Associations between self-reports of physical activity, interoceptive awareness, autonomic regulation, premature ejaculation, and erectile dysfunction in Chinese men

Premature ejaculation and erectile dysfunction are prevalent male sexual dysfunctions worldwide, causing significant distress for men and their partners. We investigated how physical activity was associated with self-reports of interoceptive awareness and autonomic regulation during sex as well as with premature ejaculation and erectile dysfunction. The sample of 1976 Chinese urban men aged 18–50 (Mean age = 31.5 ± 5.3), responded to a questionnaire on two online survey platforms (WJX and CREDAMO) in April 2022. Participants reported their age, height, and weight, and filled out the Physical Activity Questionnaire, the Body Perception Questionnaire Short Form, the Multidimensional Assessment of Interoceptive Awareness, the Checklist for Early Ejaculation Symptoms, and the International Index of Erectile Function-5. The correlation results indicated that higher Physical Activity Questionnaire scores were associated with higher Multidimensional Assessment of Interoceptive Awareness scores (total scores: r = 0.470, noticing: r = 0.369, self-regulation: r = 0.398, body listening: r = 0.440, all p < 0.01), lower Checklist for Early Ejaculation Symptoms scores (r = −0.327, p < 0.01), and higher International Index of Erectile Function-5 (r = 0.258, p < 0.01) scores. The mediation models indicated that higher Physical Activity Questionnaire scores were associated with lower Checklist for Early Ejaculation Symptoms scores (β = −0.155, p < 0.001) and higher International Index of Erectile Function-5 (β = 0.107, p < 0.001) through higher Multidimensional Assessment of Interoceptive Awareness scores. The self-report Autonomic Symptoms during sex also mediated the relationship between Physical Activity Questionnaire scores, Checklist for Early Ejaculation Symptoms scores, and International Index of Erectile Function-5 scores. We were first to investigate associations among physical activity, autonomic symptoms, interoceptive awareness, premature ejaculation, and erectile dysfunction together. These results indicate that physical exercise may enhance sexual function through both psychological and physiological pathways. However, only self-report measures were used.