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Wednesday, June 25, 2008

Obesity and Erectile Dysfunction

Yesterday, I ended my posting on the Megasexual MEGARS on the rather sobering note of erectile dysfunction.

Yes, obesity is an important risk factor for this rather embarassing and annoying, but seldom talked-about complication of obesity. (I continue to be amazed by just how many grateful male patients have thanked me for the great improvements that they experienced in their sex lives as a result of obesity treatment.)

Some, if not most of this may be related to the hypogonadotrophic hypogonadism that I have blogged about before.

Indeed, healthy lifestyle factors are strongly associated with maintenance of erectile function in men - and in obese men with erectile dysfunction - weight loss sure helps.

Perhaps the best study on this issue was done by Katherine Esposito and colleagues from the Second University of Naples, Naples, Italy (published in JAMA). They conducted a randomized, single-blind trial of exercise and weight loss in 110 obese men (BMI > or =30) aged 35 to 55 years, WITHOUT diabetes, hypertension, or hyperlipidemia, who had erectile dysfunction as determined by a score of 21 or less on the International Index of Erectile Function (IIEF).

The 55 men randomly assigned to the intervention group received detailed advice about how to achieve a loss of 10% or more in their total body weight by reducing caloric intake and increasing their level of physical activity. Men in the control group (n = 55) were given general information about healthy food choices and exercise.

After 2 years, BMI decreased more in the intervention group (from 36.9 to 31.2) than in the control group (36.4 to 35.7) while the IIEF score improved significantly in the intervention group (from 13.9 to 17.0), but remained unchanged in the control group. Remarkably, 17 men in the intervention group but only 3 in the control group reported an IIEF score of 22 or higher at the end of the study.

The authors thus concluded that in about one third of obese men with erectile dysfunction, increased physical activity and weight loss can markedly improve sexual function.

So to all obese men: if sexual function is fine - GREAT! If erectile dysfunction is an issue - obesity treatments may just be worth a shot.

Edmonton, Alberta

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