Intermittent fasting decreases the risk of type 2 diabetes and helps men rise to the occasion, so to speak.

Erectile dysfunction has been found to affect at least one in 2 Singaporean men, although the condition is seldom discussed. If you are a diabetic male, your risk of erectile dysfunction rises significantly.

Over 1 million adults are expected to be afflicted with type 2 diabetes by 2050, and up to 75% of men with diabetes will not only have erectile dysfunction, but also develop it 10 to 15 years earlier than men without diabetes. Fortunately, the latest research points to intermittent fasting as a way to significantly reduce the incidence of erectile dysfunction by controlling diabetes and improving testosterone levels in men.

Dr Sriram Narayanan, Consultant Vascular Surgeon from the Harley Street Vascular Centre

Dr Sriram Narayanan, Consultant Vascular Surgeon from the Harley Street Vascular Centre

With Ramadan in full swing, we interviewed Dr Sriram Narayanan, Consultant Vascular Surgeon from the Harley Street Vascular Centre to explain the link between intermittent fasting and erectile dysfunction in men:

Q: What is intermittent fasting and how is it similar to fasting during Ramadan?

A: Ramadan is considered one of the most sacred times of the year for Muslims. During this period, Muslims observe a strict daily fast from dawn until sunset and must abstain from eating and drinking for about 14 hours a day.

The fasting practiced during Ramadan and intermittent fasting is similar in that they both switch between periods of fasting and normal caloric intake according to a strict, routine schedule. Intermittent fasting has gained much popularity in recent years because it is less restrictive than traditional diets and because it has been proven in studies to effectively reduce fat and control type 2 diabetes, which are known risk factors for erectile dysfunction.

Q: Why are diabetes and obesity risk factors for erectile dysfunction?

A: When a man is sexually aroused, a chemical called nitric oxide is released, which signals the arteries and muscles to relax and allow more blood flow to the penis, resulting in an erection. When a man’s blood sugar levels are too high, nitric oxide levels are reduced causing insufficient blood flow to start and maintain a strong erection.

Besides poor blood supply, diabetes resulting from obesity, which affects up to 85% of diabetics, can also cause erectile dysfunction.  When men are overweight, they do not produce optimal levels of testosterone; at the same time, fat cells convert testosterone to the female hormone, oestrogen, which consequently lowers male libido and results in weaker erections.

Q: How does intermittent fasting prevent erectile dysfunction?

A: Before I answer this, we must first understand how intermittent fasting protects against diabetes. When you are on an intermittent fast, blood glucose levels are only elevated when you eat but remain low for the rest of the day. Following six to eight hours of fasting, glucose levels from your last meal are exhausted and fasting mode kicks in. Once this happens, the liver uses the last of its glucose reserves and activates a process called glucogenesis where fats are broken down to be used as fuel, which thereby reduces blood sugar levels, increases insulin sensitivity, and decreases body fat.

Intermittent fasting is believed to prevent erectile dysfunction because lower blood sugar levels increase nitric production, which allows optimal blood flow for starting and maintaining an erection. According to a study of the diets of 271 patients in a men’s clinic, those who practiced intermittent fasting were significantly less likely to have erectile dysfunction than men who were vegetarian, pescatarian (vegetarian diet with fish ), and those who consumed low-carb, keto or low-fat diets.

In other research, intermittent fasting has also been proven to reduce body fat by 3% to 8% over three to 24 weeks. This means that men who practice intermittent fasting will not only have higher levels of male hormones for a healthier sex drive, but also decreased fat in the belly region for a longer-looking penis, which can certainly boost their confidence.

Q: How does intermittent fasting work?

A: There are two main approaches to intermittent fasting, including daily time-restricted eating or the 5:2 diet. With time restricted eating, you only eat within a specific time window. Common variants involve a 16-hour fast and 8-hour feed, 18-hour fast and 6-hour feed, and 20-hour fast and 4-hour feed. A good rule of thumb is that the longer you fast, the more sensitive your body is to insulin so try to steer clear of food for as long as possible.

The 5:2 diet on the other hand, involves completely abstaining from food, or only eating a single small meal of between 300 to 400 calories two days a week.

If fasting for 16 hours every day or only eating 300 calories twice a week seems too restrictive, take comfort in the fact that intermittent fasting allows you to drink zero-calorie beverages during fasting periods to help stave off hunger throughout the day – unless of course, you’re fasting for Ramadan.

Q: What foods work best with intermittent fasting?

A: It is still wise to consume less refined sugars and processed foods as these increase erectile dysfunction’s risk factors including diabetes and obesity. If you’re unsure about what foods to incorporate in your fasting routines, try sticking to a Mediterranean diet (vegetables, fruits, fish and whole grains), which is rich in fat-inhibiting substances and reduces the risk of diabetes by approximately 20%.

Q: Besides intermittent fasting, what else can men do to improve their libido?

A: Kegel exercises are more commonly known among women, but have also shown to help men with erectile dysfunction regain normal function as it strengthens the bulbocavernosus muscle, which engorges the penis during an erection. If men would like to try Kegel exercises, they should activate the muscles which stop urination midstream, hold for six second, then relax. Repeat this 10 to 20 times, two or three times a day.

Oral medications, such as sildenafil, tadalafil, vardenafil and avanafil, are another first-line treatment for erectile dysfunction, and work by enhancing the effects of nitric oxide for better blood flow to the penis. However, certain erectile dysfunction medications don’t work with alcohol or on a full stomach, so speak to your doctor about what medications are best suited for you and your needs.


Main photo by Dreamstime. Dr Sriram Narayanan photo courtesy of Harley Street Vascular Centre.