Combining both types produces better results than doing either alone.
How does exercise affect women?
Many studies have noted that regular aerobic exercise is associated with improved arousal, lubrication, and sexual function in women, though the evidence is stronger for men with erectile dysfunction.
Sources
- Gerbild H, Larsen CM, Graugaard C, Areskoug Josefsson K. Physical activity to improve erectile function: a systematic review of intervention studies. Sexual Medicine. 2018;6(2):75-89. PubMed 29661646
- Nehra A, Jackson G, Miner M, et al. The Princeton III Consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clinic Proceedings. 2012;87(8):766-778. PubMed 22862865
- World Health Organization. WHO guidelines on physical activity and sedentary behaviour. Geneva: WHO; 2020.
This page is general health information compiled from international medical sources. It has not been reviewed by a physician and is not a diagnosis or a treatment instruction. The content is for readers aged 18 and over. If symptoms persist, please see a doctor.