On this page Jump to a section
- Key facts
- Do Kegel exercises help ED?
- Evidence: Kegels vs cardio
- How to do Kegels for ED
- Cardio minutes per week
- Can cycling cause ED?
- What each path includes
- Exercise vs a prescription
- Safety checks before ED medication
- If ED is the problem you want treated now
- Mendoxa plans and prices
- FAQ
- How we wrote this
- Sources and references
Key facts at a glance
- Kegel trial
- 40% regained normal erectile function at 6 months after a supported training programDorey et al. 2005 · PubMed
- Aerobic exercise
- +2.8 IIEF-EF points vs no exercise across 11 trialsKhera et al. 2023 · PubMed
- Weekly target
- Review recommendation: supervised aerobic training, 160 minutes weekly for 6 monthsGerbild et al. 2018 · PubMed
- Kegel routine
- Hold 3–5 seconds, relax 3–5 seconds, 10 times, 3 times a dayMedlinePlus
- Compounded status
- The Mendoxa compounded tablet is not FDA-approvedFDA compounding Q&A
Do Kegel exercises help ED?
Kegel and ED research supports a structured program—not a promise from squeezing harder. The Dorey trial paired physiotherapist-taught exercises with biofeedback and lifestyle advice; its comparison favored that program at 3 months.
After the comparison period, controls who had not responded could receive training too. The 6-month outcomes therefore describe follow-up after that crossover, not a continuing exercise-versus-no-exercise comparison. The abstract does not provide a home repetition schedule (trial methods and results).
Use the routine below as a starting point for a conversation about technique. For the wider picture, read causes of ED and how to get harder erections.
What the research shows: Kegels vs cardio
These studies answer different questions: whether a supported program helped, how questionnaire scores changed, and what training amount a review recommends. They do not establish which exercise is best in a head-to-head comparison.
| Exercise type and study | What the trial did | Result (from the abstract) | Limits |
|---|---|---|---|
| Pelvic floor (Kegel) · RCT · Dorey 2005 | 55 men with ED for 6+ months: physiotherapist-taught pelvic floor exercises with biofeedback and lifestyle advice vs lifestyle advice only; then 3 months of home exercises | Better erectile function than controls at 3 months (P < 0.001); at 6 months 40% regained normal function, 35.5% improved, 24.5% did not. Dorey et al. | Small trial with crossover; 6-month percentages are follow-up outcomes, not a controlled comparison |
| Aerobic, pelvic or combined · meta-analysis · Silva 2017 | 7 randomized trials, 478 men with diagnosed ED; follow-up 8 weeks to 2 years | Erectile function score mean difference 3.85 (95% CI 2.33–5.37); benefit “particularly” with moderate-to-vigorous aerobic exercise. Silva et al. | Risk of bias rated moderate to high (blinding not possible) |
| Aerobic · meta-analysis · Khera 2023 | 11 randomized trials comparing aerobic exercise with non-exercising controls | IIEF-EF mean difference 2.8 points (95% CI 1.7–3.9). Khera et al. | Studies varied; questionnaire change is not a percentage of men recovering |
| Aerobic · systematic review · Gerbild 2018 | 10 intervention studies (2006–2016) in men with inactivity, obesity, hypertension, metabolic syndrome or heart disease | Recommends supervised aerobic activity: 160 minutes weekly for 6 months. Gerbild et al. | Review recommendation, not one pooled effect estimate |
| Weight loss + activity · RCT · Esposito 2004 | 110 obese men aged 35–55 with ED; 2-year program to lose 10%+ of body weight vs general advice | 17 men in the intervention group vs 3 controls reached an IIEF score of 22 or higher. Esposito et al. | Men without diabetes, hypertension or high cholesterol; diet and exercise combined |
Sources: Dorey et al. 2005; Silva et al. 2017; Khera et al. 2023; Gerbild et al. 2018; Esposito et al. 2004. Accessed Oct 29, 2026.
How to read the scores: IIEF-EF measures erectile function on a 6–30 scale; higher is better (Khera abstract). A point gain is not a recovery rate, and these reviews should not be counted as independent sets of entirely different trials.
How to do Kegel exercises for ED, step by step
Learn the contraction, then practice with an empty bladder. This follows MedlinePlus guidance for bladder control; it is not the unpublished Dorey trial protocol.
- Find the muscles: imagine preventing yourself from passing gas.
- Get comfortable: empty your bladder and sit or lie down.
- Contract: tighten the pelvic floor for 3–5 seconds.
- Release: relax for 3–5 seconds before the next contraction.
- Repeat: do 10 repetitions, morning, afternoon and evening.
- Check technique: breathe deeply and keep your abdomen, thighs, buttocks and chest relaxed.
Protocol source: MedlinePlus. Accessed Oct 29, 2026.
More is not better: do not keep adding repetitions or make stopping urine your exercise routine. MedlinePlus cautions that overdoing Kegels can cause straining and says to contact your provider if you are unsure of the technique (MedlinePlus).
How much cardio helps ED? Minutes per week
Separate a general health target from an ED research recommendation. The HHS guidelines call for 150–300 minutes of moderate aerobic activity weekly; the Gerbild review recommends supervised training for men with ED and specified cardiovascular risk factors.
| Source | Weekly amount | Who it applies to |
|---|---|---|
| HHS Physical Activity Guidelines (ODPHP) | At least 150 to 300 minutes of moderate-intensity aerobic activity, plus muscle-strengthening at least 2 days a week. ODPHP | Adults in general |
| Gerbild ED review (2018) | 40 minutes × 4 sessions = 160 minutes of moderate-to-vigorous aerobic exercise, for 6 months. Gerbild et al. | Men with ED linked to inactivity, obesity, hypertension, metabolic syndrome or heart disease |
Sources: HHS guidelines; Gerbild et al. 2018. Accessed Oct 29, 2026.
A sample week based on the review
Schedule four 40-minute aerobic sessions on days you can repeat consistently. This is an example calendar for the review’s 160-minute recommendation, not a separately tested program. The review specifies supervised moderate-to-vigorous activity (Gerbild et al.).
Brisk walking is one moderate-intensity option; add muscle-strengthening activity on at least 2 days under the HHS guidelines. For related changes, see foods for erections. Bring diabetes or blood pressure concerns to your clinician when discussing a routine.
Can cycling make erection problems worse?
Cycling deserves a separate check if you spend long hours in the saddle. The NHS ED guidance suggests taking a break from cycling if you ride more than 3 hours a week. That advice is not a proven cutoff below which everyone is protected.
A NIOSH conference report on bicycle saddles links greater perineal pressure with poorer erectile function measures and reports less pressure with saddles without a protruding nose. It was not peer reviewed and does not prove that cycling causes ED in every rider.
If cycling is part of your routine, discuss riding time and saddle pressure during your assessment rather than assuming more cycling will help.
What each path includes: choose your next step
You do not have to finish an exercise program before asking about ED care. Use the evidence and your priorities to decide what to discuss at a visit.
| Path | What it includes | Timeline | Boundary |
|---|---|---|---|
| Pelvic floor (Kegel) training | Daily squeeze-and-relax sets; a physiotherapist can check technique (Dorey trial) | Measured at 3 and 6 months in the trial | Does not address every cause of ED |
| Aerobic exercise and weight loss | HHS: 150–300 minutes moderate activity weekly; ED review: 160 minutes moderate-to-vigorous activity weekly (Gerbild review; ODPHP) | Months (6 months in the Gerbild recommendation) | Review studied men with specified cardiovascular risk factors |
| Standalone ED prescription | Sildenafil or tadalafil if appropriate (Viagra (sildenafil) label; Cialis (tadalafil) label) | Sildenafil is taken about 1 hour before sex (Viagra (sildenafil) label) | Requires sexual stimulation; contraindicated with nitrates (Viagra (sildenafil) label; Cialis (tadalafil) label) |
| Mendoxa 3-in-1 visit | Online review by Independent licensed providers; Prescription required | Assessment online; treatment only if prescribed | Compounded tablet is not FDA-approved |
Sources: Dorey trial; Gerbild review; ODPHP; Viagra (sildenafil) label; Cialis (tadalafil) label; FDA compounding Q&A; Mendoxa care information. Accessed Oct 29, 2026.
Compare ED medication options before a visit, and read can ED be reversed? for what lifestyle change can and cannot do.
Make the visit useful
- Unsure about Kegel technique? Ask whether supervised pelvic floor training fits; that is closer to the trial than an unsupervised routine.
- Want treatment options now? Discuss them during an online ED visit while you establish an exercise habit.
- Erection problems keep happening? Arrange an assessment; the NHS advises getting checked because a treatable condition may be involved.
Could Mendoxa ED care fit you?
Online ED visit · Prescription required · Independent licensed providers · Not available in California
Exercise and prescription treatment have different timelines
Exercise is a longer-term project; prescription timing depends on the product. The Viagra (sildenafil) label directs use about 1 hour before sexual activity, with sexual stimulation needed. This is administration timing, not a promise of an erection within an hour.
The Cialis (tadalafil) label describes benefit up to 36 hours after as-needed dosing, not a continuous erection. These are labels for separate approved tablets; neither establishes an onset time for the Mendoxa compounded combination.
Safety checks before ED medication
- Sildenafil and tadalafil are contraindicated with organic nitrates or riociguat (Viagra (sildenafil) label; Cialis (tadalafil) label).
- An erection lasting more than 4 hours needs immediate medical care (Viagra (sildenafil) label; Cialis (tadalafil) label).
- Stop and seek care for sudden vision loss or sudden decrease or loss of hearing (Viagra (sildenafil) label; Cialis (tadalafil) label).
- Common adverse effects include headache and flushing with sildenafil, and headache, indigestion and back pain with tadalafil (Viagra (sildenafil) label; Cialis (tadalafil) label).
- The APOKYN (apomorphine) label contraindicates use with 5HT3 antagonists such as ondansetron and warns about nausea and fainting.
If sexual activity or hard exercise brings on chest pain, stop and get checked: the Viagra (sildenafil) label and Cialis (tadalafil) label caution against use when sexual activity is inadvisable for cardiovascular reasons. See ED medication and nitrates.
If ED is the problem you want treated now
Turn your exercise research into a treatment conversation. Start the Mendoxa online ED visit and describe what happens, how long it has been happening and what you have tried. Independent licensed providers assess suitability. Prescription required.
The tablet combines sildenafil, tadalafil and apomorphine; it is not FDA-approved. Ingredient references are the Viagra (sildenafil) label, Cialis (tadalafil) label and APOKYN (apomorphine) label; APOKYN is an injectable Parkinson’s treatment, and its label is not approval of this ED combination.
Bring your current medicine list and exercise routine. Read about the combination ED tablet before your visit, or use home remedies for ED to put other lifestyle claims in context.
Mendoxa ED plans and prices
The Mendoxa ED tablet is a compounded rapid-dissolve tablet with sildenafil (the active ingredient in Viagra), tadalafil (the active ingredient in Cialis) and apomorphine (APOKYN label). It dissolves under the tongue. A licensed clinician decides if it fits you and selects the strength. Compounded medicines are not FDA-approved.
| Tablets per month | 1-month total | Per tablet (1 month) | 3-month total | Per tablet (3 months) |
|---|---|---|---|---|
| 6 tablets / month | $129 | $21.50 | $329 | $18.28 |
| 10 tablets / month | $149 | $14.90 | $379 | $12.63 |
| 20 tablets / month | $179 | $8.95 | $449 | $7.48 |
The 3-month total covers three months at the monthly tablet quantity shown.
If prescribed · Cancel anytime · Available in 49 states (not California). Prices from the Mendoxa intake at try.mendoxa.co/f/ed on Oct 29, 2026. The intake always shows the current price.
FAQ
Do Kegel exercises work for ED?
They can help some men. The Dorey trial favored physiotherapist-taught pelvic floor training with biofeedback and lifestyle advice over lifestyle advice alone at 3 months. It does not show that an unsupervised routine will work for everyone.
How long do Kegels take to help ED?
Think in months rather than days. The Dorey trial compared groups at 3 months and reported follow-up at 6 months. Do not use bladder-control improvement timelines as a promise about erections.
How many Kegels should I do a day?
MedlinePlus describes 10 repetitions, 3 times daily, holding and relaxing for 3–5 seconds each. This is bladder-control guidance, not an ED-specific trial schedule. Do not add repetitions indefinitely.
Does cardio help erectile dysfunction?
Yes, on average. A 2023 meta-analysis of 11 randomized trials found aerobic exercise improved IIEF-EF scores by 2.8 points versus no exercise, with bigger gains in more severe ED.
Can cycling cause ED?
It may contribute for some riders. A NIOSH conference report describes saddle pressure and erectile function; the NHS suggests a cycling break if you ride more than 3 hours weekly. Neither establishes that every cyclist will develop ED.
Can exercise replace ED medication?
Exercise may help, but a clinician should assess whether it is enough for your situation. The Viagra (sildenafil) label directs use about 1 hour before sex; exercise studies measure changes over longer periods. You can discuss treatment while training. Prescription required.
Ready to see if the Mendoxa ED tablet fits you?
From $129/month if prescribed · Cancel anytime · Available in 49 states (not California)
How we wrote this
Written by the Mendoxa editorial team · Sources: DailyMed/FDA. Medical facts on this page come from the FDA-approved labels on DailyMed and Drugs@FDA; each drug name links to its label. Exercise results come from the linked PubMed abstracts; the Kegel routine comes from MedlinePlus guidance for bladder control, not an ED-specific prescription. We distinguish randomized comparisons from follow-up results and review recommendations. Sources checked Oct 29, 2026. Approved ingredient labels do not establish the safety, effectiveness or onset of the Mendoxa compounded combination.
Updated Oct 29, 2026. This page is general information, not medical advice. A licensed clinician decides what fits you.
References
- DailyMed: VIAGRA (sildenafil citrate) tablet, film coated, label revised 12/2017. Accessed Oct 29, 2026.
- DailyMed: CIALIS (tadalafil) tablet, film coated, label revised 3/2026. Accessed Oct 29, 2026.
- DailyMed: APOKYN (apomorphine hydrochloride) injection, label revised 6/2022. Accessed Oct 29, 2026.
- FDA (Drugs@FDA): VIAGRA (sildenafil) prescribing information, NDA 020895. Accessed Oct 29, 2026.
- FDA (Drugs@FDA): CIALIS (tadalafil) prescribing information, NDA 021368. Accessed Oct 29, 2026.
- FDA: Compounding and the FDA, questions and answers. Accessed Oct 29, 2026.
- Dorey G, et al. Pelvic floor exercises for erectile dysfunction. BJU Int. 2005;96(4):595-7. PMID 16104916. Accessed Oct 29, 2026.
- Silva AB, et al. Physical activity and exercise for erectile dysfunction: systematic review and meta-analysis. Br J Sports Med. 2017;51(19):1419-1424. PMID 27707739. Accessed Oct 29, 2026.
- Khera M, et al. Effect of aerobic exercise on erectile function: systematic review and meta-analysis of randomized controlled trials. J Sex Med. 2023;20(12):1369-1375. PMID 37814532. Accessed Oct 29, 2026.
- Gerbild H, et al. Physical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies. Sex Med. 2018;6(2):75-89. PMID 29661646. Accessed Oct 29, 2026.
- Esposito K, et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA. 2004;291(24):2978-84. PMID 15213209. Accessed Oct 29, 2026.
- MedlinePlus: Kegel exercises - self-care. Accessed Oct 29, 2026.
- ODPHP: Top 10 Things to Know About the Physical Activity Guidelines, 2nd edition. Accessed Oct 29, 2026.
- NIDDK: treatment for ED. Accessed Oct 29, 2026.
- NHS: erectile dysfunction treatment. Accessed Oct 29, 2026.
- NIOSH: Male reproductive health effects of bicycle saddles (2006). Accessed Oct 29, 2026.
- Mendoxa ED care (product, format, max 1 dose per 24 hours). Accessed Oct 29, 2026.
- Mendoxa ED intake: plan prices (term_options). Accessed Oct 29, 2026.
About Mendoxa
Mendoxa (mendoxa.co) is a US telehealth brand. Independent licensed providers (licensed clinicians in the LocumTele network) review each online visit, and prescriptions are filled by Rush Pharmacy, a licensed US pharmacy. Available in 49 states (not California).
- Prescription required. A licensed clinician reviews every visit and can say no. A prescription is not automatic.
- A compounded medicine is not an FDA-approved finished product (FDA compounding Q&A).
- Plans: 1 month or 3 months, from $129. If prescribed · Cancel anytime · Available in 49 states (not California).
Compounded medication prescribed only if a licensed U.S. clinician decides it is appropriate. Not FDA-approved as a finished product. Not available in California. This site is not for emergencies. Call 911 if you need urgent care.